Getting A Second Opinion
When the injury bug bites, getting players healthy is important; waiting three weeks to get a second opinion is not.
The Packers have once again been bitten by the injury bug. For the past two weeks, the Packers game day inactive list has been nearly all starters. With contributors like Bishop, Saine and D.J. Smith already lost for the season, the Packers “next man up” philosophy has been tested since day one of the season. Yet as the injuries pile up and the number of players on the injury report and number of games missed increases, the situation becomes an increasing concern.
As the Packers have proven year in and year out, the front office is committed to their guys and their plan. The Packers don’t make flashy trades or rash free agent pickups after injuries. Next man up.
But when you live and die by next man up and every week and every game matters as much as it does in the NFL, there are two crucial components to making the philosophy work. First you need depth. Which the Packers, so far, have proven they have. Second, you need the ability to get guys healthy. And so far this year, the Packers have struggled at that.
Yesterday it was announced that Nick Perry is seeking a second opinion on his injured knee. This is the second time this season that a Packers player has done so.
After injuring his groin in the first game of the season, and trying and failing to come back in week four, Greg Jennings sat out three more games and it was decided that he needed a second opinion. The injury wasn’t healing like they thought it would; it was taking longer.
Days before it was determined that Jennings should get a second opinion, the Packers actually hoped to get him on the practice field. In the end, Jennings needed abdominal surgery and after a delay from super storm Sandy, he’s now healing and is on the road to heading back to playing instead of just waiting.
Jennings and the Packers waited three games between when Jennings re-aggravated his groin and when he went for a second opinion. Had Jennings and the Packers decided that surgery was the best option after week four, it’s reasonable to assume that Jennings could come back after the bye week.
Nick Perry’s situation is similar. He injured his knee against Houston and has sat out three games. Like Jennings injury, recovery is different for every person. According to Weston Hodkiewicz of the Green Bay Press-Gazette, Perry was given a window of three to eight weeks recovery time. Perry is seeking the second opinion now and the Packers hope to have more information within the next two days.
While second opinions in the NFL might not be uncommon, a quick glance at other teams, the Packers do seem to be doing something different. The Jets had two players seek second opinions this year: Darrelle Revis and Santonio Holmes. However, in both situations the second opinion was used to confirm the severity of the injury and both players were placed on season ending injured reserve.
Blaine Gabbert also sought out a second opinion this year. The Jaguars used the second opinion to verify that Gabbert could play the following week. In all three cases, the players got their second opinion within days of their injury. Holmes went for his the day after he got hurt.
Why do the Packers and their players wait so long to get a second opinion? Why, in an age when every game matters more and more and when technology and travel accommodations allow for seemingly easy second opinions, do the Packers seem content to wait injuries out?
If it turns out that Nick Perry requires even a simple knee scope or any number of other procedures, why wait to find out? Why not do it immediately and start the rehab process as soon as possible?
A three week later second opinions shouldn’t be common practice. Here’s hoping no other Packers player needs one.
Jayme Joers is a writer at CheeseheadTV’s Eat More Cheese and co-host of CheeseheadRadio. She also contributes to Pocketdoppler.com. You can contact her via twitter at @jaymelee1 or email at [email protected].
Comments (27)
November 06, 2012 at 10:06 am
"Why do the Packers and their players wait so long to get a second opinion?"
They don't. The original diagnosis is right far, far more often than it's wrong. When you hit the end of the typical healing window, and there's always a range, the variability is significant from person to person, you start to question the severity more so than the original diagnosis. The only way to get a more accurate diagnosis than what the team physicians already give is to immediately go invasive. No physician does that, cases like Jennings are outliers, not the rule. On Perry, there's not knowing if the original diagnosis is even incorrect yet.
"Why, in an age when every game matters more and more and when technology and travel accommodations allow for seemingly easy second opinions, do the Packers seem content to wait injuries out?"
They exercise more caution to place a premium on having a healthy impact player for stretch runs instead of a gimpy one for the duration of the season. Almost every other team knowing it has a legitimate playoff run does the same thing, they exercise extreme caution. Imaging modalities only show so much before you get invasive. No good surgeon goes invasive for a diagnosis unless absolutely necessary.
I realize it's frustrating to see a team sustain so many injuries, but there's nothing wrong with McKenzie or his staff.
As for the Jaguars comparison, it's shallow roster with an entire front office, coaching staff and players on the hotseat. They don't have the depth to take a seat and they'll likely pay the price with lingering injuries. I'd be willing to be the specialist gives the same diagnosis 99 out of 100 times. Little variation.
Jayme Snowden
November 06, 2012 at 11:08 am
Agree with most of this, especially the Jaguars part.
My issue though is, you don't know for certain that the second opinion is more invasive. Wouldn't that depend on person and injury?
