Time for your edgamacation, neanderthals. JK JK
Posted on: September 18, 2012 at 13:15:13 CT
Shoulder bursitis goes by several names. Rotator cuff syndrome, rotator cuff tendonitis, sub acromial bursitis. Pure and simple, the shoulder is only made for underhanded activities. The supraspinatous muscle lies across the top of the scapula in a large groove. Its tendon drives through a tunnel in the scapula under a large bony growth called the acromion and eventually is attached to the proximal humerus. This muscle is primarily necessary to start the extension motion away from the chest wall. Once above 40 degrees or so, the trapezius and deltoids assist.
When you extend the arm away from your body, you are effectively completely pinching that tendon against the acromion as it courses through that tunnel. So, when you raise the football to your ear, you are effectively pinching that tendon against the acromion. The forward rotation necessary to throw the ball causes a grinding of the tendon against the acromion. MLB pitchers always talk about finding the correct arm slot. That is, they are trying to find a position that allows velocity but limits abrasion to that supraspinatous tendon. Same goes for a QB, but only much more difficult with a set of shoulder pads impeding your movements further.
JF most likely injured his suprinatous tendon when his arm was clutched by Jones near the goal line on the fumble/pass play. When considering the forces and torque being applied, it is really amazing that the tendon doesn't tear more frequently. He likely suffered some fibrous disruption, but luckily, not a complete shearing of the tendon requiring season ending surgery.
Since that time, every time he attempts a throwing motion, the sensation in the shoulder is similar to having salt thrown in your eye. Only one treatment is considered really helpful. REST.
Corticosteroids are awesome drugs when used correctly. However, most of the immediate relief from the joint injection is the administration of lidocaine. The lidocaine effectively numbs the joint and allows you to continue the activity that caused all of the initial injury. It takes 24-72 hours for the full effect of the corticosteroid. Once in the joint space, they begin to immediately reduce the swelling, inflammation, and diminish any further release of inflammatory cytokines, thus speeding the healing. That is, they turn off the inflammation cycle, some of which which abnormally prolonging the cycle of pain, suffering. The primary problem with these injections is that they radically weaken the tendon and its insertion into the humerus for the next 24-72 hours. Therefore, modest trauma can induce a complete tear of the tendon away from the bone, not acceptable in this situation.
So, in JFs situation, (Based on my assumptions only) they knew his rotator cuff was killing him, but probably thought it was routine inflammation, not unlike most QBs/athletes get during fall 2-a-days. They assumed it would be better by thursday. On Friday, they knew that they were in trouble, but by then, a cortisone shot is getting pretty risky. If he takes the cortisone then, he really is at risk for future harm and damage, not because of being "numb" to the pain but because of transient weakening of the tendon. A shot of lidocaine into the shoulder prior to gametime would have been the most appropriate way to allow him to play. Of course, that would have numbed the joint making him prone to serious injury as well.
Therefore, JF really did make the wisest of decisions, whether religous based or not. If he were to choose the injection, tuesday or wednesday was the day to give it, but, obviously he/they probably thought he would be better by saturday, which he was not. All personal opinions aside, the best day to give the injection would have been sunday after the ASU game to give him a full week to recover.
That being said, I have long been a Pinkel apologist and a fan of the way he has run this/our program. However, his comment before the game really offended me. Not only was it definitely out of bounds, it was uneducated, spiteful, and placed JF in a total no-win situation. Because he "chose" to not take the shot, Pinkel seemed upset and angry over the whole situation.
Afterall, this was really just a bad timed situation made worse by the comments made. JF is clearly a strong minded warrior on and off the gridiron. By the time it was known that he needed the injection, he didnt want it and it was not safe to administer if he had any intention of playing. In fact, I "hope" the trainer made these points to JF. That is, if we inject you now, you will probably feel better but we may weaken the tendon causing severe damage. Learning that, JF would logically make the decision to not take the shot ( regardless of his personal beliefs, morals,etc) and just hope that the natural healing would take place by saturday evening. He tried to warm up but was a no-go, end of story. Personally speaking, if I were in the situation, I would take the shot 72 hours prior. The shot would aid in my healing process and yet no put me at increased risk of further injury with that timeframe in mind. Obviously, I am SOL in regards to future injections as more thatn 2-3 per year are also considered extremely risky.
Pinkel deserves 100% of the blame for this situation, not JF. So, radio shock jocks should be after Pinkel not JF, just my opinion.