December 17, 2014
DeMarco Murray has a broken 4th Metacarpal in his left hand and had surgery to his hand on Monday. The Cowboys say that he is not ruled out for this weekends game vs. The Indianapolis Colts. Injury Science and our creator say that he will not play. Lets break it down.
The same science that led me to predict that DeMarco Murray would not make it through the season without injury also allows me to state without hesitation that DeMarco Murray will not play this weekend. For those who follow me you know that my SEP (Science, Evidence, and Performance) analysis on Murray suggested that he would miss about 3 games this season. He almost proved me completely wrong, but with 2 games left in the season and a possible playoff birth for the Dallas Cowboys, Murray may end up being the perfect poster child for the accuracy of Injury Science. Despite my faith in my SEP rating, there is a strong chance that Murray will fall short of missing 3 games. However, I attribute this inaccuracy to the timing of his injury. With the Dallas Cowboys still fighting to get into the playoffs, I believe that most of these players, coaches and owners value making the playoffs more than they value their health. If this injury happened at any earlier point in the season, I believe Murray would have easily missed 3 weeks. My colleague Dr. Starks may have said it best when I told him that I thought Murray would miss time; “Jerry Jones will have them eating through a straw rather than miss more than a few quarters”. Jerry Jones can make a lot of things happen as the most prominent owner in the NFL, but I don’t think healing bone in 6 days is in his repertoire.
The Metacarpal bone is the bone in your hand that connects your wrist to your finger. In DeMarco Murray’s case, he broke the 4th metacarpal associated with the ring finger on his left hand. The media will regurgitate over and over that Emmitt Smith had this injury and only missed a week. The Billionaire owners will tell you that it depends on how much pain he can tolerate. But Science will tell you that bone requires 6-8 weeks to heal. To be clear, I do not think Murray will miss 6-8 weeks but he has a better chance of missing that amount of time as compared to his chances of playing this weekend. Unless DeMarco Murray has Wolverine powers to heal faster than a normal human, he will be at far too much risk to play this weekend.
We have talked about bone fractures in the past and the same principles apply here. We can make an educated guess on Murray’s fracture based simply on the fact that it required surgery. A metacarpal fracture that requires surgery will generally mean that the bone is displaced or possibly even crushed. If he had suffered a simple non displaced fracture, they would have simply given him a splint and allowed the hand to heal on its own. In this case Murray is likely to need pins, plates or other hardware to properly align the bone and initiate proper healing. Once this surgical procedure is completed and the bone has the chance to start healing, the hardware can usually be removed and the healing process will continue. What the Cowboys suggest is that a surgeon will put these pins in his bone and then say “go out on the field and have fun”. I will remind you that surgeons are some of the smartest people you will find and to reach the level of working with top athletes, you are not likely in the habit of making silly decisions that cause your surgeries to fail.
If DeMarco Murray steps on the field this weekend (as an active player) he and the Dallas Cowboys would be asking specifically for failure. To review, the 3 phases of healing include: an inflammatory phase, a repair phase and a remodeling phase.
The inflammatory phase
With Murray’s fracture occurring on Sunday night, it is safe to say that he is in the inflammatory phase. In short, the inflammatory phase is when your body sets off an alarm and all the oxygen and nutrients get to work on the fracture site. Inflammation can be confused as a bad term as it usually means pain when in joints, but in this case inflammation is a good thing and is very necessary. Even with hardware to set the bone in Murray’s hand, this stage of healing means he needs to rest and let his body do its job. This process will vary from person to person but for a highly trained athlete with good vasculature, I would guess days. Lets just guess that by Sunday, he has grossly concluded the inflammatory phase. If he were to play at this time, it would mean that they have chosen to not even allow his body to start the repair process.
