Injury Analysis: One Month To Go

About a month left in the regular season and teams are going to be facing some critical questions.

Zach Parise of the NJ Devils seems to be progressing well his rehab after having a meniscal repair. He has started to take shots and practice hard stops. It appears that he is still 2 weeks from practicing with the team but these are all good signs. He has been out a little longer than expected or hoped – they were hoping that he would be back sometime in February. Both actions of shooting and stopping require the player to place significant pressure on the knee. Depending on the position of the knee, the pressure may irritate the surgical site causing pain and some swelling. The meniscal repair needs to be fully healed and the hip needs to strong and stable to control the load on the knee.

Alexander Steen of St Louis recently was diagnosed with a high ankle sprain. He is thought to be out for 4-6 weeks. As we have seen in the past, high ankle sprains are difficult to predict because the impact of rotational motions on the ankle. Rotational motions are common in skating and it is this rotational motion that can stress the syndesmosis, which has been injured in a high ankle sprain. My initial assessment of a 4 weeks recovery seems quick because he really needs to be ready by 3 weeks to allow 1 week of full practice to ensure game shape.

Barret Jackman of St. Louis will also be out 4-6 weeks after having finger surgery. As with any hand surgery, the main difficulty is regaining the grip strength needed for passing and shooting. First they will need to mobilize the joint and the tendon to regain the motion. As he regains the motion, he will start gentle strengthening exercises. He will progress as able as long as he does not have any pain or other issues. It is likely that he will not be back for the regular season.

Cal O'Reilly of Nashville is recovering from a broken fibula. He recently got cleared to have his cast removed. The fibula is a non-weight-bearing bone so it is not crucial to standing or any weight-bearing activities but it is crucial because it forms the outer side of the ankle joint so if this does not heal well and the bone does not move normally then the ankle will not move normally. This will impact a person's ability to push off and lean on the edges while making any abrupt motions. Since he is out of the cast, they will start working on getting his motion back then will start strength and functional training for skating. The length of immobilization will also affect strength in all the lower leg muscles so it will take a little time for these muscles to return to pre-injury levels.

Kevin Klein of Nashville looks like he will be out for a while. He got hit on his foot by a puck and has been seen wearing a cast on his foot. Depending on the location of the fracture, he may be out for a couple of weeks or a month or more. We'll have to see what the reports are coming out of the Predators camp. Both injuries to Klein and O'Reilly may be important because Nashville is in the heat of playoff hunt for the last playoff spot.

Patrick Kaleta of Buffalo has a severe knee bruise and this was so bad that his knee had to be immobilized. This is not a good sign because it means that the injury was bad enough that even motion could aggravate it. Movement, in most cases, is a good thing. It helps to regain normal motion, improve blood supply and normalize tissue elasticity. When movement is not wanted it cold mean that the bruise is bad enough hat it could have a chance of damaging the bone it self.

Drew Stafford of Buffalo has a hamstring injury. He did not practice on Friday and did not play Saturday. Hamstring injuries can linger and are difficult to isolate because it works closely with the glutes and groin muscles. The hamstring also works a lot to assist control the lengthening or the muscle or the eccentric portion of the muscle contraction. Hamstring injuries take a little bit of time to rehab so I would expect him to be out for a week or two as long as this is only a mild strain and nothing more serious.

Sam Gagner of Edmonton had to have to hand surgery to repair some tendons in his hand. He is expected to be out for 12 weeks and cannot exercise the hand until June. This is not a problem because there is no urgency since Edmonton is out of any playoff picture. Before any exercising, the tissue needs to fully heal, then the tissue will be gently mobilized to start to regain motion. This may be long process in some cases. The tendon may tend to stiffen when not being used so range of motion exercises may be performed repeatedly throughout the day to prevent loss of flexibility. Later, the process of regaining normal hand strength will begin.

Brent Sopel of Montreal is out indefinitely with a broken right wrist. He will first need the wrist immobilized for about 4-6 weeks then the stretching will begin. The elbow may be affected because wrist function is very closely link with the elbow. If you cannot rotate the wrist, the elbow will not be able to function normally. At times, this may lead to some compensation in the arm to over come the loss in wrist mobility. The quicker, they can regain full motion, the quicker the arm can start to work normally.