Injury Report: Aaron Ekblad 3/28/21 (fractured leg), out fishing with the boys

[ucanthanzalthetruth]

If it's a clean ankle break like Tro, he only missed 2 months. Fingers crossed there's no ligament damage and he would easily be ready for opening night in October.

 

[violaswallet]

If it's a clean ankle break like Tro, he only missed 2 months. Fingers crossed there's no ligament damage and he would easily be ready for opening night in October.

I hope we let him recover long: Trocheck came back early and is only beginning to return to form; I care about Ek over the next four years more than this season. Barky would understand this and it would not affect re-signing.

 

[SENStastic]

Jesus I watched the game live yesterday and it was incredibly painful to watch. I feel horrible for the guy, such an underrated talent. Hope he can recover soon and get back to full form by next season. Just when things finally come together for you guys everything just goes off a cliff in a matter of 2 weeks. When it rains it pours I guess. Reminds me of Trochek incident a few years back, such a pity. Best wishes to him and the Panthers, hopefully this won't derail the rest of season for the team, I'm still rooting for the cats to make a big splash in the playoff. Praying for a speedy recovery.

 

[AwesomePanthers]

This was the worst thing that could happen. Such a great season. I hope he makes a full-recovery whenever that is.

 

[McFlyingV]

Sorry for the terrible luck on this fluke injury guys. I remember just how rough it was watching McDavid go into the post on a dangerous Giordano trip and hoping it wouldn't affect him long term. Really sucks with the season you're having losing him for the rest of the year (not confirmed, but my gut tells me it's pretty much a guarantee), but I'm sure he'll be back by training camp next year.

As a rehab professional I would like to say that we shouldn't be jumping to the "career ending" or "he'll never be the same" statements that I often see posted on HF boards. It's impossible to know the extent of the injury at this point without seeing his leg without his equipment on or without being in the room to look at the MRI, but given the mechanism of injury and his age I would say the likelihood of it not affecting him long-term in his career is pretty good. I think given the way his knee bent it is almost without a doubt damage to the MCL and possible medial meniscus involvement (often injured anytime we see any severe MCL injury), with potential fracture to the tibia (him flying with the team doesn't necessarily rule out fracture, just rules out it requiring immediate surgery). It is however, sometimes hard to fully know just on observation as true knee position can be a bit deceiving with shin pads on.

The ankle definitely doesn't look like it takes nearly the amount of stress as the knee but there is some possibility of a lateral malleolar (fibular) fracture, deltoid ligament injury, or high ankle sprain, but I think those are lower likelihood given his reaction and the way they stabilized the knee. I think the one promising thing when looking at how his knee was positioned is the fact his knee is bent into a lot of flexion which reduces the risk of an ACL tear. Normally when we see a "terrible triad" injury involving MCL, ACL, and medial meniscus it is this exact stress on the knee, but with the knee in a fully extended or slightly bent position and that is because the ACL is put on max tension when the knee is fully straightened. This injury is possible but far less likely.

If I had an elite level athlete come into my clinic looking to return to pre-injury levels of play I would without question prefer an MCL tear over an ACL tear, but a good percentage of athletes do return to pre-injury levels in both cases. Anyways, I thought I'd provide some insight into what the future might hold for Ekblad. In any case I think we're looking at 3-6 months on the low end, or 6-9 months on the high end for him to return (conservative numbers as pro-athletes don't always follow usual timelines). Keep in mind it could take up to double that amount of time to see him back to complete 100% as the rehab and remodelling of injured tissue goes far beyond the time they return to play. I know it sucks for the remainder of your season, but looking at the positives Ekblad was really starting to come into his own and he should have several good to great years ahead of him. Best of luck on the rest of your season!

 

[KW]

Sorry for the terrible luck on this fluke injury guys. I remember just how rough it was watching McDavid go into the post on a dangerous Giordano trip and hoping it wouldn't affect him long term. Really sucks with the season you're having losing him for the rest of the year (not confirmed, but my gut tells me it's pretty much a guarantee), but I'm sure he'll be back by training camp next year.

