Nick Chubb Knee Injury is Too Serious for Replay - Doctor Explains
Category
😹
FunTranscript
00:00 Ron's running back Nick Chubb sustained a knee injury and was quickly ruled out with
00:02 something that looked so significant that they didn't even want to show the replay
00:06 in slow motion on TV.
00:07 But in this video we'll take a look at what we can maybe learn about the scenario and
00:10 just what we saw in the full speed play.
00:12 Welcome back everybody, I'm Dr. Brian Souter and my goal in this channel is to help teach
00:15 you about the medical side of the sports world.
00:17 So if anatomy and sports injuries interest you, then please consider subscribing to help
00:20 support the channel.
00:21 So this play, I'll admit, I didn't see anything when Chubb was down on the ground in terms
00:26 of like bones popping out.
00:28 You know, usually when we hear about an injury that's so bad they don't want to show the
00:30 replay, we worry about something like a compound or an open fracture.
00:34 As Chubb is sitting on the ground here, we don't really see anything coming through.
00:37 It looks like maybe there's a little bit of kind of contour abnormality up here with him
00:41 grabbing onto his left knee.
00:42 Nothing that right away looked too significant.
00:45 However, if we wind this back up and we look at the play itself, we can focus on Chubb's
00:50 left knee as the Steelers player comes in.
00:53 My concern here is that this is a forced hyperextension of Chubb's knee and even something as high
00:58 risk as a knee dislocation or at least a multi ligamentous knee injury.
01:03 Here we can see Chubb's left knee and leg are planting into the ground here as he's
01:08 being tackled by one of the Steelers players.
01:10 But then another Steelers player comes in with his helmet down and basically hits Chubb square
01:15 on the front of his knee, kind of right down here in this area.
01:18 And then what we can quickly see is Chubb's knee get forced into this hyperextended position
01:22 where it's kind of bent upwards and in a little bit as well with probably a combination of
01:28 some valgus load, meaning load coming from the side, pushing inward, combined with that
01:32 hyperextension with the knee getting pushed backward.
01:35 Whenever we see a hit like this, there's again, very high risk that you can have a knee dislocation
01:39 based on just the amount of force and the ligaments that can be injured.
01:41 But at the very minimum, I think we're talking about at least a couple of ligaments that
01:45 might have been completely torn.
01:47 To be honest, this reminds me a little bit of what happened with Marcus Latimore, similar
01:50 sort of mechanism or helmet kind of other player hit him, resulted in this severe knee
01:54 injury and I believe dislocation if I remember correctly.
01:57 But if you look here with our biodigital anatomy tool here, I want to highlight these different
02:00 ligaments that we're talking about.
02:02 Because when we get into territory of a knee dislocation, we're dealing with multiple ligaments
02:06 in the knee that have been torn.
02:08 Traditionally we think of the four main ligaments.
02:10 We have the MCL, which is going to sit down here on the inside of the knee.
02:14 That's the one that if you think of this being the outside, that blow coming in this way,
02:18 pushes the inside of the knee in that direction, which puts that MCL under tension and can
02:22 cause a full tear of the MCL.
02:25 We then on the outside have the LCL and then deep inside the knee, the ACL and the PCL.
02:29 And typically you need to have three of those four ligaments completely torn to have an
02:32 unstable or a dislocated knee with a little bit more complexity and nuance to that.
02:37 The big concern though with if this is a knee dislocation is there's a big blood vessel
02:42 that runs down the backside of the knee called the popliteal artery.
02:46 When you dislocate the knee, you can transiently injure that popliteal artery, which can then
02:50 cause impaired blood flow further down into the leg.
02:53 So this is something that whenever the medical staff is out there on the field, the first
02:57 things you're going to be checking is, is his knee unstable?
02:59 Is there a concern for a dislocated joint?
03:02 To do that, if you're in this situation yourself, providing sports coverage or whatever, put
03:06 the knee in full extension.
03:07 If the knee is locked in extension and is unstable, medial or lateral with varus or
03:12 valgus stress test, that implies there's been a knee dislocation.
03:16 When we typically stress the LCL and the MCL, we do it with the knee bent at about 30 degrees
03:22 to isolate just those ligaments.
03:23 But when the knee is locked in extension all the way out, even if these ligaments are torn
03:27 in isolation, the knee shouldn't gap or be unstable.
03:30 But if it does, we have to be concerned and assume there's been a knee dislocation.
03:35 The other component of this, that hyperextension, that helmet coming in, hitting the front of
03:39 the knee, bending it backwards in and of itself is a high risk for ACL, PCL injuries.
03:45 Just to recap this one more time, as Chubb comes down, steps, plants with that left leg,
03:49 Steelers defender comes in, hits the front of his knee, forcing his knee into a severe
03:53 amount of hyperextension and likely valgus from the outside inward, compromising the
03:58 ligaments in his knee, potentially leading something to like a dislocation or at least
04:03 multiples of those ligaments being injured.
04:05 I would be shocked if this is not a season ending type of injury for Chubb.
04:08 And we talk about these potential dislocations.
04:11 This is also like career threatening just because we worry about the limb and how serious
04:15 these things can be to treat and recover.
04:18 So we'll hope for the best.
04:19 Acutely right now, it's all about making sure that joint wasn't dislocated and there's no
04:22 compromised blood flow.
04:24 And then it's about trying to address those ligament injuries accordingly.
04:27 That's it for the video, everybody.
04:28 Thank you as always for watching.
04:29 Let me know any questions or comments down below.
04:31 And until next time, we'll see you later.