aka the pro football doc, Wentz throwing, even just three months after surgery, is normal and expected.
Dr. Chao also echoed some of the same sentiments as orthopedic surgeon Dr. John Kelly, MD from Novacare, when he was a guest on the WIP morning show February 20th.
“The meter has changed from ACL recovery from six months to nine months. This is an ACL plus, at least, two ligaments. If he tore the LCL, which was wrote in the press – that’s wrong.
“What I saw in the video, he had at least three ligaments on the outside of the knee damaged. That’s requires reconstruction, that’s a long rehab. And if it were my patient, I’d be thinking nine, 10, or even 11 months.”
In addition, Dr. Kelly believes Wentz may have to play with a brace for the rest of his career.
“This kid, God bless him, is probably going to be brace dependent – like Brady, like RG3 was – the rest of his career,” said Dr. Kelly. “This may be a blessing in disguise, maybe become more of a drop back quarterback that we all want him to be.”
You can read the full article from Dr. Chao here:
I also did some homework of my own.
I had the pleasure of speaking with Dr. Phil Koehler DO, MS who is currently an Internal Medicine Resident at Lankenau Medical Center and will be completing Residency at Thomas Jefferson University Hospital/Rothman Institute/Magee Rehabilitation in the specialty of Physical Medicine and Rehabilitation (PM&R) starting July of 2018.
Dr. Koehler is a graduate of Philadelphia College of Osteopathic Medicine where he completed an undergraduate fellowship in Osteopathic Manipulative Medicine (OMM) from 2014-2017.
BM: Carson tore both his ACL and LCL, can you give us an idea of what his rehabilitation could potentially be like? Is he in for a more grueling rehabilitation than someone who only tore the ACL?
DK: The first and arguably most important step in recovery is the surgery. Research shows earlier time to surgery is one of the most important factors in good outcomes. I am not a surgeon, but I do find it interesting Carson went to Dr. James Bradley in Pittsburgh. I do not think this delayed his procedure. Dr. Bradley is a legend in the orthopedic sports world, essentially another Dr. Andrews. From what I read he is known for using off label techniques like PRP (Platelet Rich Plasma) and Stem cell therapy in addition to surgery, which I have seen help patients anecdotally. I am curious as to why Wentz chose Dr. Bradley when some of the best orthopedic surgeons are here in Philadelphia. In my opinion all of these surgeons are stellar and achieve great outcomes, so what is more important to his recovery time frame is who will be responsible for managing Carson’s rehab.
BM: Do you believe that a 9 month time frame is overly optimistic?
DK: I discussed the case with a colleague and former wrestling teammate at Lehigh University, Dr. Manuel Schubert who is a budding sports orthopedic surgeon (The next Dr. Andrews or Bradley) currently in residency at University of Michigan. He agrees that a time frame of 9 months is optimistic. The healing process isn’t complete at 9 months, even in someone young, healthy, and motivated like Carson. An article in the British Journal of Medicine demonstrated that athletes who participate in accelerated rehab may continue to have abnormal joint movement and weakness for 22 months following surgery. When Adrian Peterson recovered in 9 months it was unprecedented and he was recovering from an ACL alone. An ACL and LCL adds another layer of instability, and I suspect Carson had meniscus damage that wasn’t disclosed to the public. I would compare his injury more so to Teddy Bridgewater than AP.
BM: As far as wearing a knee brace goes, can you make that assessment without knowing the specifics of the surgery, and would wearing a brace depend on the athlete?
DK: I think the use of bracing is somewhat controversial and surgeon specific. There was a large review study with 12 randomized controlled trials that showed outcomes with ACL repairs do not change with bracing. It is more surgeon preference, but if Dr. Bradley recommended to use a brace, I would use it.
BM: In your opinion, knowing both the player and injury, what is the biggest question mark moving forward?
DK: The big question is how this injury will affect the mechanics of Carson’s throw and willingness to run. His last pass of the season to Jeffery was clear example of how an injury can affect every movement. You could see he didn’t have the correct force when he planted on his front leg. His entire kinetic chain was off. What worries me most is if he isn’t rehabbed to the point where he has confidence in that planting leg, that he starts compensating by changing his mechanics, or even worse, injures other muscles and joints. From my training in Osteopathic Manipulative Medicine and PM&R, these are things that I am used to seeing. I have seen athletes “recover” in short time frames, but it is the compensations that continue to haunt their career. So my bigger concern isn’t re-injury but a change to other aspects of him functioning as a high level athlete.
This is now three (or more) experienced doctors who have warned us about the possibility that Wentz will either not be ready, or not be the same by September 6th.
Granted none of these doctors performed the surgery on Wentz, nor have taken part in the day-to-day rehabilitation process.
Wentz has gone on record saying that he believes he will be ready for week 1.
The Eagles have also gone on record that they believe Wentz will be ready for week 1.
Dr. Kelly believes that Wentz will miss the opener and possibly half of the season, while Dr. Chao believes that Wentz can be a "pocket passer" for week 1, but will not be the same run/pass threat until mid -season or longer.
For me, week 1 isn't my concern.
Dr. Koehler, Dr. Chao, and Dr. Kelly all mentioned a concern that Wentz may never get back to being the elite athlete that we have become accustomed to seeing.
That concern is my biggest takeaway from this article.
I am not a doctor or anywhere close to as brilliant as the people that I have featured in this article, but I do know sports. Wentz is going to have to evolve his game as his career goes on. He cannot take the same risks moving forward.
I also believe that he is smart enough to do so, and will continue as one of the leagues best quarterbacks for years to come.
Will he be ready for week 1?
Only time will tell, but I certainly wouldn't count out Carson Wentz.