Tuesday, October 22, 2013
Fantasy injury report: Jermichael Finley
By Stephania Bell
Green Bay Packers tight end Jermichael Finley’s injury was a frightening reminder of just how quickly the game of football can take a backseat to the matters of everyday life. Walking, talking, taking a shower. These were the things Finley was celebrating the day after his collision with Cleveland Browns safety Tashaun Gipson left him lying motionless on his left side, a hit that resulted in Finley leaving the field strapped to a spine board. He was later diagnosed with a bruised spinal cord, according to ESPN’s Chris Mortensen.
After being admitted to the ICU and undergoing extensive testing, Finley made enough improvement by Monday evening to be transferred out of intensive care, although he remained in the hospital. Finley posted this note about his progress on Twitter: “I’m happy to report that I have been transferred out of the ICU and that I have full feeling in my arms and legs. As importantly, I was able 2 walk to & from the shower today, which was badly needed after yesterday’s victory!” On Tuesday afternoon, ESPN’s Ed Werder reported that Finley is expected to be released from the hospital within 24 hours.
So what does his future hold? It’s too early to say. In the immediate sense, the primary goal following an injury where there is bruising of the spinal cord is to ensure the patient is stable, both medically (e.g., cardiac) and from an anatomical standpoint: Are the cervical vertebrae and the ligaments that support them intact? Is there a fracture that is either displaced or that could displace with movement, which would threaten the spinal cord?
The other immediate priority is to reduce any swelling around the cord. Swelling can cause compression, which impairs nerve function, something the patient perceives as loss of feeling and/or loss of strength in the extremities. The more pronounced the swelling and the longer it endures, the greater the risk of permanent damage. As the swelling resolves, the patient is observed carefully to see how the return of nerve function is progressing. In Finley’s case, based on his increased activity later in the day, he was progressing quite well.
But he is hardly out of the woods. There will be additional tests and consultations with various spine experts to evaluate what factors may have contributed to this episode. In some cases, the athlete is found to have underlying spinal stenosis, a narrowing of the spinal canal which houses the spinal cord. Decreased space around the spinal cord means there is less room for the spinal cord to move (which it normally does when the spine bends) without abutting up against another structure. Rapid extreme movements -- such as those resulting from a violent directional blow to the head and neck area -- that force the cord to collide with an adjacent structure can result in bruising (contusion) of the delicate tissue. A narrow canal increases the risk of such contact for the spinal cord, and therefore potentially increases the risk of serious injury. Stenosis can be something the athlete is born with (congenital), or it can be acquired as a result of changes in the tissue. A bulging disc, for instance, can occupy valuable space within the canal.
According to Werder, doctors told Finley that they believe his injury was caused by extreme torque and that it will not require surgery. Some athletes have returned to play following spinal cord contusions, including Baltimore Ravens linebacker Jameel McClain, but much depends on what unfolds over the course of testing following an injury. The athlete’s complete history -- including any prior episodes of neurological events -- will be evaluated in the context of determining the next steps. That process, along with the time allotted to ensure full recovery from this latest episode, is not quick, nor should it be. The Packers are not issuing any timetable for Finley, a perfectly reasonable approach given all the uncertainty around this injury.
In the meantime, the Packers are forced to evaluate their pass-catcher situation. With Finley out indefinitely, and Randall Cobb out until at least Week 15 with a fractured fibula, the status of James Jones becomes all the more important. Jones sat out Week 7 with a sprained PCL, not surprising based on the nature of the injury. The question now is if he will miss another week, or if he can return to help the team in Week 8.
Coach Mike McCarthy told reporters Monday that the team would have a better idea of Jones’ outlook Wednesday. McCarthy said the timeline provided to him regarding Jones’ injury was “probably two, possibly three weeks,” adding, “He’s genetically gifted, so we'll see what happens.”
The key for Jones is having enough quadriceps strength to control his knee with dynamic movement. Until he tests it on the practice field, there is no way to measure how close he is to a return.