Injuries plagued players in Super Bowl XLIX

2015-02-06 10:07:21 by Dr. Joe Congeni - Director of Sports Medicine, as posted on the inside.akronchildrens.org blog.

Julian Edelman played college football at Kent State. He was drafted in the 7th round by the Patriots in 2009. Julian Edelman played college football at Kent State. He was drafted in 2009 in the 7th round by the Patriots.

This year's Super Bowl XLIX was an exciting, albeit violent game. New England Patriots' Julian Edelman played an amazing game, but took a significant blow that's raising debate on whether or not he suffered a concussion.

Seattle Seahawks' Cliff Avril staggered off the field, was diagnosed with a concussion and immediately taken out of the game.

His teammate, Richard Sherman, also was injured, playing with a torn ligament in the shoulder and may be facing Tommy John surgery.

Yesterday, I had the chance to visit in studio WAKR morning show host Ray Horner to discuss these injuries and others. We also talked about NFL Commissioner Goodell's "State of the Union" address, where he stated league concussions dropped 25 percent in 2014.

Below is an audio file and transcript of our discussion. Originally aired on 1590 WAKR-AM on Feb. 4, 2015.



HORNER: In our studio right now is Dr. Joe Congeni, our good friend, Dr. Joe from Sports Medicine Center at Akron Children's Hospital. I guess, Joe, let's go back to the Super Bowl.

You and I were talking a couple moments ago, Julian Edelman (wide receiver for the New England Patriots) with just a terrific game, the Kent State University product, but there were some thoughts about one of the blows he took in that game.

Dr. Joe Congeni Dr. Joe Congeni

DR. CONGENI: Yeah, you know, there's a lot of food for fodder after that game, a lot of discussion going on and that's the way the NFL loves it.

One of the big discussions is Edelman had such a great game, but, uh, with one of the big hits he took, he got up, he looked a little bit groggy. They said that there was an evaluation.

You and I have spoken before, the clinical evaluation takes about 15 minutes. You know, it's a more detailed thing. He really did not miss much time. He finished the game. It's a, you know, being debated. Those are difficult situations.

You can contrast that with Cliff Avril (defensive end for the Seattle Seahawks), who really took a much more, you know, significant blow.

HORNER: And he didn't come back.

DR. CONGENI: He did not come back. Once he staggered off the field, he was diagnosed with a concussion and out for the game.

They kinda kept an eye on Edelman and determined he did not have a concussion. ... I guess the point is those types of decisions are very hard to make about who's concussed, who's not. There's no objective test.

HORNER: Yeah. That's what I was going to say, New England, who obviously is always pushing the envelope. On the NFL level, educate me and all of us, who does those tests? Is it someone from the NFL or is it a team physician?

DR. CONGENI: Well, it continues to evolve. It used to be the team physician, and it's a little bit more pressure when the team physician, who travels with the team, knows the team, is embedded with the team.

Then, it started going to an independent neurologist on the sidelines. But, I would submit to you not many neurologists spend much of their time on the sidelines, so making decisions like that for an independent neurologist, not the easiest thing either. They went to that system 2 years ago.

Julian Edelman, of the New England Patriots, is hit by Kam Chancellor, of the Seattle Seahawks, after a twenty-three-yard reception during Super Bowl XLIX. Julian Edelman, of the New England Patriots, is hit by Kam Chancellor, of the Seattle Seahawks, after a twenty-three-yard reception during Super Bowl XLIX.

There is an independent athletic trainer up in the box looking for "abnormal behavior."

HORNER: Oh, okay.

DR. CONGENI: And, that's kinda how in 2015 the NFL is dealing with this.

You know that at the "State of the Union" address by (NFL) commissioner Goodell, he had a lot of hot issues to deal with. One of the ones that he saw as a positive is he mentioned there was a 25 percent drop in 2014 in concussions. There was 111, he said, in his "State of the Union" address, um, State of the Union in football.

Um, I take that with a little bit of a grain of salt, too, because you see how difficult these concussions are to diagnose ... but I'll take it as a positive overall.

HORNER: Mm-hmm.

You know, as you know, speaking of concussions, I'm coaching travel baseball now, and I had one of my parents come up to me last week and she said, "I just wanted to let you know that he had a concussion last year."

He was beamed in the head. He got up; everything is okay. He sat out a couple of games and everything. She said ... "I bring this up because of the equipment issue."

I guess there is a new batting helmet that serves for kids who have had a concussion that is extra thick, has kinda like a double wall thing. You've probably seen these.

DR. CONGENI: Sure.

HORNER: And she was would it be okay. And I said, "Of course it is okay. The health of your boy is the most important thing in the world."

But, that's some advanced equipment that we're seeing on the baseball side and equipment continues to evolve in all these sports.

DR. CONGENI: Trying to come up with equipment ... equipment's one of many things, as well as, you know, heightened awareness and prevention and strengthening and other things like that. There are a lot of things that we're trying to do and learn from research, as well.

But in the middle of last week on the bad news side, there was a study that came out that said -- and most of the newspapers in the U.S. picked it up -- that there was an NFL study that looked at 42, that's a very small number, and did some cognitive testing.

Kids that had started before age 12 did not do as well as these NFL players or past NFL players as those that started later in their football career. So, you know, that one was a negative that was out there.

The problem with that, real low number. They were looking only at ex-NFL players and so, the contrast to Goodell's evidence that there was a decrease in concussions, that was a study that was concerning.

