October 26, 2015

Medical context on Jason Peters' injury

By Jimmy Kempski
PhillyVoice Staff

Mike McCarn/AP

Jason Peters' injury Sunday night wasn't nearly as serious as it first appeared.

In the first quarter of the Eagles-Panthers game Sunday night, Jason Peters went down with a minimal-contact injury that looked all too familiar to any sports fan who has seen a torn ACL or ruptured Achilles. Peters stayed on the ground for several minutes, with teammates taking a knee around him, before eventually being carted off the field.

Here's what that injury looked like on the replay:

It was later revealed that Peters did not suffer something more serious like a torn ACL or ruptured Achilles. Rather, it was determined that he had back spasms. Peters, as well as Chip Kelly, believe he will be ready to return to the field soon.

"They will see and monitor him this week," said Kelly. "I think some of those guys will stay here; those guys that need to stay here will all stay here with [Director of Sports Medicine/Head Athletic Trainer] Chris [Peduzzi] and get treatment. But from what I understand, he should be good to go for next Tuesday."

As we noted earlier this offseason, Peters entered this season as the third oldest starting offensive lineman in the NFL. Here are the five oldest starters in the league:

Age Rank	Player	Pos	Team	Birthdate	Age
Oldest	Evan Mathis	OG	Broncos	11/1/1981	33
2	Andrew Whitworth	OT	Bengals	12/12/1981	33
3	Jason Peters	OT	Eagles	1/22/1982	33
4	Logan Mankins	OG	Buccaneers	3/10/1982	33
5	Khalif Barnes	OG	Raiders	4/21/1982	33

There is a perception by some that offensive linemen play deep into their 30's, and therefore players like Peters should have plenty of tread left on the tires. Data shows that this is simply not the case. Of the 160 offensive line starters in the NFL, not a single one is 34 years of age of older. This closely mirrors what I have found when I've done offensive line age studies in each of the last five years.

There is also a perception that age and back injuries go hand in hand.

For more context on Peters' injury we spoke with Dr. Arthur Bartolozzi, former team physician for the Philadelphia Eagles and Flyers, and current director of sports medicine at 3B Orthopaedics at Aria Health.

In regard to age

"I would say only to the extent that they have more exposure to football activities, because if this is simply a muscle spasm then the answer would be no," said Bartolozzi. "If this is underlying spinal damage, then of course the longer you play the more risk you have.

"We want to say, ‘He’s getting older, he’s going to get hurt.’ I don’t think it has anything to do with that. I think it has to do with the fact that just like someone might sprain their knee or irritate a muscle there are a lot of ligaments that connect the spine to the pelvis. So the other thing that is most common for back spasms and back pain is straining either the muscles or the spinal ligaments, and I think it’s related to the stress or intensity of the game at that point."

In regard to how quickly Peters can return:

"As with any muscle injury, we know from hamstrings, which are the most common, that the recurrence rate for these types of things is high, up to 40 percent," said Bartolozzi. "Certainly, he can anticipate irritation. Whether he has the same level of irritation which results in his inability to play would be difficult to predict, but any muscle strain or ligament strain is a high risk of recurrence especially within a few weeks... He has a major advantage of having a week to where he’s going to get daily therapy, and I think the fact that there’s no pressure to perform this Sunday is really a good thing, because he would possibly be at risk if there was a game on Sunday and he came back too soon.

"If it’s a muscle strain or a minor ligament strain he can easily recover in a week and return to play. The only thing that would make you concerned is that (Peters' injury) happened so suddenly. It looked for all the world like it was a more serious injury. So muscles come on really suddenly where they’ll twist and then he just had so much pain, but I’m sure it got a whole lot better really fast, so that by the time the game ended and he had a chance to ice it and rest it he wasn’t incapacitated. If the opposite happened, where he was really incapacitated then that would indicate a much more serious problem."

As long as he can stay upright, Peters is still a very good player. The Eagles' offensive line is drastically weakened whenever he cannot play. Sunday night, the Eagles' offensive line looked like this after Peters was carted off: