Brady threw for 50 touchdowns that year and the team was on the path to completing a perfect season: 19-0. But those sacks and the pressure put on Brady disrupted his rhythm enough so so that he threw only one touchdown in that game, ending the night at 29 of 46 for 266 yards.

This year it may be different. Brady is a quick passer with two great tight ends that seem always to be open up the middle. Dumping it off to them for quick gains could be enough to make the Giants defense honest and spread the field.

Lots not forget Wes Welker.

Wes Welker is a wide receiver who can play like a tight end–except really fast. That’s what makes him such a versatile threat.

These three players–Welker, Grankowski and Hernandez–make for great quick targets. Throw in the fact that the ageing offensive Matt Light needs help, Brady ended up throwing nearly 3,000 yards on throws under 10 yards.

The Giants, on the other hand, have Justin Tuck and two-year standout Jason Pierre-Paul. Tuck recorded two of those touchdowns from four years ago and Pierre-Paul is a beast to stop. He’s easily one of the best defensive players in the playoffs so far.

And he’s healthy. So is Tuck. But there are some defensive players who are not as healthy. Here’s the injury report the Giants released today.

• David Baas C Abdomen - Limited participation in practice (LP)
• Chase Blackburn LB Calf - LP
• Will Blackmon CB Knee -  Did not participate in practice (DNP)
• Ahmad Bradshaw RB Foot -  LP
• Hakeem Nicks WR Shoulder -  DNP
• Umenyiora, Osi DE Ankle/Knee - LP
• Corey Webster CB Hamstring - DNP
• Jacquian Williams LB Foot - DNP

If the pressure isn’t put on Brady, then the New York Giants secondary has to hold up and cover the Patriots wide receivers if they want to win the game. Then again, if they can’t, Eli Manning needs to be prepared for a shootout. That’s means Nicks and Ahmad need to be healthy. Even if they aren’t fully, Victor Cruz may end up being the MVP.

Dr. Rick Lehman is a distinguished orthopedic surgeon in St. Louis, Missouri and an articular cartilage reconstruction pioneer. He owns U. S. Sports Medicine in Kirkwood, MO, and LehmanHealth. Learn more about Dr. Rick.

So what should you do in the case of an accident like a fall and you have an aching back injury? Here’s some advice.

Wear the Right Snow Boots

Snow boots maybe large and clumsy to wear and track in a lot of mud and snow, but they are superior when it comes to keeping traction as you walk. This is so important for anyone who is out shopping or going to work. You usually have to walk across a parking lot to get where you are going. The danger there is with the black ice–ice patches that are hard to see against the black pavement.

Wearing snow boots will give you better traction for your feet than dress shoes or tennis shoes, preventing you from falling.

Shorten Your Stride

When walking try to take shorter steps. This is especially important for anyone who is tall and typically has a longer stride. Putting too  much distance from your feet can force pressure on your feet at an angle that is like causing it to slide. Instead, take shorter steps and plant your entire foot down at the same time, not your heel first. And never run.

What to Do If You Fall

If you do fall on the ice and feel like you’ve hurt your back, the first thing you should do is try to get up slowly. Get up on all fours, hands and knees, being careful not to slip again as you try to stand. Keep you hand on some kind of stable object, like a rail or a car.

A fall on the ice can lead to a deep muscle strain in your back. Once you get to a safe place, say your desk or couch, try to do some light stretching and take it easy for a few hours. It may be helpful to take some ibuprofen or Tylenol for those who are cleared to take it.

Put Ice on the Injury

When you are resting put some ice on the injury for the next 48 hours, or until the swelling and inflammation goes down. Ice always relieves pain better than heat. Apply a heat pack after a few days if your back doesn’t feel any better. Avoid using electric heating pads since these devices can lead to burns. Instead, use a pad you heat in the microwave. A simple home remedy is to get a sock, fill it with rice and tie it off. That heats up well and holds heat. Never leave a heating pad on overnight.

When You Should See a Doctor

Deep muscle strains from falls usually don’t require you seeing a doctor. However, if you have a risk of osteoporosis or thinning bones, you might want to see a doctor who can pull some x-rays. This includes trouble breathing, sitting or standing or if you have a shooting pain running down your leg that occurs any time you try to straighten out your knee. This may be caused by a herniated disc, which can get better but usually requires some PT, maybe injections or even surgery.

