The Carolina Panthers have had two major injuries in the early part of their training camp. There starting right tackle Daryl Williams suffered a dislocated patella and torn medial collateral ligament three days ago and one of their potential starting cornerbacks, Ross Cockrell, fractured both his tibia and fibula.
Panthers CB Ross Cockrell carted off the field in an air cast pic.twitter.com/gTzD98iQ87
— Tadd Haislop (@TaddHaislop) July 30, 2018
The fracture occurred following him going against wide receiver Torrey Smith in a one-on-one drill.
#Panthers CB Ross Cockrell, who yelled to teammates today that he thought his leg was broken, did in fact break his leg, source said. Another rough blow for Carolina.
— Ian Rapoport (@RapSheet) July 30, 2018
Anatomy Review:
The Tibia and Fibula are the two bones that make up the lower leg. The tibia is the larger of the two and it’s the lower leg bone that bears most of the weight and contributes to the knee joint and the ankle joint. The tibia provides attachment site for many muscles of the hip, thigh, lower leg, and foot. The fibula is the smaller of the two bones and contributes to the ankle joint. It’s often an attachment site for muscles of the thigh, lower leg, and the foot.
Fractures of the tibia and fibula are usually caused by high impact collisions and trauma to the lower leg. The severity of the fracture is determined by several factors:
- Artery or Nerve involvement
- Location of the fracture
- closer to the knee
- the middle
- closer to the ankle
- Type of fracture
- Open – breaks skin
- Close – doesn’t break skin
- Pattern of fracture
- Transverse – break is straight across
- Oblique – break is diagonal
- Spiral – break is diagonal and around the entire bone
- Comminuted – break is in several pieces
An X-ray and MRI can confirm the severity of damage occurred. And surgery will occur once some of the swelling as gone down. What you are hoping for is a clean break without an neurological or circulatory involvement.
Rehabilitation Overview:
Like many severe lower leg injuries, the concepts of standing, balancing, and walking are going to dominate the early phase of physical therapy.
Creating strength through the foundational lower body exercises (squats, deadlifts, carries) will be introduced in the middle portion of rehabilitation. Progression from two-legged exercises to single-leg exercises is a must.
There are physical therapy clinics that believe in using unstable surfaces and bosu balls to help in parts of rehabilitation to help improve balance. I’m not a big fan of adding unstable surfaces such as those below.
There are other ways to help build balance in a rehabilitation setting. Simply by performing exercises with a narrow base of support or on a single leg is a start. Taking away senses such as sight (eyes closed) is another way to improve balance. While I’m not overly sure how closing your eyes and doing squats is effective, it is another way to test balance.
How I am apart of the treatment team right now is manual work. I’ll do a lot of manual work on the front and back of the lower leg to help with tissue healing and help with muscle tissue health. Making sure that the range of motion is maintained in the ankle, knee and hip. It’s going to be important in the first phase of rehabilitation to restore and maintain the range of motion in all three joints listed because he’s going to be in a boot which will:
- Alter gait mechanics
- Immobilize the ankle joint
Season Outlook:
It has not been determined or reported if the season is over for the Carolina cornerback. With his time table scheduled to be anywhere from four to six months. That is based off an estimation that there is no nerve or blood supply damage and without any setbacks or complications. The earliest he could be back is December 1 and the latest would have him back for the Super Bowl. I think it’s more than likely they will eventually announce that he is out for the season and will be placed on Injured Reserve. While it is safe to say he’ll be ready for the start of Organized Team Activities and Mini-camp in the spring of 2019, his 2018 season is most certainly in doubt.
I’m not taking credit for any photographs. All that belongs to reporters and photographers from national and local publications: NFL, Sports Illustrated, ESPN, USA Today.