NFL Injuries

Will Cam Newton (shoulder) return to MVP form?-Dr. Morse

Photographer: Cliff Welch/Icon Sportswire

Cam Newton, the 2015 NFL MVP, suffered a partially torn right rotator cuff during the Panthers’ Week 14 win against San Diego during the 2016 season. Newton struggled with his accuracy and passing yards this past year, as compared to the year before. Decreasing from 7.7 yards per attempt to 6.9 yards per attempt, partially secondary to repetitive wear and tear on his shoulder, resulting in only 19 TD passes along with 14 interceptions (chipping in 5 rushing TDs as well). Compared this to his 2015 MVP season – where he passed for 35 TDs with only 10 interceptions, also running for another 10 TDs. The increase in interceptions from 10 to 14 was nominal but the decrease in touchdowns from 35 to 19 is significant, and could likely be due to his shoulder injury.

The Shoulder – A Complicated Joint

Cam was diagnosed with a right rotator cuff tear; so let’s briefly talk about the rotator cuff. There are four muscles that make up the rotator cuff (supraspinatus, infraspinatus, subscapularis and the teres minor). Let me get a little medically technical here and describe exactly how the rotator cuff muscles work within the shoulder joint. The rotator cuff is actually a group of (the aforementioned) four muscles whose goal is abduct (move away from the body) the humerus (supraspinatus), externally (infraspinatus and teres minor) and internally (subscapularis) rotate the arm. Collectively the rotator cuff muscles are vital in moving the shoulder and maintain glenohumeral joint (shoulder joint) stability. The supraspinatus is the most commonly injured muscle of the four rotator cuff muscles. These muscles originate from a bone in your back called the scapula, and connect to the head of the upper arm bone (humerus). The easiest way to think of the shoulder joint is to think of a golf ball sitting on a golf tee. Where the golf ball is the head of the humerus, and the golf tee if the shoulder joint.

Now imagine if the shoulder joint, or the golf tee in our comparison, were weakened or damaged in some way – that is what Cam Newton is dealing with. Since Cam throws the ball with his right arm, any shoulder injuries like a rotator cuff tear could possibly cause pain, instability, loss of strength, and even loss of certain movements depending on which part of the shoulder joint is damaged. In the case of a rotator cuff injury, this not only causes pain and weakness, but also loss of the ability to raise the arm away from (and sometimes above the head) the person’s body. In terms of a quarterback, this can cause them to have decreased velocity, command of their passes and ‘tightness’ of the ball’s spirals. Quarterbacks with rotator cuff strains or tears find it very challenging to both place the ball in certain locations as well as to get the correct amount of velocity on the ball to get it to the receiver in an appropriate time.

Shoulder injuries and they throwing athlete present a unique challenge because the act of throwing itself actually brings the shoulder to an extreme in terms of stress and motion. As the athlete continues to progress through high school, college and (if they are good enough to eventually make) the pros, their shoulder has taken a lot of wear and tear over the years due to repetitive throwing. The drive to succeed for many of these throwing athletes leads them to push through times of fatigue – the time when your body is normally saying ‘stop and rest’ but instead athletes usually push through injury. This in turn that leads to further injuries because of the lack of time to properly allow the body to heal. The dominant shoulder is subject to extreme positions and significant amount of stress during a routine delivery of either a pitch or an overhead throw of a football. Transferring the amount of force required from the legs to the core and then to the arm requires a significant combination of muscles and joints. These muscles and joints need to work in conjunction with the perfect timing in order to accurately achieve pass velocity and accuracy for the athlete.

How do shoulder injuries occur?

Shoulder injuries often occur due to overuse, muscle fatigue and poor mechanics this can change the athletes actual throwing motion. These changes and throwing motion along with the aforementioned issues can lead to a variety of different injuries. Some of these include capsular tightness, internal impingement, superior labrum anterior to posterior (SLAP) tears, articular-sided partial rotator cuff tears and even full thickness ruptures of the tendon. Based on reports, Cam Newton suffered an articular-sided partial rotator cuff tear.

How are shoulder injuries diagnosed?

The initial diagnosis of a shoulder injury is physical examination by a medical professional, preferably either in physical therapist or sports medicine trained physician, who can help to assess which of the muscles, tendons or bones are injured by having the patient/athlete move the arm in various directions. If certain movements cause pain or are unable to be performed, then the muscle corresponding to the movement is often involved. The best way to identify if a muscle is injured is to get an MRI of the shoulder.

If the MRI and physical exam showed that there are indeed some structural integrity issues then the most common initial approach is non-operative treatment encompassing of rest, steroid injections and a disciplined rehabilitation program to improve the scapular kinetics and normalize the glenohumeral/shoulder range of motion. Non-operative management remains the mainstay from most throwers, but in cases where this non-surgical conservative approach fails to relieve the athlete of their pain or their performance continues to suffer, then surgical intervention with arthroscopic debridement as an effective alternative surgical option for those with refractory symptoms. Cam Newton falls into this latter category; as he required off-season arthroscopic shoulder surgery performed by Dr. Pat Connor at the Carolina Medical Center in late March 2017. My suspicious is that Newton only had a minor procedure, where they just had to take down and repair the rotator cuff.

After performing the surgery, Dr. Connor was pleased with the results. Netwon was not allowed to throw (at all) for at least 12 weeks, and not allowed to throw with the team for 16 weeks. We are currently about 13 weeks out from his surgery date based on reports, which would give Newton 3 more weeks in July to ramp up to get ready to start throwing. The Carolina Panthers training camp starts on July 26 at Wofford College in Spartanburg, South Carolina. I anticipate that Cam will be ready and able to start this day, but he will have to slowly ramp up in order to be able to participate in the first or second preseason games, which are scheduled during the first and second week of August.

After sustaining this injury and undergoing the repair, what type of expectation should you have for Cam Newton in fantasy football this year?

Newton is currently going as the number seven quarterback, being picked in the seventh round in between Derek Carr and Russell Wilson, and ahead of the likes of Ben Roethlisberger and Kirk Cousins (based on their current ADPs). I think this is a very good spot for Newton, as he has the potential to be a top five quarterback this year because has a safer floor then Wilson, Roethlisberger, and Cousins.

I believe Cam Newton has the potential to pass for about 3700 yards, about 24 TDs with 13 interceptions, and rush for another 500 yards with five rushing TDs. I personally would draft him ahead of the names of Dak Prescott, Stafford, Winston, Carr, Roethlisberger and Tyrod Taylor.

Expect Newton to utilize his new two rookies Christian McCaffrey and Curtis Samuel, as Newton tries to change the way he plays, focusing on getting out of the ball out of his hands faster. This will likely utilize quicker passes similar to what the Brady and the Patriots do. In an effort to decrease wear and tear on his body, he’s attempting to stay away from sweets, with a goal of dropping down to the his lowest off-season weight yet. Look for Cam Newton to bounce back strong in the 2017 NFL season.

I have confidence in the repair and clean out that was completed by Dr. Connor and think that Newton have a strong season but keep an eye on him early in training camp to make sure that his shoulder and rotator cuff are responding appropriately. Now that you’ve read this article you have a competitive advantage upon others in your league that did not – but please don’t be afraid to share! Consider Newton a low-risk, high-floor, safe quarterback in the QB 5-10 range.

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: Keep an eye out for my next article!

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