The “DL” Report: NFL Week 5

With the start of Week 6 underway on Thursday night featuring the Philadelphia Eagles and the New York Giants, there are plenty of injuries to discuss that occurred in the match-ups of the previous week. While I was debating on what to talk about in regards to which type of injury because there are several notable players out with foot injuries. But I came to the conclusion that we are going to discuss what happened in the Washington Redskins vs New Orleans Saints game, and specifically Adrian Peterson. While the concern is his right shoulder. He did happen to take a few hits that left you wondering is it just his shoulder?

Or how about his knee? or quad? or hip?

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Anatomy Review:

When we are discussing shoulder dislocations, one of the bones you look is the scapula. The scapula creates the “socket” portion of the ball and socket joint. The socket is created by the glenoid cavity. It’s not the bone that “dislocates” when a dislocation occurs. Another important piece of the shoulder are the rotator cuff muscles. The scapula provides the anchor points for the four rotator cuff muscles. Not only do muscles attach to the scapula, but since the shoulder is inherently mobile, the ligaments that attach to the scapula also provide stability to the joint as well.

The other half of the shoulder joint (glenohumeral joint) is the humerus. Also known as the arm bone, it provides the distal attachments for the rotator cuff muscles and the distal attachment for ligaments of the shoulder. It’s the “ball” of the ball and socket joint.

The muscles and ligaments that attach to the scapula and humerus provide improved stability to a joint that is inherently unstable. The shoulder sacrifices stability for mobility, so the shoulder reinforces itself with muscles, ligaments, and tendons. The four rotator cuff muscles that stabilize the shoulder:

• Supraspinatus
• Infraspintaus
• Teres Minor
• Subscapularis

When talking about dislocations, it is when the ball is forced out of the socket. Usually when a dislocation occurs it’s because the traumatic force is greater than that of what the muscles and joints can stabilize. While many dislocations occur when you are falling or trying to catch yourself from a fall with an outstretched hand, usually in the NFL it’s from being tackled and landed on that shoulder.

There can be several complications with a shoulder dislocation that need to be checked out when the initial injury occurs:

• Nerve damage sustained – the brachial plexus exits out the armpit, you want to check peripheral nerves
• Blood supply damage – the shoulder and arm are enriched with a vast blood supply, you want to make sure there are no changes in color in the fingers or hand
• Instability – how much damage was sustained – if there was a tear of any tendons or a tear of any ligaments that support the glenohumeral joint

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Rehabilitation Outlook:

With a dislocation ruled out and further damage not being sustained. He’s going be strengthening the muscles of his shoulder. And since he’s not in the market for basic shoulder strengthening exercises and doesn’t need to a bunch of standing external rotations; there are certainly more effective shoulder stability exercises he could be doing.

A set of exercises I like using for the populations I work with are banded pull a parts. I think bands are a great option in building shoulder stability. I’ve been doing my best to convince the quarterbacks and all our throwers to do banded shoulder work on a daily basis!

What you can build off that is holding the band fully pull apart and then move your arms while the band is at full tension.

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Season Outlook:

With an MRI report that revealed no further damage of his right shoulder. And there has been nothing in regards to further examination of his knee or ankle. With professional athletes getting treatment everyday for several hours (before and after practice) and with him practicing today, it seems unlikely he is going to miss anytime.

He came back into the game on Monday night after a potential season-ending knee injury and a potential dislocated shoulder. I think he missed two drives on offense. He’s one of the toughest athletes that I’ve seen play since he’s entered the league and he’s been a physical marvel as well. He puts an extraordinary amount of time into this body so for him to not miss time is not surprising. Expect a full load on Sunday.