I also mentioned this concern previously… that tendonitis is a risk factor for subsequent injury.
Big Ben had mentioned he was having elbow pain for quite awhile before he tore the flexor tendons in his elbow. Based on the info given so far (tendonitis, baseball-like, rest needed)… it would appear that Stafford could have tendonitis of the flexor tendons.
here is some background anatomy…
On the inner and outer sides of the elbow, thick ligaments (collateral ligaments) hold the elbow joint together and prevent dislocation. The ligament on the inner part the elbow (closer to the body) is the ulnar collateral ligament. It runs from the inner side of the humerus to the inner side of the ulna and must withstand extreme stresses as it stabilizes the elbow during overhand throwing.
Several muscles, nerves, and tendons (connective tissues between muscles and bones) cross at the elbow. The flexor/pronator muscles of the forearm and wrist begin at the elbow and are also important stabilizers of the elbow during throwing.
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Moral of the story (anatomy review)… is that tendonitis is damage to the tendons… which form at the end of the flexor mucles. If the tendons and/or muscle are inflamed… it means tissue damage has occured, and can make the elbow less stable. That is what leaves the UCL vulnerable to injury.
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As for quantifying the risk of “Tommy John” surgery to repair the UCL in the elbow…
Here is a link to a study abstract, where baseball players (MLB and minors) were studied from 2010-2014.
from the link:
In MLB, 134 forearm flexor injuries occurred with a mean player age of 28.6 years and 111 (82.8%) were pitchers. In the minor leagues, 629 injuries occurred with a mean age of 22.8 years where 494 (78.5%) were pitchers. The highest percentage of injuries occurred in the month of July in both MLB (17.2%) and the minor leagues (17%). The median time spent on the disabled list (DL) for MLB players was 42 days (mean 128.1) compared to 28 days (mean 105.7) in the minor leagues. Of the players in MLB who sustained a forearm injury, subsequent injuries included 50 shoulder (37.3%), 48 elbow (35.8%), and 24 forearm (17.9%) injuries. Over the study period, 26 (19.4%) MLB and 56 minor league players (8.9%) required UCL reconstruction within 365 days of sustaining a forearm injury. Performance declined in virtually all categories in the season leading to the injury when compared to the previous season (n = 75) and significant differences were present in walks plus hits per inning pitched (WHIP) (from 1.24 to 1.34, P = 0.04) and strike percentage (63% to 62%, P = 0.036).
Conclusion:
Flexor-pronator injuries are responsible for considerable time on the DL in elite pitchers. Injury may be preceded with declines in performance and be associated with subsequent injuries to the shoulder and elbow.
One last note… is that unlike pitchers… QBs often have their arm hit while throwing the ball.
Any kind of contact (i.e. QB hand hits DE’s hand) to the throwing arm or even hand can significantly increase the stress on the tendons and ligament (UCL) of the inner elbow. Stafford may have to take care to throw the ball even quicker to make sure he doesn’t have his hand/arm hit this year.