HORNER: I saw just a stat last night that there were so many people that were a little weary of the NFL with the head contact, that it was gonna take away the violence of the game, instead of leading with your shoulders and such.

The new study said that has not been proven at all, that it's still a physical game and leading with the shoulders has not taken anything away from the game at all.

You look at football games completely different, Joe, than most of us do. Still a violent sport?

DR. CONGENI: Oh for sure. There's no way with the bigger, stronger, faster you're going to take that out of it. No way. But if we're to believe the studies, the last couple of years there is a decrease.

The NFL would beg to differ, and making rules changes and equipment changes, as you said, and prevention changes, that it is decreasing. But you know, it's going to take time and more study to prove that.

HORNER: Okay, let's go to Richard Sherman now, uh, the Seattle Seahawks. Played the game, I guess, with a torn shoulder or something like this. We saw him in the NFC Championship game holding that elbow like he was Apollo Creed against Rocky, but then he looked to be okay with that shoulder in the Super Bowl. What's the story ... and I hear Tommy John surgery?

DR. CONGENI: Yeah, yeah, yeah. The Seattle secondary was like a primer for upper extremity injuries.

HORNER: Yeah.

DR. CONGENI: They had a nickelback that broke his forearm. In the NFC Championship game, Earl Thomas (Seattle Seahawks safety) dislocated his shoulder and tried to play through it. He looked like he struggled a bit in the Super Bowl. And then Richard Sherman tore the ligament on the inside of his elbow. It took about 5 miles per hour off his fastball in the Super Bowl.

Joking about that, that is the one that is the Tommy John ligament. For most athletes, we don't have to operate on that. We allow it to heal over time. Now, 2 weeks later and then playing in a Super Bowl wasn't ideal. And, the first we heard was that he was going to have it tightened up and operated on and now there's some discussion about maybe they'll give him more time.

Obviously, when you look up to the level of the NFL, a lot of guys this time of year are getting things fixed that maybe high-school athletes, college athletes would not be getting done because the body will heal itself in a lot of situations. But in the NFL, they don't want to mess around.

If he has Tommy John surgery, it's unusual because usually that ligament will heal on its own like an MCL in the knee. But, I did see that they were talking about him for Tommy John surgery.

HORNER: In baseball, you understand. You're throwing the baseball with that elbow, so it's a need. In the NFL, how critical is that ligament to you?

DR. CONGENI: Well, it's critical, but the fact is you'll end up losing a little bit of stability and it will be a little bit looser. But for most sports, and even our wrestlers, and our football players that are high school, they play very well 6 weeks later, 3 months later, 6 months later. They really don't miss a beat.

But in a situation like an NFL guy, they don't want to take any chance. He's such a valuable commodity. Gosh, you see nobody throws his way. He's an amazing cornerback. And they may not want to take any chances and just say fix it. Even if it takes him from 80 percent to 95 percent, they'll say it's worth it to go ahead and fix it.

HORNER: Final question. I heard somebody say jumper's knee. This guy had jumper's knee over the weekend, and I'm scratching my head, and I said, I think I've heard Joe talk about that. I wasn't sure what they were talking about. What is jumper's knee?

DR. CONGENI: Yeah, so jumper's knee is one of our classic overload, overuse injuries. The volleyball players, the basketball players all have it. At this time of year, many have it. A gentleman by the name of LeBron James was reported to have it, as a part of his sitting out for a period of time.

So the big, strong tendon below the kneecap absorbs all the shock when you jump repetitively, over and over and over again. It starts to become inflamed for a few weeks and then later it becomes scar tissue. And then, guys are stiff and they don't jump and move the same.

We were all commenting LeBron didn't seem to have as much explosion and stuff early in the season. There's some degree of jumper's knee that needs some treatments, but ultimately, even some rest to get it to be better.

There are certain times you can rest and there are certain times you can't rest, but I think one of the things we saw with his jumper's knee and back strain is the time did him very good.

And I've used that very much in my office to explain to some of these kids, hey, we have to take a few weeks off for this overload knee injury called jumper's knee to get it better.

HORNER: Oh okay. So rest is basically how you cure it?

DR. CONGENI: Rest and rehab.

HORNER: Rest and rehab.

DR. CONGENI: You really can rehab this and there are good treatments, including massage and stim and ultrasound that the physical therapists do in a full-court press to get them better. So, that definitely helps.

HORNER: Alright, Joe, good stuff this morning. Good insight.

DR. CONGENI: Hey, I just wanted to say, happy National Signing Day today.

HORNER: Yeah.

DR. CONGENI: You know, I saw one statistic: 17 out of the 48 starters in the Super Bowl, 17 of 48, one-third were 3 stars or 4 stars, no 5 stars. So that means two-thirds of the starters were not even 3, 4 or 5 stars.

You know, we talk about this big signing day thing. The fact is part of the reason, a lot of these kids get injured down the road. That's why Ohio State needs to be 3 deep today. They need to sign a bunch of linebackers and a bunch of running backs 'cause kids get hurt.

HORNER: Yeah, they do. Alright, thanks, Joe

DR. CONGENI: Okay, have a great week. Thanks, Ray.

HORNER: Good insight. Dr. Joe Congeni, Sports Medicine Center at Akron Children's Hospital. He joins us in studio once a month and each and every Wednesday here on the Ray Horner morning show.

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