Contusion Confusion

Shaq Lawson has a nerve contusion. You’re probably thinking, what is a nerve contusion and is this another crazy Bills injury? You’re also thinking, when did this occur and how will this affect him the rest of the season? During today’s post, I will help understand what happened, how it occurs, and long term effects.

First off, let’s break down a contusion. A contusion is some type of injury or blow to an area which can cause restrictions in movement or sensation. Basically a big bruise. However, a typical bruise to the area would cause a black and blue discoloration mark due to superficial blood vessels being disrupted and broken. This can cause pain during touch, muscle/joint movement, and limited mobility. In the case of Shaq, he sustained a nerve contusion, which is more specific.

A nerve contusion is a injury which can cause disruption to the conduction of the nerve. In a case like this, an injury to the area would cause numbness, pain, and weakness. This would present as a pins and needles feeling, significant pain immediately after the injury, and possible partial or temporary loss of control of the muscle that it innervates. Due to recent reports stating that Lawson sustained a nerve contusion of the leg allows me to deduct that he injured the peroneal nerve.

The peroneal nerve branches off the sciatic nerve that branches off the spinal cord. This branch of the nerve innervates the muscles of the lower leg including the anterior tibialis and extensor hallucis/digitorum longus. These, along other muscles, assist in lifting the foot up and in which is known as dorsiflexion and inversion. These muscles are vital for running, cutting, planting; basically everything that Lawson would need to perform during game day.

An injury like this would occur when the outside of the leg gets hit hard during a play such as a tackle or when a body falls on the area. The nerve runs down around the fibula which is the outer bone that makes up part of the outside of the ankle. This area is more associated with high ankle sprains such as what Odell Beckham is recovering from at the moment. While it is listed on the Bills injury report as a foot, this is the area that is being affected via the nerve, hence the designation.

Final question, how will this impact him for the long term outlook? Professionally, I don’t believe that this will be a long term issue, pending unknown severity. I expect him to possibly be limited over the next several days as the nerve continues to heal and will be a possibility to play against the Broncos. He may miss the next game if he has more damage that initially reported. The Bills have done fantastic with managing injuries thus far and I expect this trend to continue.

Thankfully, this injury was not more severe. To understand how severe it could have been, please direct your attention to the Dallas Cowboys roster and find LB Jaylon Smith. As most fans know, Jaylon Smith wrecked his knee and nearly his NFL career in his last college game, tearing his ACL/LCL and causing extensive damage to his peroneal nerve which cost him his entire first season in the NFL. In severe cases such as this, foot drop will occur. Foot drop is seen more commonly in older individuals who have suffered a stroke. These individuals will be fitted with an AFO or ankle foot orthosis which locks or assists the ankle into neutral/slight dorsiflexion allowing the foot to swing through during walking and preventing the foot from dragging. Thankfully, Smith has recovered to be the Cowboys leading tackler, but took nearly 18 months to even have the chance at playing.

While spinal cord injuries do not heal, peripheral nerve injuries can and do heal, with varying levels of success. To keep it simple, the nerve can have 3 stages of injury which impacts healing. The first stage is damage to the outer covering of the nerve which typically heals on its own. The second stage of nerve injury is where the outer covering becomes totally damaged and has disrupted regular nerve function. The final stage of nerve injury is total disruption and severance of the connection. In Lawson’s case, I can comfortably state that he suffered a stage one injury. Jaylon Smith sustained a stage 3 and his recovery was so long due to the nerve having to regenerate which can occur at a rate of 1-5 mm/day based on the size of the nerve. The fact that Smith has returned to such a high level of play is incredible in itself. The fact that Lawson escaped with a relatively minor injury is lucky.

I expect Lawson to continue building off his rookie season and increasing his level of play to be the disruptive defensive end that he was in college. I will continue to update with any changes or new information that occurs. Look for future articles to analyze the Bills injury report for Week 3 and identify any new complaints that require further breakdown. Go Bills!