Zay’s Shoulder Struggles

Discussing Zay Jones recent shoulder diagnosis, types of dislocations and causes, and expected outcomes following surgery.

As the NFL continues to maintain the fans attention year round, constant news is churned out that help shed light on players issues during the season and provide answers to questions not fully explained. New information regarding Zay’s rookie season has brought up courtesy of the most recent The Bills Wire podcast. In the latest episode, managing editor Rob Quinn interviewed Robert Jones, Zay’s father, who revealed Zay had played his entire rookie season with a torn labrum in his shoulder.

What makes this comment interesting is the fact that Jones only appeared with a shoulder injury as a full participant in practice at the end of October before the Jets game. This issue was never publicly identified as a complaint until this interview. Today’s post will identify and discuss what the labrum is and its role in shoulder movement, how it possibly affected his play, and long term outlook following his upcoming surgery.

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Credit: http://gomidwestsports.com/surgical-procedures/labral-tear/

The labrum is a fibrous layer of tissue in the shoulder that deepens the socket in which the head of the humerus articulates with the glenoid fossa of the scapula. This allows for stabilization to the moving shoulder joint and prevents the joint from separating. Other structures including ligaments, rotator cuff, and connective tissue allow for additional support. Finally, the long head of the biceps tendon feeds into the glenoid and serves as an attachment for the biceps to contract. All these structures together help make up the shoulder joint and maintain stability through motion.

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Credit: moveforwardpt.com

The labrum can be torn by many different ways due to the structure of the joint. As with other joints, with increased mobility, there is decreased stability. Ways a shoulder can dislocate include a direct blow to the front of the shoulder, fall on outstretched hand also known as FOOSH which can cause posterior dislocations. In cases of anterior dislocation, extreme distraction to the area such as sudden pulling or placing the shoulder in extreme end ranges in external rotation and abduction. To picture this movement, envision the cock-backed position of the arm when throwing an object.

As a result of the shoulder dislocating, there is tearing of the labrum. There are various types of tears including SLAP tears or Bankart lesions and Hill-Sachs lesions, but not knowing the mechanism of injury prevents us from identifying specifically which lesion Jones suffered. However, upon dislocating, there is concern for damage to the nerves, blood vessels, and muscles to the surrounding area. The head of the humerus could pinch on one of those structures and cause long term issues if not addressed immediately. Once x-rays are taken and corresponding symptoms are assessed, the joint may be reduced and stabilized.

Most dislocations occur anteriorly with the literature stating that 97% occur in this manner. The remaining 3% are classified as posterior. When a dislocation occurs, the joint surfaces that articulate with each other become dislodged and remain separated until they are reduced manually. There are instances where the joint partially dislocates and relocates by itself which is defined as subluxation. In either instance, this creates damage and further instability leading to the possibility of future complications.

In Zay’s case, it was mentioned that he suffered the same injury in college during the 2015 season. While his father did not identify which shoulder he damaged, I will assume that he re-injured the same shoulder which according to the above posted article is the left shoulder. Jones did have surgery to repair the shoulder in college but due to the nature of the joint, it is very possible to re-tear the labrum on the same side, which appears to be the case. Unfortunately, the tissue in the area cannot be reinforced by other means which forces the surgeon to sew up and anchor the available tissue and immobilize in order to heal.

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Credit: http://www.shouldersandknees.com/labrum-tear.html

It is possible to surgically repair the area if it tears multiple times. However, repeated tears to the labrum has been described to me as trying to sew water together by an orthopedic surgeon as there becomes less and less tissue available to fix. Following surgery to anchor the tear down, immobilization in a sling allows the tissue to begin healing is typically the first step followed by range of motion and strengthening of the area to stabilize the area. This is followed by dynamic stability and strengthening with return to function over a 6-9 month period.

It is unknown when Jones suffered his torn labrum but due to his position, he was able to play with greater ease compared to QB Andrew Luck who had missed all of 2017 due to post surgical complications with the same injury. Had Jones suffered acute symptoms of the tear during the season, immediate pain and instability would have been present along with difficulty with overhead movements and weakness during resisted movements. This would have translated to difficulty creating separation between defensive players and himself along with trouble hauling in catches due to decreased strength of the affected arm.

The above mentioned complaints are the kind of symptoms that would have landed any player on the injury report. It is possible that these issues led to his early season struggles, but not confirmed. Jones could have also suffered the injury during the season and not initially been aware of the severity which could explain why he did not spend time on the injury report. It was reported that the tear was found at a routine end of season MRI.

Returning to comments made by Robert Jones, specifically, if Zay were to pick up a glass of water, his arm could dislocate; this is highly unlikely and hyperbole. A shoulder that has suffered a torn labrum that repeatedly dislocates can demonstrate significant instability which could eventually lead to minimal forces required to dislocate. However, picking up a glass of water would unlikely dislocate a shoulder as muscles of the upper arm and forearm primarily control this action . If his arm did dislocate this easily, he would no longer be playing football and he would have had many other conservative interventions prior to letting it get that severe. Adding in the fact that in between dislocations, the body is constantly trying to heal, laying down scar tissue to stabilize the area.

As Jones is a professional athlete, instability in a violent sport does not equal long term success when it comes to health. This surgery will assist in stabilizing the area and hopefully prevent any further issues. Thankfully, Jones should be able to return to full form in time for training camp and have no setbacks. He should not experience the issues that Andrew Luck had as he does not have to throw the ball or place his shoulder in extreme positions.

This injury news was totally unexpected, but it is common for NFL players to play through injuries varying in severity and still perform at a high level. I have full confidence that Jones will return to full health and build off his sub-par rookie season. Continue to check back for articles including Kelvin Benjamin’s meniscectomy and other procedures including possible surgical interventions for Cordy Glenn. Follow me on Twitter @kyletrimble88 for updates, thank you for reading and GO BILLS!!

Author: Dr. Trimble

My name is Dr. Kyle Trimble and I am, first and foremost, a Buffalo Bills fan!! When I am not cheering on the Buffalo Bills, I am a Physical Therapist. To give a background on myself; I was born and raised in Erie, PA, moved to Buffalo in 2006 to begin my studies at D'Youville College towards becoming a Physical Therapist at which time I became a devoted Buffalo Bills fan.  I graduated in 2013 with my Doctorate in Physical Therapy and moved home for several years. Moving back to the Buffalo area in 2016, I have gained extensive experience in outpatient orthopedics, skilled nursing, acute care hospital, and home care. Having obtained a significant wealth of knowledge that continues to grow, along with a undying fandom of the Bills, puts me in the unique position to educate my fellow fans about our great team. 
I am currently an injury spotter working with Dr. David Chao, Orthopedic Surgeon @ProFootballDoc based out of San Diego. In this role, I provide real time updates regarding injuries during the game. I hope you enjoy what I publish and I welcome any comments or questions you may have.
Disclaimer: My opinions are my own.  Any thoughts I have on the injuries is based on media reports, my knowledge of the injury, and speculation based on the information currently available.


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