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Wednesday, August 17, 2011

Analysis Of The Injury To ND Football Player Freshman Tate Nichols

During Tuesday’s Media Day Press Conference, Coach Brian Kelly somewhat elaborated on the injury to Freshman Safety Eilar Hardy.  He has suffered a knee injury, will undergo surgery and will be lost for the season.  Freshman Cameron Robinson who also sustained a serious knee injury (torn lateral collateral ligament (LCL) and a partially torn anterior cruciate ligament (ACL) during spring ball is out for the 2011 season as well   Our thoughts, prayers, and best wishes for speedy recovery goes out to them both.  You can read more about Cameron Here.

It had been previously reported by Kelly that Tate Nichols has a dislocated knee and according to Kelly is making great progress.  The original prognosis was for two weeks immobilization and two weeks rehabilitation.  Hmmmm.  The injury to Nichols must be less serious than a fully-dislocated knee.  Good news!

Subway Alumni Station called in our resident Physical Therapist Alex Brenner to help us through this latest knee injury.  Alex has over 15 years of physical therapy experience in the military, private clinics and the U.S. Public Health Service. He is rated as a DPT, Doctor of Physical Therapy.  Alex jumped on the Red Line and came right over.   

The technical, munbo-jumbo that you have to go to school to understand:

Patellar Dislocation (Knee Cap)

The patella is a classified as a sesmoid bone meaning that it is independent bone that is enveloped within a muscle tendon where it passes over an angular structure.  In this case, the end of the femur bone of the knee joint (see below). 

The main stabilizers of the patella are the quadriceps tendon and patellar tendon .The other stabilizers are small ligaments that surround the patella called the patellofemoral ligaments. Other ligaments that provide stability are the medial and lateral collateral ligaments.

The patella is dislocated or subluxated commonly in two ways 1) Direct trauma 2) Non-contact twisting injury. A subluxation is where the patella has popped out of the patellar groove and back into the groove on its own. A dislocation is where the patella popped out of the groove and had to be relocated into the groove by a medical provider.

Regardless of the two mechanisms listed above, ligaments are either sprained (a ligament stretch injury usually resulting in a subluxation) or they are completely torn (usually resulting in a complete dislocation). Obviously a complete ligament tear is more serious and will subsequently require a longer recovery. To determine ligament integrity and whether the are completely torn or sprained a MRI can very helpful.
For rehab considerations is it important to know if Niclols completely dislocated his patella or was it a patellar subluxation. Information gathered from the MRI are also very helpful in determining recovery time. A patellofemoral ligament tear, depending on the severity could result in a surgery. If this is the case, recovery would require 8-12 weeks before return to practice. A subluxed patella or a dislocated patella without ligament rupture could potentially be rehabilitated by a physical therapist. If this is the case, recovery can be in as little as 6-8 weeks.

By the description above and remarks by Coach Kelly, the injury appears less serious than first thought.  We hope so. 

Maybe we should have Alex give us a post on knee braces and knee injuries in general.  It seems to be mandatory for all Notre Dame interior linemen to wear braces.  Was Nichols wearing a brace?  Did it lessen the severity of the injury?  What about Hardy and Eilar? 

Well last year was the Year of the Hamstring and 2011 is turning out to be the year of the Knee.

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