September 01, 2017
The Philadelphia Eagles played their final preseason game Thursday night, and for the fourth time in as many games, backup quarterback Nick Foles did not play.
Foles, of course, has missed a big chunk of camp with what the team consistently classified as "arm soreness." After Thursday's game with the New York Jets, however, Foles himself was a little more revealing about the specific injury he suffered.
"It’s a strained flexor tendon," Foles said. "When you’re a throwing athlete, sometimes you have to deal with it, and a lot of throwing athletes have dealt with it."
Indeed they have. We followed up with Dr. Mark Pollard, the Assistant Professor of Orthopedic Surgery at Cooper University Hospital to gain more clarity on flexor tendon injuries.
"Essentially, they’re the muscles that flex when your wrists go down, attached to the inside of the elbow," Dr. Pollard explained. "Most commonly we see this kind of thing in baseball pitchers, but obviously it can happen in quarterbacks because they throw quite a bit.
"The concerning thing is that the pain in that area is also the same place that the ulnar collateral ligament (UCL) is, the Tommy John ligament.
"In pitchers, with any pain there, oftentimes you have to make sure it’s not the UCL, so presumably as part of their workup for this, they’ve gotten an MRI study, which is really the best way to visualize that area to make sure it’s not, in fact, a problem with the ligament, and just a problem with the muscle attachment, which is what the flexor strain would be."
If it were more than just a strain, and instead, a partial tear, the tendon could require surgery.
Dr. Pollard explained, "If there were a partial tear of the muscle attachment, if the conservative measures didn’t work, and indeed there were a tear – but they’re telling us it’s a strain so it’s not likely to be a tear – but if there were a tear, that would be the kind of thing sometimes that surgery is considered, and recovery would be a long time. And obviously, if it did turn out to be the UCL, then that would be a much bigger issue on a quarterback’s throwing elbow, because then you’re talking about UCL reconstruction surgery, or Tommy John surgery, which typically takes a year to come back from.
When asked if surgery is an option, Foles emphatically said that it is not.
"No, no, no, no, no," Foles repeated. "I know everyone is freaking out because no one has really gotten a lot of answers, but it feels great.
"Obviously, it’s good to get reps and all that, but sometimes injuries do happen and this was one those occurrences that’s unfortunate, but I feel great. The training staff has done an awesome job. I’ve been getting a lot of mental reps and I was able to get out there for a few practices. But we just felt that it was time to continue to treat it and just continue to get it healthy because the season is right around the corner and you want to be healthy for the season."
Dr. Pollard agreed that the best medicine for a flexor strain is rest.
"Usually the treatment is rest," he said, "and you try some rehab type exercises on it. I guess it would be a bit concerning if it were an ongoing problem that’s keeping him out of game multiple times, and it would be even more of a concern if it dated back to last season.
"Normally, something like this is recovered from pretty successfully. Usually, it’s in a matter of weeks instead of multiple months as far as having it rest and allowing the tendons to heal.
"One of the things that sets you back – it’s just like a hamstring – a muscular issue, so it’s the kind of thing if you try to do activities before it’s all the way recovered, sometimes you can re-aggravate it and prolong the recovery time."
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