Recovery Time of Back Injuries

You can expect most back injuries to get better by a few days if not a few weeks if there aren’t any nerve irritation or fractures in the bones, as proven by a medical evaluation.  Stretching and strength exercises are critical to getting back to health.

Dr. Rick Lehman is a distinguished orthopedic surgeon in St. Louis, Missouri and an articular cartilage reconstruction pioneer. He owns U. S. Sports Medicine in Kirkwood, MO, and LehmanHealth. Learn more about Dr. Rick.

Then there are the people who have to work in the weather. And if you’ve lived in this area long enough you know how quickly the weather can change.

For instance, I once knew a guy who ran in the Kansas City marathon. The race started early in the morning at 40 degrees. Since you should dress for weather about 20 degrees than the current temprature, meaning at this race runners were dressed for 60 degree weather, most runners were wearing shorts and a sleeveless t-shirt. The guy I knew wasn’t as brave so wore long pants and long sleeved shirt.

Well, halfway through the race the weather changed.

The temperature dropped from 40 to 30…and then it started to rain. That rain turned into slush, sleet and finally huge junks of snow. Under-dressed runners were carted off and rushed to the hospital. At the end of the race an entire tent was devoted to medical assistance as people suffered from frostbite and hypothermia. The guy I knew finished the race and was cold, but didn’t suffer any further harm.

Suffering from Hypothermia

Running, exercising or even working out in cold weather will expose you to hypothermia. What is hypothermia? Your body temperature at the core is 98.6 degrees. Hypothermia occurs when your core body temperature drops and your body responds by shipping blood away from your arms and legs to your core trying to keep that temperature up.

When that starts happening, no matter what you are doing, you will experience a drop in performance. That drop will further complicate the issue if you don’t do something to bring your entire body temperature up.

It’s important to recognize that it doesn’t have to be extremely cold to suffer from hypothermia. Running or working in the rain when it is chilly or excessive sweating in chilly weather can induce hypothermia.

Recognizing Hypothermia

There are typically three phases of hypothermia, which each level getting worse and more serve. You need to recognize the symptoms to avoid severe medical issues.

• Mild hypothermia occurs when the body is at around 95 to 97 degrees and you generally have a cold sensation that include moderate shivering, goose bump and possibly numb hands.
• Moderate hypothermia occurs when the core body temperature drops to around 90 to 95 degrees. At this stage you are stumbling, probably shivering uncontrollably and even speaking with great difficulty.
• Severe hypothermia occurs when your body core temperature plummets below 90 degrees. At this stage you do not have good muscle control or coordination and you will stop shivering. At this stage you will appear confused and if left untreated can die.

It’s best to recognize the early symptoms of hypothermia and cut a workout short to avoid descending into the second and deadly third stage. Live to run or work another day.

The Other Cold Weather Threat: Frostbite

If having to worry about hypothermia was not enough, you also have to worry about frostbite. There are four stages to frostbite:

• Cold response. This looks like a red, severe color on the skin. You’ve probably seen this if you’ve been out in the cold and had to take your gloves off for any reason for a long period of time. The cold response is usually painful, too, and is indication you need to go inside.
• Frostnip begins when a part of your body goes numb and turns white. This stage is reversible. The next two are more than likely not.
• Superficial frostbite is where your skin is completely soft and white without any feeling at all.
• Deep frostbite occurs when you do not end the exposure to your skin to the cold. Your skin at this point becomes firm.

Anyone working or running outside also needs to be aware of the wind chill factor, which can speed up the process off hypothermia or frostbite. What can further cause problems is your own wind chill you can create, whether you are running or cycling. If you are running into a 5 mile per hour wind and running at 6 miles per hour, then you are creating a 11 mile per hour wind chill factor.

Always consider the wind chill factor when dressing for the cold. Remember, a runner’s body is a heat producing machine, so add 20 degrees to the temperature, but always dress appropriately. Keep your skin, fingers and face covered. And I would say run in the cold as long as you are comfortable…it’s really a personal preference. You can always run on a treadmill or just bundle up.

Also make sure someone always knows where you are going and carry a phone with you.

