NFL Injuries

The curious case of Andrew Luck-Dr. Morse

Photographer: Zach Bolinger/Icon Sportswire

Andrew Luck, the quarterback of the Indianapolis Colts, had a very solid 2016 NFL season. In 15 games he completed 346 passes with a 63.5% completion rate for 4,240 yards. Throwing for 31 touchdowns and only 13 interceptions, adding 341 rushing yards with 2 additional TDs. Now what if I told you that Luck had been playing for the past year and a half with a tear in the labrum of his throwing shoulder; impressive to say the least. Luck is more accurate and has better arm strength with a torn labrum (to what extent we do not know) than most other quarterback with (presumably) healthy shoulders. Imagine what he can do with a healthy shoulder!

How long has Luck been dealing with this shoulder injury?

It appears that Andrew had been dealing with this for a long time even requiring weekly corticosteroid and other painkilling-injections before games as far back as 2015. Despite resting for the entirety of the 2015 offseason, presumably not throwing, Luck’s shoulder did not improve significantly. So much so that last season (2016) he required mandatory off-days on Thursdays to help with the pain. This is not routine, as he should be able to throw on Thursdays during the regular season if there isn’t any pain or issues. Obviously Luck was dealing with a significant amount of pain, and he was only able to cope with it using a combination of rest, scheduled non-throwing days, NSAIDs, steroid/pain-killing injections, and intense rehabilitation. Luck knew that once the 2016 NFL season ended, he had to do something about the pain in his shoulder.

Unfortunately the labrum of Andrew Luck’s shoulder did not respond to every possible form of conservative therapy, and the decision was made to undergo surgery in January 2017. By completing this surgery, Luck can ensure that his shoulder will be fully healed and be able to start to the season strong for the first time in at least a year and a half. Roughly one-year-ago Luck signed a monster 6-year $140 million deal with the Colts, $47 million fully guaranteed. It is safe to say that Luck is the Colts’ franchise player. They need to make sure that he is healthy to take on the season as he is a staple in their offense and vital to their potential playoffs and Super Bowl hopes.

What type of surgery did Luck have?

Shortly after the surgery was completed, Indianapolis Colts owner Jim Irsay claims that Luck underwent a “simple labrum repair” and that everything went really well. Based on reports, it appears that Luck underwent simple arthroscopic labral repair, and there was no bicep muscle, humerus, or the rotator cuff involvement (or subsequent repair). Who was the last major NFL QB to undergo this surgery? The first one that comes to mind that underwent this same type of surgery was Drew Brees in 2006. Brees’ surgery involved a larger part of the labrum, as he underwent what is called a complete labrum tear repair, by the famous Dr. James Andrews. To speak to the efficiency and importance of the surgery, Drew Brees claims that the operation saved his career. And by the level that he is still playing, I think that is safe to say.

If you’ve read my last two NFL related articles, about Travis Kelce and Cam Newton, you know that I’ve talked about the shoulder quite a lot lately. Unfortunately for Luck his injury was different from that of the two aforementioned players. Luck’s shoulder injury is much more significant, in that a typical recovery from labral repair surgery can be anywhere from 6 to 9 months.

What is a shoulder labrum?

Since we have not discussed the labrum of the shoulder in detail yet, let’s briefly discuss it now. Think of the labrum as a strong smooth ring of cartilage that encircles the shoulder to help support and stabilize it. This labrum helps deepen the shoulder joint/socket by up to 50%, so that the head of the upper arm bone (humerus) has a better fit. Additionally it helps to serve as the attachment site for several important ligaments and tendons, like the biceps tendon, which attaches to the top portion of the labrum.

What is the most common way to injure or tear your labrum?

The most common injuries resulting in a torn labrum are from either acute trauma or repetitive shoulder motions. It is unclear if Luck sustained either or both of these or just a combination of his repetitive throwing over the years that caused this tear. Some of the other examples of causes include falling on an outstretched arm, a direct blow to the shoulder, or a violent overhead reach, as if trying to stop a fall. As you can tell all of these things could have easily happened in the middle of the brutal game that we call American football. Luck could have sustained a direct blow to the shoulder in any one of his dropbacks, or in the middle of getting hit where he could have put his outstretched arm out trying to break his fall. It is unclear exactly when or how the injury happened, we just know that it indeed was torn. Baseball pitchers are prone to labral tears because of the act of throwing causes the biceps tendon to pull strongly against the top part of the labrum. Similarly, weightlifters and golfers can suffer labral tears due to the nature of their sports as well.

What are the most common symptoms of a labral tear?

 Patients who have suffered labral tears often complain of pain with overhead activities. They can also experience popping, locking, catching or grinding of the shoulder as well. Although not as common, some people complain of shoulder pain at night or pain with everyday routine activities. The most common complaints are experiencing a decreased range of motion, loss of strength and feeling that the shoulder is ‘unstable.’

How is a labral tear diagnosed?

Similar to most other sports injuries, a thorough physical examination is the first step. If a labral tear is suspects, typically the best course of action is to start with shoulder X-rays and then progress to either CT or MRI using contrast medium (dye) which helps to identify the tear better.

What should I expect from Andrew Luck this upcoming season?

Andrew Luck is currently being drafted this season as the 4th quarterback this fantasy football season, with the 6th pick in the 5th round, 54th overall. He is being drafted after Aaron Rodgers, Tom Brady and Drew Brees, and before the likes of Matt Ryan, Derek Carr and Cam Newton. I think this is a very good spot for Luck, but I’d prefer to wait a round or two if am able to. I think Luck has the potential to put up monster numbers this upcoming season, especially now that he has a healthy throwing shoulder. Would I personally draft Luck as my team’s starting/primary QB? Yes. Knowing how effective Luck was with a partially torn labrum in his throwing shoulder, and understanding that he can be even better now that is now fixed has me drooling at the mouth. Draft him as a top-5 QB with confidence!

This was written for the @TheFantasyDRS by Dr. Jesse Morse. I am a Family Medicine trained physician, and I am currently completing a Sports Medicine Fellowship at the University of South Florida in Tampa. If you have any questions or comments, you can contact me directly at @DrJesseMorse or visit my website at: www.DrJesseMorse.com. Keep an eye out for my next article!

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