Understanding Cam Newton's injury: an interview with Dr. David Geier

Dr. Geier is one of the nation's top experts in athletic related injuries. He's consulted for US Women's Soccer and assisted with orthopedic care for the St. Louis Rams. He's also the head physician for many high schools and recreational sports leagues. Dr. Geier reached out to us at CSR and we were able to get a better understanding of Cam Newton's injury. He did not SPECIFICALLY care for nor do the surgery for Cam, but he's well aversed in these injuries and was able to provide valuable insight to us fans

-Where did you go to med school? What did you go to med school for?

I attended medical school at the Medical University of South Carolina. I did my general orthopaedic surgery residency at the Campbell Clinic. I did my orthopaedic sports medicine fellowship at Washington University in St. Louis.

-Can you explain the injury that Cam Newton suffered?

Based on media reports, Newton was limited by ankle instability. When an athlete sprains his ankle, most commonly he injures one or more of the ligaments on the outside of his ankle. Normally these ligaments heal uneventfully, and the athlete returns to sports without much difficulty. A small percentage of athletes continue to have ankle sprains. This ankle instability can limit their ability to perform their duties on the field.

-Can you explain the surgery that was done to repair his ankle? Have you ever done this surgery before?

Again, based on media reports, Dr. Anderson tightened the ligaments on the outside of his ankle. Essentially a surgeon can make an incision on the outside of the ankle and find the stretched-out ligaments. He can then cut into them and sew them back together in a tightened position. Once the repair of the ligaments heals, the stability of the ankle joint is restored. Yes, I have performed it.

-Why would Cam Newton wait to get surgery?

I can’t speak specifically for Cam Newton. Again, a majority of athletes regain normal stability, motion, strength, and functional ability of the ankle after an acute ankle sprain. With time for the ligaments to heal and adequate physical therapy to restore those functions, most athletes do not need surgery. Trying a non-surgical course of treatment first is usually warranted. At some point, if an athlete is still having instability of the ankle and cannot perform as well as he would like, he and the surgeon can discuss surgical treatment.

-What are potential complications Cam could experience during recovery?

Any athlete who undergoes surgery for ankle instability has to regain full strength and motion of the ankle. Stiffness can be tough to overcome early because the surgeon and physical therapist have to protect the repair while it heals. Also, it is possible to develop recurrent instability despite the surgery. If that happens, more extensive surgeries involving ligament reconstruction can be necessary.

-Is there cause for concern that this could happen again? (Same foot, other foot?)

Recurrent instability of the involved ankle, despite surgical treatment, is unlikely, but it does occasionally occur.

-What’s the rehabilitation process look like for this injury?

After surgery, the surgeon often immobilizes the athlete’s ankle in a splint for 7 to 14 days. He then can switch the athlete into a removable boot. The athlete can start working on range of motion of the ankle, taking care to avoid stretching out the repaired ligaments. The athlete can also work on some early strengthening exercises in ways that can avoid stretching out the ligaments. When the surgeon feels that the ligaments have sufficiently healed, the athlete can progress to jogging. If jogging goes well, then he can start performing more functional, sport-specific activities such as cutting and landing on the ankle. Overall, the rehabilitation and return to sports process can take three to four months.

-What’s the success rate for 100% recovery?

The success rates for these operations are generally felt to be very good. Specific numbers are hard to give without knowing the specifics of the injury and surgery and any associated findings.

-Will Cam Newton experience any long term effects from this surgery?

If an athlete’s surgical repair goes well and the rehabilitation process proceeds uneventfully, he can usually return to sports at the same level of play. Depending on the specific nature of the injury and surgery, or any other findings at the time of surgery, an athlete can develop other problems. For example, if the articular cartilage of one of the bones in the ankle joint is found to have an area of damage, it is possible for that athlete to develop arthritis of the ankle joint over time. In Cam Newton’s case specifically, Dr. Anderson would be better able to answer that question.

-Do you think this injury could affect his "mobile quarterback" play style?

It is possible that an athlete does not regain complete function of the ankle and ability to play that he had before the injury or before surgery. If he doesn’t get his full motion back or loses some of his proprioception (a joint position sense), then he might struggle with planting his foot and changing directions. Generally, though, the goal of these surgeries is to get the athlete back to the same level of ability and type of play as before the injury.

-Are there any other athletes who have gone through this surgery/recovery? How did they fair?

There are likely many athletes who have undergone ankle ligament reconstruction. Steph Curry comes to mind as an athlete who has battled recurrent ankle instability and several ankle surgeries.

Dr. Geier also provided me with a copy of his new reference guide,Sports Medicine Simplified: A Glossary of Sports Injuries, Treatments, Prevention and Much More. It's a great reference for understanding more about sports related injuries, and can be picked up as a kindle book on various different websites. I found it to be helpful in understanding Cam's injury, and highly recommend it.