Last December, Tony Romo rather suddenly underwent back surgery to treat a herniated intervertebral disc in his lower back. The surgery ended Romo's season, preventing him from playing in a Week 17 loss to the Philadelphia Eagles—a game that decided the 2013 NFC East champion.
Tony Romo diagnosed with herniated disc. Surgery necessary, per sources— Chris Mortensen (@mortreport) December 23, 2013
According to ESPNDallas.com's Todd Archer, Romo is nearing a return to full speed as of this week—about five months after his operation:
I'm getting close," Romo said. "We're just going to be smart during the OTAs and have a little bit of a pitch count but we're going to go out there each day and try to do all that we can. The guys are working hard and doing great and I think we're going to be ready.
Over the coming weeks, the Cowboys' signal-caller will likely complete the rehab process. Based on his progress so far—and barring any unforeseen setbacks—it seems he will do so well in advance of the 2014 season.
A review of his operation and rehab shows how far he's come.
Conceptually, microdiscectomies and discectomies address the symptoms of a herniated, "bulging" disc—such as pain, numbness and weakness in the legs—by literally removing the problem, thereby decompressing the area. As a result, the pressure on and around the affected nerve lets up, which then slowly but surely begins to resume normal function.
For more details on how a herniated disc causes symptoms, see this author's article from December.
In one sense, Romo's recovery began the instant his surgeon—Dr. Andrew Dossett—cut out the offending portion of the troublesome disc and allowed the nerve to start recovering. It's also possible Dr. Dossett removed the entire disc altogether, but as always, precise medical details are not publicly available.
Following surgery, Romo likely began his rehab within a few weeks. He almost surely started off very slowly—such as working on merely walking without pain. Back stretching exercises probably soon followed.
That said, Romo's medical team likely forbade him from placing significant stress on his back for quite some time following the procedure. After all, repeated forceful twisting and bending—both on his own and with the "assistance" of opposing defensive linemen and linebackers—probably led to the problem in the first place.
As the days and weeks went on, Romo could then progressively work on regaining his range of motion—including bending forward and backward, leaning from side to side and twisting in either direction.
Back and abdominal core muscle strengthening surely came early in his rehab as well. Stabilizing the midsection can take stress off of the healing spine and tissues surrounding the surgical site.
All the while, the damaged nerves were healing, too.
How many regular-season games will Tony Romo start this season?
Depending on a number of factors—such as how long a nerve's function suffered as a result of a herniated disc—the aforementioned pain, weakness and numbness of a herniated disc can linger for days or weeks after surgery.
Yet with any luck, those symptoms steadily improve with time.
For example, the pain that probably shot down Romo's leg with certain movements prior to surgery should continue to lessen. Additionally, any muscles suffering from weakness and atrophy—both as a result of immobility as well as nerve dysfunction—should build back up once more, and numb areas of the skin should regain sensation.
Regrettably, discectomies do not always sufficiently relieve symptoms. For a multitude of reasons, they can persist even after the presumed source of the problem—the bulging disc—is gone. The risk for another future disc herniation also remains.
Fortunately for Romo, nothing yet suggests the above scenarios will come to pass.
Quite the opposite, actually.
As the best spinal surgeons tend to do, Dr. Dossett rejuvenated Romo's career. As a result, it looks like the veteran is in line to start the regular season.
Romo's final step will be taking contact without the recurrence of symptoms—something the Cowboys may not test out until preseason matchups begin later this year. After all, it would be a shame if Romo suffered a setback during less-than-meaningful preseason activities.
In other words, while this may not be the last time the Cowboys captain's back speaks up, for the time being, it looks like all is going as planned in Dallas.
Dr. Dave Siebert is a resident physician at the University of Washington who plans to pursue fellowship training in Primary Care (non-operative) Sports Medicine. The above information is for informational purposes only and should not be taken as medical advice for Tony Romo or anyone else.