Witten Spleen Injury (1 Viewer)

[netnalp]

Cowboys are quickly becoming one of my "do not draft" teams. Just bad vibes resonating.

Yeah I would stay far away. The O-Line is just horrific.

That wasn't the starting unit was it?

unfortunately for the cowboys it was....

:X Ooof. That's rough. I thought they had 2-3 starters out on the line. Reminded me of the line play in that Bears game where they had two QBs knocked out of the game.

 

[FGITLOTR]

Bump Dez

 

[FantasyTrader]

Cowboys are quickly becoming one of my "do not draft" teams. Just bad vibes resonating.

Yeah I would stay far away. The O-Line is just horrific.

That wasn't the starting unit was it?

unfortunately for the cowboys it was....

:X Ooof. That's rough. I thought they had 2-3 starters out on the line.

They did. The announcers noted midway through the first quarter that the guy playing center was the Cowboys' FOURTH stringer due to injuries along the O-line. Perhaps some Cowboys homers can chime in but if the injuries along the O-line are minor in nature Witten could be solid value. As a Witten owner I'm actually more encouraged that it's his spleen than I would be if it was a hamstring, groin, sprained ligament, etc. At least with an internal organ when it's healed, it's healed.

 

[Multiple Scores]

Otis had apparently put him on his Hawk-Screech All Star team to be released later today.Par for the course.get well soon.

Bath Salts

 

[sspunisher]

NFL Network made a good point. If he misses Week 1, it'd give him 11 extra days rest since they play on a Wednesday. Under normal circumstances I think this would be the route to go, but Witten will probably resist this since it's the Giants.

 

[Donnybrook]

Bump Dez

If the O-line is as bad as advertised, bump the IDPs.

 

[Manster]

Witten/Romo/Murray should've never seen the field on Monday. That patchwork O-line was a joke against a first team NFL defense.

Romo should've thrown the ball away on the play that Witten got hurt. Granted, Romo was under heavy duress, he set Witten up to take that vicious hit. Again, the porous O-line is ultimately to blame. Romo could've easily been hurt. 3 series behind that dog crap line!!!

As for Witten, I bet he's back for week 1. Looks like he wont need surgery, and he's tough as nails.

I don't know. It's not the type of injury that you just have to get to where you can play with it. Can't just tape it up. He has to wait till it's completely healed or he risks making it much worse. The hit he took didn't seem very hard at all. He could take several hits like that in a regular game. Especially if opponents make a point of giving him a shot in the mid section any chance they get.It'll probably be up to the doctors when he can play, not the player.

Actually, if you see it in a couple different angles, it was a hard shot. What made it worse was his ribs/midsection was left unprotected while making the reception. When I first saw the play, I thought his ribs might have taken a good shot. Thats why I was wishing Romo would have thrown the ball away. Instead he kinda left Witten hangin to take a big shot.The main reason I'm thinking he may be able to play week 1 is, I've seen "slight laceration" mentioned, and surgery has been ruled out as of now. I'm no doctor, but I know the spleen is very vascular, which is why a laceration to the spleen can be serious. Seems to me if it's not a very bad laceration it should heal in a couple weeks and he's good to go??????

 

[Manster]

Cowboys are quickly becoming one of my "do not draft" teams. Just bad vibes resonating.

Yeah I would stay far away. The O-Line is just horrific.

That wasn't the starting unit was it?

unfortunately for the cowboys it was....

:X Ooof. That's rough. I thought they had 2-3 starters out on the line.

They did. The announcers noted midway through the first quarter that the guy playing center was the Cowboys' FOURTH stringer due to injuries along the O-line. Perhaps some Cowboys homers can chime in but if the injuries along the O-line are minor in nature Witten could be solid value. As a Witten owner I'm actually more encouraged that it's his spleen than I would be if it was a hamstring, groin, sprained ligament, etc. At least with an internal organ when it's healed, it's healed.

As far as I know the week 1 starters should be Free RT, Smith LT, Costa C, and Bernadeau/Livings at G's. Bernadeau just came back from hip surgery. Livings was out. Costa was out. Thats why I was saying Romo/Witten/Murray shouldnt have seen the field behind that crapshack line. SO, the line should be better than that moving on. But, i'm thinkin they still aint settin the world on fire.

 

[Ace08]

Not a doctor, but I lacerated my spleen in college and I can honestly say I'd be shocked if he plays week 1. If they are opting to avoid surgery (my case was the same) they are hoping a "callus" forms internally around the laceration which will protect the spleen going forward.

