Tony Romo's quick return to play no surprise for medical professionals

2014-11-13 09:40:32 by Dr. Joe Congeni - Director of Sports Medicine, as posted on the blog.

Zennie Abraham / Flickr Zennie Abraham / Flickr

After Tony Romo’s recent back injury, many fans were shocked by his return after only 2 weeks — not to mention his 3 touchdown passes in a 31-17 win over the Jacksonville Jaguars in his first game back.

Romo suffered from 2 cracked vertebrae, or what’s called transverse processes. And unlike other vertebrae injuries, this particular one is not a big deal. He cracked the bony prominences on either side of the vertebrae, which don’t play a major role, so it’s okay to play.

Today, I had the chance to speak with WAKR morning show host Ray Horner about this injury. Though it's a painful one — and I’m sure Romo was taking pain meds during the game — playing through this injury won't cause any long-term complications.

Below is an audio file and transcript of our discussion. Originally aired on 1590 WAKR-AM on Nov. 12, 2014.

HORNER: In studio, it’s our good friend, Dr. Joe Congeni, Sports Medicine Center at Akron Children’s Hospital. We really get into the sports health.

And, Joe, I gotta tell you, Tony Romo (quarterback for the Dallas Cowboys), down and out, 2 cracked vertebrae, gets up, throws 3 touchdown passes. I’m gonna let you expand on this.

I’m thinking how in the world … ? This guy can barely stand up. He’s out there playing football. Talk about the cracked vertebrae. How serious is this injury? I also heard a football analyst over the weekend say, “Oh I had that. It takes you about a week or so to recover and you’re okay.”

DR. CONGENI: Ah boy. I don’t know about a week or so. That’s a painful injury.

HORNER: I would think.

Dr. Joe Congeni Dr. Joe Congeni

DR. CONGENI: And, again, we’re looking at these NFL players and boiling it down. I don’t think we’d wanna push with a high school player, even a college player, and we do see this occasionally. It takes a couple of weeks. It’s very painful.

I guarantee you he played with something to control the pain. I would say there’s a very good chance of that.

But, the point is there are these projections that come off the vertebrae on the sides that … are not near the spinal cord. They’re just for stability, and also some of the back muscles attach to these things. On that injury, I think it was a Monday night Washington game where a guy rolled over the top of him.


DR. CONGENI: These little transverse processes, they’re called, these small bony prominences on either side of the vertebrae, they don’t have a real important role, so as soon as you can play with them, it’s okay to play.

It’s not a stabilizing thing, so it really surprises people. Some fractures, you’d say, “Hey, you’re done for the year.” It might be career threatening and all this. And, here’s an injury where you’re back playing in 2 weeks. Now, that was a little bit fast, but this transverse process really is not a very big deal.

HORNER: How do you look at this? It was interesting when I saw Jerry Jones (owner and general manager of the Dallas Cowboys) get behind a podium — I know you saw this as well — in London and say, “If he can stand up and he can play, we expect him to play.”

From a doctor’s medical perspective now, you hear that, that sounds to me a lot of pressure to get up and play this football game, Tony Romo, from a medical side, how did you look at that?

DR. CONGENI:  Yeah, I mean, that’s even more difficult as you look at it. I talk all the time here about the big pyramid. You’re looking at the people on top of that, now what am I going to go back and tell the high-school kid? “Hey, if you can walk, you have to be able to play.”

So, we’d have to temper it. Most parents and coaches in the high school setting, in the youth setting, understand that things are, you know, at a little bit higher level in the pros and all that kind of stuff.

The problem is you need medical people to tell you are you going to burn any bridges for the future. I think what Jerry Jones was saying between the lines, to give him the benefit of the doubt, is that this was an injury that didn’t have any long-term complications or implications.

So, we have to know that. If it’s something that’s gonna cause them a problem down the road, that if they play through this, may be leading to surgery down the road, or terrible arthritis or inability to walk later in their life, or a neurologic injury to the spinal cord, but none of those were the issue. And, I think he was implying that. But still, it makes it hard for me with the younger kids that I see in the office.

HORNER: Yeah, and that was my next question, when you look at cracked vertebrae like this, what about Tony Romo’s future outside of the NFL? What does it look like when his playing days are done? Is this an injury that will really complicate his life in 10 years?

DR. CONGENI: Well, you and I talk about injuries that kind of become cumulative and start to unravel a little, and I think that’s maybe what you’re getting at


DR. CONGENI:  We always use Grady Sizemore as an example. You might be keeping an eye on him.

I’m just gonna tell you a guy by the name of Derrick Rose (of the Chicago Bulls) this year, his knee injuries were pretty significant. Then all of a sudden he gets ankle and other things. It’s gonna be tough, but not this injury to Romo.

There should be absolutely no long-term implications — none — related to this injury. That’s why I wanted to talk about it. You just need to know what is a big deal. What kind of injury is something that’s a big deal and what is something that has absolutely no long-term effect.

HORNER: And this is not a big deal?

DR. CONGENI: This is not a big deal.

HORNER: For long-term?

DR. CONGENI: For long-term.


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