As a rehab professional I would like to say that we shouldn't be jumping to the "career ending" or "he'll never be the same" statements that I often see posted on HF boards. It's impossible to know the extent of the injury at this point without seeing his leg without his equipment on or without being in the room to look at the MRI, but given the mechanism of injury and his age I would say the likelihood of it not affecting him long-term in his career is pretty good. I think given the way his knee bent it is almost without a doubt damage to the MCL and possible medial meniscus involvement (often injured anytime we see any severe MCL injury), with potential fracture to the tibia (him flying with the team doesn't necessarily rule out fracture, just rules out it requiring immediate surgery). It is however, sometimes hard to fully know just on observation as true knee position can be a bit deceiving with shin pads on.

The ankle definitely doesn't look like it takes nearly the amount of stress as the knee but there is some possibility of a lateral malleolar (fibular) fracture, deltoid ligament injury, or high ankle sprain, but I think those are lower likelihood given his reaction and the way they stabilized the knee. I think the one promising thing when looking at how his knee was positioned is the fact his knee is bent into a lot of flexion which reduces the risk of an ACL tear. Normally when we see a "terrible triad" injury involving MCL, ACL, and medial meniscus it is this exact stress on the knee, but with the knee in a fully extended or slightly bent position and that is because the ACL is put on max tension when the knee is fully straightened. This injury is possible but far less likely.

If I had an elite level athlete come into my clinic looking to return to pre-injury levels of play I would without question prefer an MCL tear over an ACL tear, but a good percentage of athletes do return to pre-injury levels in both cases. Anyways, I thought I'd provide some insight into what the future might hold for Ekblad. In any case I think we're looking at 3-6 months on the low end, or 6-9 months on the high end for him to return (conservative numbers as pro-athletes don't always follow usual timelines). Keep in mind it could take up to double that amount of time to see him back to complete 100% as the rehab and remodelling of injured tissue goes far beyond the time they return to play. I know it sucks for the remainder of your season, but looking at the positives Ekblad was really starting to come into his own and he should have several good to great years ahead of him. Best of luck on the rest of your season!

Thanks and the inside scoop is that this is about the Indian Burial Grounds revenge. The current Panthers stadium was built on such a site, the ancestors are mad and that’s where we are. Thanks for the good wishes, or if you can do a curse-cancel, that would be even better!

Oh, and I’ll take the 3month estimate please...

 

[Prominence Problem]

Sorry for the terrible luck on this fluke injury guys. I remember just how rough it was watching McDavid go into the post on a dangerous Giordano trip and hoping it wouldn't affect him long term. Really sucks with the season you're having losing him for the rest of the year (not confirmed, but my gut tells me it's pretty much a guarantee), but I'm sure he'll be back by training camp next year.

As a rehab professional I would like to say that we shouldn't be jumping to the "career ending" or "he'll never be the same" statements that I often see posted on HF boards. It's impossible to know the extent of the injury at this point without seeing his leg without his equipment on or without being in the room to look at the MRI, but given the mechanism of injury and his age I would say the likelihood of it not affecting him long-term in his career is pretty good. I think given the way his knee bent it is almost without a doubt damage to the MCL and possible medial meniscus involvement (often injured anytime we see any severe MCL injury), with potential fracture to the tibia (him flying with the team doesn't necessarily rule out fracture, just rules out it requiring immediate surgery). It is however, sometimes hard to fully know just on observation as true knee position can be a bit deceiving with shin pads on.

The ankle definitely doesn't look like it takes nearly the amount of stress as the knee but there is some possibility of a lateral malleolar (fibular) fracture, deltoid ligament injury, or high ankle sprain, but I think those are lower likelihood given his reaction and the way they stabilized the knee. I think the one promising thing when looking at how his knee was positioned is the fact his knee is bent into a lot of flexion which reduces the risk of an ACL tear. Normally when we see a "terrible triad" injury involving MCL, ACL, and medial meniscus it is this exact stress on the knee, but with the knee in a fully extended or slightly bent position and that is because the ACL is put on max tension when the knee is fully straightened. This injury is possible but far less likely.

If I had an elite level athlete come into my clinic looking to return to pre-injury levels of play I would without question prefer an MCL tear over an ACL tear, but a good percentage of athletes do return to pre-injury levels in both cases. Anyways, I thought I'd provide some insight into what the future might hold for Ekblad. In any case I think we're looking at 3-6 months on the low end, or 6-9 months on the high end for him to return (conservative numbers as pro-athletes don't always follow usual timelines). Keep in mind it could take up to double that amount of time to see him back to complete 100% as the rehab and remodelling of injured tissue goes far beyond the time they return to play. I know it sucks for the remainder of your season, but looking at the positives Ekblad was really starting to come into his own and he should have several good to great years ahead of him. Best of luck on the rest of your season!