This entire ordeal is extremely painful. It hurts to laugh, coughing is a killer....imagine getting hit by a 240 lb outside linebacker who runs a 4.55 forty. I'm not doubting he can gut it through the pain and play....I'm doubting the spleen will be able to sustain NFL impact and continue the healing process.

It's a very iffy injury especially when you choose to avoid surgery. All you can do is rest and give it time.

 

[growlers]

FBG Second Opinion post re: Witten

There is no standard timetable for a return from a splenic injury. Depends on grade of initial injury, how quickly blood resorbs and tissue heals and whether there are any complications in the next 14 days. 4-6 weeks isn't impossible, with six weeks being more likely. Also not out of the realm of possibility that he could be held out for 6+ weeks and through the Cowboys' Week 5 bye.

Jene,Er doc here. I would think he would be out longer if they treat this nonoperatively as then you have to worry about increased risk of reinjury because of increased intrasplenic capsular pressure from the hematoma. An analogy would be the risk of splenic rupture after mononucleosis.

If they take it out, the risk is solely postoperative and easier to gauge IMO.

What are your thoughts on this?

Note to be clear to everyone else I'm obviously not advocating taking out his spleen to get him on the field faster. There are major long term ramifications to splenectomy outside of football issues like increased risk of infection.

 

[Mr. Soup Nazi]

FBG Second Opinion post re: Witten

There is no standard timetable for a return from a splenic injury. Depends on grade of initial injury, how quickly blood resorbs and tissue heals and whether there are any complications in the next 14 days. 4-6 weeks isn't impossible, with six weeks being more likely. Also not out of the realm of possibility that he could be held out for 6+ weeks and through the Cowboys' Week 5 bye.

Jene,Er doc here. I would think he would be out longer if they treat this nonoperatively as then you have to worry about increased risk of reinjury because of increased intrasplenic capsular pressure from the hematoma. An analogy would be the risk of splenic rupture after mononucleosis.

If they take it out, the risk is solely postoperative and easier to gauge IMO.

What are your thoughts on this?

Note to be clear to everyone else I'm obviously not advocating taking out his spleen to get him on the field faster. There are major long term ramifications to splenectomy outside of football issues like increased risk of infection.

Growlers,I'm not a doctor, nor do I play one on TV, but I'm pretty sure the Cowboys have this one under control.

Okthanxby

 

[Jene Bramel]

FBG Second Opinion post re: Witten

There is no standard timetable for a return from a splenic injury. Depends on grade of initial injury, how quickly blood resorbs and tissue heals and whether there are any complications in the next 14 days. 4-6 weeks isn't impossible, with six weeks being more likely. Also not out of the realm of possibility that he could be held out for 6+ weeks and through the Cowboys' Week 5 bye.

Jene,Er doc here. I would think he would be out longer if they treat this nonoperatively as then you have to worry about increased risk of reinjury because of increased intrasplenic capsular pressure from the hematoma. An analogy would be the risk of splenic rupture after mononucleosis.

If they take it out, the risk is solely postoperative and easier to gauge IMO.

What are your thoughts on this?

Note to be clear to everyone else I'm obviously not advocating taking out his spleen to get him on the field faster. There are major long term ramifications to splenectomy outside of football issues like increased risk of infection.

The surgeons I've spoken with and a couple of recent studies suggest healing is possible within 4-6 weeks for Grade I or II lacerations. I understood that to mean complete healing of the capsule and resolution of hematoma on imaging. But I share your concerns that may be an optimistic return to play estimate. I think six weeks may be the minimum even if things progress without complication, and there's definitely reason to think it may be 8+. That week 5 bye strikes me as a target for sure.I also asked the question whether an elective lap splenectomy might be considered as a way to get him on the field more quickly -- possibly as soon as opening weekend. Didn't include that in the blog post because I'm with you that it's not realistic and can't see a surgeon agreeing to perform the procedure.

 

[netnalp]

There is also the concern with how out of football shape he may get depending on how long he's unable to perform any activity. He's not even allowed to do stuff in the pool or ride a stationary bike now. He might be at risk for a hamstring type injury if he's limited for too long.

 

[Mr. Soup Nazi]

I think they should just shoot him and put him out of his misery.

 

[growlers]

Growlers,I'm not a doctor, nor do I play one on TV, but I'm pretty sure the Cowboys have this one under control.Okthanxby

Sigh. Thanks for reminding me why I'm a lurker. I'll go slink away to my cave again and not post any medically relevent points based on my profession and just read all the speculation from everyone else in the thread without contributing.

