SBJ/April 23-29, 2012/In-Depth

The big question: When can they play again?

For every part of the body, there are specialists around the U.S. who try to repair the knees, spines, hands or feet of injured athletes. And for each new player treated, the question always comes back to: When can the athlete get back on the field? We asked some of those specialists to highlight the typical injuries they treat, and the average recovery times.

Foot, ankle
Dr. David Porter, an orthopedic surgeon in Indianapolis, is a go-to guy for foot and ankle injuries, whether it involves a gymnast or a player in the NFL. Although Porter sees a variety of athletes, the injuries tend to be the same across a certain sport.

For example, in the NFL, Porter treats many athletes suffering from turf toe, an injury to the joint and connective tissue between the foot and one of the toes. Recovery time depends on the grade of injury. The lowest grade requires one to four weeks of recovery, Grade 2 usually requires four to eight months of recovery, while Grade 3 generally requires surgery and is usually season ending.

In the NBA, Porter most often treats lateral ankle sprains, which are treated without surgery. Recovery time is one to six weeks, Porter said, depending on the severity.

Basketball players also can get stress fractures in their feet, which do require surgery. The most common types are the Jones fracture of the fifth metatarsal, which has an average recovery time of two to three months, and the navicular stress fracture and medial malleolus stress fracture, both of which have recovery times of four to six months, Porter said.

Hand
Dr. Michelle Carlson, a surgeon in New York, specializes in sports injuries of the hand. In baseball, she typically treats players who have suffered finger fractures and ligament injuries. Baseball players, with all the throwing they do, are more likely to sustain pulley or tendon injuries.

While hand fractures may heal in three weeks, wrist fractures take longer — six weeks to three months, Carlson wrote in response to questions from SportsBusiness Journal. After the injury heals, athletes typically require therapy before they can return to play, she said.

“Injuries in each sport can be very similar but the ability of the athlete to return to play and the timing of that return vary significantly between sports and positions within each sport,” Carlson said. “After a wrist fracture, linemen can play in a cast that immobilizes the wrist, but hockey players need motion of their wrist.”

Ricky Rubio of the Minnesota Timberwolves walks on crutches following ACL surgery.
Photo by: NBAE / Getty Images
Knee
Nothing strikes fear in the hearts of sports fans more than hearing that their favorite athlete has a knee injury. Many of those athletes will find their way to Dr. Anthony Miniaci, a surgeon at the Cleveland Clinic Sports Health Center.

Miniaci said there are three main types of knee injuries requiring surgery: Meniscus tears, articular cartilage fractures, and anterior cruciate ligament tears.

The amount of time to repair a meniscus tear can range from four to six weeks, to four to six months, depending on the severity of the tear and the surgery required. For articular cartilage fractures and ACL tears, recovery time after surgery can be as long as six to nine months, Miniaci said.

“I am sure you see more of them [ACL tears] in football than in hockey, because there is more action where the foot is planted and pivots,” Miniaci said. “For guys who play at a very high level, I would say 75 to 80 percent get back to that level, but some of them lose that edge, which can make a difference.”

Spine
Dr. Robert Watkins III of Marina Del Rey, Calif., treats spine injuries that, like those treated by other specialists, often vary based on the sport. Twisting injuries are more common among baseball players, for example, while the contact in football produces a different type of cervical injury.

In a written response to questions, Watkins said that because of the range of injuries he treats, it’s difficult to provide an average recovery time. Athletes must complete different levels of exercise before they can be cleared to return to play.

“We have for each position in each sport a plan on when they can start throwing, when they can start running, when they can start weight lifting, based on their stabilization level, and they are not cleared to return until they can do the appropriate level rehabilitation program,” Watkins said.
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