I think there's a really good chance that Jaylon Smith will play this year

[cowboyfan4life2]

He only needs to hope he can get back by next year. That is the real question here.

Jerry is going to take a beating if the kid doesn;t play next year.

 

[Toruk_Makto]

Precaution against what?

We can't have these players getting hurt playing football!

 

[CyberB0b]

Nerve issues aside, Adrian Peterson had one of the fastest recoveries in the NFL from a less severe injury, and it took him 9 months to recover. From my understanding, he didn't have any issues with the nerves like Smith has. I would say December is a realistic timetable, all things considered.

 

[Eskimo]

I'm not trying to be snarky so please don't read this into my question, but are you a doctor or do you have medical training?

Thanks.

Yes, I'm a doctor trained in electrophysiologic studies of peripheral nerves and muscles.

 

[pansophy]

Highly unlikely he plays this year. Just be happy that there is a reasonable chance that we will only need to worry replacing Lee or Mo next year and not both.

...still could be both though...

 

[cowboys2233]

Yes, I'm a doctor trained in electrophysiologic studies of peripheral nerves and muscles.

Trained, huh? Trained in electrophysiologic studies, huh?

You are so full of ****.

 

[RoboQB]

Let's not forget he tore his ACL and MCL. To fully recover from these injuries usually takes a full year. I realize many players play before that year is through, but they are not at full strength with their leg muscles and often suffer other injuries compensating for this. Sit him for the year.

On Christmas Eve, 2011, Adrian Peterson suffered an ACL and MCL tear in a game against Washington. Eight months later, he started week 1 of what would become an MVP season.
Now, I realize Peterson is a freak of nature... Just saying... it can be done.

 

[RoboQB]

All this talk, nerve damage, foot drop, blah blah, .. back in the day you didnt even need a foot to play this game.... bunch of wussies!
Tom Dempsey

Your post reminds me of the time I fought off a grizzly bear with my loose leaf notebook on my way to school.
Nobody's tough anymore....smh... lol

 

[Eskimo]

Trained, huh? Trained in electrophysiologic studies, huh?

You are so full of ****.

That's why I don't post here much anymore, sigh.

 

[Zimmy Lives]

That's why I don't post here much anymore, sigh.

I think cowboys2233 was trying to say you are so full of medical insight and knowledge; it is a privilege to have you as a member of this board. Please continue to post!

 

[pansophy]

On Christmas Eve, 2011, Adrian Peterson suffered an ACL and MCL tear in a game against Washington. Eight months later, he started week 1 of what would become an MVP season.
Now, I realize Peterson is a freak of nature... Just saying... it can be done.

Correct me if I'm wrong but the nerve wasn't damaged do AP I don't think. This is all about the nerve regrowing and firing.

 

[Zimmy Lives]

Correct me if I'm wrong but the nerve wasn't damaged do AP I don't think. This is all about the nerve regrowing and firing.

This is true but it will fire again because...

 

[Eskimo]

Sounds like you are saying the same thing with the regeneration.
I did not see the part about the EMG published anywhere, but that is probably your professional expertise.
So you expect the nerve fibers to grow within the established perineurium?
May be that is what his doctor meant by stretched but not elongated?
And thus near-zero chance for 'attaching to the wrong places'?

If so, we can celebrate...

Thanks.

Nerve regrowth is difficult to follow clinically because there is no output to study on EMG until the nerve reaches its organ (the muscle). What you do see when it first arrives is very small scrambled up waves (small polyphasic waves also called nascent potentials) on the screen.

What you can see clinically before the nerve reaches its end target is Tinel's sign. If you tap at the end of the nerve where active growth is occurring you cause a funny tingling sensation. You can follow this along to see how the nerve is growing.

In terms of the comments from the surgeon what he is getting at is the outer nerve sheath was not significantly deformed. He is then inferring it is much more likely that the inner architecture of the nerve may not have been disrupted too badly. That is the key to good recovery. If the endoneurium is intact (the smallest nerve sheaths) then the axons have a supportive environment to grow in and will find their way back to the correct spot fairly quickly for a short segment injury. However, if the endoneurium was significantly damaged then the amount of recovery will be less and the recovery will take longer.

