Tua Tagovailoa #13 of the Alabama Crimson Tide is helped off the field after being injured on a play ... [+]
Today, the University of Alabama football team won 38-7 over Mississippi State but at the same time suffered a big loss. Their star quarterback and Heisman Trophy candidate Tua Tagovailoa took a tumble while being tackled. The result was a right hip injury as seen after the 4:40 mark in this ESPN video:
According to ESPN’s Mark Schlabach, Tagovailoa is done for the season with a right hip dislocation and a posterior wall fracture. Ouch plus ouch multiplied by ouch. This is bad news for the Alabama football team, but more importantly what does it mean for Tagovailoa? Well, that really depends on the extent and complexity of the injury.
Normally, your thigh bone (also known as your femur) connects to your hip bone (also called your pelvic bone) via a ball-and-socket joint. Your femur, which rhymes with the words lemur, screamer, and juice reamer extends from your hip down to your knee. As you can see in the picture below, the top portion of your femur (known as your femoral head) forms a ball that sits inside a round pit in the side of your pelvic bone that serves as a socket:
Here is an illustration of the bones of the pelvic girdle. (Photo By Encyclopaedia Britannica/UIG ... [+]
The socket is otherwise known in medical speak as the acetabulum. It is pronounced “ass-eh-tab-yule-um.” The first part of this word may be easy to remember because the structure is close to that part of your body. Assuming that you are not a caterpillar, you should have no more than two femur-acetabulum pairs, one on each side of your pelvic area.
This ball-and-socket type of arrangement allows you to move your thigh and hips in many different directions and do things like splits, high kicks, and The Funky Chicken dance, not necessarily in that order. Muscles and ligaments are supposed to keep your femoral head in your acetabulum on each side, just like your friends are supposed to keep you from doing The Funky Chicken on the dance floor.
But both of these safeguards aren’t always enough. When a strong force pushes your femoral head outside your acetabular socket, it’s called a hip dislocation. This can occur more readily when a portion of your acetabulum is broken (which in medical speak is a fracture) thus compromising what’s supposed to be a rather tight fit between your ball and socket.
When it comes to your hip, posterior means towards your butt, and anterior means the opposite direction, towards your front side. Therefore, a posterior acetabular wall fracture means that the back, closer-to-your-butt portion of your socket has a break in it. An anterior wall fracture is when the front portion of your socket is broken. A column fracture versus a wall fracture extends beyond the wall of your acetabular socket into the rest of the pelvic bone.
Posterior hip dislocations and acetabular fractures are more common than anterior ones. That’s because one of the most common causes of hip disclocations are car accidents in which the knees hit the dashboard and thus push the femur head backwards.
Of course, whenever a fracture or dislocation occurs, the big question is whether surgery is the next step. As the saying goes, surgery is only minor when it is done on somebody else. And hip surgery can be quite major and serious surgery. Therefore, typically you want to avoid surgery whenever you can.
With a hip dislocation and acetabular fracture, if your femoral head can be put back in your socket, if all of your bones remain in the right places with the edges of the fracture directly next to each other, and if there is no other damage to your surrounding structures, you could avoid surgery. Time and keeping weight off your affected hip for a while can allow the fracture to heal. That means using crutches or a walker for up to three months. That may also mean wearing or using some type of device to keep your femoral head from slipping out of your acetabular socket until things in and around your hip are adequately strengthened.
Most cases of acetabular fractures require surgery though. So that you can maintain full and smooth range of motion in your hip, both sides of the femoral-acetabular joint needs to be very smooth and so does the surface of your socket. Any rough surface could also make it more likely to develop arthritis in the area. This means that any disruption should be fixed. During the operation, the surgeon will move all the pieces of your bones back to where they belong and may insert screws and a metal plate to hold them in place.
After surgery, assuming that no complications occur, you can’t place any weight on your hip until at least six to eight weeks after the surgery. Then you can begin to place some weight but not all until about three to four months of healing have occurred. Whether you get surgery or not, effective physical therapy will be an essential part of your recovery. Thus, it is important to not only get a good surgeon but also a good physical therapist.
If you are wondering how soon you can return to sports after such surgery, consider what the American Academy of Orthopedic Surgery (AAOS) website says: “it can take from 6 to 12 months to return to more vigorous sports activities.” A half-year to a year may seem like quite a wide range. Nonetheless, this isn’t surprising because such hip injuries and how people respond to them can vary quite significantly.
When the damage to a hip is extensive, a surgeon may insert an artificial hip replacement.
Comparisons between Tagovailoa’s situation and that of former powerhouse NFL running back Bo Jackson may be a bit premature. Yes, Jackson suffered a hip dislocation and posterior wall fracture when tackled during a playoff game against the Cincinnati Bengals, back in 1991 when the Bengals and the word “playoffs” actually went together. However, Jackson’s injury got a whole lot more complicated after his hip was popped back into place. This popping back tore through some blood vessels, which then deprived certain areas of his hip of blood and oxygen. Without blood and oxygen, bone tissue can deteriorate and die in a condition called avascular necrosis. Ultimately, the damage got so severe that Jackson had to get an artificial hip replacement, which eventually ended his football career. This certainly was not a typical situation but is in the realm of possibilities of what could happen.
Regardless of whether Tagovailoa ends up getting surgery or how minimal the surrounding damage was, he won’t be available for the Crimson Tide for the rest of the season. Of course, if you are thinking of writing off Nick Saban’s Alabama team for this season, realize that his team is like Thanos’ army. It’s very deep with lots of talent, and with five national championships during his time at Tuscaloosa, Saban has gotta have the Infinity Stones hidden somewhere.
Last week Tagovailoa's team lost to the LSU Tigers. (Photo by Kevin C. Cox/Getty Images)
The bigger question is how will this injury affect Tagovailoa, who as currently a junior in college may enter the NFL draft next year. It is difficult to tell at this point as the full extent of Tagovailoa’s injury hasn’t been revealed yet. Hopefully the injury won’t be too complex and the surrounding structures have not been significantly damaged. Knowing more about this and the subsequent outcome of his surgery, if he gets surgery, will then help determine if and when he can make a full recovery.
