Patriots

Dr. Flynn: Updating the injury situations for Tom Brady and Julian Edelman

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The best guy at throwing the ball and the best guy catching the ball are working through significant injuries. As new reports are surfacing, I’m getting a lot of great questions on Twitter, email, and text messages. I’ll try to answer them all for you here!

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First up, we all know that Tom Brady has been dealing with a throwing elbow injury for at least a month or so now. He works very hard preventing injuries like this and wrote in his book that he hasn’t had elbow issues since he started working with his body coach, Alex Guerrero.

It was reported today on NFL Network that Brady has been hampered by lateral epicondylitis, known commonly as “tennis elbow.” Lateral epicondylitis is an overuse injury to the tendons that control the wrist and attach to the bony prominence on the outer (if your palm is facing up) part of the elbow. These tendons allow the athlete to extend or cock back the wrist and supinate the forearm (rotate the palm up). Over time, the tendons can develop tiny micro-tears from repetitive work (throwing) and the area around the bony attachment gets inflamed. Patients I see complain that they can’t lift a jug of milk or even a cup off coffee without pain, it hurts to shake hands or grip.

The treatment? Immobilize the wrist. … I know, it’s weird for an elbow issue to be treated with a wrist brace, but remember those tendons are under stress when they’re moving the wrist. Therapy, pliability work on the muscles that attach to those tendons and TIME. Lots of patients want to hurry things up with a steroid injection, but I always try to avoid it. Steroids stop the healing process. The body needs to make a big deal about an injury like this, with swelling and irritation, to get growth factors to the area to fix the problem for good. Steroid injections stop that process.

How could this impact Brady’s game?

I think we’re seeing it already. Brady struggled a bit with accuracy during the first half of the Bengals game. It’s not just about zip on the ball, or distance. It’s about reliable accuracy. Some throws could be great, others uncharacteristically off. Another issue can be ball security. Grip is very painful with lateral epicondylitis. This could be a contributing reason to why we’re seeing Brady throw the ball away on some plays a bit sooner than we’d expect.

Can this sort of thing get better in the coming weeks or is this just life now for the remainder of the season?

It’s unlikely that there will be a sudden improvement, so I suspect this is something that will need to continue to be managed. We’ve seen more uncomfortable body language from Brady over the past few weeks which could mean that it’s getting a bit worse. I suspect he’ll continue to manage in games. I think the biggest impact this injury has on the Patriots’ offensive play is the lack of repetitions in practice. I know, I know …. it wasn’t on the injury report this week. But come on, this guy needs more reps with his young receivers than he typically does this time of the year.

I’m going to switch from the passing side of the ball to the receiving side now. As I wrote about early in the week, Julian Edelman has been dealing with a patellar tendon issue in his left leg. He was a shell of himself in last Sunday’s game and was spotted limping through practice on Wednesday. In short, it’s an overuse injury that is clearly limiting his ability to accelerate and change direction. If the tendinopathy/tendinosis/tendonitis he’s dealing with includes a small tear, this is an injury that could turn into a much bigger issue if that tear gets bigger or becomes complete. I do not think that his tendon issue could be significantly better in one week. If we see a more impactful Edelman today, it will be because he’s decided to push through the pain. I’ll be watching with fingers and toes crossed that he doesn’t suffer a worse injury as a result.

That’s all I’ve got for now. Please feel free to leave more questions below or on Twitter. I’ll get to as many as I can!

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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 mailbag? You can send those to her at any time via email (docflynn@bostonsportsjournal.com), or you can Tweet them to her here.