Groin Pains for Murphy

Exploring why Trent Murphy’s groin injury isn’t healed yet & what this means for the rest of preseason.

As the local media continues to find story lines to report on, injuries are always an easy topic to report because it usually affects the quality of play on the field for that particular game and can affect the season as a whole. New Bills DE Trent Murphy is no exception. As detailed in past posts, he is coming off an ACL tear that caused him to miss the entire 2017 season. Unfortunately, Murphy has not been able to show off the talents that scored him a new contract due to a groin strain suffered a week into training camp. Today’s post will explore why Murphy is slowed with his groin and how it’ll affect him the rest of the preseason.

Previous posts have explored muscle strains including severity and general healing times. Murphy’s groin is no exception. The groin muscles are also known as adductor muscles. They attach from the pubic region of the hips and go down to the inside portion of the femur or thigh bones. These muscles allow the leg to adduct/cross midline and medially/laterally the femur rotate based on hip position. They also assist with hip flexion; all of these motions assist with running/cutting/juking motions required of football players.

We know that Murphy tore his left ACL last year and has worked steadily back into athletic shape. As for his groin injury, regrettably, I have unable to find which side of his groin he has injured as media reports do not specify. Overall, this won’t really affect recovery time but may shed light on how his body is compensating following the surgery. It’s possible that both sides are injured but we are unsure. He wasn’t able to really participate in OTA’s due to his recovery from the ACL surgery. Since then, he has been cleared for full practice but is still attempting to overcome a full year of restricted activity due to rehab. Normal population may have an ACL reconstruction and not deal with injuries with returning to sport, but as a high level athlete in the case of Murphy, small deficits can become bigger detriments as he asks the most out of his body. Despite being functionally strong enough for football, his body is still relearning the proprioceptive movements required for the position and this is most likely the reason why he is suffering other injuries because the hips/groin and ankle are having to compensate for the knee as he regains his football abilities. A quick refresher, proprioception is the ability to understand where your body is in space in relation to movement. Think of your leg like a chain in which each link is the ankle, knee, and hip. If there is a weak link in the chain, it will break. Same thing can happen in people, if one joint is injured or weak, others begin compensating and may cause further injury.

What does this mean for Murphy going forward? I believe he will eventually be able to play without restrictions by the time the regular season starts. It appears as though he initially suffered a Grade 1 strain which can take anywhere from 1-2 weeks to heal after injury, with some taking up to 3 weeks. This is supported by the fact that he first reportedly sustained the injury August 1st, which is 2 weeks ago today. As stated above, it normally takes 1-2 weeks to heal under normal circumstances. I believe Murphy felt as he was able to return to practice after a week, re-injured going full speed and will require further rest. He will probably need another 1-2 weeks max to fully recover. While teams do want their athletes to heal fully, re-injuries still occur. The big question is whether that timeline for recovery restarted or this is a minor setback. I personally believe this is a minor setback but allows other guys including DE Shaq Lawson to get more looks and earn their way onto the roster.

He will most certainly miss the Browns game, should be able to play against the Bengals game if practice goes well, and ideally have no issues and be available for the Bears game. There is a possibility this could linger all season, but considering this is the preseason, the Bills will allow for extra rest time over return to play.

I expect Murphy to start against the Ravens on opening day. I’m going to also state that this won’t be an issue that lingers all season. I also believe that Murphy may have a slow start to the season and come on later in the second half as his body re-acclimates to football. I may be totally wrong on everything as this is only speculation, but this is highly educated speculation. However, I fully believe Murphy should be ready to go soon.

Continue to check back for the latest updates on the latest injury news and updates. Follow on Twitter @BangedUpBills, on Facebook at Banged Up Bills, online at www.bangedupbills.com, and on reddit at u/BangedUpBills. As always, thank you for reading and GO BILLS!!

NFL Injury Series- Sprains

An overview of general sprains, severity, and recovery times

As we continue to delve into common injuries seen around the NFL, today’s post will consist of an overview of general sprains. Sprains are very similar to strains, but differ in function and location. Sprains are an injury to a ligament or multiple ligaments based on location. Ligaments are found all over the body and provide connections between bones to create a joint. When an injury occurs to the area, instability, pain, and swelling occurs based on severity.

Hamstring-Gr1-3.jpg
Credit: therapydiadenver.com

Grade 1 sprains are when the ligament is stretched minimally and minor swelling/pain occurs. This can cause some players to miss time based on location and position, but typically can be managed conservatively in order to return to prior level of function. These types of injuries are week-to-week and can be played through if absolutely required, though increased risk of injury occurs. X-rays may be performed to ensure no fractures have occurred but are usually diagnosed through physical examination.

