Adam Levitan

Injuries in Depth

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Injuries In Depth: Gronkmare

Friday, June 14, 2013

In 2009, Rob Gronkowski slipped to the second round of the NFL draft due to concerns surrounding his back. Fantasy owners are preparing to give him similar treatment.

Over the last seven months, Gronkowski has fractured his left forearm twice, incurred an infection and had four surgeries on that arm. Yet somehow, that’s the least of his concerns. Later this month, Gronk will undergo the second discectomy of his career, leaving his status for Week 1 is in serious doubt. A surefire first-round fantasy pick that has 38 touchdowns in his first 43 NFL games is now draped in red flags.

To get a better handle on exactly what’s going on with Gronk’s back and what to expect going forward, we talked with physical therapist Dr. Brian Eckenrode. Brian is an assistant professor of physical therapy at Arcadia University who has experience working with collegiate and professional athletes. Note that he has not personally examined Gronkowski, or seen any of his MRIs.

Q) Let’s start with the forearm issue. Now that he’s had two breaks and an infection in the same area, is he more likely to sustain another fracture?
A) If it happens again, it will probably be one of those freak things, unless there was some kind of healing complication. Once the infection is cleared out and there’s adequate healing, he will be stressing it during rehab and stressing it during practice. For the most part he should be pretty normal with wrist and hand function when all is said and done.

Q) OK, let’s get to the back issue. What exactly is a discectomy?
A) A discectomy is a surgical procedure where the surgeon will cut out or remove a piece of disc material from the lower back. Our lumbar spine is made up of five vertebrae. They stack on top of each other, and you have a disc that’s kind of like a jelly doughnut, a space in between them. Sometimes that jelly can actually push out to the back and to the side. This can potentially pinch down or cause pressure onto the nerves that control the sensation and strength of the legs.

In a discectomy case, they’ll go in and cut out, or debride that piece that had pushed out. It’s considered a minor procedure because it’s not a huge big, open incision. With some rest, the hope is that it will scar down and not be an issue anymore.

Q) How are Gronkowski’s 2009 discectomy and this one related?
A) Research has shown that people who have has a previous back injury are at a higher risk for another back injury. The bones of the spine require coordinated muscle strength and mobility to function, and with an injury or loss of motion there can be an increase in stress to other structures of the spine.  Gronkowski’s current back injury and upcoming procedure sounds more minor than his one in college, but I would suspect that they’re probably closely related. 

Q) How does someone sustain this kind of back injury?
A) It could be from a number of things. People get this from something as simple as poor sitting posture at their desk. It could be a gradual weakening of the discs from the amount of football and training he puts himself through. There are certain activities that put the back at more of a risk. Gronkowski plays a violent sport where he's getting tackled, he’s getting twisted, etc.  Repetitive loads and forces placed on the back can cause weakening of the structures of the spine. 

Q) We’ve heard a 12-week recovery timetable for Gronkowski following the procedure. Is that realistic, based on your experience?
A) Usually most people are instructed take six weeks of relative rest. And then after that six-week period, they begin a program of strengthening, flexibility and early conditioning. Certainly professional athletes may be cleared to be a little more progressive starting some early rehab under the doctor’s guidance. 

Q) Could these seemingly chronic back issues shorten Gronkowski’s long-term career?
A) Based on his production in the NFL, the first procedure didn’t affect him very much. I’d certainly be more favorable to say he’s going to have a pretty successful rest of his career as long as he takes care of himself. We’ve seen that with other injuries and recoveries. The top stars, the higher caliber players can recover and get back to their level whereas mediocre guys don’t have the same success. It could be motivation, genetics and expectations for their return. Look at Adrian Peterson.

Adam Levitan is in his sixth season covering football and basketball for Rotoworld. He won the Fantasy Sports Writers Association award for Best Series in 2011 and 2009, and ESPN's overall fantasy football title in 2000. Find him on Twitter.
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