Thanks for the professional insight.
I know you can only do so much seeing the replay on TV, but would you rule out a PCL tear, much like your boy McDavid? I say that because I sprained my PCL 3 years ago on the ice where I fell straight backwards.
I know Ek fell a little bit on his left on his left leg. Just wondering if it's a PCL injury possibly? Thus, my early diagnosis would be six to eight months. Again, let me stress, I'm no professional. Just more MRIs than you can count in the last 8 years.

 

[McFlyingV]

Thanks for the professional insight.
I know you can only do so much seeing the replay on TV, but would you rule out a PCL tear, much like your boy McDavid? I say that because I sprained my PCL 3 years ago on the ice where I fell straight backwards.
I know Ek fell a little bit on his left on his left leg. Just wondering if it's a PCL injury possibly? Thus, my early diagnosis would be six to eight months. Again, let me stress, I'm no professional. Just more MRIs than you can count in the last 8 years.

I'd say unlikely personally. Usually you're only going to see a PCL injury when a lot of force goes directly through the tibia causing it to slide backwards in relation to the femur. Think knee to dashboard in a car accident, knee to post at high speed (McDavid), low blow just below the knee (linemen in football), or falling forcefully onto the knee in a flexed (bent) position.

Now just about anything is possible when enough twist and torque is put on the knee, but a PCL would be the least likely imo to worry about (it's a very strong ligament and usually requires a lot of force to tear either from an impact or being forced into hyper flexion). PCL and ACL timelines would be longer timelines for tears (think 6-9 months), while MCL would be more in the 3 to 6 months range depending on a variety of factors including extent of the damage, surgery, meniscus involvement.

At first look the amount of pain he is in still makes me lean toward some sort of fracture or patellar dislocation with potential ligament damage as well. Normally you wouldn't see a guy needing a stretcher and vacuum cast or that degree of sustained pain for just a torn ligament.

 

[Prominence Problem]

I'd say unlikely personally. Usually you're only going to see a PCL injury when a lot of force goes directly through the tibia causing it to slide backwards in relation to the femur. Think knee to dashboard in a car accident, knee to post at high speed (McDavid), low blow just below the knee (linemen in football), or falling forcefully onto the knee in a flexed (bent) position.

Now just about anything is possible when enough twist and torque is put on the knee, but a PCL would be the least likely imo to worry about (it's a very strong ligament and usually requires a lot of force to tear either from an impact or being forced into hyper flexion). PCL and ACL timelines would be longer timelines for tears (think 6-9 months), while MCL would be more in the 3 to 6 months range depending on a variety of factors including extent of the damage, surgery, meniscus involvement.

At first look the amount of pain he is in still makes me lean toward some sort of fracture or patellar dislocation with potential ligament damage as well. Normally you wouldn't see a guy needing a stretcher and vacuum cast or that degree of sustained pain for just a torn ligament.

So an MCL injury with the probability of a fracture or something along those lines, would you think surgery is almost a sure guarantee?

 

[McFlyingV]

So an MCL injury with the probability of a fracture or something along those lines, would you think surgery is almost a sure guarantee?

Yes fracture or patellar dislocation were my first thoughts given his reaction and the medical team's respone, and then the obvious stress and twist on the medial knee would definitely have me suspecting MCL +/- meniscus, with a lesser likelihood of ACL involvement if I had to guess just going off very limited information. The ankle could have been involved as well, but it didn't look like it took near as much of the impact that the knee did.

Surgery isn't always necessary for an MCL tear and would depend on a lot of factors including meniscus damage. As we saw with McDavid, he elected to not go the surgical route and his PCL somehow managed to heal (this is very rare, but surgery for PCL injuries also aren't the most reliable procedure for many reasons). An MCL can heal a lot better without surgery than an ACL or PCL for example by just bracing the knee for several weeks and that is for multiple reasons. The MCL and LCL are extracapsular ligaments while the ACL and PCL are intracapsular ligaments. What this means is they are outside the joint capsule vs inside, and that means much easier to immobilize the joint in a position where the two ends can meet and scar together, while also receiving substantially more blood flow than the ACL/PCL do. Generally areas that receive more blood flow heal a lot more reliably and faster than areas that don't. Sometimes MCL reconstruction surgery is necessary if the ligament is damaged beyond what they believe can heal in an immobilized position.

