Monday Morning MD — About These QB Injuries

What is with all the quarterback injuries?

Despite all of the rules changes and increased enforcement, quarterback injuries still dominate the news. Can’t use the helmet, can’t hit the QB in head, can’t hit him low, can’t land on him, can’t drive him to the ground, can’t lift him off his legs. And yet the injuries still happen.

Jimmy Garoppolo tore his ACL, Aaron Rodgers injured his knee, Marcus Mariota hurt his elbow all in the first few weeks this season. Last year Carson Wentz and DeShaun Watson tore their ACLs, Rodgers broke his collarbone (and that led to a new rule). Two years ago, both Derek Carr and Mariota broke their ankles. Tony Romo’s career literally ended because of four different injuries. And this doesn’t even mention the myriad injuries to Ben Rothlisberger, Cam Newton and Russell Wilson.

How is it that all of these athletic quarterbacks that have the mobility to outrun or avoid the rush have been hurt, yet two of the least mobile QBs Eli Manning and Philip Rivers have remained unhurt and not missed games?

The many rules to protect the QB only do so when in the pocket. As soon as the QB becomes a runner, the protections go away. As QBs look to extend plays, the injury risk becomes higher. Manning and Rivers know their limitations and tend to be traditional pocket QBs who throw the ball away when their internal clock is up rather than always looking to extend. And the rules protect these types of players.

Garoppolo’s season was ended tearing his ACL trying to gain extra yardage after already getting the first down. He received criticism on why he just didn’t just step out of bounds and take advantage of the rules that would prevent him from being hit. This is what Peyton Manning did and what his little brother does. Is it really the training methods and avocado ice cream that keeps Tom Brady healthy or is it his pocket awareness and willingness to get rid of the ball that keep him off the injury reports? Would Romo not be broadcasting but playing if he choose to throw the ball away on four occasions when he was hurt extending plays resulting in two different spine fractures and twice fracturing his collarbone?

Recently, Rodgers on an already injured left knee tweaked his right hamstring when he choose to scramble for positive yardage while already limping. Mariota was hit and injured his elbow/ulnar nerve on an RPO play carrying out a ball fake making him a target. All of the previous QBs mentioned from Wentz to Rodgers were hurt running or extending plays.

In the end, if the QB runs routinely as part of the offense, it is a recipe for eventual injury. If you run only when you have to like the older traditional signal callers, you lessen that risk.

The new generation is here with the athletic quarterback. High schools select them that way and no longer choose the statue with a strong arm. Colleges train them that way with non-traditional NFL offenses that involve risk to the man under center (and in most cases not even under center anymore). These QBs can have success freelancing and taking chances in college, but at the next level, every defender (including the defensive lineman) is as fast or faster, not to mention bigger.

I can’t help but think the way sports is covered affects the behavior as well. Every athlete is aware of ESPN’s Top Ten plays. I call this the SportsCenter effect. In baseball, no more running under the ball to wait to make a two-handed catch. Instead outfielders want “diver’s” for web gems as that is what makes the highlight reels. In basketball, the art of the mid-range jumper is lost as replays only focus on dunks and three-pointers. In football, the attention is on the wide receiver circus catch, unless the QB makes like Houdini before completing the pass.

I am not the “get off my lawn” guy complaining about anything new. My point is only to say the game has changed and the rules only protect the old school QB.

The age of the run/pass athletic QBs are here. And no amount of rule changes can protect them if they don’t protect themselves.

Each Monday, Dr. David Chao will recap the weekend’s injuries and what to expect. As a practicing orthopedic surgeon specializing in sports medicine expert, serving as the SiriusXM Sports Medical Analyst and also the medical analyst for the San Diego Union-Tribune/Los Angeles Times, the ProFootballDoc brings his almost two decades of experience as a NFL head team physician to the readers.