Perry's second opinion could be just to wait and rest longer. And it doesn't make first opinion wrong. I just think that in some cases where it could be a question, why not just find out? Finding out doesn't always mean more invasive.
I'm not asking for a gimpy player to come back quickly and I don't see the connection to how thinking that second opinions could come more quickly means more gimpy players. Players would still be able to heal fully.
November 06, 2012 at 11:19 am
"...you don’t know for certain that the second opinion is more invasive.."
I meant to get the initial opinion 100% right, with little uncertainty, you go invasive. Otherwise you take a standard approach that works the vast majority of the time.
I don't disagree with 2nd opinions, but they are a waste to pursue immediately following an initial opinion (unless you're talking HOW to repair a known injury). You just don't fly players all over the country to see specialists when the original diagnosis and course of treatment are right almost all the time.
As for seeking a premature 2nd opinion, it's often irrationally done by players, agents or a coaching staff feeling pressed to get back on the field and they didn't like the first response they received from the team doc.
I get the article, enjoyed reading it. But it's clear fans want a 'why' or 'who's fault is this' when there is no rational answer. People like order and easy explanations. This is random and unfortunate.
November 06, 2012 at 02:30 pm
"This is random and unfortunate."
Precisely, it is random, and in randomness there are always clusters or streaks. It happens, in human minds we need organization, what we perceive to be random is actually quite organized. What is truly random is actually very hard for people to comprehend or accept.
From everything I have heard from other experts and what not the Packers have a very good medical staff that is a very conservative medical staff. And while we as humans and fans naturally want to correlate events and such together, sometimes there just arent any.
Did you ever think that maybe the injury problem is TT's fault? Maybe he is targeting players that work too hard, and yes when it comes to physical activities you can work to hard. Maybe the players are pushing themselves too hard. It seems bizarre and even weird to suggest it, but so does blaming the medical staff for injuries or the length of injuries IMHO.
November 06, 2012 at 10:41 am
DR. McKenzie might need a second opinion of his job status at this rate. Get your shi% straight!
November 06, 2012 at 10:45 am
You mean the same physician/surgeon they've won 3 super bowl titles under and was, during the injury ravaged 2010 Super Bowl season named the Jerry "Hawk" Rhea Award for NFL physician of the year?
November 06, 2012 at 12:23 pm
Not a biggie, but three Superbowl titles?
He was there in Superbowl II?
I WISH we had three since then, but I am afraid we have only won two.
Sorry to point it out, but I know we're all on point fans here, so figured I would mention it.
November 06, 2012 at 12:24 pm
My bad, there for the last three appearances, they won 2 of 3.
November 06, 2012 at 12:54 pm
I kind of am in the whats going on mode. He has been around for a long time, but in the last few weeks i know of 2 injured players seeking a 2nd opinion. In Greg Jennings case, he needed surgery. Didn't Dr. McKenzie see that? Could have Jennings been back by now if he had surgery when this first happened? Perry's case from what i heard he went for a 2nd opinion to see if he is fully healthy, and how soon he can return.
Either way sounds a bit like the players are starting to lose trust in Dr. McKenzie.
November 06, 2012 at 01:15 pm
"Either way sounds a bit like the players are starting to lose trust in Dr. McKenzie."
I don't know how you come up with this. There are better than a dozen other players diagnosed and out with injury that appear to be just fine with their diagnosis and course of treatment. That doesn't even count the players working through injury (Lang (elbow), Rodgers (calf), etc.) that have expressed no issue with there course of treatment or diagnosis.
That's the point. You seek a 2nd opinion when a sub-specialist needs to be brought on board due to the oddity of the injury and inability to heal, or; you seek a 2nd opinion when prompted by your agent, in consult and referral with the current physician or on your own volition for a variety of reasons.
Would be willing to bet 2/3rd's of the roster undergo weekly treatments with various diagnosis and don't seek an alternative opinion.
November 06, 2012 at 11:02 pm
Word. Let's get that 5th soon!
November 06, 2012 at 10:42 am
I wonder how much of the 2nd opinion is determined by the Packers and by the player? Was it Jennings that was the one who decided, "hey this isn't right maybe I need to speak to someone else?" or was it the staff that was finally like "WTF mate, let's get a second look?"
November 06, 2012 at 10:46 am
It's a mix. Sometimes they consult with the team physician and agree to refer out, sometimes it's player only decision. They surgeon Jennings went to see sub-specializes in hernia repairs. You would be surprised how sub, sub specialized various surgical specialties have become.
November 06, 2012 at 01:54 pm
Not a fan of the need to blame someone/something for everything...especially when we have virtually no information as to what went into the decisions to 'rest' vs the alternative. And especially when those players were likely involved in the decision to initially try the 'rest' option.
November 06, 2012 at 02:19 pm
Just an FYI: Silverstein says Perry's second opinion is for his wrist, not knee.
