00:00This is the Injury Report, presented by NYU Langone Health.
00:05J.J. McCarthy is ready to get back on the field, but is his hip ready for another round of
00:10NFL hits?
00:10The Giants quarterback suffered a hip point in Sunday's game against the Eagles,
00:14and now he's turning around just four days later to face Washington on Thursday night.
00:18So, how much can that hip heal in such a short time, and what are the risks of playing through
00:23the injury?
00:23To break it all down, we're joined by Dr. Daniel Kaplan, a sports orthopedic surgeon with NYU Langone Health,
00:28for this edition of the Injury Report. Dr. Kaplan, how are you doing?
00:33I'm great. Thanks for having me on.
00:35Oh, always good to talk to you, sir. Dr. Kaplan, let's start with the injury itself.
00:39J.J. McCarthy suffered what's called a hip pointer after taking a hard hit against the Eagles.
00:44What exactly is a hip pointer, and what happens inside the body when it occurs,
00:48and how serious can this type of injury be?
00:51Yeah, a hip pointer is confusing because it's a crazy name. Like, what does that even mean?
00:55So, a hip pointer is, it's basically a bruise of the front of what's called your pelvis or your iliac
01:02wing.
01:02So, usually that's when people take a shot from a helmet or something like that, or a knee pad right
01:06in that area.
01:07So, you can kind of think of it, for all intents and purposes, as like the worst bruise of your
01:11life.
01:11What it really is, is around our bones, bones are covered by something called periosteum.
01:16It just means some of the soft tissue around it.
01:18And even if the bone doesn't break, the tissue around it can be injured and bleed and cause pain.
01:24So, that's really at its heart what a hip pointer is, contusion or hit to some of that soft tissue
01:29around the bone.
01:31Okay. So, now we understand what it is.
01:33I want to talk about the position that J.J. McCarthy plays, which is quarterback.
01:36So, for a quarterback, so much of throwing the football depends on hip rotation, balance,
01:41and then transferring power from the lower body.
01:43So, how can a hip pointer affect those mechanics, and could McCarthy experience limitations with his arm strength or accuracy,
01:50even if he feels well enough to play?
01:52Totally. I mean, the short answer is yes, for all those reasons you outlined.
01:56Throwing is a very complicated motion.
01:58It's not just the arm. It's not just the hand.
02:00It's, like you said, a chain starting from the feet, generating power through torque and rotation at the hips,
02:06and then advancing that power, transferring it to the arm to advance the ball.
02:09So, if anywhere along that chain is disrupted, such as in the hip pointer, it can negatively affect you.
02:16Now, this is a pain thing, not necessarily purely a weakness.
02:20It's not like he has a tear.
02:21So, I do think it's something he'd be able to play through.
02:24I'd be optimistic about it.
02:25But he would feel it on a deep throw, especially.
02:28Okay. So, he could feel it on a deep throw.
02:30Here's the other thing I have to ask you, because he's also a quarterback who uses his legs to extend
02:35plays.
02:36So, with this type of injury, how much more difficult can it be to scramble, change direction, or absorb contact
02:41from a defender?
02:42And of those three that I just mentioned, those movements, which would concern you the most?
02:48So, it will be running straight ahead will probably be the easiest.
02:52And quick lateral movements would probably be the hardest.
02:56Obviously, getting another shot to the side of the hip would be extremely painful.
03:01It wouldn't necessarily put him at much worse of a position.
03:03It might just hurt and set him back a little bit.
03:06So, he would be able to do those things.
03:08But, as you know, for these high-level elite athletes, if you're in pain and maybe you're just a half
03:15second or an eighth of a second slower,
03:17that's the difference between a first down and a loss for a sack.
03:20So, it is something to be aware of and something he'll have to play through.
03:24I think he will be able to play through it, but he'll feel it again.
03:26Okay.
03:27Feel that he'll be able to play through it.
03:28And this brings us to the next thing, because one of the biggest factors here is turnaround.
03:33McCarthy suffered this injury on Sunday and is preparing to play just four days later against Washington.
03:38How much does that shortened recovery window matter with the hip pointer?
03:42And what's happening, as you mentioned, inside the inside injured area during those first couple of days as the players
03:48trying to recover?
03:49Yeah.
03:50So, I mean, the normal timeline, like if you were to look up online, it's probably like one to three
03:55weeks, probably closer to the one-week side,
03:58but typically longer than four days.
04:00You know, he's got a short week.
