First of all, before we get into the meat of the article, lets just run through Dr David Geier's credentials:
While Dr. Geier has not treated Mark Sanchez, he is one of the country's top experts in sports injuries and recovery. He has served as a medical consultant for the U.S. Women's Soccer and is the head physician for many high schools and recreational sports leagues. A graduate of the Medical University of S. Carolina, he completed his residency at the Campbell Clinic in Memphis and a sports medicine fellowship at Washington University, where he served as team physician and assisted in the orthopedic care of the St. Louis Rams. His sports medicine interests include knee, shoulder and elbow injuries, pediatric and adolescent sports medicine, arthroscopy of the shoulder, elbow, and ankle, and sports injury prevention.
So with that said, I spoke to Dr Geier and asked him some questions that were on my mind in relation to Mark Sanchez's injury:
What role does the labrum in the shoulder play in the mechanics of a quarterback?
The labrum is a cartilage bumper that surrounds the socket of the shoulder. It helps to provide stability of the shoulder so that the humeral head (ball) doesn't slide out of the glenoid (socket). It also has a shock-absorbing effect.
What long term implications will an injury like this have on a Quarterback?
A labral tear is important because the shoulder often becomes unstable with this injury. When this happens, the humeral head can completely or partially slide out of place. Any instability of the shoulder makes overhead activities like throwing difficult, especially at a high level. If the labrum is repaired and heals appropriately, normal shoulder function can be restored.
Will surgery on the labrum affect his arm strength going forward?
Regardless of whether the surgeon must reattach the labrum or simply smooth it out, an athlete will work hard with a physical therapist to regain strength and range of motion. Usually athletes do regain full function of the shoulder, but it can take 6 to 12 months.
Should Sanchez have elected to undergo surgery sooner?
I can't really say without being involved in his case specifically. In some tears, the labrum is only frayed. An athlete can play through that injury and undergo surgery to smooth out the tear at the end of the season. Other types of labral tears involve the labrum being pulled off the socket. These injuries require surgical reattachment. An athlete can try to play through that type of injury, but his ability to play would be much less predictable.
Could waiting for the surgery have any negative impact on the injury itself, could it now be more severe as a result?
In theory, if an athlete had a labral tear that allowed his shoulder to continue to pop out of the socket, he could potentially do more damage to it. Generally though, the more likely effect of any athlete delaying surgery to have the labrum repaired would be extending the time it takes to return to play.
How will this impact his effectiveness in offseason workouts?
Again it is hard to say without being involved in his case and knowing what the surgeon found at the time of surgery. Typically a labral repair, meaning reattachment of the labrum to the socket, requires shoulder immobilization for 4 to 6 weeks. The athlete then works with a physical therapist to regain shoulder motion and strength, which can take about four months from the time of surgery. He then starts a throwing program to get back to his prior functional level. This process can vary in length depending on how his shoulder is functioning.
If he were to have surgery this week, when would you expect him to be back up to full speed?
For an overhead throwing athlete, labral repair surgery usually requires about six months before he starts to be able to perform those activities close to the level he was before an injury. Sometimes he continues to improve for about 12 months after surgery. All overhead athletes are different in the speed of their recoveries.
Typically, how do athletes recover from these types of injuries?
The rehabilitation process is very structured, as I mentioned briefly above. The surgeon usually immobilizes the shoulder to get the labral repair to heal. The surgeon avoids any stress to the repair that could prevent it from healing. When he feels that the repair is solid enough to start withstanding some stress, the physical therapist starts gradual motion and strength. The patient then works with the physical therapist on overhead activities and progressing to functional activities and throwing. The process slows down or speeds up depending on how well the athlete progresses through each step.
Personally I find this all very interesting. It is important to note that Dr Geier has not diagnosed Mark, however his expert opinion and extensive experience in these matters give us an idea of what to expect.
I would like to thank Dr David Geier. God forbid any other Jets picking up a serious injury, but if they do, we'll know where to go for an expert take. Don't forget to follow Dr Geier on Twitter and check out this website.