Einstein Injury Analysis Report Podcast: Week 11 Player Commentary

Posted by Christine Skiffington on Nov 18, 2016 11:59:50 AM

wip_injury_report_social_1200x1200-1.jpgEinstein's own sports medicine expert Brett Sweitzer, MD, joins Ike Reese on Sportsradio 94WIP this week to discuss the most important injuries of interest to Philadelphia football fans. Going into week 11 of the season, Dr. Sweitzer weighs in on diagnosing concussions like the one cornerback Nolan Carroll experienced during last week's game. Plus, he discusses Jordan Matthews' back spasms and the dangers of Brent Celek playing with a broken rib. 

Cornerback Nolan Carroll was diagnosed with a concussion during last week’s game. Is there any way besides testing symptoms that you can diagnose a concussion?

That’s a great question. Without a doubt, readily recognizing the symptoms of concussion is the best way to diagnose a concussion. 

Unfortunately, there isn’t a blood test, x-ray or even an MRI that can definitively diagnose a concussion. There is some ongoing research looking at brain scans and brain metabolism, but even these are in their infancy in terms of usefulness. 

For now, the standard of care is to recognize the injury, pull the athlete out and monitor their symptoms closely. This is followed by cognitive function tests that look at things like verbal and visual memory, processing speed and reaction time. Athletes must be asymptomatic and return to their baseline before beginning an interval return to their sport. 

It’s a very closely monitored and step-wise process that’s a bit labor intensive for the medical staff, but for now it’s the best tool that we have at our disposal.

Jordan Matthews has been dealing with back spasms. What exactly can that mean?

A back spasm is a pretty non-specific diagnosis that literally means the back muscles are tight – almost like a cramp in the back. This obviously can be very painful and limiting for an athlete, but the bigger concern is that it can sometimes be related to some other more significant problem. 

A spasm is the body’s way of trying to protect itself by tightening the muscle and limiting mobility, which sort of acts as a splint. This could be in response to a muscle strain, which is fairly common in football players, but it also could be a sign of an underlying disc problem, or even a pinched nerve. 

The key is to rest the back, get the muscle to calm down with some gentle stretching, anti-inflammatory medicines, heating pads, and other modalities that the athletic trainers can utilize, and then gradually get the athlete back onto the field.

Hopefully this won’t limit Matthews too much, but I would caution that this can be a nagging problem that can wax and wane, especially if there’s some other underlying issue.

Brent Celek has been playing with a broken rib. Is that dangerous?

I would say the risks are minimal. Of course, we discussed this earlier in the season when Carson Wentz was playing with a broken rib.

A broken rib can be very painful initially. It’s difficult to even breath comfortably, let alone play football. However, rib fractures readily heal, and with a short course of rest and occasional pain medicine, the pain drastically subsides within the first three weeks as the fracture heals. Major risks, such as a pneumothorax, where the rib punctures the lung and causes it to collapse, are extremely rare. 

At this point, I expect Celek is a little sore if he takes a hard hit, but he should be relatively comfortable blocking and running. Occasionally the team doctors will give an injection of numbing medicine around the rib to give some relief, which does carry a small risk of pneumothorax, but this usually isn’t necessary. He certainly will be wearing some extra padding around his rib cage, which will also help mitigate any risk of further injury. The only thing he really needs to worry about is keeping the pain to a minimum.  

Ultimately, once the fracture is healed, there is absolutely no long term functional consequence, so I expect this will have minimal impact on the rest of Celek’s season.

Be sure to check back soon for next week's report. Have questions about your favorite NFL player's recovery? Post them here and our sports injury experts may be able to answer them on next week's show. 

Topics: Sports Medicine, Injury Analysis Report

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