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Everyone is uncertain on which route Jayden Daniels and the Commanders will go in regards to his elbow injury. In this segment, Dr. Jesse Morse joined The Sports Junkies to explain the different options that Jayden Daniels has in front of him right now. Do you think JD5 should get surgery on his elbow?
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00:00Dr. Jesse Morse, doctor and injury expert.
00:04Doctor, good morning.
00:05Thanks again for appearing on the show.
00:07My pleasure.
00:09Good morning.
00:09Yeah, good morning.
00:10So those of us that are Skins fans, not so great.
00:13It's kind of an awful week, you know, seeing Jaden go down like that.
00:18Again, second time with this issue.
00:21We all understand there's no fracture, according to the x-ray.
00:25There's got to be some compromised ligaments, right?
00:28Oh, yeah.
00:29So for sure there's some compromised ligaments, whether they're torn, stretched, I don't know.
00:33What is your best guess as to what they're going through right now?
00:39So the fact that the x-rays were negative is good, which is pretty common for that type of re
00:45-injury.
00:46But the only way that can happen is if the ligaments stretch even further and possibly partially tore.
00:53Yeah.
00:55Namely the UCL, which would allow that bone to pop out of its socket, which is essentially what happened.
01:01Right.
01:02Is it similar?
01:02Can you compare it somewhat similarly?
01:04Although I think the shoulder is almost more complicated.
01:06So when a shoulder pops out once and then it pops out again and then again and again and again.
01:11It just can happen more frequently and more frequently and easier and easier and easier until you get some sort
01:16of repair.
01:17Which, by the way, is not foolproof because you could get it repaired and it'd pop out again.
01:22I mean, it just happens.
01:24Yeah, that's actually what happened to Malik Nabors last night.
01:26Yeah.
01:27That's what it's worth.
01:28Yeah.
01:28So in general, the elbow is much rarer, thankfully.
01:33Yeah.
01:34And the issue with the elbow is that you have a tendency to lose a significant amount of range of
01:38motion.
01:39Yeah.
01:40With that type of injury.
01:42And Kurt Warner was actually speaking yesterday and he did this in 07 to his non-throwing elbow, his left
01:48elbow.
01:49Right.
01:49And he put a brace on and played the next week.
01:52Yeah.
01:54Which, the ironic part is his wife commented on that saying, now you can't lift us up while dancing and
02:04you can't do normal things with that elbow.
02:06Yeah, I mean, so there are consequences.
02:08A hundred percent.
02:09Yeah.
02:10You know, so that's part of the concern.
02:11And this is actually the third time he's injured it.
02:13So remember, he re-injured it again late last season that they shut him down for.
02:17And this is the third time he's done it.
02:19Yeah, but I don't think it dislocated the second time.
02:21I think it just hurt like hell.
02:23He had the brace on the second time.
02:25Can you explain, Doc, can you explain?
02:27So my understanding with ACLs is, like, you know, all the offensive linemen all wear braces, especially like big time
02:34D1 programs, pro level, to prevent rollover ACL injuries.
02:39But it doesn't really prevent, or it's very poor at preventing internal non-contact, right?
02:45You plant, it explodes inside.
02:47It's not really going to help that.
02:49So can you explain?
02:51Right.
02:51So can you explain the difference now with the elbow brace?
02:54I don't know this for a fact, but intuitively, it seems to me that an elbow brace, you know, your
02:59elbow pops out differently, that maybe that would actually be more stable and might actually help more than, say, an
03:07ACL brace.
03:09Correct.
03:10Yeah, so 75% of ACL tears are non-contact, meaning the ligament was already torn or partially torn, and
03:16that was just the straw that broke the camel's back.
03:18Whereas this is not a traditional injury like that.
03:21This is specifically because he injured it in the past.
03:24And as a result of it injured in the past, he injured it again because those ligaments were not properly
03:31rehabbed, or at least weren't rehabbed enough.
03:34Now, the tricky part is, if he has surgery, he's done for the year.
03:39Yeah.
03:40So my guess is he's probably going to miss about three weeks, which is what happened the first time, and
03:44then he's going to come back with a brace and try to play the rest of the year.
03:48But he's going to have to change his mechanics because, you know, he does stuff with his left hand, and
03:52he holds the ball with the left hand, you know, kind of gripping onto it.
03:55So there's a lot of variables there.
03:58But the more it re-dislocates, the more damage to the joint, the more damage to the ligaments.
04:05And when I say damage to the joint, that usually leads to arthritis in the long run.
04:09Right.
04:09One question, QuickCakes.
04:10I'm sorry.
04:10How effective, though, is an elbow brace in an instance like this in reducing the number of dislocations?
04:19Very good.
04:20Significant.
04:21Right.
04:21So that's good.
04:22It would be very difficult for him to re-dislocate with the brace on.
04:25Right.
04:25So that's a great thing, I think.
04:28So, Doctor, if Jaden was your patient, what would your recommendation to him and his team and his team of
04:35advisors to be to do?
04:37Would it be to brace up, go out and play, and then get the surgery in the offseason?