Dr. Rick Lehman is a distinguished orthopedic surgeon in St. Louis, Missouri and an articular cartilage reconstruction pioneer. He owns U. S. Sports Medicine in Kirkwood, MO, and LehmanHealth. Learn more about Dr. Rick.

The short answer is “yes.” If you grew up in St. Louis or any where north of St. Louis, then you probably learned to ice skate at a rink or a frozen lake. You probably fell a lot, hurting your bottom, hands, wrists and knees. And you probably never wore a helmet.

But what you probably don’t realize is that ice skaters tend to hit their heads and faces more frequently than do in-line skaters, yet we are easy to put a helmet on our child to avoid a sports injury like concussion.

Research back five years ago proved that ice skaters tend to hit their heads in a greater proportion of falls (13%) versus in-line skaters (5%) and roller skaters (4%). The researchers behind the study looked at data from 1993 to 2003, what was about 1.2 million injuries suffered while children skated.

Over 80% of the injuries were sustained from falls, with ice skaters sustaining the most concussions (4%). In-line skaters suffered just eight-tenth of a percent of concussions, with roller skaters suffering even less (0.6%).

Typical Sports Injuries When Skating

The main sports injuries that roller skaters and in-line skaters suffered was injuries to their arms, wrists and hands. In-line skating caused the most (48%).

What’s interesting about the research is that the researchers looked at video footage of falls suffered by ice, roller and in-line skaters and found that all typically pitched forward in their falls, but that roller and in-line skaters tend to catch their falls with their hands while ice skaters fall faster and could not catch their falls, thus striking the ice with their faces and heads.

For ice skaters who could catch their falls, the attempt proved unsuccessful since ice is slippery.

No surprise that roller and in-line skaters, then, tend to injure their wrists and hands. No surprise also that they are encouraged to wear wrists guards to protect their wrists, hands and arms. Of course we put a helmet on these children, too.

Naturally it seems wise to then recommend that all children ice skating should wear helmets, but the problem is that the typical helmet may not protect the child’s head adequately since most falls are forward. Your typical helmet is designed to protect a child’s head if he falls backwards.

So, for the best protection a child could wear a hockey helmet with a face guard…but it’s hard to see them giving in to that.

Another option is to have your child wear non-slip wrists guards that keep the hands from slipping out from under your child when they try to catch their fall, but getting that helmet on is essential.

Dr. Rick Lehman is a distinguished orthopedic surgeon in St. Louis, Missouri and an articular cartilage reconstruction pioneer. He owns U. S. Sports Medicine in Kirkwood, MO, and LehmanHealth. Learn more about Dr. Rick.

The Sports Concussion Library was created by a team of doctors and specialists who, concerned about the overwhelming growing threat of concussions in sports and a general lack of how to prevent and treat the injury, created the site to provide both basic information and detailed, peer-reviewed papers on concussions.

There are more than 2,300 journal articles, 61 book chapters, concussion legislation on the federal, state and local levels, documentary videos, thesis research enteries and even a SCAT2 test (this is the tool that medical professionals use to assess whether a player has endured a concussion on the sidelines) which you can download.

The researchers behind the project make up a list of some of the best experts on concussions, like Dr. Robert Cantu, Dr. Michael J. Stuart and Dr. Charles Tator.  Ontario doctor and concussion researcher, as well as a team doctor for junior hockey teams, Paul S. Echlin, an leads the project.

You can search through the documents by sports–baseball, football, hockey, soccer and other contact sports. You can watch some of the most recent information on the topic, like a concussion primer for children and parents, a PBS documentary on high school football or the New York Times piece on the life and death of Derek Boogaard.

Athletes can search a list of topics relevant to their side of the sport and injury, including the concussion assessment tool and general information an athlete should know. On the site you’ll also find modules that will allow you to work your way through a few concussion related scenarios, asking you for the right decision. And there is a right or wrong decision. The point behind the modules is to provide an interactive learning tool to bring more awareness to the injury.

Everybody agrees there needs to be more awareness, especially since the death of three young hockey players from deaths that are thought to be related to concussions sustained in the sport of hockey, namely as enforcers.

