The League

Dr. A. Brion Gardner
Orthopedic Surgeon

Dr. A. Brion Gardner

Staff Orthopedic Surgeon at Camp LeJeune

Hurt or Injured?

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"Are you hurt or injured?"

This is a question every Pop Warner league football coach has asked his player laying on the field. The answer determines whether you can continue to play the game. Usually, if you are hurt or hurting, you can continue to play after a period of rest. If you are injured, you can not continue to play and may miss future games.

This basic question is even more important at the highest level of football, the NFL. The livelihood of the league is heavily dependent on having the star players on the field. Therefore, there is a tremendous amount of pressure for a player to compete while hurt and sadly, often times while injured.

Again, injuries in professional football range from trivial to life or limb threatening. And, there is always a delicate balance between taking a short term risk by allowing the player play versus sacrificing the future of the team.

The latest example is Jason Witten of the Dallas Cowboys. He has expressed his desire to play despite being diagnosed with broken ribs. His particular injury is one in which I would consider him "hurt". In general, broken ribs do not require surgery. They are treated with pain medication to allow comfortable breathing. An individual is returned to activity as tolerated, only restricted by their level of pain. If a person has a job that allows for a brief period of time off from work, it is not unreasonable to allow time for the pain to subside. In professional football, that is a risk/reward decision that is made. There may be pressure applied by the management and coaching staff or the player may place pressure on himself for reasons of pride and financial gain.

If Jason Witten is provided medication that controls his pain and wears extra padding to decrease the impact to his rib cage, he should be able to compete safely. There is a small possibility that an extremely hard blow can increase the severity of his broken ribs and potentially compromise his breathing. In the worst case scenario, this can be very serious and cause long term problems. I think this is a small, but possible reality.

So, he may be able to play and not miss any games. It is difficult to predict at this point how successful he will be. If he has a decreased number of plays and doesn't get hit, he may be very effective. If he endures a constant pounding, he could potentially miss some playing time.

Each player injury is different and affects the player differently. Each team has the responsibility to first determine if it is safe for the player to play with little to no risk of worsening the injury. Secondly, the team must determine whether the player is going to be effective, given his limitations. Lastly, given the amount of money that is at stake in the NFL, I don't think there is an owner out there that believes the pressure to too great. There are also players lower on the depth chart that would gladly play "injured" in attempts to achieve that star status or secure their spot on the roster.

By Dr. A. Brion Gardner  |  October 29, 2008; 1:32 PM ET  | Category:  Medical , NFL Save & Share:  Send E-mail   Facebook   Twitter   Digg   Yahoo Buzz   Del.icio.us   StumbleUpon   Technorati  
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