JIMMY GAROPPOLO WILL BE HEALTHY ENOUGH TO MAKE EVERY THROW IN WEEK 4!

The recent injury news on Jimmy Garoppolo may be confusing to many fantasy football owners. My guess is that Bill Belichick likes the news to be confusing for his opponents, but this trickles down to those who are just trying to set their fantasy lineups. This news is not just about Garoppolo, but will also effect those who plan to start Rob Gronkowski, Julian Edelman, or any other New England Patriots skill player. The news has outlined every scenario from Garoppolo starting to Jacoby Brissett starting, and as far as Julian Edelman being the starting quarterback. With this level of confusion, it becomes very difficult to make a solid decision.

If you listen to me, I will make your life easier. Injury Science is very valuable in predicting these types of things. We just watched J.J. Watt go down for the season; and while some were surprised, I looked back at a post that I wrote in July that should have given fantasy owners a major heads up on the likelihood of J.J. Watt not making it through the season as he clearly came back to soon from an injury that has high recurrence. All injuries are not created equal and Injury Science can help separate the injuries that you need to stay away from and those that you need to flock to. Especially if you play daily fantasy football, flocking to a player that others are scared to play means that you will likely have a unique line up that can win a lot of money.

In this case, I am telling you that you can play Garoppolo and all the other New England Patriots that you would otherwise play. This is not about the reports or even the video that has surfaced of Garoppolo making a couple of throws. It truly is about Injury Science and the injury profile of Garoppolo’s injury.

Garoppolo suffered an acromioclavicular (AC) sprain in week two, and by the week four game, he will have had two weeks to rest this injury. Generally a sprain like this will take two to four weeks to heal. His sprain was a Type II, which indicates that initially there was some instability in the joint. All of this may sound complicated and just make you fade Garoppolo as a fantasy play this week, as hearing that he has an unstable throwing shoulder doesn’t sound good for a starting quarterback. However once you understand the shoulder joint a bit better, you will see why I am confident that Jimmy Garoppolo will be healthy enough to make every throw in week 4.

https://phoenixshoulderandknee.com
https://phoenixshoulderandknee.com

The AC joint is made up of the clavicle (collarbone) and the acromion (what most refer to as the shoulder-blade). You can run your finger out on your collarbone to your shoulder and hopefully appreciate the location of the joint. Structurally this joint is important for stability, but in the case of throwing, there are a few other stabilizers that can compensate for a short time. Functionally this joint is important, as the shoulder complex relies on the humerus and scapula being in synch; however the AC joint should not be a major limiter to the throwing motion. With two weeks of limited activity to the AC joint, Garoppolo is likely to only have minor limitations with range of motion and pain.

One of the important considerations here is that the New England Patriots only need Garoppolo for this week as Tom Brady will return from suspension next week. This means that although Garoppolo may suffer some strain to other stabilizing structures and may even incur a set back in the stability of the ligaments at the AC joint; the Patriots should be able to give him plenty of rest and treatment after this game.

As for the production and performance you can expect from Jimmy Garoppolo with this type of injury, I believe he should be able to make every throw on the field. While it is likely that by the time he takes the field he may still have range of motion limitations and some pain, neither of these things should limit his throwing motion or arm strength on game day as the pain can be controlled and full range of motion is not needed to throw a football. Much of a quarterbacks arm strength comes from their core muscles and legs, but even the part that comes from the arm is more dependent on structures like the rotator cuff muscles providing stabilization, while the elasticity of the ligaments and muscles around the shoulder joint contribute to the speed and power during the throwing motion. The AC joint should be able to effectively hide itself within the many  movements that occur during shoulder mobility, with the only major risk I see being a hit that takes Garoppolo down similar to how he was injured in the first place.

There may be a conscious effort to call plays focused on short throws, as short throws require less arc during the passing motion which should spare Garoppolo from any range of motion stressors or pain. Short and quick passes may also be an effective way to limit the risk of Garoppolo getting taken to the ground. With that said, I believe that if Garoppolo wants to throw deep, that he will be able.

