How Long Will Justin Herbert be Out?

viagra generico 25 mg pagamento online a Torino The Oregon Ducks football team has been forced to be resilient early in the season in the face of several injuries to key players.  Most notably, their starting QB Justin Herbert will be out indefinitely with a fractured collarbone (clavicle) on his non-throwing left side, which happened in the first quarter in Saturday’s game against California while rushing for a touchdown. Coach Taggert says Herbert “will be out for a while” but may return this season. Let’s look at this from a medical perspective. The right and left clavicles connect each side of the torso to the arms and are positioned immediately above the first ribs.  Its medial sides connect to the sternum, while the lateral ends connect with the shoulder blades.  The middleportions of the clavicles are S-curved and are referred to as the shafts. Clavicular fractures are usually confirmed via X-ray and usually happen when a person falls on the shoulder (like Herbert did) or with an outstretched hand.  When fractured, moving the arm and/or touching the clavicle itself can be especially painful, in which the person may also complain of nausea and/or dizziness from the pain. 

puchase finasteride from online drugstore For many years, “basic” clavicular fractures were treated without surgery and yielded positive outcomes, especially in children (J Pediatric Orthop 2011).  What I mean by “basic” is that the clavicle had a clean break in the shaft as opposed to being comminuted (i.e., in multiple pieces), breaking the skin and/or damage to surrounding nerves and/or blood vessels (JBJS 2009).  Another indication for surgery is location of the fracture, as a break in the lateral part of the clavicle usually requires surgery because the bones in this area tend not to grow together well (J Orthoped Trauma 2009). 

go to link Robert Sandmeier, MD, a Tigard-based orthopedic surgeon specializing in shoulder reconstruction, states, “Management of clavicular fractures has changed significantly in the last five to 10 years.  Surgeons used to treat virtually all of these fractures without surgery, and now surgery is far more common.  Most people recover similarly in either case, although the main advantage for an athlete like Herbert is that he can initiate more aggressive physical therapy earlier with surgery because his fracture is stabilized by a plate as opposed to waiting for the bones to heal together.”

prezzo levitra 20 mg in farmacia While we don’t know at this point if Herbert will have surgery, research suggests that the majority of surgeons would probably opt to surgically repair his clavicle, given Herbert’s status as a high-level throwing athlete (Sports Med 2007).  Studies comparing surgical vs. non-surgical clavicular fracture repair in adult athletes suggest advantages in post-operative strength, quicker return to sport and reduced re-fracture rates (Br J Sp Med 2003, Acta Orthop Belg 2006, Am J Sp Med 2010).  Again, it all depends on the nature of the fracture.

enter site Initially, Herbert will likely be in an arm sling in order to minimize clavicle stress and help it heal. The focus will be on pain control and maintaining/increasing range of motion, as muscles and ligaments surrounding the clavicle and neck will rapidly shorten in response to the injury.  Herbert will also likely engage in low-impact endurance training (e.g., elliptical, stair-stepping machine, shown) on a daily basis for at least 30 minutes each session, which has been shown to expedite healing, reduce pain, improve range of motion, minimize gains in body fat and enhance mental confidence (Arch Phys Med Rehab 2006, 2010; New England J Med 2003; Sp Med 2008).  These benefits apply even if you’re not a competitive athlete, so make sure to include endurance exercise as part of your rehabilitation program if you want to recover faster.

quanto costa viagra generico 25 mg online a Firenze As soon as Herbert can tolerate it, strengthening exercises will begin to regain function and expedite return to competition.  In particular, strengthening the entire back, rotator cuff (4 muscles surrounding the shoulder joint), chest, neck and arm muscles will help restore Herbert’s left shoulder to a point where it will complement his throwing arm.  Of course, this must be done carefully and in accordance with the tending surgeon to ensure that appropriate stress is being imparted to the repaired clavicle.

go to site After watching Herbert play, the hardest part may be slowing him down.

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