Grade 2 sprains are when the ligament is partially torn and moderate swelling/pain occur. These types of sprains typically keep players out for some time and cause moderate loss of function. A conservative expectation for a Grade 2 sprain could be anywhere from 4-6 weeks, though could vary based on location. At this time, an X-ray is performed to rule out any fractures. An MRI is performed to support physical examination and determine extent of damage.

Grade 3 sprains typically involve near or complete tearing of the ligament leading to significant loss of function and possible season ending surgery based on location of area. At this point, the ligament is classified more of a tear than a sprain which is why you do not see this as a Grade 3 sprain. Typically, ACL, PCL, and severe MCL tears can be categorized as such along with AC joint sprains. Ankles, shoulders, and wrists are also common areas for complex ligament damage to occur. It is common to see other structures become damaged as the result of a severe sprain/tear. MRI’s are performed to determine severity of tear and to assess for any injuries missed by physical examination or initial swelling.

In most cases, a sprain can be due to an overload to the joint as a direct blow, violent twisting/pivoting, or excessive tension on the ligament. As with all other materials in the body and in nature, everything has a breaking point. Injuries such as these can be reduced but not totally prevented. Preventative measures include playing on forgiving surfaces such as grass which reduce the friction and prevent cleats from sticking in the surface. Proper strengthening to the area and proprioceptive exercises which include body awareness activities help keep the body from overloading the joint. Bracing and taping may also give support to an area if there is a high risk for injury or prior instability. Taped wrists, knee braces on lineman, and ankles braces assist in limiting excessive range of motion, reducing the risk.

Continue to check back regarding updates on Bills news and general injuries in the coming days. While it is impossible to review every injury, this is merely a guide to assist you in understanding the severity and expected timeline upon injury. Follow on Twitter @BangedUpBills and at http://www.bangedupbills. As always, thank you and GO BILLS!!

NFL Injury Series- Muscle Strain

An overview of general muscle strains, grade severities, and recovery times.

The Buffalo Bills training camp continues to roll right along with no major injuries to report. The only reported injuries so far is TE Nick O’Leary who suffered an ankle injury which kept him out of practice for a short time but did not appear to be anything serious as he was able to return to full practice after several days rest. TE Logan Thomas was limited in practice but no further updates have been released regarding his current injury.

As we continue with the NFL injury series, today’s post will consist of identifying several terms used to describe injuries and educate on how to differentiate on what is being reported. I have used many of these terms before and have done my best to describe them, but I believe they are worthy of their own article. Today’s overviews will consist of the common muscle strain.

A muscle strain can occur in virtually any muscle within the body if the muscle is suddenly overworked, stretched, or fatigued to the point where the muscle becomes injured. A strain is classified as a strain due to an injury to the muscle itself or the muscle bone attachment which is called the tendon. There are varying grades of muscle strains which can progress up to a muscle tear, avulsion fracture, or rupture.

Grade 1 muscle strains are relatively minor and is when a small portion of the muscle is torn; function may be limited, but is typically not serious and can heal up relatively quickly with proper management. This usually consists of stretching, icing, anti-inflammatory medications, and light strengthening exercises to restore proper movement. With effective management, this can be a day-to-day injury with some lasting up to a week or two. Most of these injuries are able to be played through with proper rehab and rest.

Grade 2 muscle strains are where a moderate portion of the muscle is torn which is typically associated with bruising, swelling, and partial loss of function which is demonstrated as difficulty performing the muscle movement and is typically limited secondary to pain. Rehab management will consist of generally the same procedures as Grade 1, but will require a longer duration to recover. I can not make a blanket statement and state that a Grade 2 muscle strain will take “X” number of weeks to heal up. It is typically more than week-to-week, but based on location and job duties of the position may dictate how long the player is out.

foot_posterior_tibial_tendon_causes02.jpg
Credit: eorthopod.com

If a Grade 1 or 2 muscle strain occurs close to the tendon attachment, if not healed up correctly or chronically injured/overused, the muscle or tendon may develop into a tendinitis based on healing. The suffix “-itis” is Latin for inflammation, which indicates that the tendon is irritated and may become painful over time. Most muscle/tendon fibers have consistent, linear striations, such as in a nice cut of beef or in the picture above. When the tendon does not heal correctly, the connective tissue heals in an uneven pattern as seen in the picture below. This does not allow for effective contraction of the tendon, leading to increased pain, weakness, and loss of function. This could lead to tendonosis which is the chronic form of tendinitis and becomes even more difficult to treat. Eventually, this can lead to a higher risk of rupture in the tendon later but is not a requirement for a rupture to occur.

