What Lies Ahead for Dion Jordan as He Recovers from Shoulder Surgery?

Dave Siebert, M.D.@DaveMSiebertFeatured ColumnistApril 17, 2013

PASADENA, CA - JANUARY 02:  Defensive end Dion Jordan #96 of the Oregon Ducks calls out in the second quarter as the Ducks take on the Wisconsin Badgers at the 98th Rose Bowl Game on January 2, 2012 in Pasadena, California.  (Photo by Harry How/Getty Images)
Harry How/Getty Images

Among the many medical concerns heading into next week's NFL draft is the recent shoulder surgery of former University of Oregon defensive standout Dion Jordan. The fact that Jordan is widely regarded as likely being one of the top overall picks only complicates the situation.

News of Jordan's torn labrum and looming surgery first surfaced during February's NFL Scouting Combine (h/t Kareem Copeland, NFL.com). Despite the injury, however, he participated in all combine workouts except the bench press, putting up a 40-yard dash time of 4.60 seconds in the process (h/t official NFL Scouting Combine statistics). He underwent surgery after the event.

According to Copeland, Jordan's recovery will likely require a total of three to four months, and such a timeframe could prevent him from participating in early team activities this summer. Fortunately, once he fully recovers, he should experience minimal lasting effects for some time, and as a result, his draft stock should not be affected much, if at all.

Nevertheless, labrum tears can be tricky. In some cases, they can be painless and lead to no limitations whatsoever. In others, they can drastically affect shoulder range of motion and strength. Since Jordan played with the injury (h/t Nate Ulrich, Akron Beacon Journal) and also participated in most combine workouts, it's safe to say his injury is on the minor end of the severity spectrum.

However, the injury still required surgery for proper repair. A brief detour into the anatomy of the shoulder explains why.

The shoulder labrum is a ring of cartilage that sits around the shoulder socket. By doing so, it serves to extend the surface area of contact between the bone of the upper arm, the humerus and the socket—also called the glenoid.

The labrum is necessary because the glenoid is a very shallow socket. Imagine a golf ball sitting on a tee—the ball falls off with very small gusts of wind or bumps from a golf club. By deepening the socket—imagine a metal washer sitting around the top of the tee, the labrum decreases instability while helping coordinate the complex movements of the shoulder.

When the ring of cartilage tears, the normal stability and motion of the head of the humerus as it sits in the glenoid is disrupted. Inflammation and tissue deformities can lead to not only pain, but also range-of-motion limitations. The shoulder can even lock in place, and it is also more prone to dislocations—an injury that occurs when the humerus slips out of the glenoid altogether.

Okay, but why did Jordan need surgery? After all, he played through the injury, right?

Well, yes, but it's not that simple.

Blows to the shoulder or falling on an outstretched hand—hallmarks of football and also, unfortunately, the cause of labrum tears—can worsen the injury. In the worst case scenario, the stability and range of motion in the shoulder becomes permanently altered. Such a disaster would greatly limit Jordan's effectiveness as a player.

To complicate matters further, shoulder labrums are very stubborn about healing on their own.

Why? Like all cartilage and ligaments, labrums carry relatively low blood supplies when compared to tissues such as the skin or muscle bodies. As such, their self-healing ability is very limited—the body relies on the influx of inflammatory and healing cells from the blood for healing to take place.

Without surgery, many labral tears will never heal. In fact, many people probably walk around with minor, painless tears for much of their lives. Labral blood flow simply isn't sufficient for the repair process to take place naturally or efficiently, and injuries can persist for months or even years.

That's where surgery comes in.

By stitching together the tear or tears in the cartilage ring, the repair process is sped up by several orders of magnitude, as the brunt of the work—reattaching the cartilage—is done surgically. All that remains is strengthening the shoulder as the cartilage fully cements itself back into place.

Unfortunately, even with surgical assistance, that process can take a significant amount of time.

Following surgery, Jordan must work at slowly increasing the stress he places on his shoulder while it heals. Rehab begins with simple range-of-motion exercises, progresses to strengthening and conditioning and finishes with live-action practice drills. In severe tears, rehab can require upwards of six months.

That appears to not be the case with Jordan.

Though exact medical details are unavailable—the projected three- to four-month recovery time suggests the labral tear is located at the point where the biceps tendon connects to the cartilage ring.

Such an injury is referred to as a "SLAP" tear—standing for "superior labrum from anterior to posterior." Basically, the top of the labrum ring tore from front to back.

A Bankart tear—where part of the labrum ring actually separates downward from the shoulder socket—would likely require a longer recovery.

Nevertheless, no labral tear is the same, and Jordan's may very well be either type—or another altogether. No one can be sure from the outside looking in.

As torn tissue is never quite the same even after it heals, it is also possible that Jordan's shoulder could be at higher risk for re-injury down the line. The NBA's Dwight Howard faced several aggravations of a labral tear this season. Howard has not yet received surgery for a repair, but it would not surprise anyone to see him go under the knife after the Lakers' season ends.

That said, Jordan's definitive surgical repair should help minimize any complications. Alas, it's impossible to predict his shoulder's future with any certainty.

What is certain, though, is that Jordan's draft stock should be minimally affected.

Jordan played with the injury. What's more, he worked out at the combine—except for the bench press, an exercise that places too much stress on even a mildly ailing shoulder. Finally, he carries with him a recovery time that could get him to the field as early as late May.

In short, teams should not shy away due to medical risk. Matt Miller—Bleacher Report's NFL draft lead writer—agrees:

"Jordan has potential to be drafted as high as No. 1 overall, and that's with teams knowing about his shoulder. It never affected his stock."

All told, while it probably proved a painful nuisance over the past few months, Jordan's shoulder shouldn't limit his potential next weekend. By the time training camps roll around, he should be ready to show what he can do at the next level as well as he possibly can.


Dave Siebert is a medical writer for Bleacher Report who will join the University of Washington as a resident physician in June. Medical information is based on his own knowledge. Quotes were obtained firsthand unless otherwise noted.

Follow Dave on Twitter for more sports, medicine and sports medicine.


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