 

[simmonjm]

From what I read today is that the Cowboys are going to check the healing process in 10 days and have a better idea at that point. The 4-6 week estimate by some in this thread are the same timeframe if he underwent surgery which seems a bit long.

 

[Carter_Can_Fly]

Growlers,I'm not a doctor, nor do I play one on TV, but I'm pretty sure the Cowboys have this one under control.Okthanxby

Sigh. Thanks for reminding me why I'm a lurker. I'll go slink away to my cave again and not post any medically relevent points based on my profession and just read all the speculation from everyone else in the thread without contributing.

Don't get discouraged, there are plenty of people who will read your post and be thankful.I was one who enjoyed reading your response and found it worthy. Feel free to keep posting anything you like but especially medical things that you feel may be relevant to a thread like this.

 

[Manster]

FBG Second Opinion post re: Witten

There is no standard timetable for a return from a splenic injury. Depends on grade of initial injury, how quickly blood resorbs and tissue heals and whether there are any complications in the next 14 days. 4-6 weeks isn't impossible, with six weeks being more likely. Also not out of the realm of possibility that he could be held out for 6+ weeks and through the Cowboys' Week 5 bye.

Jene,Er doc here. I would think he would be out longer if they treat this nonoperatively as then you have to worry about increased risk of reinjury because of increased intrasplenic capsular pressure from the hematoma. An analogy would be the risk of splenic rupture after mononucleosis.

If they take it out, the risk is solely postoperative and easier to gauge IMO.

What are your thoughts on this?

Note to be clear to everyone else I'm obviously not advocating taking out his spleen to get him on the field faster. There are major long term ramifications to splenectomy outside of football issues like increased risk of infection.

Thanks for the input Doc, it is much appreciated. I didnt think about the pressure from a hematoma. Wasnt thinking about the spleen as incapsulated. I was assuming the blood from the injury would be reabsorbed fairly quickly.They grade these injuries 1-5 I guess. With 1 being most mild. I wonder what his is graded, and then what that will mean for a safe return.

 

[moderated]

f the docs say 6 weeks min then i'm saying away.

the only thing worse then a spleen is the dreaded lisfranc

 

[growlers]

They grade these injuries 1-5 I guess. With 1 being most mild. I wonder what his is graded, and then what that will mean for a safe return.

Almost certainly a 1 or 2. 5 always goes to the OR, a 4 almost always does unless the trauma surgeon wants to REALLY avoid surgery and watch the person for 5+ days in the hospital, and many threes get embolization, which we would have heard about in the media reports. Also, if he was a three, my guess is they would have just taken him to the or and if they didn't he would be out a minimum of three months.There is no published guidelines that state a difference in recommended return to an activity such as football between a 1 and 2, and I can guarantee there is no useful research data on the subject as no one could feasibly do a study on such a question.Edit: does anyone know how long he was in the hospital/ is still there?If < 72 hous it's not a three.

 

[growlers]

f the docs say 6 weeks min then i'm saying away.the only thing worse then a spleen is the dreaded lisfranc

I respectfully totally disagree. Spleen is a solid organ in the abdomen, so way less sensory nerve supply, and once it's healed it's healed. Lis franc injuries involve joints that can swell, develop arthritis, and are prone to reinjury. I'm not an athlete and I'd rather have a splenic injury than a lis franc injury looking at the long term. You have essentially a zero percent chance of developing long term chronic pain from a nonoperative splenic injury.

 

[HurryUpSundays]

I think they should just shoot him and put him out of his misery.

If we had some way of weeding out people looking for attention or to be laughed at, this forum would be that much better.

 

[BigTex]

FBG Second Opinion post re: Witten

There is no standard timetable for a return from a splenic injury. Depends on grade of initial injury, how quickly blood resorbs and tissue heals and whether there are any complications in the next 14 days. 4-6 weeks isn't impossible, with six weeks being more likely. Also not out of the realm of possibility that he could be held out for 6+ weeks and through the Cowboys' Week 5 bye.

Jene,Er doc here. I would think he would be out longer if they treat this nonoperatively as then you have to worry about increased risk of reinjury because of increased intrasplenic capsular pressure from the hematoma. An analogy would be the risk of splenic rupture after mononucleosis.

If they take it out, the risk is solely postoperative and easier to gauge IMO.

What are your thoughts on this?

