Hey Dolfans, it has been awhile since I wrote an article due to school but, I’m glad to be back writing about our beloved Miami Dolphins. After having a few weeks to deal with the news of Tannehill’s injury, I debated writing an article explaining his injury and what it means for the future, but I talked about that in an article last off-season, so I decided to write about the reasons we shouldn’t be surprised this (re)injury occurred.
Much of the current research shows that re-injury is extremely common within the 1st year of an ACL tear (no matter if you do surgery or not).
The majority of fans are very angry that Ryan Tannehill and the Miami Dolphins decided not to pursue surgery after his initial injury, but most current research supports their decision since all reports indicate that the initial injury was not a full tear of the ligament. A recent 2012 systematic review1 combined the results from 10 different studies to create a population of 650 subjects with partial ACL tears, to find there was no significant difference in the risk of re-injury after ACL surgery or just undergoing conservative treatment specifically physical rehabilitation to work on increasing stability around the knee. While I would assume that Tannehill went through very physically demanding rehabilitation, along with the reported stem cell therapy, to get the knee as stable as possible. The honest truth is the ACL takes a very long time to fully heal due to a low blood supply to the area and most likely needed more time to fully heal.
A partial tear of the ACL normally involves a rupture of one of the two main bundles of tissue that make up the ACL (seen in the picture below). If it normally tak
es a fully torn (both bundles) ACL 9-12 months of rehabilitation after surgery to heal, it should not be a huge surprise that the accelerated 6 to 8 month return of Tannehill increased the likelihood that re-injury would occur. I know many of you might be thinking “but Will, wasn’t RT’s knee brace supposed to be providing some additional support to ensure he can take hits?” Well this brings us to the next topic…
Research has been going on for years and is still inconclusive whether or not knee braces do anything to prevent injuries when used prophylactically.
While knee braces are utilized by many players in the NFL the American Association Academy of Orthopedic Surgeons released a statement in 19842 indicating that there was no definite evidence that prophylactic knee braces can prevent knee injuries. While there has been many research studies done since then, the AAOS has not changed this statement for the last 33 years. In fact a recent 2000 study3 indicated that, biomechanically, the use of knee braces provides little to know protection for rotational forces (which are most common to produce ACL tears) but require an increase energy expenditure, decrease agility, and provide a false sense of security after ACL recovery. While I am not against the use of knee braces in appropriate situations such as the acute part of recovery. At the professional level knee braces have been shown to provide no true help in reducing knee instability.
One thing that we should feel good about.
Miami Herald’s Armando Salguero reported that Ryan Tannehill did undergo ACL reconstructive surgery on August 17th. This means that he will be able to take a much slower approach towards rehabilitation this year. A past example we can look at would be Sam Bradford who underwent a surgery in 2013 after an ACL tear in week 7 of the season. Bradford then returned for most of the offseason before tearing his ACL in the preseason on august 25th. This injury fell within the 1 year window shown to display a high recurrence of injury. Since taking an entire year to recover from the injury Bradford has had no further issues with that knee. While comparing Bradford to Tannehill might not very uplifting to most fans it is a good sign that Tannehill should be at a significantly decreased likelihood of reinjury for the 2018 season. But until then we will enjoy the antics of our new QB “Smokin” Jay Cutler and hope he can successfully hand off the ball to Ajayi and make the occasional big throw to Parker, Landry and Stills.
Will Merring SPT.
- Papalia, R., Franceschi, F., Zampogna, B., Tecame, A., Maffulli, N., & Denaro, V. (2014). Surgical management of partial tears of the anterior cruciate ligament. Knee Surgery, Sports Traumatology, Arthroscopy, 22(1), 154-165.
- John D. Hsu, John W. Michael, John R. Fisk, (2008) AAOS Atlas of Orthoses and Assistive Devices. Philadelphia PA, Elsevier Inc
- Paluska, S. A., & McKeag, D. B. (2000). Knee braces: current evidence and clinical recommendations for their use. American family physician, 61(2), 411-8.