Derek Boogaard is the most high-profile, a feared enforcer from a small town in Canada who worked his butt off to get into the NHL, but died this past May. He was 28, and the original cause of death was a combination of oxycotin and alcohol. His parents donated his brain to an organization that discovered he suffered from a degenerative brain disease, possibly caused by the concussions.

The other two recent deaths were Rick Rypien and Wade Belak. Rypien was in his late 20s and committed suicide. Belak was 35 and while it was originally treated as a suicide most believe it was accidental.

But concussions aren’t a problem for professional athletes only. In a recent University of Calgary study that looked  at over 9,000 11 to 12 year old hockey players, the researchers found that 700 had sustained concussions. During a study of his own in which he evaluated two junior league hockey teams over a season, Dr. Echlin discovered that the rate of concussion has risen seven times.

On a more personal note, as reported in Jeff Klein’s New York Times piece, Echlin said that he had a young player walk into his office one day and say he never wanted to play hockey again. He had already suffered two concussions. And he was only eleven years old.

Dr. Rick Lehman is a distinguished orthopedic surgeon in St. Louis, Missouri and an articular cartilage reconstruction pioneer. He owns U. S. Sports Medicine in Kirkwood, MO, and LehmanHealth. Learn more about Dr. Rick.

The injury and the surgery that he underwent today and the rehabilitation that must follow, however, does put his 2012 season in doubt. The typical time for recovery from a ACL surgery, if successful, is anywhere from 8-11 months.

Some players have been able to shorten that recovery time, but regardless, with the 2012 season starting in August, even if Peterson were able to recover fully getting back up to professional playing speed is doubtful given the time frame. It is possible to return to top performance shape after ACL surgery with the right conditions, both those vary.  This is one of the reasons head coach and team doctors for Peterson are non-committal about his true return.

It’s just so hard to tell.

For instance, the full extend of Peterson’s injury wasn’t discovered until days after the injury. While it was understood that he did damage the ACL, he also tore the medial and lateral meniscus and further medial collateral ligament (MCL) damage, too, which complicates the ACL treatment and recovery. The team tentatively hopes for a 2012 return.

Peterson was originally scheduled to undergo surgery next Tuesday, but due to the excrutiating pain he was undergoing they moved up the surgery to today. No doubt the torn menisci contributed to the pain.

According to Viking’s head coach Leslie Frazier, the surgery was successful, which raises the question: what is a successful ACL reconstruction surgery?

By reminder, ACL reconstruction surgery involves the creation of a new ligament which is then attached to your knee. We can assume that this is what happened with Peterson. He has a knew ligament, the other injuries will be allowed to heal on their own, depending on their severity. Whether the menisci was operated on is not known.

How long it takes to heal depends on a few factors, like protecting the knee and allowing it plenty of time to rest. Those are factors that you have control over. What you don’t have control over is your own body and how it responds to the surgery.

So the going time is 8-11 months for such an injury.

In my professional opinion, though Peterson is critical for the success of the Vikings, it would benefit the team and Peterson in the long run to keep him out for as long as possible. Rushing the healing of an injury, as see with trying to install Sam Bradford too soon into the line up, can only agravate the injury and lead to long-term chronic pain.

As noted before, most second knee surgeries fail. I do believe this is Petersons’ first.

Dr. Rick Lehman is a distinguished orthopedic surgeon in St. Louis, Missouri and an articular cartilage reconstruction pioneer. He owns U. S. Sports Medicine in Kirkwood, MO, and LehmanHealth. Learn more about Dr. Rick.

Please share and enjoy the playoffs!

Torn Knee Cartilage [Meniscus]: Common Football Injuries

Tearing the cartilage that stabilizes your knee–it’s called the meniscus–can be a minor, medium or major injury. Here’s how to protect that little rubbery band on your knee.

Football Injuries: Lacerations

Lacerations–think cuts–happen pretty frequently on the grid iron. Most injuries are minor and can be ignored. Others are more severe and need attention immediately. Here’s what you need to know.

Common Football Injuries: Burners (Neck Injury)

What’s the fastest way to open up the eyes of a 6’5″ 320 pound lineman? Give him a burner. Read more.

A Short Guide to Dislocated Shoulders

Dislocated shoulders are pretty common when it comes to playing football. Constant rotation and exposure to hits from being tackled or tackling make it a common injury. So how do you prevent shoulder dislocations and treat them? Here’s how.

