Hi everyone! I really appreciate all of the great questions you submitted this week. Would love to hear from you for future editions, so make sure you check out the contact information at the bottom of the page.
The biggest thing on everyone’s mind this week? Gordon Hayward. Right after the injury occurred, I wrote about it here on BSJ. Since then, Hayward has had surgery and is on his way toward recovery. There have been varying reports from sources around Hayward and sometimes reports sound like a bad game of “telephone,” where the reported end-product doesn’t sound so much like the initial message. I’ll do my best to decipher them for you here.
The question is in reference to Gordon Hayward. Based on the information that has been disclosed (‘clean’ broken tibia, dislocated ankle) is the recovery time frame of 4 months accurate? - (Nathaniel Donovan)
Hayward’s injury has been confirmed to be a tibiotalar fracture-dislocation. This means that the ankle joint was disrupted - in this case, the tibia was fractured, ligaments were torn. I know that initial reports were that it was a “clean break” and there was “no ligament damage,” but after the surgery, our own Brian Robb reported the following:
Lots of structures in the ankle joint need to break or tear for an ankle to look like Hayward’s did. My initial timetable of 4-6 months is unchanged. I do not think that we will see any meaningful basketball from the Celtics’ forward this season.
Here’s the silver lining: I do expect to see LOTS of meaningful basketball next season, and the season after. Last night Mike Petraglia reported that league sources had told him “no joint damage is the key reason that those close to Gordon Hayward feel optimistic for full (relatively fast) recovery.” Here’s the thing - the joint was traumatized. There was a ton of joint damage. But I suspect that this may mean there was no joint surface damage. If the shiny, silvery cartilage lining (silver lining) of the joint is injured that can be a much longer recovery. This is great news for next season and Hayward’s career going forward.
Another Hayward question - I’m sorry, I could only pick a couple!
Getting my question in a bit early this week, but after seeing the injury last night to Hayward, and feeling ill for the first time in forever, I’m wondering how different a break is from ligament tears in terms of returning to peak performance. I.E., is an ankle break like last night’s easier to come back from and be at the top of your game than say an ACL injury like Edelman’s? Or is it really up in the air and completely individual? The reason I ask, other than wanting to hear something positive, is I tore a couple ligaments in my foot/ankle a couple years back, and was told recovery is actually longer and more inexact than if I had just broken my ankle and I’m wondering if that’s at all true. Also, I really appreciate the articles I’ve seen from you on BSJ. Not sure what the deal is with people being offended, but I guess that’s their prerogative. I like it though, for what it’s worth. (Josh P.)
In general, most simple fractures tend to heal more simply, reliably, and quickly that soft tissue/ligamentous injuries. There are always exceptions. For example, fifth metatarsal fractures are notoriously long to heal, mostly due to the less rich blood supply to the part of the bone often injured. Edelman dealt with a fifth metatarsal injury a couple of seasons back and it lingered for over a year and impacted his ability to stay on the field. Some injuries are harder than others to recover from, but it depends on so many factors including the sport and position you play, your overall health (fractures heal more slowly in smokers for example), and the degree of injury.
Hayward’s injury is generally one that heals within six months as long as it is not complicated by articular cartilage injury or post-operative complications. I would expect Hayward to return in the spring and gradually get more comfortable with his new ankle in the first 6 months back. Recovery from ACL reconstruction in the NFL is anywhere from 9-12 months, with athletes most often returning to their best football about one-and-a-half to two years after surgery. Both injuries are traumatic to the joint and increase risk of osteoarthritis down the road.
Recovery from foot and ankle soft tissue injuries is quite variable, unfortunately. Part of the reason is blood supply — the foot is the farthest part of your body from your heart, blood flow in and out can be an issue, part of it is the particular person’s body (shape of your foot, way stresses are distributed, health of your body in general), and part of it is injury pattern. Recovery is frustrating for weekend warriors and professional athletes alike. I wish you a speedy and full recovery!
Is it normal (for Stephon Gilmore) to have effects of concussion so long after the impact? Slightly worrying. - (Oliver Fairlamb, @Maryland84 via @PatsCap and @MikeReiss)
Another week, another surprise last-minute addition to the Patriots’ injury report. The team announced on Saturday that cornerback Stephon Gilmore was ruled out for last Sunday’s match-up against the Jets with a concussion. This was a head-scratcher since Gilmore had practiced all week and was not listed with a concussion prior to Saturday. To further complicate things, there did not seem to be an opportunity in practice for the cornerback to sustain a practice injury.
Hi Dr. Flynn. I live next to a guy that used to be the Bruins' team dentist in the 70s, and I'm out in Colorado. It made me wonder, are team doctors among the most sought-after jobs in the business in which they are the best of the best? Or are they just good high paying jobs? Thanks for taking the time to educate us! - (Nunoc3)
This is such a great question, mostly because it made me consider how busy the Bruin’s team dentist must be! It is considered a real honor to be asked to be a professional team doctor. It generally means that the surgeon is well-respected in their field and very skilled at their job. That being said, I don’t know if it’s necessarily the most sought-after job. Doctors at the theoretical “top” of their field tend to have very successful, busy practices. Adding team responsibilities to a job like that is immensely taxing. I don’t know anything about the salary offered for team physicians, but I suspect that it does not come close to what those physicians can bring in from their normal practice. Much of the reason for that is the amount of time they must dedicate to the team — traveling to games, calls at all hours of the day and night (those are not going to an intern), shuffling regular clinic hours around during playoffs and for in-season emergencies. It’s a lot of work and not all doctors are interested in adding that to their already busy schedule. I’m personally amazed by the local team docs — they must have some sort of secret way to fit 30 hours into a 24-hr day.
If Rob Gronkowski truly has twinkle toes, as Belichick has said, what’s the impact on his availability for Sunday night’s game? :) — (Bob Bell, @rjbell4)
Twinkle toes are one of the rare orthopedic afflictions that actually reflects an increase in performance. While I’m not a huge personal fan of prancing into the end zone (save your celebrations for after you actually do the thing), I hope the Patriots’ training staff does not try to correct the tight end’s toe condition.