What is going on with Matthew Stafford’s elbow?
Over the past few weeks, dozens of reports out of Los Angeles have stated that Super Bowl champion Matthew Stafford has been dealing with an elbow injury. Reports are that Matthew Stafford’s elbow injury is”abnormal” and “unusual.” But what should fans and fantasy players make of this injury? Let’s discuss the different types of elbow injuries and their potential impact on performance.
The Mystery of MAtthew Stafford’s Elbow Injury
For the most part, LA has done a good job of keeping the details of Matthew Stafford’s elbow injury quiet. Initially, we had reports that this was a severe case of tendinitis, but more recent reports are calling it “throwers elbow.” Let’s clear up the dialog here, as sometimes these can be the same thing.
As we can see here, on August 4th, Ian Rapoport reported Stafford’s injury to be a tendon injury.
Also, on August 4th, Jourdan Rodrique contrasted Rapoport’s report by stating that McVay declined to call Stafford’s injury a tendon injury. Well, what is a tendon injury? And if it’s not a tendon injury, what else could it be?
The term “tendinitis” refers to inflammation of the tendons. The suffix “itis” means inflammation, and the tendon is the tissue that connects muscle to bone, allowing movement. This is very frequently an improper label. The more accepted terminology in the medical literature today is “tendinopathy.” Tendinopathy is more encompassing, as tendon injuries are not always inflammatory; however, the suffix “itis” indicates inflammation, as explained above.
Rather than all tendon injuries being inflammatory, many are degenerative, with literal fraying of the tendon tissue. Imagine an old rope or shoelace, and the ends of the fibers begin fraying in all directions. The name for this term is tendinosis, with the suffix “osis” indicating degenerative changes and fraying of the tissue.
As fans, do we care whether it’s tendinitis or tendinosis? Not really. Yes, the treatment is slightly different, as tendinitis (inflammatory) will respond better to anti-inflammatory treatments, whereas tendinosis (not inflammatory) will not, but otherwise, the rehab is primarily the same. Unfortunately, elbows are notoriously challenging to treat in throwers and often don’t get better without shutting down throwing for an extended period of time.
ulnar Collateral Ligament Injury
A common injury labeled as a “thrower’s elbow” is an Ulnar Collateral Ligament (UCL) injury. Think pitchers undergoing Tommy John surgery, a surgery to repair the UCL. The UCL is a ligament that links the inside of the upper arm bone (Humerus) to the inside lower arm bone (Ulna).
During the throwing motion, the UCL gets stressed as the arm whips forward. Typically this ligament can withstand this stress over and over again, but in some cases (potentially with Stafford), microtears of the UCL occur (called a sprain), which is painful.
We see this more frequently with baseball pitchers, who have many different release points of their arms to throw various pitches. However, this is a fairly uncommon injury in quarterbacks. With McVay stating that Stafford’s injury is “abnormal for a quarterback” and “things that MLB pitchers deal with” makes a UCL injury appear more likely.
The rehab process for both a tendon and a UCL injury is challenging, as the injury is usually not due to the elbow itself but an issue somewhere else in the throwing motion. Rehab involves rest, elbow isometrics, and eccentric strengthening to build the tendons capacity and often requires a great deal of shoulder blade strengthening (lower and middle trap, rhomboid, serratus anterior muscles) and, in many cases changing the mechanics of the throw to take the stress off the tendons and/or UCL.
Obviously, with the season a month away, Stafford does not have time to rest or change his throwing mechanics, and LA’s training staff is likely looking at how they can best “manage” his elbow rather than fully heal it this season.
Other means of management include injections (PRP, stem cell). Injections can be beneficial to stimulate healing but are not always successful.
Are we concerned about Matthew Stafford’s Elbow injury?
If Stafford’s elbow pain is due to tendinopathy or a UCL injury, it’s unlikely this issue will go away at any point this season. He will have to manage his symptoms by reducing practice reps, physical therapy, and injections. This may worsen throughout the season. The good news is I would not expect him to miss time due to this injury (unless it gets much worse). Early in the season, it is unlikely it will impact his performance, but if pain worsens, we may see him begin to miss throws and lose power.
Fantasy impact of Matthew stafford’s elbow injury
At this time, I do not believe this impacts Stafford’s ADP (QB 12), although I am growing increasingly concerned. As mentioned, he can play through this (for now). If this worsens, however, it can begin to impact performance. Pain alters movement, therefore impacting performance. Stafford obviously states that this is not a concern, but as mentioned, elbows do not respond well to treatment, particularly for throwers.
How about Stafford’s offense? Well, that is directly linked to how Stafford is performing. Since we don’t think Stafford’s performance will be impacted, there is no reason to believe Kupp, Allen Robinson, Van Jefferson (who is dealing with his own injury), Tyler Higbee, Cam Akers, or Darrell Henderson’s outlooks are impacted. However, allowing this to be a tie-breaker during drafts is acceptable.
Many analysts have Cooper Kupp, Jamar Chase, and Justin Jefferson as their tier 1 WRs. It is reasonable to allow Stafford’s elbow concerns to be the difference maker in drafting Chase or Jefferson over Kupp.
Tom Christ, PT, DPT, OCS