Are Bruises Really That Simple to Treat? Football Injuries

Bruises are easily the most common injury suffered in football. What with the constant physical contact from helmets, knees, shoulders and sometimes shoes, every football player is bound to walk off the field with at least one bruise. So how do you treat and even prevent them. Read on.

Football Injuries: Concussions

Concussions are getting a lot of attention in football recently, one because we are starting to learn the long term impact that concussions have on players. But it’ also getting a lot of press because of how much we don’t understand–or misunderstand–about the injury. Here’s what you need to know.

Football Injuries: Neck Sprains

When it comes to sports injuries and football, neck sprains are pretty common. But football players can get them in some of the most unusual ways. Take Gus Ferrotte, for example.

Injury Prone Football Players: Danario Alexander

You can’t avoid injuries in football, especially at the professional level. Some players bounce right back never to get injured again. Others aren’t so lucky, like wide receiver on the Rams team, Danario Alexander.

High Ankle Sprains and Sam Bradford

About mid season, Rams quarterback Sam Bradford suffered a high ankle sprain. What is a high ankle ankle sprain? It’s a sprain of the syndesmotic ligament, the ligmament that connects the tibia with the fibula of the lower leg. Let me explain.

Dr. Rick Lehman is a distinguished orthopedic surgeon in St. Louis, Missouri and an articular cartilage reconstruction pioneer He owns U. S. Sports Medicine in Kirkwood, MO, and LehmanHealth. Learn more about Dr. Rick.

Meniscus Tear: What Is It?

The meniscus is a cartilage in your knee, and it being torn is a common injury. The meniscus is a disk that’s shaped like a crescent. It’s also rubber-like. The purpose of this cartilage is to cushion your knee. In each knee you  have two menisci. One is at the outer edge of the knee and the other one is at the inner edge.

By balancing your weight across the knee, these menisci keep your knee stable, which means a torn meniscus will make your knee unstable.

How Do You Know You’ve Torn Your Meniscus?

You can break these tears down into three categories.

• Minor tears will give you swelling and a slight pain that disappears after a few weeks.
• You will know that you have a medium tear if you feel pain at the center or side of your knee. The swelling should also get worse over the next 3 days after the injury. In fact, your knee may feel stiff and you may not be able to bend your knee, but you can still walk. Other symptoms include a pain when you twist your knee or squat. You might experience these symptoms for few weeks, but if not treated can last for years. Of course your susceptibility to re-injuring it is high if you don’t get it treated.
• A severe year occurs when you actually tear a part of the meniscus and then it falls into the spaces between the joints. If you have a severe tear, your knee will pop, lock or catch. You probably won’t be able to straighten it and your knee may wobble, or feel like it does. It may also give out without warning. Swelling is also another reaction that can occur, as well as the joint becoming stiff.

For older people, this injury may occur without you knowing why since your meniscus is likely to have been worn.

How Do You Treat a Torn Meniscus?

There are a couple ways to go about taking care of the torn cartilage. It depends on the severity of the tear–minor, medium or severe–your age and how much you do physically.

Some treatments are basic, some more complex and involve surgery, including:

Because small tears to the outer edges of the cartilage will often heal with a little rest, for minor torn meniscus, this is how you treat it:

• Apply ice
• Wrap the knee
• Prop up the leg

For a medium tear, you might do all the above and also see a physical therapist. But you also might see a physical therapist with a minor injury, too.

For a severe tear, however, you may be looking at surgery. It’s a better option for tears that are larger and at the outer edges. But for tears near the center may not be the best approach. Also, young people might react better to surgery and get more benefit out of it than older people.

Recovery time from surgery all depends on what type of surgery you have, but your plan will more than likely include special exercises, plenty of rest and walking to strengthen the knee. Naturally consult with your doctor.

Dr. Rick Lehman is a distinguished orthopedic surgeon in St. Louis, Missouri and an articular cartilage reconstruction pioneer He owns U. S. Sports Medicine in Kirkwood, MO, and LehmanHealth. Learn more about Dr. Rick.

Under Armor received a total of six reports of injuries which involved a recall of 541,000 of  the $20 straps.