tendinosis-chronic-injury.jpg
Credit: mendmeshop.com

However, when a severe muscle strain occurs, this is classified as Grade 3. This is where most of the muscle is torn, there is typically significant damage and surgery is possibly required to repair the structural damage. There is significant swelling, bruising, and pain to the area due to the sudden and forceful nature of the injury. The muscle no longer is able to function as intended and pain limits the possibility to attempt. At this point, several other injuries may have occurred including an avulsion fracture or ruptures. If an avulsion fracture or rupture has not occurred, surgery still many be indicated to assist the muscle in healing correctly.

images.jpg
Credit: physicaltherapyct.com

In the case of an avulsion fracture, the tendon that attaches the muscle to the bone and acts as the anchor pulls away from the attachment point and takes a chunk of the bone with it. While this injury is uncommon, it still does happen. Surgery is sometimes indicated to reattach the bone to the original area and requires extended time missed, requiring the body to build up toleration to the muscle pulling on the attachment point without re-injuring the area.

70.jpeg
Credit: tylerfootclinic.com

Finally, a tendon rupture is when the tendon tears away from the attachment point but does not take a piece of bone with it. This is commonly seen in biceps and Achilles’ injuries, among other areas. If this injury occurs, the player may feel a pop with immediate loss of function. The muscle may act like a bungee cord and rebound violently and become balled up, leading to a deformity. These types of injuries also require surgery and cause a player to miss extended time due to the requirements of the muscle contraction and the actions of the muscle. As there are a variety of potential tendon ruptures and recovery times, it is difficult to state a general timeline without having specific information.

This is just a brief overview of the muscle strain and how to understand the various nuances of the wording and injury. Sometimes injuries such as calf and hamstring strains can appear to follow a player for their career or never fully heal without significant rest. The best thing that a player can do is hydrate well, stretch effectively, strengthen properly, and listen to their bodies. While the NFL is a tough sport, pain is expected, but trying to play through an injury may only worsen it and cause further complications down the line.

This completes another article in the NFL injury series as we prepare for pre-season games and the regular season. There is much more to come regarding the common injuries we will inevitably see over the next several weeks. Continue to check back for posts regarding other general injuries and broaden your knowledge base. Follow on Twitter @BangedUpBills and at http://www.bangedupbills.com. As always, thank you for reading and GO BILLS!!

Speculating Sprains

Breaking down the latest Bills news and an overview of general sprains and their severity.

As the Bills come off their well deserved bye week, two new pieces of information have arisen since last post. The Bills have signed WR Deonte Thompson and released RB Joe Banyard. Thompson has been with most recently the Chicago Bears before being released last week and had previously spent time with Buffalo the past two off seasons. This will help add depth to the WR corps and give Tyrod Taylor a deep option as WR Kaelin Clay hasn’t made much noise since acquiring him earlier this season from the Panthers.

In other news, it has been reported that WR Jordan Matthews is ahead of schedule in regards to his thumb fracture. He has been seen in practice without padding and with just a bandage over the area, though not cleared to catch balls yet. While not fully recovered, this is a promising sign. I had initially thought that Matthews would not be ready to return until the Jets or Saints game, giving him 4-6 weeks to heal. While healing times do vary person to person, it is still early to state when he will play.

Regarding return to play, I could see Matthews sitting out the Buccaneers game, possibly returning against the Oakland Raiders, giving the passing game a much-needed boost after losing Charles Clay last game. The key thing with his recovery is how quickly the bone has healed, the strength/range of motion in the hand, and his ability to manage pain effectively. I continue to hope that these players exceed expectations with return to play and contribute towards making the team more dynamic.

Today’s post will consist of an overview of general sprains. Sprains are very similar to strains, but differ in function and location. Sprains are an injury to a ligament or multiple ligaments based on location. Ligaments are found all over the body and provide connections between bones to create a joint. When an injury occurs to the area, instability, pain, and swelling occurs based on severity.

Hamstring-Gr1-3.jpg
Credit: therapydiadenver.com

Grade 1 sprains are when the ligament is stretched minimally and minor swelling/pain occurs. This can cause some players to miss time based on location and position, but typically can be managed conservatively in order to return to prior level of function. These types of injuries are week-to-week and can be played through if absolutely required, though increased risk of injury occurs. X-rays may be performed to ensure no fractures have occurred but are usually diagnosed through physical examination.