 

[Prominence Problem]

Thanks again, I'm learning so much about knees here. I'm sure we will learn a lot more in the next couple of days as information is shared with the public.

One last question, if he goes into surgery route, is there a timeline that the surgery has to be done by a certain date? Example, 8 days from the point of injury.

 

[McFlyingV]

Thanks again, I'm learning so much about knees here. I'm sure we will learn a lot more in the next couple of days as information is shared with the public.

One last question, if he goes into surgery route, is there a timeline that the surgery has to be done by a certain date? Example, 8 days from the point of injury.

Not a problem. Keep in mind this is from a rehab perspective and not that of a surgeon so I am giving information from my perspective and the limited knowledge I have on actual surgical procedures themselves. With that in mind if they were going the surgical reconstruction route for an MCL then technically no, there isn't exactly a timeline. Obviously sooner the better to avoid atrophy and expedite the return to play timeline, which for a professional athlete is never really a hurdle they get in quick if they need these procedures (not exactly the case for the general public). Many people wait several months for ACL reconstruction for example. I haven't actually looked into any existing evidence though surrounding long-term outcomes and their relationship to immediate vs. prolonged surgery times for ligament reconstruction. Maybe some night time reading for myself after the Oilers game if I have the time

 

[Gizmo Tkachuk]

Were we supposed to get any update today?

 

[McFlyingV]

Were we supposed to get any update today?

Kind of what I expected given his reaction. Lets hope for no soft tissue injury.

 

[Panthers Propaganda]

Update, it’s a break folks.

 

[Prominence Problem]

Were we supposed to get any update today?

I am thinking today is a complete day off for the team. Not only do you have a gruesome injury that happened to one of their star players, but they are also flying home from out west.

Edit - well what do I know!?

 

[Gentle Man]

 

[violaswallet]

Win it for Ekblad

 

[ScottyMascotty]

Kind of what I expected given his reaction. Lets hope for no soft tissue injury.

So no ligament tears?

 

[Dread Clawz]

I guess it's good it's a break if it's clean? Depends where though.

 

[Gizmo Tkachuk]

Meh wish I didnt ask

 

[McFlyingV]

So no ligament tears?

Not sure that has been determined yet. Surgery for the bone would be number 1 priority as that needs to be addressed in the first few days. If it is only a broken bone though that would be good news.

 

[harv33173]

Not a problem. Keep in mind this is from a rehab perspective and not that of a surgeon so I am giving information from my perspective and the limited knowledge I have on actual surgical procedures themselves. With that in mind if they were going the surgical reconstruction route for an MCL then technically no, there isn't exactly a timeline. Obviously sooner the better to avoid atrophy and expedite the return to play timeline, which for a professional athlete is never really a hurdle they get in quick if they need these procedures (not exactly the case for the general public). Many people wait several months for ACL reconstruction for example. I haven't actually looked into any existing evidence though surrounding long-term outcomes and their relationship to immediate vs. prolonged surgery times for ligament reconstruction. Maybe some night time reading for myself after the Oilers game if I have the time

anyone know if prp, or stem cells might be a valid, good, or additional step to aid in recovery and healing? there is a doctor in boca raton, world renowned for working with and healing profesional as well as ordinary people. i personally use him and have been able to forgo knee replacement surgery for 20 years now even though all knee specialists recommended surgery. i believe tro used him for his shoulder injury. wishing aaron the best.

 

[Gentle Man]

Taking my Eky jersey out of the closet and leaving it on display till he gets better

 

[McFlyingV]

anyone know if prp, or stem cells might be a valid, good, or additional step to aid in recovery and healing? there is a doctor in boca raton, world renowned for working with and healing profesional as well as ordinary people. i personally use him and have been able to forgo knee replacement surgery for 20 years now even though all knee specialists recommended surgery. i believe tro used him for his shoulder injury. wishing aaron the best.

Haven't done a lot of personal reading on the subject, but I have heard that the research around PrP has been promising so definitely could be worth while. McDavid used a hyperbaric chamber for his knee injury which I thought was pretty cool. There's a lot of emerging therapies that pro-athletes are able to access that the general public isn't which is why I urged people in my original post to not be part of the "his career is over" or "he'll never be the same" crowd.