Lacerations are not uncommon in football, including equipment, but in this case, this is unusual. What other ways could a player get a laceration when playing football?

• A players fingernails could tear the skin of another player during a tackle or when both were going after the football.
• Being hit by the face guard of a helmet with such a blunt force that the skin is torn.
• Stepped on by the cleat of another player while arm, leg or hands or some other part of the body is on the ground.
• Obstacle in the ground that players skin runs across, causing a tear in the skin.
• Injury to the chin from the helmet of another player coming into contact with the said player’s chin.
• Strings on the football, if drawn across the skin of the player harshly and quickly, can also cause injury to a player’s skin, tearing it open.

Most football players can play through a laceration. What kind of treatment they should get depends on the severity of the wound. If it’s just a small cut, take the following steps:

• Stop the bleeding by applying force directly to the cut area.
• Clean the wound with warm water and soap.
• Protect the wound by applying an antibiotic ointment. This will reduce the chance of infection and then apply a clean bandage over the cut.

If the cut is deep and won’t stop bleeding or is over a joint, or can’t get the cut clean, then you should probably see a doctor. You should also visit a doctor if the person has had not a tetanus shot in the last 5 or 10 years or if the cut is from a human bite, which watching the antics of a Albert Haynesworth or Ndamukong Su, you’ll know it’s possible.

Follow Up

To promote better healing, take off the bandage after a few days. If you see signs of infection like swelling or pus and redness and excessive pain, go see a doctor.

Dr. Rick Lehman is a distinguished orthopedic surgeon in St. Louis, Missouri and an articular cartilage reconstruction pioneer He owns U. S. Sports Medicine in Kirkwood, MO, and LehmanHealth. Learn more about Dr. Rick.

The cause of the injury occurs in the nerves that give feeling to the arms and hands. This nerve starts in the neck, branches into the brachial plexus, weaving together as they pass under the collar bone and then head down to the shoulder.

How You Get a Burner

The football player will injure this nerve usually by striking another player with his shoulder. That direct blow to the top of the shoulder will drive it down and cause the neck to bend away from the shoulder, stretching the nerves. That stretch, which can even compress the nerves sometimes, will send a viscious bolt of electricity down to the tips of your fingers.

Unfortunately this electrical discharge will cause the motor fibers of the nerve to limit the function of the arm, namely showing up as a weakness in the arm. The athlete will notice it when he tries to lift the arm away from the body or bend it at the elbow or when he grips something. You’ll probably also feel intense tingling sensations in the arm and hand, maybe even a stinging pain. How bad the injury is can vary. The pain may only last for a few minutes, but the weakness could linger longer, up to years. The injury hardly ever causes permanent damage.

The player will usually run to the sidelines after the injury, his arm limp by his side. A team doctor or medical professional will examine the athlete, his cervical spine, looking at the nerve function in the neck and upper back. He’ll test muscle strength and reflexes.

A burner will causes these symptoms in only one arm, so you know that it’s probably not something else. But you can have other injuries, like a fracture or dislocation with a burner. You can even damage the ligaments of the cervical spine. That’s why the team doctor will examine the spine closely, protecting it from further injury.

If the injury is more than the burner, then symptoms will radiate to the other arm and possibly to the legs.

Are Certain Athletes Prone to Burners?

Indeed, because of the narrow space in their necks through which the spinal cord travels, some atheletes may suffer more burners.

You can return back to the game only when the team doctor clears you. He does this by seeing the sensitivity of feeling and strength in the athletes arms and hands, and testing the neck motion. He’s also looking for reflexes to return to normal.

The type of protective gear you’ll see athletes wearing to protect their neck and shoulders from this type of injury are called neck roll, lifter and Cowboy collar. Sometimes an athlete will wear additional shoulder pads, but avoid attaching restraining straps to the helmet. These can lead to more severe injuries. If you do suffer a burner during a game, make sure you have your team doctor examine you throughout.

Post injury symptoms tend to be a stiff neck.

Preventing Burners

Tackling properly is the key to preventing a burner. Never spear or lead with your head. When it comes to your equipment, make sure you are using shoulder pads and a neck roll that are in decent shape. Finally, get involved in an exercise program that helps you develop your range of motion fully, strengthening the shoulder and neck muscles, too.