Grade 2 sprains are when the ligament is partially torn and moderate swelling/pain occur. These types of sprains typically keep players out for some time and cause moderate loss of function. A conservative expectation for a Grade 2 sprain could be anywhere from 4-6 weeks, though could vary based on location. At this time, an X-ray is performed to rule out any fractures. An MRI is performed to support physical examination and determine extent of damage.

Grade 3 sprains typically involve near or complete tearing of the ligament leading to significant loss of function and possible season ending surgery based on location of area. At this point, the ligament is classified more of a tear than a sprain which is why you do not see this as a Grade 3 sprain. Typically, ACL, PCL, and severe MCL tears can be categorized as such. Ankles, shoulders, and wrists are also common areas for complex ligament damage to occur. It is common to see other structures become damaged as the result of a severe sprain/tear. MRI’s are performed to determine severity of tear and to assess for any injuries missed by physical examination or initial swelling.

In most cases, a sprain can be due to an overload to the joint as a direct blow, violent twisting/pivoting, or excessive tension on the ligament. As with all other materials in the body and in nature, everything has a breaking point. Injuries such as these can be reduced but not totally prevented. Preventative measures include playing on forgiving surfaces such as grass which reduce the friction and prevent cleats from sticking in the surface. Proper strengthening to the area and proprioceptive exercises which include body awareness activities help keep the body from overloading the joint. Bracing and taping may also give support to an area if there is a high risk for injury or prior instability. Taped wrists, knee braces on lineman, and ankles braces assist in limiting excessive range of motion, reducing the risk.

Thank you for your time today and please continue to check back regarding updates on Bills news and general injuries in the coming days. While it is impossible to review every injury, this is merely a guide to assist you in understanding the severity and expected timeline upon injury. I hope you continue to enjoy and GO BILLS!!

Studying the Strain

Educating and understanding the general muscle strain, grade severity, and complications.

Today’s post will consist of identifying several terms used to describe injuries and educate on how to differentiate on what is being reported. I have used many of these terms before and have done my best to describe them, but I believe they are worthy of their own article. Today’s overviews will consist of the common muscle strain.

A muscle strain can occur in virtually any muscle within the body if the muscle is suddenly overworked, stretched, or fatigued to the point where the muscle becomes injured. A strain is classified as a strain due to an injury to the muscle itself or the muscle bone attachment which is called the tendon. There are varying grades of muscle strains which can progress up to a muscle tear, avulsion fracture, or rupture.

Grade 1 muscle strains are relatively minor and is when a portion of the muscle is torn; function may be limited, but is typically not serious and can heal up relatively quickly with proper management. This usually consists of stretching, icing, anti-inflammatory medications, and light strengthening exercises to restore proper movement. With effective management, this can be a week-to-week injury.

Grade 2 muscle strain is where a moderate portion of the muscle is torn which is typically associated with bruising, swelling, and partial loss of function which is demonstrated as difficulty performing the muscle movement and is typically limited secondary to pain. Rehab management will consist of generally the same procedures as Grade 1, but will take longer to heal up. I can not make a blanket statement and state that a Grade 2 muscle strain will take “X” number of weeks to heal up. It is typically more than week-to-week, but based on location and job duties of the position may dictate how long the player is out.

foot_posterior_tibial_tendon_causes02.jpg
Credit: eorthopod.com

With an injury such as this close to the tendon occurs, if not healed up correctly or chronically injured/overused, the muscle or tendon may develop into a tendinitis based on healing. The suffix “-itis” is Latin for inflammation, which indicates that the tendon is irritated and may become painful over time. Most muscle/tendon fibers have consistent, linear striations, such as in a nice cut of beef or in the picture above. When the tendon does not heal correctly, the connective tissue heals in an uneven pattern as seen in the picture below. This does not allow for ideal effectiveness of the tendon, leading to increased pain, weakness, and loss of function. This could lead to tendonosis which is the chronic form of tendinitis and becomes even tougher to treat. Eventually, this can lead to a higher risk of rupture in the tendon later but is not a requirement for a rupture to occur.

tendinosis-chronic-injury.jpg
Credit: mendmeshop.com

Grade 3 is where most of the muscle is torn, there is typically significant damage and surgery is possibly required to repair the structural damage. There is significant swelling, bruising, and pain to the area due to the sudden and forceful nature of the injury. The muscle no longer is able to function as intended and pain limits the possibility to attempt. At this point, several other injuries may have occurred including avulsion fracture or ruptures. If an avulsion fracture or rupture has not occurred, surgery still many be indicated to assist the muscle in healing correctly.

images.jpg
Credit: physicaltherapyct.com

In the case of an avulsion fracture, the tendon that attaches the muscle to the bone and acts as the anchor pulls away from the attachment point and takes a chunk of the bone with it. While this injury is uncommon, it still does happen. Surgery is sometimes indicated to reattach the bone to the original area and requires extended time missed, requiring the body to build up toleration to the muscle pulling on the attachment point without re-injuring the area.

