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Will Pennington Return To The NFL After Another Shoulder Surgery?
Published: September 30, 2009
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When Chad Pennington dislocated his shoulder in Miami’s loss to San Diego this past Sunday, many were thinking, “Will Pennington be able to come back and play in the NFL?” Let’s examine Pennington’s injury history, what he currently is suffering from, and whether it is feasible to expect another comeback from this tough NFL quarterback.
Pennington has twice suffered tears in his rotator cuff — a group of four shoulder muscles that are responsible for shoulder stability and strength. Each time he had the rotator cuff repaired, he was able to return after a period of rehabilitation. In fact, his inspirational play during the 2006 season, earned the Jets a playoff appearance, and Pennington the NFL Comeback Player of the Year award.
Pennington’s injury this time is somewhat different. The shoulder is a ball (humerus) and socket (glenoid) joint. A shoulder dislocation is when the upper arm bone (humerus) comes out of the shoulder joint (glenoid) and needs to be returned to the joint (reduced).
This entity is frequently confused by the lay press with a shoulder separation. This occurs when the clavicle is “separated” from the acromio-clavicular joint — a less serious injury. In a shoulder separation, the athlete rests for a few weeks and the area scars down, allowing return within a few weeks of the injury.
Shoulder dislocations are more serious. In order for the humerus to be dislocated from the glenoid, the soft tissue that holds the shoulder together must be damaged or torn. This soft tissue is composed of the inner labrum and the surrounding capsule. Both of these are usually damaged in a dislocation. In fact there may be boney deformities as well, affecting the humerus and the glenoid. These boney changes occur when the bones impact each other during the dislocation and reduction. This often causes boney changes which make the chances of a recurrent dislocation greater.
News reports indicate that Pennington damaged his capsule, and undoubtedly Dr. Andrews will fix this during the surgery. He may also repair any lesser damage done to the rotator cuff or the labrum — both a distinct possibility given his previous injuries.
Provided the surgery goes smoothly, Pennington will then undergo an arduous rehabilitation period beginning with early passive mobilization, and then gradual strengthening of the shoulder. In the first 6 weeks post-op, he will regain some shoulder strength, and at about the two month mark he may slowly begin a structured “throwing” schedule. This gradual increase in shoulder strength will take four to six months, at the end of which time he could begin throwing in simulated game situations.
A reasonable goal for Pennington would be a return to near full shoulder strength by the beginning of NFL training camp in 2010. Some of the things that could thwart this goal are as follows: He may not want to go through another grueling rehabilitation program or may not be able to successfully gain all his strength back as a result of the damaged tissue, and the inability of the surgery to satisfactorily repair the shoulder. His age may also play a factor in that as an athlete gets over 30 years of age, his capacity to rehab and return to his previous level of functioning are not as good as if he were in his twenties.
Ironically, many of the same things that Pennington is fighting against — age and multiple surgeries — may ultimately give him the best chance for recovery.
When an athlete dislocates his throwing shoulder, we as physicians are concerned about the very real threat of recurrent dislocation. Younger athletes are actually more prone to recurrent dislocation, as the tissue holding the shoulder joint together is more flexible in the late teens and twenties. As an athlete approaches 40 years old, much of this connective tissue becomes stiffer and less pliable, making the chances of recurrent dislocation less common.
Finally, Pennington has gone through 2 previous rehabilitation programs, where he has successfully come back to play at a high level. He knows what awaits him, and realizes what he must do in order to regain his previous form. If he is willing to repeat the long hours of rehabilitation and strength training, he will certainly have an excellent chance of return to the NFL.
The fact that Pennington is the NFL’s all time leader in completion percentage will also help get him back on the field. Because his game is predicated on short, accurate throws, rather than deeper passes, Pennington has the added advantage of being able to return to competition without having as much arm strength as other quarterbacks.
At the very least, Pennington will be able to become a serviceable backup in the league next year. Furthermore, if he lands in the right system, he may yet again become a starting NFL quarterback.
David Webner, MD
Co-Director, Sports Medicine Fellowship
Crozer-Keystone Health System
Suburban Philadelphia
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