04:41Would it be to get the surgery now to strengthen the elbow going forward?
04:45What would you recommend?
04:48Assuming there's no cartilage damage and there's no fracture, which, since they've already said it hasn't been, at that point,
04:57you are predominantly dealing with just a, quote-unquote, just a ligament damage.
05:01With that being said, you then have to take into consideration the sport he's playing and so on and so
05:09forth.
05:09So, in my opinion, I am a stem cell specialist, so that's what I would use.
05:14I would reinforce every single angle of that elbow.
05:17So, you know, up to the forearm, all the way laterally, medially, in the upper bicep, everything that's going to
05:25reinforce that entire area.
05:27And then at that point, I would make sure he's physically ready to learn the nuances of using that left
05:36hand, left elbow, left arm differently than he has been.
05:39Then I would put him in a brace and see if he's ready to go and hope that it doesn't
05:45tear again.
05:46And then in the offseason, if it's something he's interested in, then he can have it reconstructed.
05:51You mentioned how Kurt Warner said he went out the next week.
05:54Is it feasible that he could come?
05:56I know he's been ruled out already, but could he brace it up, take a pain-killing shot, and play
06:01this week or next week?
06:03Yes.
06:04Yes, he could have.
06:05He could.
06:06Assuming, again, there's no fracture.
06:08The fracture rules things out.
06:10But if he had a fracture, which it doesn't sound like he does, then it is a swelling, pain-tolerance,
06:15instability issue.
06:16And if he can figure out how to use his right hand more and not use his left hand and
06:22use a brace, yes, he could theoretically come back.
06:24But you're also potentially compromising not only his playoff, his future because of instabilities with that elbow,
06:32but his long-term life in terms of how he would use his elbow going forward.
06:38Right.
06:40Are you an expert at all on the medications, or is it just so dependent on the person?
06:45Because obviously you don't want him to take anything that's horrible for you, like Toradol or some of these notorious
06:51pain things that guys have taken in the NFL for decades that are bad.
06:54Are there effective pain meds that he could take that wouldn't be sort of catastrophic to his long-term health?
07:02Unfortunately, Toradol is the most likely option.
07:05They'll give him some classic narcotics and stuff like that.
07:07But there's only so much they can use for him safely and allow him to mentally do his job, right?
07:16Yeah.
07:17You still have to allow him to process and react and everything like that.
07:20The more narcotics and the more anything that's going to interact with his CNS, his brain, then obviously that's going
07:27to potentially compromise his ability to react accordingly.
07:31Right.
07:32So there's that fickle, and some of that is it because this isn't like a lineman or something where he
07:40can kind of figure it out and deal with it.
07:43He has to be cerebral, right?
07:45And that's the tricky part about this type of position.
07:48You know, same with concussions, you know, very similar.
07:51What exactly happens in the surgery?
07:53Can you explain that?
07:55They would likely, I'm not an elbow reconstruction specialist, but they would likely basically tighten up and reinforce the area
08:05where it would be essentially dislocating.
08:10Yeah.
08:11Tighten up the ligaments, essentially.
08:13So, I guess we're going to hear Thursday what the extensive result is.
08:21But, so do you think if he doesn't, Cakes just asked you this, if he doesn't have the surgery, you
08:26think it's definitely possible to play in two weeks?
08:28He's not going to play this week.
08:30Yes.
08:30But in two weeks, it's possible.
08:31I think this week is, yeah, I think, yeah, I think this is, they ruled him out on purpose for
08:35his own benefit.
08:36But, yes, I think that two weeks, I think they might slow play it a little bit longer because of
08:43the swelling, the inflammation, and, you know, but it's only a matter of time.
08:49Maybe it's a schedule thing.
08:50I don't know if they have a Wednesday, you know, like a Thursday game.
08:52Like, I don't know their schedule.
08:54So, it says, you know, let's not bring him back on an early week or a short week or whatever.
08:58Don't they go to Europe or something?
08:59Yeah, they go to London, I believe.
09:00Skip that.
09:01Yeah.
09:02Yeah.
09:02Yeah, so there's some intricacies with that.
09:05And that's sometimes what will actually impact the game, the decision.
09:10I feel like it's, you know, the team is being criticized because, you know, since he dislocated it last year,
09:18he did wear the brace.
09:19And, obviously, you know, they took him out of the next game.
09:21I think it was a pain.
09:22It didn't re-dislocate, but it was very painful.
09:26And the optics of it all was awful.
09:27So, they just shut him down for the rest of the season.
09:29But they've been criticized that either, A, they didn't recommend a surgery.
09:34Maybe they did.
09:34Nobody knows.
09:35Or, B, that, you know, he just didn't wear a brace to start this season.
09:40I saw a story about Drew Brees where his was dislocated.
09:45And then he just had the offseason and it healed.
09:48And he never wore a brace and it never happened again.
09:50So, I don't, I want to, I want to exonerate the team because I think there's this perception that the
09:55team has been negligent here.
09:57And you just don't know if a person will dislocate it again or they won't.
