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  • Writer's pictureRob Mullen

"The Injury Report" featuring Dr Bruce MacKellar

Hey Bruce....once again, "Thank you" for sharing your wisdom with us this morning, and want to let you know that we've received a lot of good vibes and feedback from our first edition of "The Injury Report" and have some very interesting questions we hope you can clear up for our followers and our staff at 24/7 Buffandemonium.


Starting off: "How was your week and any thoughts regarding 'Championship Weekend'????


There's been a lot of controversy regarding the AFC game with claims that is was "Rigged", but certainly a lot of questioning of the officiating. Almost to a point of embarrassment for the league in some ways.


Bruce: "I have to admit I wished both KC and Cincy had lost that game....lol.


Even though we know that's not possible....the big story of the game was how well Mahomes played on a bad ankle.


The KC medical staff has to be commended for getting him ready for the game with just one weeks therapy.


The officiating, on the other hand, has already been beaten to death by the media and everyone else. And I firmly believe the NFL should have full time "paid" officials with benefits and should use consistent crews throughout the season and playoffs rather than the mix and match of "All-Stars".


With that said....I'm really looking forward to the Eagles putting a "Hurts" on the Chiefs.


Should be a good game...."




Well said Dr. Bruce....are you ready for some questions from our followers???? Let's begin:


David C. from Buffalo, NY asks: "Jordan Phillips has lost a lot of playing time this season at DT, this time around the injury is a "torn" labrum....could you explain the injury and expected time table of recovery seeing he's a much needed man in the middle for 2023?"


Bruce: "The Labrum is a cartilage ring that helps form the surface that the arm bone (Humerus) rests on in the shoulder. The rotator cuff muscles, tendons, and ligaments hold the arm bone in the shallow socket that is formed by the Labrum.


If this cartilage is "torn", the socket of the shoulder has a gap in it and the arm bone can slip out of the socket more easily.


Watching Jordan play with one arm and seeing the injuries occur, it seems that he has more than just the cartilage damage. I suspect he may have started with just the cartilage tear and then had a second injury that tore at least one of his rotator cuff tendons (most likely the supraspinatus).


This type of injury will require a surgical repair with a typical time course of 1-2 months of limited to no motion of the joint and then a several month rehabilitation to get full range of motion and strength to return. I suspect he will get a 'surgical' repair and be a full go for training camp and the 2023-24 season.


Go BigJ97....love his energy."


As we do yours Dr. Bruce....well explained and an easy read for those of us, like myself, who need medical terms explained in the easiest to understand way as possible.


Next question is seemingly on a lot of minds of late and understandably so....


Jarrod R. from the Finger Lakes Mafia asks: " Dr. Bruce....if possible, can you shed some light on the Damar Hamlin situation????" And I'll add to that Dr. Bruce in asking why it took so long for any diagnosis or explanation as to what happened on the field and just exactly what is 'Commotio Cordis'????


Bruce: "The Damar situation is somewhat complex. Most of what I will say is based upon incomplete information since I am not one of his physicians and have not seen his test results, etc.


It does remind me of another episode of this and I believe it as in 1998 when Chris Pronger (NHL Great) was hit in the chest with a puck. Fell to the ice, got up, and collapsed once again. He was resuscitated and continued to play hockey for a number of years afterward.


Commotio Cordis is an extremely rare condition.


Most frequently seen in teens or young athletes who have thinner and more flexible chest walls. And it requires a significant impact (something traveling around 40 mph or more) in a small area of the chest right above the heart at just the right moment to get the heart out of rhythm. This moment happens when the heart is between beats and the electrical activity of the heart is resetting for the next beat. The impact at the moment basically short out the system and the heart goes into fibrillation (a disorganized twitching that doesn't pump blood).


The rapid response of the medical teams to recognize this and start CPR and then quickly defibrillate (electrically shock the heart back into rhythm) led to a good outcome.


Once an event like this occurs, the patient is usually chemically paralyzed and put on a ventilator to breathe (commonly referred to as a medically induced coma). This takes all the strain off the system and allows it to rest and heal.


After 24 hours or so the paralysis is reversed and we see what if any damage to the brain/nervous system other organs has happened.


In Damar's case, it appears that no brain damage has occurred as a result.


Then there are a battery of tests done to look for other causes of the event. This requires some time, possibly weeks, and involves checking the hearts electrical circuits to make sure they work correctly, as well as making sure other organs such as the lungs, liver, and kidneys are also functioning properly.


Providing everything else checks out properly, then and only then can the diagnosis of Commotio Cordis be made. Since it appears that all of Damar's tests were negative....he probably suffered from Commotio Cordis.


Watching the play, I guess it was caused by the elbow of the other player, Tee Higgins, hitting his chest as they spun and hit the ground.


Of note....only about 15% of people who have this injury actually survive.


Commotio Cordis and Hypertrophic Cadiomyopathy (can answer questions about) are the 2 leading causes of sudden death in athletes.


In regards to the long-term prognosis for Damar, unless he decides not to play football ever again, there should be no problem with him getting back onto the field unless something else is discovered that we don't know about. (Love for 3....Go Bills)


Thanks for the questions and support of this website....keep the questions coming and I'll do my best to answer them all."


- Dr. Bruce



Wowwww....so well said Dr. Bruce. I feel like I just got a degree in Sports Medicine in some ways and all kidding aside, that was very informative and to the point where I can honestly carry on an extended conversation about Commotio Cordis. Amazing.


Well guys....that wraps up this weeks edition of "The Injury Report" and hats-off to Dr. Bruce for imparting on his wisdom and love for our Buffalo Bills.


Til next week....keep the questions coming, you know what to do, simply scroll down to the bottom and let us know what you'd like Dr. Bruce to answer.

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5 comentarios


Swank
Swank
04 feb 2023

More great content from Dr.Bruce and Rob! Love these and Look forward to more!

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Jarrod
Jarrod
04 feb 2023

Awesome Insight!!! Dr. Bruce, regarding Jordan Phillips surgery: What are the chances something like “Frozen Shoulder” finds its way in the mix, especially with recovery involving limited to no mobility of the joint?

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Dr. Bruce
Dr. Bruce
04 feb 2023
Contestando a

The immobilization is not total as there will be early passive range of motion to limit any chance of developing a “frozen” shoulder. This would include non weighted rotation and other movements to keep the other non repaired tendons from tightening up. After the initial healing process an aggressive mobility and strengthening regimen should lead to full range of motion and return to full strength. With the team of physicians and therapists available to the Bills players there is little to no chance of having that happen.

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Scott Reed
Scott Reed
04 feb 2023

Thanks Dr. Bruce…love the injury info . It’s hard to watch our injured players play hurt knowing they can’t give there 100%...especially in the playoffs. Commotio Cordis is going to be a hot topic for a while. Do you think the NFL will now spend money , time and research on changing equipment to prevent such a rare event?

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Dr. Bruce
Dr. Bruce
04 feb 2023
Contestando a

I’m sure the NFL is already researching how something like this can be avoided. The exposure of this injury on prime time may lead to some equipment change but since it is such a rare occurrence I doubt we will notice a Reduction in similar injuries. I suspect that the type of flak vests that some players already wear may reduce the likelihood of an event but these also limit a player’s mobility and may be a hard sell to some players since the risk of this type of injury is so low

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