04:02We're unlucky with that, with the Thursday night game.
04:04Again, it is doable because the injury is safe.
04:07It's really a player comfort and pain thing.
04:09So, it's not that he won't be able to physically do some of those things, but he has less time
04:14for that inflammation and blood to go down.
04:17He will be in more pain than if he was able to give it a few more days to cool
04:21off.
04:21So, what the body is doing is it's helping dissipate or reduce the amount of inflammation and some of even
04:26that blood in that area.
04:27That way, he can get back to feeling the way he would.
04:30A few more days would be, let's say, advantageous.
04:33But if he feels up to it and he has a great medical staff that feel like he's up to
04:37it, then I'm sure he is.
04:39All right.
04:39So, that brings us to the medical staff because he enters Thursday without injury designation.
04:43From a medical standpoint, what specific tests or physical benchmarks would doctors look for before clearing him to play?
04:51And is there an important difference between being cleared to play and then being fully healed?
04:56Yeah.
04:57So, in terms of benchmarks that he'd have to pick clear to play, there's always the same progression.
05:02So, first is, do you have full range of motion, painless?
05:06Then, can you do things like run, sprint, painless and full strength?
05:12And then, number three is, can you do position-specific moves with pain-free?
05:18So, can he rotate and throw?
05:21Can he move side to side, you know, in a scrimmage, non-contact setting?
05:25And if he clears all those benchmarks, you can then start clearing him to play.
05:30But like you said, there is a difference between being allowed to play and being at 100%.
05:34And I would be surprised if he's at 100% four days after this injury.
05:38But like all things, nothing's black and white.
05:41There's grades.
05:41There's severity.
05:42Not all hip pointers are created the same.
05:44So, if he had maybe a lesser, severe one, it's a lot more reasonable for him to come back on
05:49the earlier side versus one that's, you know, if the hit was a little bit harder, it'd almost have been
05:54a broken bone.
05:55That one probably takes a few more weeks to come back from.
05:58Right.
05:58All makes sense.
05:59It's all relative to the pain experience and the player.
06:01So, with such limited times, Dr. Kaplan, between the games here this week, what can a team's medical staff realistically
06:08do to manage the pain and inflammation that you talked about from a hip pointer?
06:12And when it comes to extra padding or pain management treatments, how effective are those options at protecting a player
06:19from further injury?
06:20So, padding can help you just at least to mitigate further injury.
06:24That's not going to help with anything with the pain he's currently feeling, but it can help for the future.
06:29Everything's going to be targeted at inflammation.
06:31So, that's going to be like cold plunges.
06:33That's going to be icing in between plays.
06:36That's going to be anti-inflammatory medications.
06:38Think of like the Advil type of family of medications.
06:40And then the last thing would be the family of injections.
06:43So, there's numbing medication.
06:45So, that's like lidocaine.
06:46That's purely to help with pain.
06:48And then there's cortisone injections, which are strong anti-inflammatories.
06:52Both are reasonable to consider in this.
06:54And I'm sure he's having that conversation, pros and cons, things like that with his medical staff.
06:59But those would be like the suite of options that a medical staff could have in a limited time frame.
07:04Gotcha there.
07:05Last thing for me here, Dr. Kaplan, let's talk about the bigger picture.
07:08If McCarthy, let's say, takes another hard hit to that same hip before it's completely healed, what are the risks
07:15of making the injury worse?
07:17And could playing through a hip pointer lead to longer term complications?
07:20Or is this just generally an injury that heals without lasting effects?
07:25It should heal.
07:27It's not like he's at risk for then it going from a bruise to like a broken bone.
07:32That would be very, very, very, very unlikely.
07:34I think his biggest risk is if you go back too early and you take a big hit, think about
07:38like if you have a bad bruise on your arm.
07:40Like that bruise should heal.
07:41But if someone keeps hitting you in that arm, that bruise is not going to get better.
07:45I think it's more like that.
07:46So he feels like he can play now after four days.
07:48But if he takes another huge hit, I suppose it's possible then instead of being out for just a week,
07:53total of a week, now he's out for like two weeks, you know, or plus.
07:56So I think the biggest risk would be a prolonging time of not being game ready.
08:02There you go.
08:03Giants fans hoping that he is game ready on Thursday night against the Washington Commanders.
08:08That is Dr. Daniel Kaplan doing a fantastic job with NYU Langone.
08:12Dr., thank you for joining me and breaking it all down in this edition of Injury Report.
08:15We appreciate you.
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