2017 AFC Championship

Dr. Flynn: A range of possibilities for Tom Brady’s finger injury

(Ron Chenoy/USA TODAY Sports)

Tom Brady reportedly “jammed” his right (throwing) hand in practice on Wednesday when he was accidentally struck it during a handoff. Unnamed sources say that he had x-rays that revealed “no structural damage,” and some that he had a “cut.” He was limited in practice Wednesday (presumably after the injury) and did not practice today — the first time all season he has not practiced on a Thursday. He was seen on the practice field stretching at the beginning of practice wearing gloves on both hands, but reporters were dismissed before the quarterbacks began to throw.

That is all that we know.

In photos from today’s practice, it did appear that Brady had either a wrap or a brace around his thumb. I’m uncomfortable commenting too much on this injury because it is much more speculative than other injuries — I don’t have any video to review and we haven’t seen the hand or possible brace to get any medical clues.

If this is an injury to the thumb of Brady’s throwing hand, that could significantly affect his grip on the ball which, in turn, can cause problems with accuracy, particularly with long passes. It can also cause issues with ball security — it may be more difficult to hold onto the ball if a defender is trying to bat it away.

There are a range of injuries that could interfere with a quarterback’s ability to practice. Please refer to the above (very rough - be kind) diagram of a thumb to see where, anatomically, I’m referring to below.

The least severe injury possibilities include a simple laceration (cut) that requires medical closure, a bruise, or a mild sprain. If the hand was struck, a bruise with a laceration is a possibility. A dislocation of one of the thumb joints is a possibility as well. The least serious would be a dislocation of the interphalangeal (IP) joint. These can be open (the bones displace so much that they poke through the skin) or closed (no associated skin wounds). Open dislocations of the IP joint are often reducible on the field and are quite stable after reduction. The main concern with an open dislocation would be closing the wound and risk of infection.

A metacarpophalangeal (MCP) joint dislocation is more significant because often these are not as stable. Even without a true dislocation of the joint, an injury to the ulnar collateral ligament (UCL), one of the rubber band-like structures that stabilize the MCP joint, can lead to significant impairment. A sprain of the UCL is painful, particularly with gripping. A tear of the UCL, which former Patriots QB Jacoby Brissett suffered when playing during Tom Brady’s suspension, most often requires surgical repair to ensure joint stability (he eventually landed on injured reserve).

That’s a pretty big range. Athletes have played with both open PIP dislocations (J.J. Watt) and UCL tears (Brissett). Brady has shown in the past that he is very capable of playing through injury without letting it distract him. We’ll have to wait and see how the next 24-48 hours play out. Hopefully, Brady is able to practice tomorrow and we’ll get a closer look at his hand when he meets the press tomorrow afternoon.

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.

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