70.jpeg
Credit: tylerfootclinic.com

Finally, a tendon rupture is when the tendon tears away from the attachment point but does not take a piece of bone with it. This is commonly seen in biceps and Achilles’ injuries, among other areas. If this injury occurs, the player may feel a pop with immediate loss of function. The muscle may act like a bungee cord and rebound violently and become balled up, leading to a deformity. These types of injuries also require surgery and cause a player to miss extended time due to the requirements of the muscle contraction and the actions of the muscle.

This is just a brief overview of the muscle strain and how to understand the various nuances of the wording and injury. Sometimes injuries such as calf and hamstring strains can follow a player for their career or never fully heal for sometime. The best thing that a player can do is hydrate well, stretch effectively, strengthen properly, and listen to their bodies. While the NFL is a tough sport, pain is expected, but trying to play through an injury may only worsen it and cause further complications down the line. Continue to check back for posts regarding other general injuries and broaden your knowledge base. GO BILLS!

Lawson’s Gimpy Groin

Assessing Shaq Lawson’s latest injury and impact for Sunday’s showdown against the Atlanta Falcons.

It was reported that Shaq Lawson injured his groin in practice Thursday and is now a game time decision for Sunday against Atlanta. Lawson has been on a tear this season in limited action, totaling 10 tackles, 2 sacks, nearly equaling his output from last year. He has begun to live up to draft expectations coming out of Clemson in 2016 and is a reason why the Bills defense has returned to top form this season.

As Lawson is a game time decision on Sunday, it would be better to understand what a groin injury is and how it affects his play. The groin is a series of muscles that attach from the lower hip in the hip crease to the inside portion of the thigh. These muscles assist in bringing the leg to midline, flexing the hip up, and internally/externally rotating the hip. These actions are vital to the actions of the defensive end with regards to shuffling, running, and pivoting. This is typically seen when trying to run down a player or having to stop suddenly. This can also be seen during eccentric contraction of the adductors which is seen during blocking and shuffling along the line.

groin_injuries.jpgIllustration 1: Credit: physioworks.com.au

Lawson reports that his groin is sore and that he will be alright. Despite a positive outlook from Lawson, it is still beneficial to understand how the groin is injured. Typically, the groin muscles are injured when the individual is sprinting or changing directions quickly. As this is a soft tissue injury, there are various grades that the muscle strain can be broken down into to assess severity based on location and mechanism of injury.

Grade 1 involves an injury to the area due to overloading the area, causing microtears and weakening the anchor point, causing pain and inflammation. This is usually a week-to-week injury and if rehabbed properly, should not be an issue long term. The injury typically is seen more in the muscle belly, which is the meaty portion of the muscle. Pain may be felt in the inner thigh or in the groin itself if the muscle is overloaded.

Grade 2 involves a partial tear to the muscle belly or attachment point leading to an inability to walk normally, much less perform the duties of the position. This injury takes longer, anywhere from 4-8 weeks based on severity and must be managed conservatively. Typically, injuries closer to the attachment points can become more chronic and lead to extended time missed. This is due to the nature of the muscle having to pull on the anchor in order to function properly. If the anchor point is not secure, pain and ineffective use of the muscle continue to occur.

Grade 3 typically involves tearing of the attachments closer to the femur, which is known as the distal insertion points. Commonly, the muscle is torn partially or fully away from the bone, leading to surgical intervention. These type of injuries do not happen often, but as with any muscle injury, can occur.

It is not known what caused Lawson’s injury, but it is certainly significant enough to cause him to be a game time decision. I believe that Lawson’s groin injury is a Grade 1, supported by the remark that it is sore and that he will be alright. An athlete knows his body best and barring any re-injury during warm ups, should play Sunday. There is always the risk to increase the severity by playing through, but with proper stretching and warm ups, along with the continued limited snap count, Lawson should be fine. Considering that Lawson has been playing up to the level we expected when drafted, it will be beneficial to have him pressuring Matt Ryan and the Falcons offense. This is a winnable game if the Bills play to the level they did last week against a very good Broncos team. Continue to check back for updates and further analysis regarding Bills injuries, GO BILLS!!