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Sims: Looking At Veldheer's Triceps Tear And Taveras' Ankle Sprain

By Abby Sims
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Left tackle Jared Veldheer of the Oakland Raiders is undergoing surgery to repair his partially torn triceps tendon. Though the injury caused the player to seek an MRI, he continued to play when the initial radiology report was negative.

In other words, pain + loss of function + no findings on MRI = pretend nothing is awry. Let's get real here -- it was preseason, not the playoffs. The only positive thing to come out of Veldheer playing through his symptoms is that the persistent pain motivated him to get a second MRI, which revealed the tear. Thus the equation changed, at least this time around.

Like Ray Lewis and Justin Smith -- who recently had surgery to repair partial triceps tears -- it seems prudent for Veldheer to forego an attempt at conservative management in an effort to both hasten and assure recovery.

By continuing to play until his diagnosis was official, Veldheer risked his partial tear becoming a complete rupture. That would have resulted in a more involved surgical procedure and a more extended recovery time. Smith took that calculated risk when he opted to play through the Super Bowl -- with what was reportedly a 50-percent tear -- before undergoing surgery last February (Smith's injury occurred in December).

Anatomy and Mechanism of Injury

The triceps muscle group is comprised of three distinct muscles in the back of the upper arm. All originate in different places but converge into one tendon that attaches at the elbow to the uppermost portion of the ulna -- the larger of two bones in the forearm. The triceps' primary role is to extend (straighten) the elbow.

In football, a player contracts his triceps when blocking or pushing an opponent. If impact causes sudden stretching of the tissue by forcefully bending the elbow while the triceps are active and in a shortened position, tears may result.

If a tear pulls off a portion of the bone where the tendon attaches, it is called an avulsion. In the case of a complete rupture, the triceps muscle retracts because there is nothing to anchor it to its attachment. Immediate surgery is required in order to have the best possible outcome. In the case of a non-operative partial tear, full healing may take up to a year and also depends on the extent of the injury. As after most soft tissue injuries, the involved area may never be the same. There are no guarantees.

Healing of the soft tissues must be sufficient before the surrounding muscles are strengthened. After triceps surgery, rehab also focuses on restoring full mobility at the elbow as well as flexibility and strength throughout the extremity.

Similar but Different -- Oscar Taveras

One of baseball's top prospects, Cardinals outfielder Oscar Taveras, will reportedly have ankle surgery this week. Taveras continued to perform well after sustaining a high ankle sprain in May, until symptoms forced him from the Triple-A lineup. He played in only one game after June 23 while focusing on rehab to avoid surgery.

A high ankle sprain is a tear -- ranging from minimal to partial or complete -- of the ligaments that connect the two bones of the lower leg just above the ankle joint. Disruption of these ligaments creates instability.

Might Taveras have avoided surgery had he managed his condition conservatively from the outset? We can only speculate. However, with post-injury stats that kept him running the bases -- even stealing a few in the process -- it seems that he didn't do himself any favors. Why would the Cardinals' organization risk the health of a player who had risen from Baseball America's third-best prospect in spring training to the second best by midseason? It doesn't compute for me.

Clearly, playing hurt might have caused Taveras further injury -- not only to his ankle, but to any number of muscles weakened by his injury, those forced to compensate or to joints sustaining undue forces due to altered mechanics. The kid is fortunate the only thing requiring surgery now is his ankle.

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