10:01Now, once they do it twice, you know he's cooked and it's just going to keep happening.
10:04I would say that, I think.
10:05Yeah, I agree.
10:06So, Brees and Warner, to an extent, both got lucky in that regard that, as far as we know, they
10:12never re-dislocated.
10:13But, unfortunately, Kayla, or, you know, Kayla was in separate discussion.
10:17But, you know, Jaden, unfortunately, did.
10:20And he's already, you know, in his short-lived young career, he's already had multiple issues with it.
10:25So, I think.
10:25It's going to keep happening.
10:26I think he has to.
10:27You know, I think he has to.
10:28Unfortunately, it's too high risk.
10:29There's a correlation with shoulder dislocations with age.
10:33The younger the person is, the higher the incidence of dislocation.
10:37So, I don't know if, you know, there's strong enough data for elbow.
10:40But it wouldn't be surprising given the nature of the age, the, quote-unquote, recklessness, and the nature of the
10:46profession.
10:46And, also, can you explain to people, too, that, like, when a person dislocates, the pain is incredible.
10:52Like, it's the first time, especially.
10:53It's incredible.
10:54You can tell.
10:54But then when you pop it back in, it's almost like back to normal.
10:57Now, they're sore and lingering.
10:58But then each subsequent time that it happens, it hurts a little less, a little less, a little less.
11:03And you pop it back in, and they kind of feel normal, right?
11:06So, for people to understand that, like, Jaden probably feels pretty good.
11:09Probably tender and sore.
11:10But it's the second or third time.
11:11And he probably feels kind of okay.
11:15Correct.
11:15Yeah, 100%.
11:16And that's the first time when you partially tear those ligaments and you really stretch them.
11:23That's when the majority of the damage is done.
11:25Now, they just kind of stretched them a little bit more, and then allowing it to pop out, and then
11:31it popped back in.
11:32So, the amount of damage, the amount of stretch receptors and injury to those stretch receptors is significantly less.
11:39So, as a result, that's why I was like, oh, it's not as bad.
11:41I mean, because he's already done it.
11:43If this was the first time, he'd be hurting like he was last year.
11:47So, Dr. Jaden's teammate, Nick Cross, had to stay in Dallas Sunday after suffering a, seems nebulous, internal injury.
11:54What would be your best guess as to what that might have been that kept him hospitalized for a night?
11:59So, I've heard rumblings that this was an injury to an organ.
12:06Usually, that's either liver or spleen.
12:08It can be lungs sometimes.
12:10Sometimes, it just depends.
12:12More often than not, these are fractures secondary to the ribs, and the rib turns into basically a protectile or
12:20protrusion, and as a result, ends up basically cutting whatever is nearby.
12:25And then those have significant vascular supply if it's the liver or the spleen.
12:30And as a result, it's going to bleed into the cavity, the peritoneum.
12:34And then that obviously causes a significant amount of issues.
12:38The more laceration, the more longer he's going to be out.
12:42You can reference Keenan Allen many years ago with his kidney.
12:45Whereas lung is a different story because that's a balloon, and then you have to repressurize it, and that would
12:50lead to flying issues.
12:52So, if he's allowed to fly, then it wasn't as long.
12:54And if he's discharged, then he got lucky, and it was a grade one or a mild, quote-unquote, mild
13:00injury to the organ.
13:02But a lot of the times, they still miss a couple weeks to a month, depending on the specifics.
13:07Yeah, it's a brutal sport.
13:08We just can't get out of the way.
13:09It's a brutal sport.
13:09It definitely keeps you busy, all the NFL injuries.
13:12So, it sounds like, before we let you go, Doc, it sounds like best-case scenario with J.D., he'll
13:17miss the next two weeks because he's obviously out this week.
13:20They're not going to play him in London the following week.
13:24They play at San Francisco.
13:25Maybe that one.
13:26Maybe that one.
13:27That sounds like the best-case scenario.
13:29Worst-case scenario is obviously out for the year because he's going to have surgery.
13:33No, I think it's –
13:34Yeah, I think that's realistic.
13:36Then it's Giants, then San Francisco.
13:38Yeah.
13:38I'm sorry, the Giants game, yeah.
13:39Yeah.
13:40So, the Colt game is in London.
13:41So, it may be Mariota versus Janus Winston.
13:46Right, right, right.
13:47Yeah, it might be.
13:48You're right.
13:48Well, Doctor, we appreciate the time.
13:50Really good intel.
13:50Thanks again.
13:51We'll have you on again soon.
13:53My pleasure.
13:54Take care, guys.
13:55Appreciate it.
13:55It's Dr. Jesse Morris.
13:57He's an injury expert.
13:59You can follow him on Twitter.
14:00Get all your latest NFL injury news and updates.
14:04When we come back, we'll take your calls at 800-636-1067.
14:09If surgery would fix Jaden's elbow, do you want him to get it done now or wait until the offseason?
14:17800-636-1067.
14:20We'll take your calls on that next here on The Fan.
14:22We'll take your calls on that next here on The Fan.
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