Dr. Cass - Dr. Blue's Unofficial Assistant - Dwight Freeney

Sorry for stealing your gig Dr. Blue, but just like everybody else, I'm wondering what's going on with Dwight Freeney. He is so ridiculously important to this team that an extended absence (like an ACL tear) could and probably would sink this team. So, I decided to take my extra time on Monday before class (my 1st one isn't until 12:30) and do a little research into just what could be wrong with Dwight Freeney based on what we know. A fair warning beforehand: This post won't be as awesome or detailed as the Dr. Blue entries. I'm not that good. Oh, also, I'm not a doctor. I'm pretending to be an unofficial assistant to a fake doctor. How sad is that?

OK, this is what we know about the injury so far from interviews and my own eyes:

1. The injury was to Freeney's right quadriceps muscle.
2. Freeney had his leg bent strangely when going after Kurt Warner.
3. Freeney had no problems walking off of the field, holding interviews after, and appeared to be in little pain or possibly none. Of course, I'm not Freeney so I can't know that for sure.
4. He's going to have an MRI either today or tomorrow.
5. Freeney said he felt/heard something pop.

So, then I did a little research. I found out from this handy site that the fact that the injury is to his quadriceps and that Freeney heard something pop (the most helpful information given out yet), makes this injury initially consistent with a right quadriceps strain. Whether you heard something pop or not is an essential question the doctor asks you when diagnosing a quad strain.

By the way, full disclosure states that I also found out that rupturing your quadriceps tendon also results in hearing a pop (which is a very serious injury), but I am 99% sure Freeney doesn't have it, because a symptom of a quadriceps tendon rupture is the complete inability to bear weight on the leg, and we all saw him walk off the field and take those interviews. No way it was a tendon rupture.

So, you may ask, it's a right quadriceps strain. What's next? The next step is to determine the grade of the strain. Luckily, it looks like we're able to do that with our information available. Thanks to this equally handy site, the parameters for each grade (or severity) of the strain are spelled out for us. It's also a sports injury site, so we don't need to adjust the symptoms and treatment to athletic terms. Let's go through the symptoms for each of them now, starting with a Grade 1 (least severe):

• A twinge in the thigh is usually felt.
• A general feeling of tightness in the thigh.
• Mild discomfort on walking.
• Probably no swelling.
• Trying to straighten the knee against resistance may be uncomfortable.
• An area of local spasm may be felt at the site of the suspected tear.

That doesn't sound too bad of an injury. Now let's look at the symptoms for a Grade 2 quadriceps strain:

• A sudden sharp pain when running, jumping or kicking.
• Unable to play on.
• Pain affects walking.
• The athlete may notice swelling or even mild bruising.
• Pain on feeling the area of the tear.
• Straightening the knee against resistance causes pain
• Unable to fully bend the knee.

OK, I've bolded the 2 most important things for you there. I didn't see anything affecting his walking when he went off of the field, and I'm pretty sure he wouldn't be standing up and taking those interviews if he was in enough pain to affect his walking. By the way, for a Grade 3 strain, you can't walk without crutches, so that's not it for sure. Based on what we've seen, my (very early) diagnosis is a Grade 1 quadriceps strain.

So, what's the treatment/prognosis for this injury? First, Freeney must apply RICE (rest, ice, compression, elevation) for 24 hours. Considering the MRI time, that would probably lead into Wednesday. Then you must use cold therapy and rest for 3 days. That leads into the weekend. If there is no pain then, Freeney can come back to practice (with the doctors' all-clear of course). So, what does this tell us about Freeney's future (considering my diagnosis is correct)?

1. This is nowhere near a long term injury. The popping noise is worrying everybody, but it doesn't always signal the worst case scenario. Freeney walking on his own with no limp off of the field is what we can really focus on.
2. Freeney is out vs. Seattle Sunday. Once the diagnosis comes, Freeney will be resting and staying off of it until the weekend. No way Freeney can come back for the game. Luckily, we shouldn't need him against Seattle. The Colts are on fire right now, and the Seahawks are not a good team.
3. Freeney will most likely not play vs. Tennessee either. With the fact that the Colts have a bye week directly after this game and knowing the Colts' injury tendencies in recent years, I have a strong feeling that Freeney will probably be 80-90% going into this game and Polian will keep him out to prevent any further injury. Then Freeney will be ready to go right after the bye week.
4. There is no evidence that this kind of injury will affect Freeney's play down the road. He should be fine once he's fully healed.

So, to sum up my diagnosis and prognosis:

(Early) Diagnosis: Grade 1 quadriceps strain

Return to the field: 100% by St. Louis game (Game #6)

[Update] Dwight Freeney did in fact turn out to have a mild Grade 1 quadriceps strain as I diagnosed. But instead of taking it a little easy and resting until the St. Louis game, Freeney was ready to go and played on passing downs in the very next game (vs. Seattle). He looked great and was well enough to execute his famous inside spin move on his second play in and record a sack in garbage time. So, my diagnosis was correct, but I was happily way off on the prognosis. Freeney's a tough beast. There's no way around it.