November 06, 2012 at 04:01 pm
Interesting.
November 06, 2012 at 04:53 pm
Very good news!
November 06, 2012 at 06:57 pm
Or is it!
November 06, 2012 at 04:54 pm
Very glad to hear that Perry's second opinion is for his wrist and not his knee. Doesn't mean he's out of the woods, but definitely much better news than what we thought yesterday. Hopefully he'll be ready for Detroit!
November 06, 2012 at 05:16 pm
maybe they're waiting to see if they're healthcare provider will pay for a second opinion.
November 06, 2012 at 05:25 pm
http://profootballtalk.nbcsports.com/2012/11/06/nick-perrys-second-opini...
November 06, 2012 at 09:38 pm
Nick Perry. Wrist Surgery. Going to IR? @#$!!@&#^%*&^!@%#&*!@%^#
November 07, 2012 at 07:51 pm
Thank god for our draft and develop strategy. If we were a team like chicago, they would be sunk when Mclellan, peppers, briggs, brigg's backup, Idonije, and whoever starts opposite Tillman went down.
I am sick of seeing this every year. Why don't they just get a couple more team doctors, because it is now obvious their is some incompetence here. I agree, when one game means so much, and considering your paying these guys hundreds of thousands per game, missing 3 games could easily amount to paying a player several million dollars to sit on the bench. At that point, why would you not fly the best specialists in, or put Jennings on a private jet and let him tour the country for a few days seeing 5 or 6 specialists. When your . When your paying out over 12 million dollars in players salary per game, why are we taking such a huge risk and continually getting burned by relying on one doctors WAG. Imagine how much better we would be if even half of our injured players were healthy thanks to competent diagnoses.
November 08, 2012 at 02:06 pm
1) We just have to face the facts that most of the guys in the sport get "assistance" for their prowess. This creates greater damage when they collide (hence all the froo-froo penalties), and it also makes their bodies more fragile because while you make certain physical parts stronger, you can't with other parts, so they damage themselves simply pitted against themselves.
2) With new collective bargaining the players have about three padded practices in camp. So not only is case 1) on the table, they then are less in tune with muscle memory as to how to move, take a hit, or fall (like the Bishop injury IMO). We just have accept (or reject) this modern football where these bio-machines are making huge money, are creative in how they put themselves in position to make that money, and they don't want to risk it for nothing (like practice). It may seem counter-intuitive, but the more money there is on the table, the more the owners want flag football and the players want to just jog through practice. And the net result is a game barely like the one I grew up on. It's millionaires playing flag football.
As for second opinions, probably the reason for the delay is there is no question there will need to be surgery, but whether a guy can heal up enough to play the rest of the season, or is it necessary right away (like Reggie White in 1995). And that is pure opinion. In the case of Perry, they were going to have him play the season with his wrist and wait for the off season, but the knee was going to keep him out X number of games anyway, so they probably decided to move ahead on the wrist now.
November 08, 2012 at 01:41 pm
when you are layed up with an injury or recovering from something...seems like the wrist is always the first thing to go.
November 08, 2012 at 07:15 pm
Do the rules state there can be no cyborgs on a team? Or what about animals? I could see a 800 lb silverback-if properly trained- making a nice nose tackle, or a 1200 lb Clydesdale making a good vehicle for Cobb to ride right up the middle.
With 200 million a year in player salaries, you would think they could develop a few robots that could easily replace Jarret bush, if not, at least Mason Crosby. Or at the very least train a great ape to charge after Matt Stafford.
November 09, 2012 at 10:51 am
My gut tells me that the Jennings-gets-a-second-opinion-and-'needs'-surgery is not the indication that Dr. McKenzie and the Packers don't know what they are doing.
My gut tells me that Jennings injury may fall under the classification of nagging injury- the type you can hope to play through, but it won't really be right and may re-aggravate until you give it surgical attention and ample time to fully heal (like an entire offseason).
Those types of injuries are the types players always want to play through,even if they aren't 100% so they can be on the field playing next to their team mates, helping their team win games, and more importantly, not loosing their starting job to a young up and comer.
My gut tells me that's the kind of injury Jennings had, and my gut tells me the bottom line is the Packers wanted to attempt to get some production out of Jennings if they could this season, but Greg Jennings (and more importantly, his agent) decided they want the surgery now, season be damned, so Greg can hope to be 100% before free agency opens up... So he can be 100% when going to work out for other teams in the NFL. This also acts to keep him from performing at less than 100% on the field THIS season, hence, there will be less chance of him performing poorly on tape for other teams to use as leverage and a basis for not bidding as high for his services as a FA.
IMO, this whole Jennings scenario is about BUSINESS DECISION, and probably has little to do with the Packers MEDICAL STAFF. Just my gut.