Note to be clear to everyone else I'm obviously not advocating taking out his spleen to get him on the field faster. There are major long term ramifications to splenectomy outside of football issues like increased risk of infection.

Thanks for the insight. The Cowboys tend to not give the most accurate of time tables when it comes to injuries.

 

[Mr. Soup Nazi]

I think they should just shoot him and put him out of his misery.

If we had some way of weeding out people looking for attention or to be laughed at, this forum would be that much better.

My bad....forgot my meds last night.Carry on with you highly important discussions on magic football.

 

[[icon]]

I think they should just shoot him and put him out of his misery.

If we had some way of weeding out people looking for attention or to be laughed at, this forum would be that much better.

My bad....forgot my meds last night.Carry on with you highly important discussions on magic football.

THIS IS MAGIC FOOTBALL GUY! Cool it with the jokes and get in Goosestep!

 

[Cookiemonster]

It's unfortunate the IGNORE feature has become so much more difficult to use.

 

[Manster]

I think they should just shoot him and put him out of his misery.

I'm sure the same has been said of you at some point, with your shining personality and all.

 

[Jene Bramel]

They grade these injuries 1-5 I guess. With 1 being most mild. I wonder what his is graded, and then what that will mean for a safe return.

Almost certainly a 1 or 2. 5 always goes to the OR, a 4 almost always does unless the trauma surgeon wants to REALLY avoid surgery and watch the person for 5+ days in the hospital, and many threes get embolization, which we would have heard about in the media reports. Also, if he was a three, my guess is they would have just taken him to the or and if they didn't he would be out a minimum of three months.There is no published guidelines that state a difference in recommended return to an activity such as football between a 1 and 2, and I can guarantee there is no useful research data on the subject as no one could feasibly do a study on such a question.Edit: does anyone know how long he was in the hospital/ is still there?If < 72 hous it's not a three.

I haven't seen anything to suggest it's a Grade 3. I looked for information about a hospital stay yesterday and found nothing. I'm not sure that definitely rules out a Grade 2 (despite the Grade +1 standard of observation) though, and I'd speculate that's the most likely situation reading between the lines of the comments yesterday.

 

[Bird]

per Rotoworld:

ESPN's Adam Schefter reports that Jason Witten will avoid surgery on his lacerated spleen, and is "questionable" to play in Week 1 against the Giants.

Personally, I still have not seen what Grade the injury is being classified so who knows for how long he is "questionable"

 

[[icon]]

Growlers,I'm not a doctor, nor do I play one on TV, but I'm pretty sure the Cowboys have this one under control.Okthanxby

Sigh. Thanks for reminding me why I'm a lurker. I'll go slink away to my cave again and not post any medically relevent points based on my profession and just read all the speculation from everyone else in the thread without contributing.

Don't get discouraged, there are plenty of people who will read your post and be thankful.I was one who enjoyed reading your response and found it worthy. Feel free to keep posting anything you like but especially medical things that you feel may be relevant to a thread like this.

Ignore the tools. This board is made up of about 10% of them... but unfortunately they make about 30-40% of the posts. Shake em off.

 

[biju]

It's unfortunate the IGNORE feature has become so much more difficult to use.

But something still exists? Can you describe, because I've got a few folks I'd like to put on ignore. I'd post here more if I could weed out the people only looking for attention.

 

[Da Guru]

per Rotoworld:ESPN's Adam Schefter reports that Jason Witten will avoid surgery on his lacerated spleen, and is "questionable" to play in Week 1 against the Giants.Personally, I still have not seen what Grade the injury is being classified so who knows for how long he is "questionable"

If Witts spleen is just leaking a little blood he should be good to go, that is not that big of a deal. Would like to see him get a couple of snaps in the last X game though.

 

[Jene Bramel]

per Rotoworld:ESPN's Adam Schefter reports that Jason Witten will avoid surgery on his lacerated spleen, and is "questionable" to play in Week 1 against the Giants.Personally, I still have not seen what Grade the injury is being classified so who knows for how long he is "questionable"

If Witts spleen is just leaking a little blood he should be good to go, that is not that big of a deal. Would like to see him get a couple of snaps in the last X game though.

Actually, it would be a very big deal if Witten's spleen were still oozing this long after the injury. He'd still be restricted from nearly all activities and there would likely be discussion about an embolization procedure. The fact that they've been able to say he won't have surgery this soon after the injury (many studies report a concern for delayed rupture up to 14 days after injury) is a very good sign and almost certainly means that there is no concern for any ongoing bleeding. There's still variability in the amount of time it may take for the leftover blood to resorb and capsular irritation to settle, but I think there's a good chance he could return before the Cowboys' bye week now. Hopefully, Witten is healthy enough to make his return within 4-6 weeks rather than 6-8.