I think it is an educated guess based on the doctor's reports that he has a predominant 2nd degree injury (intact endoneurium) as there are no reliable tests that will sort this out for you. Based on how aggressively they drafted him they must believe his chances of recovery are very good. It is one of those things where only time will tell. His leg power will be very good regardless of how the nerve recovers because all the main propulsive muscles are intact. The key issue will be ankle stability. They can try taping him up so much that little ankle movement occurs although that may be at the expense of his agility.

 

[RoboQB]

Correct me if I'm wrong but the nerve wasn't damaged do AP I don't think. This is all about the nerve regrowing and firing.

My comment was in response to someone who said an ACL and MCL tear would take a year to recover from... I am aware of the nerve saga and trying to pay attention...

 

[tyke1doe]

Yes, I'm a doctor trained in electrophysiologic studies of peripheral nerves and muscles.

Thank you. I need to go back and re-read all your posts.

 

[waldoputty]

Nerve regrowth is difficult to follow clinically because there is no output to study on EMG until the nerve reaches its organ (the muscle). What you do see when it first arrives is very small scrambled up waves (small polyphasic waves also called nascent potentials) on the screen.

What you can see clinically before the nerve reaches its end target is Tinel's sign. If you tap at the end of the nerve where active growth is occurring you cause a funny tingling sensation. You can follow this along to see how the nerve is growing.

In terms of the comments from the surgeon what he is getting at is the outer nerve sheath was not significantly deformed. He is then inferring it is much more likely that the inner architecture of the nerve may not have been disrupted too badly. That is the key to good recovery. If the endoneurium is intact (the smallest nerve sheaths) then the axons have a supportive environment to grow in and will find their way back to the correct spot fairly quickly for a short segment injury. However, if the endoneurium was significantly damaged then the amount of recovery will be less and the recovery will take longer.

I think it is an educated guess based on the doctor's reports that he has a predominant 2nd degree injury (intact endoneurium) as there are no reliable tests that will sort this out for you. Based on how aggressively they drafted him they must believe his chances of recovery are very good. It is one of those things where only time will tell. His leg power will be very good regardless of how the nerve recovers because all the main propulsive muscles are intact. The key issue will be ankle stability. They can try taping him up so much that little ankle movement occurs although that may be at the expense of his agility.

Hi Eskimo

Thanks.

I don't understand your description of the Tinel's sign, and I cannot quite figure it out using google.
We need the motor neurons to regenerate and make contact to the target muscle.
How would you feel any tingling sensation with motor neurons?
Do motor neurons feel sensations as well as sensory neurons?
Or can one infer motor neuron recovery from sensory neuron recovery?

Thanks again!

 

[GimmeTheBall!]

I think there's a really good chance that Jaylon Smith will play, in fact, if the Cowboys are thinking ahead here, Jaylon will sleep in a hyperbaric chamber every night from now until his nerve completely regenerates. That makes his recovery happen ASAP.

That's why I think he will play this year.... thoughts???

So sad that we find ourselves wishing for a highly touted draft pick will play the same year. There was a time when draftees came ready to play, not ready to rehab.

 

[pansophy]

Hi Eskimo

Thanks.

I don't understand your description of the Tinel's sign, and I cannot quite figure it out using google.
We need the motor neurons to regenerate make contact.
How would you feel any tingling sensation with motor neurons?
Do motor neurons feel sensations as well as sensory neurons?
Or can one infer motor neuron recovery from sensory neuron recovery?

Thanks again!

If you ever have hit your 'funny bone' then you know what they are looking for by Tinel's sign. Tapping the end of the nerve produces the same tingling feeling. As the nerve grows you have to tap farther down, so in this way you can chart the growth of the nerve.

 

[waldoputty]

So sad that we find ourselves wishing for a highly touted draft pick will play the same year. There was a time when draftees came ready to play, not ready to rehab.

Actually this is calculated gamble that may pay off very well for the Cowboys.
Not that different from taking Staubach, Hennings or Walker.
Staubach and Hennings could have been killed on duty.
Walker could have gotten hurt in the USFL.

What is sad is a 21 year old having gone through hell as witnessed by the emotional call with Jerry.

 

[waldoputty]

If you ever have hit your 'funny bone' then you know what they are looking for by Tinel's sign. Tapping the end of the nerve produces the same tingling feeling. As the nerve grows you have to tap farther down, so in this way you can chart the growth of the nerve.

Sorry if I am being thick.
Does a nerve have both motor neuron axons and sensory neuron axons?