A hammy and a Sammy

Thursday night games leave a lot of time for next week’s game prep, for coaches and fans alike. Let’s take a look at some nagging injuries of two marquee players in next week’s Pats-Bills matchup. Rob Gronkowski has been dealing with a hamstring tear since mid-August and returned in a limited capacity this week against the Texans. Bills receiver Sammy Watkins broke his foot in a game against the Bengals on October 19,2015 and had surgery in April of this year. There are reports that earlier this week his surgically repaired foot was stepped on in a walk-through and he is now questionable to go against the Cardinals this weekend.

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I took this photo on August 9th during a joint preseason practice with the Saints. That was a week before Rob Gronkowski pulled up while running a route for Tom Brady in 7 v 7’s in a joint practice with the Chicago Bears. Sometimes hamstring injuries are acute without warning, and sometimes there’s a nagging tightness that suddenly gives way to a tear. It’s unclear which was the case for Gronkowski.

Hamstring tears can range from mild to severe and generally do not require surgery to heal. The initial injury often happens while sprinting or accelerating, making it common in receivers and mobile tight ends. Any time you have a hamstring strain (pulled muscle = strain, stretched ligament = sprain) that is followed by bruising either immediately or a week later you are dealing with a muscle tear. Hamstring tears can make things as simple as getting into a car or sitting on a toilet almost impossible. In general, the only hamstring injuries to be surgically treated are complete avulsion (pulling off) of the tendon from it’s bony attachment. These injuries result in significant loss of strength and athletes with this injury are often unable to walk without crutches.

Recovery time from hamstring injury depends on both severity of the injury and demands of the player’s position. Treatment by training staff focuses on recovery of normal muscle flexibility, making sure that the tear scars over but not too much. Once the initial inflammation improves a gradual return to activity can begin. It can take anywhere from 4-8 weeks for athletes to recover from moderate tears. Gronk returned to practice on a very limited basis 2 weeks after injury and worked his way up to game play at 6 weeks.

I was initially surprised that Gronk only played 11 snaps in the first half against the Texans. Part of his limitation was that they didn’t really need him (in the second half he played a mere 3 snaps). Last year in his first game back after missing 2 games for what was thankfully only a bone bruise in his knee, the Pats were also playing the Texans.  On the second play of the game, Gronk reeled in a 45 yard pass from Tom Brady to get to the second yard line, allowing every Pats fan to breathe a sigh of relief. Gronk was back.  This time around, Gronk hadn’t played in game conditions since the postseason on January 24th. He was simultaneously trying to recover from an injury and get back into game shape. He didn’t seem to re-injure his hamstring on Thursday night, so hopefully we’ll see a gradual increase in his speed and snap count over the next few weeks.

 

NFL: DEC 04 Bills at Raiders

Sammy Watkins of the Bills can be a dominant wide receiver — when he’s healthy. Unfortunately, Sammy has dealt with a multitude of injuries, most recently a fracture in his foot. The official report is a “fracture of a small bone in his foot” which occurred last October. It is being unofficially reported that this is a 5th metatarsal fracture. The 5th metatarsal is the bone on the lateral (outside) border of your foot. It sustains a lot of stress with quick changes of direction. Fractures to this bone can be chronic stress fractures or acute fractures sustained during a single injury. In a stress fracture, initially there is no true break in the bone but the player feels a slowly increasing pain with running and cutting that can culminate in a fracture event. In an acute fracture the ankle generally inverts (turns in) and the bone cracks. We don’t know which Sammy has, but we do know that it isn’t healing in the expected timeframe.

The blood supply to the fifth metatarsal isn’t great. Since bloodflow is important for healing, a fracture to the fifth metatarsal takes a while to heal. If the fracture is in a particularly bad location in this bone then it is called a Jones fracture. Jones fractures are often treated surgically to improve the healing time and likelihood that it will heal fully. The idea is that inserting a screw across the fracture site will compress the bone which leads to enhanced healing. Sometimes even surgery and rest are not enough to get this stubborn bone to heal, however. Surgeons consider bone grafting for patients who continue to have pain and do not show healing on xray.

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(Photo courtesy of AAOS )

Jones fractures have variable healing times, but the average recovery time is 6-8 weeks after surgery. Dez Bryant broke his fifth metatarsal last year and came back in about 7 weeks but dealt with nagging issues later in the season. Kevin Durant sustained a Jones fracture just before the start of the 2014-15 season and had multiple surgeries throughout the season to try to get it to heal. Julian Edelman seems to be doing well after a Jones fracture last season, but his return has not been without bumps in the road.

Regardless of whether or not Sammy Watkins has a stress fracture or an acute Jones fracture, one thing is clear. He is not playing at 100%. His most recent setback this week makes him a question not only against the Cardinals this weekend but also against the Pats in week 4.

 

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