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  • Writer's pictureRob Mullen

"The Injury Report" by Dr. Bruce MacKellar re: Von and Josh's injuries (2/11/23)

Hey Bruce....hope your week went well and are getting ready for the Super Bowl.

Speaking of you have a prediction for us regarding the score and what do you see happening game-wise????

Dr. Bruce: "I think the Eagles really are the best team in football right now. Their offensive line is just dominating and they have a great running back in Sanders (Go PSU).

Add to it a very mobile QB and some aggressive play calling as well a team that's just hard to beat. Then again, KC and Mahomes with Kelce and Andy Reid, they always seem to find a way to win.

I predict a great game with Eagles winning: 31-28".

So I'd like to mention a lil factoid about Bruce that he is not only a Die-Hard Buffalo Mafia Member and dedicated fan dating back to the Rock-Pile days.....he also is a bit of an Eagles fan due to his time living and working in South Central Philly area and has casually followed the team through ironically, the Andy Reid years and recent.

But I can attest no where near the level of fandemonium he shares as a Buffalo Bills fan. In fact, so much so he's designed and calls home to an amazing 'Man Cave' themed in his fandum of the Bills where he enjoys taking in the Bills away games. It's absolutely filled with nostalgic memorabilia, autographed pictures, game worn jerseys, helmets, etc.etc.etc. onto this weeks "Injury Report" questions from the followers:

Sharon P. from Buffalo asks: "Von Miller had a knee injury this past season that some are saying he may miss part of the 2023 regular season. Dr. Bruce, can you explain the difference between an MCL injury and an ACL tear, which I think Von had? And Dr. Bruce, when should we expect Von back in the lineup"?

Dr. Bruce: "Great question, let's start with the MCL (Medial Collateral Ligament).

This is a ligament on the inside of a knee that prevents the knee joint from opening up on the inside of the knee. On the outside of the knee there is the LCL (Lateral Collateral Ligament) to offer stability. These two keep it so the knee doesn't wobble side to side. They hold the bones together and allow the knee to move forward and back kind of like "hinges". (my orthopedic friends are going to roast me for that one)

The MCL is most often injured with a force hitting the outside of the knee forcing the knee to flex sideways inwards stretching or tearing the ligament.

This then leads to pain, swelling, but doesn't decrease the real function and strength of the joint. This is why many athletes can get back on the field quickly and just use a brace to stabilize the knee. A corrective surgery can be done but because this ligament doesn't need to support as much force, etc. the recovery is much faster. And worth noting that the LCL is rarely injured because it is difficult to apply as much force to the inside of a knee to damage it.

Now the big one the ACL (Anterior Crucial Ligament). This is a strong ligament that goes from the outside back of the upper leg bone (the femur) to the inner part of the main bone of the lower leg (the tibia). This keeps the lower leg bone from slipping forward or twisting out of line with the upper leg bone. Most of the injuries to this ligament are "non-contact" injuries. This makes up about 80% of the injuries actually to the knee. This injury typically happens when a player stops abruptly and rotates to go in the opposite direction (making cuts) with the foot planted on the ground. Which leads to a tear or rupture of the ligament and affects the main strength and stability of the knee.

With a partial tear, rest and time including rehabilitation will allow healing over a period of a month or two.

With a complete tear, surgery using a piece of the patellar tendon or part of the hamstring tendon to make a new ligament is done. Most frequently they use the patellar tendon as this will have a piece of bone attached that helps it heal into place faster.

Because of the forces on the knee and the healing time this takes a long time to regain strength and mobility after surgery. The usual time from in this regard is about a full year but with an athletic person like Von and the rehab staff that the Bills utilize, a time frame of 9-10 months is very possible and reasonable. This would allow Von to be ready for the beginning of the season....yet unlikely not for training camp or pre-season.

Amazing detail Dr. Bruce....thank you for the insight of this and should set some expectations as to when to expect Von back in the line up as we all know he is needed.

Alright....let's keep the questions coming:

Jerry S. from Prattsburg asks: "What was the injury Josh Allen had and it seemingly was the same one that San Franscisco QB Brock Purdy had inwhich he's said to undergo Tommy Johns surgery. Can you explain the difference in what happened with Josh and Brock Purdy and why Allen was able to play the rest of the season?"

Dr. Bruce: " The UCL is actually 3 ligaments that hold the elbow together. They are most commonly injured by over-use because of repetitive throwing movements overhead.

If injured, it causes pain with activity like throwing but generally doesn't weaken the joint.

A partial tear or strain will heal with rest as was the case in Josh's situation. However, it may cause pain that impacts throwing.

A complete tear in a QB or a Pitchers arm will lead to difficulty throwing and loss of strength to even grip the was the case for Brock Purdy. This will make it so a player can't throw as far of as many times without significant pain or swelling. This can be repaired but because the elbow is a smaller joint and has 3 bones, the forearm needs to rotate and there is a lot of force applied to a small ligament when throwing hard, it has a longer recovery time of approximately one year. Those of us that aren't professional athletes can live without a repair as the elbow structure will remain mostly intact."

Dr. Bruce....once again, amazing incite. We cannot thank you enough for imparting your wisdom with us and I can safely speak for the staff of 24/ that we all benefit and learn so much from your Question and Answer segments on a weekly basis.

We appreciate your time and effort....and please forward any questions for Dr. Bruce below in the comment section of this blog, just simply scroll down below and send away.

Lastly Dr. Bruce....while I have your attention before we conclude hear this morning. Give us an idea of what you'd like to see our beloved Bills do to improve this off-season in the draft and through Free Agency:

Dr. Bruce: "I think we need to address the offensive line and look for possible Safety help as we not only are likely to lose Poyer, but we are not sure of the overall ability of Damar Hamlin making a comeback.

After that, I think we need to make sure we have interior Defensive Tackles that are stout as we truly missed both Jones and Phillips down the stretch of 2022, especially in the playoffs vs Cincy.

In the draft, I'd go for a Guard/Center with the first pick at #27 as there may be some cost effective Safeties we can obtain through FA or possible trades.

But I'll leave all of that to the real draft followers in picking the rest.

Thanks again for having me and we will talk next week....keep the questions coming."

- Dr. Bruce MacKellar, "The Injury Report"

112 views2 comments


Scott Reed
Scott Reed
Feb 11, 2023

Josh Allen has had a few UCL injuries - luckily non of which have been complete tears. Could this eventually lead to some very bad tennis elbow/ tendinitis following his games? Besides rest and ice , maybe anti inflammatories - is there any other treatment that can keep Josh ready and pain free weekly?

Dr. Bruce
Dr. Bruce
Feb 12, 2023
Replying to

Great question. With a sprain or incomplete tear the usual treatment is a brief period of rest, anti inflammatory medication and routine icing after activity. This is usually followed by a rehabilitation of physical therapy to strengthen the muscles and stabilize the joint better with the stronger more balanced muscles. One of the other newer therapies for ligament injuries is use of platelet rich plasma injections. This is a treatment where blood is drawn from the person and then the platelets and blood plasma are separated and injected into the area of the damaged ligament or joint. This leads to release of certain biological chemicals called cytokines which help the healing process.

As to leading to tendinitis and more specificall…

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