Advice

What Do Recent Hip Surgeries Mean for Jordy Nelson and Sammy Watkins?

 

Jordy Nelson

Jordy Nelson, Green Bay’s excellent wide receiver who is turning 30 on May 31st, underwent arthroscopic hip ‘clean-up’ (debridement) after the Pro Bowl. Nelson had a great 2014 (helping many of my fantasy teams – thanks, Jordy), and certainly didn’t play like his hip was bothering him. I read that it started bothering him at the Pro Bowl. The implication is that he had his hip evaluated soon afterwards and surgery was recommended. Due to the minimally-invasive nature of this procedure, he’s expected to return to the team within 2 months, i.e. in plenty of time for OTAs.

But that’s not really the issue.  The issue is that a 30-year-old wide receiver required a hip ‘clean-out’ in the first place. There are two main possibilities for why Nelson required this surgery:

  1. Nelson has hip ‘impingement’. This means that there’s a piece of bone on either the acetabulum (hip socket) or the femur (thigh bone) that’s hitting against the other bone during motion. In this case, the offending piece of bone can be removed, leading to pain relief, and Nelson should be fine. A fairly recent study showed that 95 percent of professional athletes (and 85 percent of collegiate athletes) were able to return to their previous level of play following hip arthroscopy for hip impingement.1
  2. Nelson’s hip has a degenerative (ie. arthritic) process developing, where the articular cartilage has been compromised. This means that the smooth lining of his joint is no longer normally smooth. As hip impingement is a major cause of hip arthritis in young people, Nelson could easily have both conditions. However, once an arthritic process has begun it’s a much bigger problem unto itself. Degeneration of the hip cartilage is analogous to the problem I discussed in an earlier article on Jadeveon Clowney’s loss of knee cartilage.

A recent study noted that 77 percent (30 of 39) of elite athletes returned to play following arthroscopic hip microfracture surgery.However, the question is how well Nelson will play. An arthritic hip condition could easily affect Nelson’s performance, especially as the season progresses and the arthritic process causes inflammation of that hip. If a degenerative process was painful enough to need surgery, it will worsen over time, arthroscopic treatment or not. In this case, the surgery will only provide temporary relief. Hip pain can affect a receiver’s ability to sink his hips for sharp cuts, leading to less effectiveness in his route running, and less ability to gain separation from defenders. This often becomes a pain tolerance issue. If Nelson does have early arthritis, he’ll still be able to play, probably just not at 100 percent.

We’ll know more as Nelson starts training camp. If he’s bothered by his hip, that’s bad. If he’s totally back to 100 percent, that could mean that his hip impingement was treated in time, and he’ll do well. But if his hip bothers him occasionally, that could mean that he has an arthritic process that will probably affect him more and more as the season wears on, and as the years go by. Not a bad time to sell high in dynasty, or let somebody else select him in redraft.

Sammy Watkins

Sammy Watkins, the soon-to-be second-year wide receiver for whom Buffalo traded multiple draft picks, suffered a hip injury on November 30, 2014, against the Browns. He played through the pain and finished the season. Watkins underwent an arthroscopic hip labral repair around the time of the Pro Bowl (February 1st). He’s expected to be limited for OTAs, but 100 percent by training camp.

Maybe. If the labral tear was his actual source of pain, then I’d expect him to do well and be at minimal further risk for problems with this hip.  However, hip labral tears are a very common finding on the MRIs of competitive athletes. And these “MRI findings” of a labral tear don’t always mean that the labral tear is the actual cause of the athlete’s pain. So, despite Watkin’s ‘MRI diagnosis’, his hip pain could be coming from another source, such as a tendinitis. In this case, any labral findings seen during arthroscopy would be incidental (i.e. asymptomatic, and not the cause of his pain). And repairing a non-painful structure won’t help him.

The good thing is that we’ll probably have a good idea how Watkins is going to do when he gets into training camp. If he’s running well, his problem is probably solved. If not, his problem hasn’t been solved and I’d be wary of drafting him this year.

References

  1. Byrd JW, Jones KS. Arthroscopic management of femoroacetabular impingement in athletes. Am J Sports Med. 2011 Jul;39 Suppl:7S-13S.
  2. McDonald JE, Herzog MM, Philippon MJ. Return to play after hip arthroscopy with microfracture in elite athletes. Arthroscopy. 2013 Feb;29(2):330-5.

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By Jeffrey E. Budoff, MD | @JeffBudoff | Archive

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