Dak Prescott Injury Analysis: A step back in the right direction

Cowboys QB Dak Prescott is expected to make a return at the start of the 2021 NFL season, going into what will be his 6th season in the league, after suffering a compound ankle fracture and dislocation of his right ankle last year. The injury that took place in Week 5 last year required immediate surgery and forced him to miss the remainder of the season; fast forward to now, after months of rest, rehab, and non-contact action, Dak is gearing up to resume play, leaving some to wonder just how ready is. Let’s take a dive into the situation and look at what to expect for this season.

First, let’s discuss the ankle complex and the injury. The ankle, or talocrural, joint, is made up of the three main structures, the tibia, fibula, and the talus. An ankle

dislocation occurs when the tibia and talus separate from each other; ankle fractures

are often caused by a sharp blow or unusual stress to the bone, potentially involving twisting or rotation. A compound fracture is one in which the bone breaks through the skin exposing the area to possible infection. We aren’t entirely sure which bones were broken, but judging by the severity of the injury, it could have been a trimalleolar fracture involving the lateral, medial, and posterior malleoli; it is likely that ligaments were involved as well.

With the injury happening in October and the season set to begin soon, Dak has reliably recovered and experienced all the phases of rehab. It takes 6 weeks on average for a bone to heal and about 4-6 months (or longer) to return to play from the type of injury. By about 1 year, the majority of players resume activities with no issue. Those who have smoother transition back to sport tend to be male and younger, have had a less severe fracture and no or mild systemic disease.

The next complication of note is the right latissimus strain Prescott experienced during the 1st day of 2021 training camp. Pulled himself from practice (1st day of training camp) on July 28 2021 because of shoulder soreness and was shut down from throwing for two weeks. The initial report stated that it was a right shoulder strain, but was revealed to have been a right latissimus strain per MRI. Following the incident, the QB was shut down from throwing activities for 2 weeks. The latissimus dorsi is a muscle whose action is to depress, adduct, extend, and internally rotate the arm at the shoulder. It is also an accessory muscle to throwing and a shoulder stabilizer. The severity of the strain is unknown but it is unlikely to have been a grade 3 strain and most unlikely not grade 2, due to the 2-week timeframe given for return. This injury doesn’t seem to be anything that affects him in the short term, but the situation could be exacerbated due to the nature of his position requiring repetitive throwing for months on end. Even if it was a mild strain, this could turn into a more severe strain with lack of proper rest to recover. It has been pontificated by some that this strain may have arisen due to an overcompensation of the right ankle during throwing mechanics.

Some athletes have similar injuries to Dak’s ankle injury and have come back to continue on with their NFL careers just fine. One doesn’t have to look too far to see other situations in which just that happened: Alex Smith had a much worse leg injury that was infected and required 17 surgeries to fix. He rehabbed and actually was able to touch the field again. It’s hard to determine how things will play out for him long term, but his career is not over by any means. If anything, it’s worth keeping an eye out for how he readjusts to his body at the position and if he may experience other setbacks due to psychological or physical barriers. With Week 1 around the corner, as far as we know, Dak was given the full vote of confidence both internally and externally by ownership, coaching staff, and the like. Expect him to be back up and at ‘em for the start of the 2021 season.