 

[growlers]

per Rotoworld:

ESPN's Adam Schefter reports that Jason Witten will avoid surgery on his lacerated spleen, and is "questionable" to play in Week 1 against the Giants.

Personally, I still have not seen what Grade the injury is being classified so who knows for how long he is "questionable"

If Witts spleen is just leaking a little blood he should be good to go, that is not that big of a deal. Would like to see him get a couple of snaps in the last X game though.

Actually, it would be a very big deal if Witten's spleen were still oozing this long after the injury. He'd still be restricted from nearly all activities and there would likely be discussion about an embolization procedure. The fact that they've been able to say he won't have surgery this soon after the injury (many studies report a concern for delayed rupture up to 14 days after injury) is a very good sign and almost certainly means that there is no concern for any ongoing bleeding. There's still variability in the amount of time it may take for the leftover blood to resorb and capsular irritation to settle, but I think there's a good chance he could return before the Cowboys' bye week now. Hopefully, Witten is healthy enough to make his return within 4-6 weeks rather than 6-8.

I agree.It looks like they are making decisions based on a CT scan done at the 7 day mark. If they are, reading between the lines this means that he either had a grade 1 or a very mild grade 2.

For the others reading the thread besides Jene, the way the grading system works is that all grade 1's are essentially the same injury (<10% of the subcapsular surface area and may or may not have a small laceration) but grade 2's actually have a pretty wide range (10-50% surface area and up to a 3 cm laceration).

If he had a grade 2 that was more on the severe side, he would be getting a day 14 CT scan before any definitive decision was made IMO.

I was basing my opinion of when he was coming back based only on my speculation that he didn't have a grade 3-5. I was thinking it would be after the bye week, and of course had to factor the possibility in of delayed surgery.

Although I again stress everything I've posted in this post is of course only an educated guess, I felt comfortable taking him last night in a draft a few rounds earlier than if there was no announcement - I wasn't expecting an update until day 14. I think he is back before the bye.

 

[Wreckincrew]

Good job Growlers, very informative.

 

[Shutout]

They had a little bit of an update at halftime and made a pretty good point, saying that Witten is so restricted from exercise due to the injury that, even if he is cleared, he likely isn't going to be in football shape for a bit.

Tough hit on a guy that has been so durable.

 

[treat88]

per Rotoworld:

ESPN's Adam Schefter reports that Jason Witten will avoid surgery on his lacerated spleen, and is "questionable" to play in Week 1 against the Giants.

Personally, I still have not seen what Grade the injury is being classified so who knows for how long he is "questionable"

If Witts spleen is just leaking a little blood he should be good to go, that is not that big of a deal. Would like to see him get a couple of snaps in the last X game though.

Actually, it would be a very big deal if Witten's spleen were still oozing this long after the injury. He'd still be restricted from nearly all activities and there would likely be discussion about an embolization procedure. The fact that they've been able to say he won't have surgery this soon after the injury (many studies report a concern for delayed rupture up to 14 days after injury) is a very good sign and almost certainly means that there is no concern for any ongoing bleeding. There's still variability in the amount of time it may take for the leftover blood to resorb and capsular irritation to settle, but I think there's a good chance he could return before the Cowboys' bye week now. Hopefully, Witten is healthy enough to make his return within 4-6 weeks rather than 6-8.

I agree.It looks like they are making decisions based on a CT scan done at the 7 day mark. If they are, reading between the lines this means that he either had a grade 1 or a very mild grade 2.

For the others reading the thread besides Jene, the way the grading system works is that all grade 1's are essentially the same injury (<10% of the subcapsular surface area and may or may not have a small laceration) but grade 2's actually have a pretty wide range (10-50% surface area and up to a 3 cm laceration).

If he had a grade 2 that was more on the severe side, he would be getting a day 14 CT scan before any definitive decision was made IMO.

I was basing my opinion of when he was coming back based only on my speculation that he didn't have a grade 3-5. I was thinking it would be after the bye week, and of course had to factor the possibility in of delayed surgery.

Although I again stress everything I've posted in this post is of course only an educated guess, I felt comfortable taking him last night in a draft a few rounds earlier than if there was no announcement - I wasn't expecting an update until day 14. I think he is back before the bye.

Thanks for the quality info doc.Appreciated.