Trust that this is an injury that Jimmy Garoppolo can and will play through. I will definitely consider some New England Patriots in in my DFS lineups this week and if I had Jimmy Garoppolo as my handcuff until Tom Brady returns, I would play him with confidence. 

Good Luck!

ADRIAN PETERSON OUT 2-4 WEEKS? (Update: Peterson out 3-4 months)

(Update: after publishing this, reports confirmed that Adrian Peterson would miss 3-4 months. It is clear that Peterson must have suffered injury to the portion of the meniscus that has little blood supply and needs surgery to repair. I had already suggested that this may be the beginning of the end, but with this news it may just be THE END!)

Adrian Peterson is reported to have a right knee meniscus tear and the timetable for his return seems to be unclear. Many of the injuries we see in the NFL have little tells and clues that allow me to make a very educated guess on how it will play out, but a meniscus tear may be one of the trickiest injuries to forecast without explicit details.

There are two menisci in the knee, the medial meniscus (inner part of the knee) and the lateral meniscus (outer part of the knee). These structures are fibrocartilage that basically serve as the pillows for the knee-joint and act as joint stabilizers. When the knee is straight, the menisci are typically at little to no risk as they are safely tucked into the knee-joint space. As the knee transitions to a bent position (usually for a squatting or lunging like motion) while the foot is in contact with a surface (usually the ground), the menisci assume a position in which they seem to peek out of the joint. During this peek is when most meniscus injuries occur. Adrian Peterson demonstrated this well if you watch the position of his right knee as his injury occurred.

this image shows a tear to the medial meniscus
Medial meniscus tear

The problem with speaking about a meniscus injury that you do not have intimate knowledge of is that the variables are countless. The details of the tear is important with a meniscus, as the inner 2/3 of the meniscus is avascular, meaning it has no blood supply. The outer 1/3 has blood supply and therefore typically has a better healing prognosis.  Aside from the site of the tear, the size of the tear and the subsequent position of the torn tissue are other factors that play a big part in giving a prognosis for recovery.

I can see how some may believe that Mike Zimmer is just playing injury report games by not ruling Peterson out for next weeks game vs. the Carolina Panthers, but meniscus injuries have a broad enough range that Peterson could play next week or this could effectively end his career. The answer is likely somewhere between.

The fact that surgery has not been mentioned suggest that this is likely an injury to the vascular outer third of the meniscus, which means there is a chance that Peterson will only need conservative interventions such as Physical Therapy and modalities to heal. On the other hand the optics of Peterson being carried out, being unable to even touch the ground with his right foot leads me to believe the tear may be more significant. I have treated patients who are in and out in a matter of weeks for meniscus injuries, patients who take months to get back on track, and the worst are the ones who you think are healed and months later they’re back. When a meniscus is torn it may have significant symptoms such as pain and clicking which is usually the torn tissue getting caught in the knee-joint as the joint bends and straightens, but for some the torn tissue is in a good spot and doesn’t cause any interference with joint movement. The most annoying part about a meniscus is sometimes you get both sets of symptoms. One day there is no clicking and no pain, and one squat or bend later, the torn tissue is caught between the femur and tibia and the patient can’t stand to bend their knee.

The meniscus has an annoying quality of re-injury and symptom fluctuation. Based on the position of the cartilage and its peekaboo type movements during bending, many people who have to return to repetitive bending activities will eventually catch the meniscus peeking too long and suffer some level of setback.

If I had to give a ball park guess, I would guess Adrian Peterson will be out for two to four weeks. The problem is that an NFL running back won’t be able to avoid forceful bending, which means that upon his return, the chances of re-injury are higher than most.

When you consider the elephant in the room that he is a 31-year-old running back, and that productive running back play after 30-years old is rare; my advice is find a strong plan B for Adrian Peterson as this may very well be the beginning of the end. 

The common training thread between The Two Best Wide Receivers of the past 10 years

(featured image from Stack.com)

The wide receiver position is in the spotlight with fantasy football now after taking down the running back position as the most important fantasy position, but what will they do with it.