The repair phase
The repair phase is essential, as this is the phase in which many of these injured players are returning to play. While this may be fairly common, returning too early in the repair phase may lead to malformation of bones and loss of function that could last a life time. Even if DeMarco Murray is a fast healer, you would still expect him to be in this phase for a month or so. With surgery, the hardware in the bone will help protect disruption during this phase. However in a game as violent as football with a “Freaky Talented” athlete such as Murray, the amount of force that is generated during his play, is not likely to be tolerated by his healing bone despite the assistance from hardware. If Murray is taking hits on his left hand, stiff arming with his left hand, falling on his left hand, or even catching a hard pass with his left hand; he will be challenging the vascular growth and immature callus and tissue that are attempting setting up to allow the bone to fully repair. The goal of the surgical hardware is to immobilize the bone, and the average person will have mobilization precautions for 6 weeks or so after surgery. The range of difference between being put in a splint and not challenging your hand for 6 weeks vs. going on a football field and running the ball 30 times in the NFL is drastic. The earlier Murray takes hits during this phase, the higher his risk of facing dysfunction in that left hand will be. The outcome of these actions may affect the rest of his career and maybe his life.
The remodeling phase
This phase happens over months and sometimes years and as I stated before, most NFL players will not wait until this phase to return to play. During this phase, the bone regains its full strength. For most NFL players, my concern during this phase would be whether the remodeling of the bone is consistent to the bones initial form or has the disruption of the early healing phases caused a deformity which is now being finalized.
Some people move through the phases of healing faster but we all go through the same phases. The difference is that the players sometimes disregard the process and simply sacrifice that body part to continue playing. For DeMarco Murray I do not think this would be wise as he needs to be able to carry and catch the ball with his left hand. A dysfunctional left hand could prove to be significant when he is looking for that last contract.
What You Need to Know
One of my favorite movies of all time is My Cousin Vinny. As most of you should know, the star Joe Pesci played a slick lawyer from New York who was getting his nephew off on a crime he didn’t commit. At one point in the movie he discredited a witness because the witness spoke of putting on a pot of grits and then referenced the crime happening while he was eating those grits. To make a long story short (because I know I am butchering my description of this scene), he implied that his grits cooked in 5 minutes. Joe Pesci’s then ripped into him asking if he ate instant grits or real grits…..when he replied real grits, Pesci’s ranted “how do your grits cook in 5 minutes while everyone else’s take 20-30 minutes”. He went on to ask do you get your grits from the same person that sold Jack his beans? (much funnier in the movie)
That long ramble is to say, why would we believe the Dallas Cowboys when they say DeMarco is a game time decision? Is DeMarco Murray the Wolverines cousin? Does he have bones that heal in 6-8 minutes and not 6-8 weeks? What you will notice is these statements are coming from the Jones family. The last time I checked none of them are Doctors. I think all in the medical field are firmly on the same page, and that page says that there is NO WAY you put DeMarco Murray on that field this Sunday. Whenever he returns, I am sure it will be earlier than he should. But a return this Sunday would simply be irresponsible by all parties including Murray himself. I know a hand or finger injury may seem minor when you compare it to some of the big injuries that have occurred with players like Cam Newton or Colt McCoy, but your hands are pound- for- pound 2 of your most important body parts if you plan to play a skilled position in the NFL.
So if you weren’t keeping score God and Injury Science win! God blessed us to be able to heal, and Injury Science studied how this occurs so we can heal efficiently. Jerry Jones is a powerful man, but I am sure he will lose this battle.
If you are a league player, the most obvious option is Joseph Randle as he is likely to get the carries this weekend. Especially in a keep away game, as I am sure the Cowboys don’t want Andrew Luck on the field for long. If you have to dig deeper than Randle at this time of year, then you are in for slim pickings. Chris Polk is a touchdown thief in Philly and he gets most goal line and all garbage time carries; I would give him a try vs. the struggling Redskins. Another back that is likely available is Juwan Thompson who backs up C.J. Anderson. WIth a matchup against the Bengals on Monday night in the beautiful Ohio winter weather, I think Peyton will be handing the ball off as much as possible. I do not think Anderson can keep up the volume and I believe Coach Fox agrees; I would look for more carries for Thompson this week.