Advice

Rob Gronkowski Injury Update

Rob Gronkowski, New England’s elite tight end, injured his back on November 27, playing against the New York Jets. He underwent surgery on December 2. What surgery was performed, and what is his fantasy football outlook?

Medical records are not public, but it was reported that his latest procedure was probably a redo L5-S1 microdiscectomy. Gronkowski previously had an L5-S1 discectomy performed in 2009, and also had a L4-5 discectomy performed in 2013.

Procedure

Disks are numbered for the spinal bones they lie between. L4 (the 4th lumbar vertebral bone) is above L5 (the 5th vertebral bone), which is above S1 (the 1st sacral/tailbone vertebral bone). L5-S1 refers to the disk between L5 & S1. L4-5 refers to the disk between L4 & L5, which is 1 level above the L5-S1 disk.

L4 is above L5, which is above S1

 

“Discectomy” means removing the part of a herniated disk that is protruding from the spine and pressing on a nerve.

2a

2b

 

 

 

 

 

Side view and cross-aection of a herniated disk compressing a spinal nerve root.

 

“Micro-discectomy” means performing this procedure through a small incision with minimal dissection and minimal trauma to the surrounding tissues in order to minimize pain and downtime.

3

Microdiscectomy uses slender instruments to remove the herniated portion of the disk

 

Following his surgery, Gronkowski was initially given an estimated eight week timetable for return, meaning that it was thought he could play on a limited basis in the Superbowl, should the Patriots make it to the NFL championship game. Instead, he went on injured reserve and his 2016 season is officially over. He’ll be ready to play at the start of the 2017 season, but the question arises how this disk issue will affect Gronkowski’s future fantasy production.

Outlook

Unfortunately, the need to have a second surgical procedure on the same disk does pose a threat to Gronkowski as a future fantasy football asset. A redo/revision discectomy is a big deal. Having to go into the same disk a second time basically means that there’s something wrong with that disk. Many surgeons would perform a fusion when performing a second discectomy at the same level. In fact, many of you reading this column would probably undergo a fusion if you were to have a disk operated on for a second time.

The problem with performing a spinal fusion on Gronkowski is that it would end his professional football career. That means that his troublesome L5-S1 disk is still lurking as a potential source of future problems. And should this disk herniate for a third time, Gronkowski might require a fusion. In other words: ‘three strikes for that disk and Gronk could be out’ as far as playing football goes. Even without a fusion, another disk procedure could easily land him back on IR, ending another season prematurely. So, if you roster Gronkowski please understand that you’re relying on a disk that’s twice declared itself a problem to behave through all of the stress that playing tight end in the NFL subjects it to.

And even if Gronkowski doesn’t have any more back surgeries, after three back surgeries he’s at increased future risk of ‘flareups’ of low back pain and back spasms, which can limit his practice time, limit his game reps, cause him lose effectiveness when he plays, and lead to missed games. How long can his problematic lower back hold up under the demands of professional football? He might only have a few years left. I’ve heard that Gronkowski hasn’t spent much of his NFL salaries through the years, so he probably doesn’t need to continue playing for financial reasons. Put it all together and Gronkowski’s value in dynasty definitely takes a hit, and his risk even in redraft is increased.

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

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