With week one ending with at least three of the top 20 wide receivers being injured, will this position be able to hold its advantage over the running backs who were shunned due to poor reliability. While the wide receiver position holds a lower injury risk with contact injuries, it seems that the dynamic nature of the position may be neck and neck with running backs when it comes to non-contact injuries.

This made me look a little closer to find trends to these injuries. I initially went with my usual thought process which is valid but can be trumped. I typically believe that Freaky Talented players are at a higher risk for injuries as their bodies endure so much force from their above average size and/or speed. I thought I would find that the receivers were just getting so talented that injuries were increasing with that talent.

This hypothesis led me to the most recent, best wide receivers I could think of….

Calvin Johnson retired last year as the best wide receiver in the league. His production faded a little toward the end of his nine years, but I can win the argument that he was the best when he left.

NFL: Detroit Lions-Training Camp

The best argument to Johnson being the best when he left would have been the current best receiver in the league Antonio Brown. I am sure some of you will point to Julio Jones as an argument, but I will simply sit this link right here and in my most manly voice say “boy, bye!”

antonio

These two wide receivers are clearly the two best receivers of the last decade or so, but they are like night and day if you just glance at them. Calvin Johnson stands 6-foot and 5-inches tall and weighs in at 236 when he retired and Antonio Brown is a pedestrian 5-foot 10-inches and weighs in at 186 lbs.  Physically I could find no comparison to explain why both receivers who played nearly every play for their team were able to stay on the field and avoid injury.

At first glance I would have expected ligament and joint injury from Calvin Johnson, considering he moved that 236 lbs around faster than nearly every wide receiver in the league with a 4.35-40 yard dash time. Johnson was rumored to have bad knees but they couldn’t have been that bad as he only missed 9 games in 9 years and is scheduled to hit the “Dancing with the Stars” stage this season.

At first glance with Antonio Brown, I would have expected a DeSean Jackson type wide receiver who has missed 17 games in 8 seasons as his small frame appears to make him vulnerable to injury. Brown defies this logic as in six seasons, he has only missed three games due to injury.

In essence Calvin Johnson should have been getting beat up by his body and Antonio Brown should be getting beat up by other bodies.

This has not been the case, and it makes sense when you study each player closely. I have always been a proponent of functional training that incorporates balance and control. I value eccentric movements more than concentric movement, as eccentric usually protects from injury, while concentric many times causes injury. This is why I frown upon players who seem to only focus on becoming more explosive. Like many things in life, the best decision is to have balance be the goal.

The best way to avoid an injury is to be in control. Almost every non contact injury you can think of stems from losing control. If your body moves in a direction too far, something gets injured. If something moves too fast, something gets injured. Control is the key, and it seems that Johnson and Brown both understand this.

Both of these star wide receivers incorporate Pilates into their training, and I believe this is one of the primary reasons they enjoyed such healthy careers.

The three factors I like to look at first when I analyze a players injury profile is their weight, speed, and training regimen. Often times I get to the training part and see the same thing over and over. Players are focused on more speed, more strength and more explosion. I have nothing against these areas of focus when there is a need, but sometimes I feel like athletes are trying to put more water in a glass that is already full. This reminds me of the guy in the gym who only bench presses, despite the fact that his chest is huge, his max is 500 lbs, but his calves look like toothpicks. In this scenario, the explosive skill set that players are striving for represents the chest and the lack of control that some of these athletes have are the toothpick calves.

I hate to see a player coming back from injury show off these crazy fast twitch muscle fiber drills as a sign that they’re back. I usually want to jump through the screen and encourage them to meditate, do yoga, join a Pilates class, or focus on some eccentric contraction activity. 

I am glad to see that some of them get it, when it comes to how to train a body and skill set that has been blessed with talent. Sometimes talent just needs to be controlled.

If players like Julio Jones and Odell Beckham Jr. follow in the footsteps of Calvin Johnson and Antonio Brown with training regimens that are conducive to preservation and progression in a balanced way, we all win by getting to watch their greatness for longer.