Dr. Flynn's Mailbag: On Malcolm Mitchell, Chris Hogan, Rex Burkhead & Dustin Pedroia

Hi everyone, happy long weekend! Sorry if you’re working Monday like me. This is my first official Friday mailbag of the NFL postseason. I really enjoyed this week’s Q&A with B-Robb on Gordon Hayward’s brace-less ankle, hope you got to read it. Today’s weather reminded me that spring is just around the (very snowy) corner and that means spring training. I’d love to get to some more Red Sox questions as the season nears, so send yours my way.

Today we’ll hit on how healthy the Patriots look going into the playoffs. And for all of you Red Sox fans who are counting the days until they pack up for Florida, I’ll share my thoughts on Dustin Pedroia’s comments this week indicating he might be ready for the season opener?!

I know everyone is excited about Malcolm Mitchell's return, but what can realistically expect, considering he hasn't played meaningful snaps in almost a year? Will he be on a "minutes restriction" of sorts?
— Josh Pilling, @joshpilling

Malcolm Mitchell has not yet been activated to the 53-man roster, so he will not be in a uniform today. Mitchell has been working his way back from a knee injury all season and has been at Patriots’ practice for the past couple of weeks. The only concrete information that we have about that knee is that he has had an ACL reconstruction in college, and subsequent meniscus surgery a year later. I am suspicious that he is dealing with some sort of cartilage issue and possibly could have had a procedure to address it shortly after training camp. It’s a positive thing for his career that he has been able to get back onto the practice field. I do not think you should expect Mitchell to have a significant impact on the Patriots’ postseason performance. He’s been away from practice for months and will likely need to put in significant extra work to re-establish his timing with Tom Brady. I suspect that the team is more focused on getting the Brady-Chris Hogan connection back up to speed at this point. Speaking of Hogan….

How much do you think Chris Hogan will contribute this weekend?
— Doc Flynn, @jessdeede (I haven’t done it all year, give a girl a break!)

I think Hogan is ready to go. I do not expect he will be on any type of restriction this weekend. Still no confirmation of his exact injury, but given the video, it could have been an AC injury or clavicle fracture. It’s been almost a month since he last attempted to play and today's performance should be a significant improvement for him.

Looking forward to your mailbag! Everybody practicing. Who is the most likely to have the most trouble with their injury?
— Jim Clark,@nunoc3

Added question: Do you want to say something about Gronk, too? Seems like you do…

Thanks! I’m not sure what knee injury Rex Burkhead is dealing with, but it sounded like he was still a bit hobbled in practice on Thursday. If he is active, he may be one to watch. Otherwise, do you mind if I twist this question a little to make it fit my agenda? Oh, you don’t? Awesome, thanks.

One person who I am so very happy to see NOT having trouble with his injury is Rob Gronkowski. I credit his work on flexibility and it sounds like a good deal of that work has been with Alex Guerrero at TB12. Big picture from my perspective: Gronk was a super tight, muscle-bound guy who grew up bench-pressing his older brothers and drinking protein shakes since he could hold a sippy cup. As a result, the tight end has a pretty messed up back (yes, that’s the medical term). After three microdiscectomy surgeries, his back injuries have threatened to shorten his bright career. This season, Gronk clearly put in a lot of work on flexibility and as a result, he looks much less stiff and has stayed off of the injury report for the most part. I’m going to steer clear of the Guerrero story for a while because we’ve all had enough, but I do think that Gronk’s willingness to walk away from a training style that he literally grew up with to focus instead on a more “touchy-feely” flexibility and resistance training protocol has most certainly paid off.

Dustin Pedroia told WEEI this week that he expects to be ready for opening day. That’s a big change from earlier other projections. Why might that be? Does his history and age play a factor?
— Greg Bedard @GregABedard

Dustin Pedroia has been dealing with knee issues for years and I wrote about it last spring on my blog. As his nagging cartilage injury became more symptomatic, it grew harder and harder for him to be able to play. In October, Pedroia made the decision to try to treat the injury more definitively with a cartilage restoration procedure. This type of surgery replaces the area of cartilage loss with “new” cartilage from another part of the knee that doesn’t need it as much, cadaver cartilage or his own cartilage cells grown in culture and re-implanted in his knee. The average recovery time for a surgery like that is approximately 6-to-8 months. The Red Sox announced in October that Pedroia would be expected out for at least 7 months, leaving no consideration that he would be ready to play on this year’s early opening day, March 29th. That’s why it surprised all of us when the second baseman told Rob Bradford this week on WEEI that he just might make it back during spring training.

“I’m hoping I get cleared next Wednesday to start running and get after it,” he said. “And that way, that leaves me enough time to get to spring training to where I’m a part of it from the get go.”

That would put Pedroia returning approximately 4-5 months after surgery. I think that’s pushing it. Pedroia points to the fact that his surgeon said he’d heal faster than other athletes with similar surgery because he’s a lot smaller than many of those athletes. While it is true that his size can impact the amount of force he puts on his knee on a daily basis, he will still need a substantial amount of healing time to allow the cartilage and bone graft to heal in. I hope to see Pedroia early in the season, but I would not expect to see him until a minimum of 5 months. Considering he is hoping to be cleared to run at his follow-up appointment next week, he still has a way to go before returning to the playing field. One take-home message from his interview, however, was that his knee is feeling better than it has in a long time. Almost like he has a new knee. Technology is amazing - can’t wait to see him back out there.

Dr. Jessica Flynn is a sports medicine physician at Lahey Hospital and Medical Center in Burlington, MA. She writes about injuries in professional sports on her blog, DocFlynn.com. You can follow her on Twitter @jessdeede.

Have a question for Dr. Flynn's weekly mailbag? You can send those to her at any time via email (docflynn@bostonsportsjournal.com), or you can Tweet them to her here.