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Dalvin Cook – Can he shoulder the load?

Dalvin Cook’s history of shoulder injuries dates back to his days at Miami Central High School. He first injured his left shoulder after suffering a torn labrum, later going on to have his labrum repaired prior to leaving for FSU. Then, shortly after arriving on campus in 2014 in Tallahassee as an early enrollee, Cook had his first surgery on his right shoulder to repair a tear in the front part of the labrum. After a successful freshman and sophomore campaign, Cook suffered a second injury to his right shoulder, this time tearing the back part of his labrum during a pass blocking drill. Cook later went on to miss FSU’s spring game, but came back healthy in 2016 without limitations. So, in all Cook had one surgery on his left shoulder and two surgeries on his right shoulder, all to repair tears in different parts of the labrum.




So now that we know about Cook’s injury history in his shoulders, what exactly is the labrum, and what does it do? The labrum is a tiny piece of fibrocartilage that lines the joint surface between the upper part of the shoulder blade and the upper part of the humerus to form the ball and socket joint. Due to the shape of the bones in the shoulder, the joint itself is inherently more susceptible to a variety of pathologies, or injuries. A common analogy used for the shoulder is thinking about a golf ball (the head of the humerus) sitting on top of a tee (the socket of the shoulder blade). As you can imagine, it’s relatively easy for the ball to fall of the tee. However, the labrum’s main role is to deepen the socket in order to provide joint stability so that the golf ball doesn’t fall off the tee, or in other words, dislocate. Due to its poor congruency, the shoulder relies a lot on many of the muscles around your shoulder to provide that joint stability in conjunction with the labrum.

Whenever an athlete tears their labrum, it creates concern for potential instability, particularly any time the arm is elevated overhead or when the athlete plays a contact sport. Without the labrum being in place, the head of the humerus is more susceptible to subluxation or dislocation, which involves either a partial or complete displacement of the joint, respectively. As a result, the vast majority of these injuries are treated surgically in high level athletes, and in my personal experience, I’ve never treated a football player who hasn’t had their labrum repaired. Given that this surgery is necessary for a football player to get back on the field, what does the research say, and what does it mean for Cook long term?




According to a study by Arner et al., 93% of American football players with an arthroscopic labral repair returned to play and 79% of these athletes returned to football to play at their pre-injury level. Similarly, a group of researchers in Birmingham, AL looked at 60 NFL players who underwent labrum repair surgeries. They found that 54 out of 60 (90%) of players return to play in at least one regular season game, and the average time it took to get back on the field was 8.6 months. However, none of the players were able to return in the same season if the player opted to have surgery during the season. Overall, it is very possible for the athlete to return to the field and find success, and Cook is no different, re-writing the Florida State record books by setting the school record for rushing yards, all while only missing one game in his college career. Despite the multiple injuries, Cook has been a dependable workhorse for Florida State, and he can be that same player for your dynasty team. Long term, I’d only be concerned about Cook if he suffers a third injury to that right shoulder. Given that most of us play in that #TwotoThreeYearWindow, my best advice would be to enjoy the fantasy goodness that Cook will deliver and then sell high before he suffers that next shoulder injury.

Sources:

Dalvin Cook Injury details taken from PalmBeachPost.com and tallahassee.com

Arner, J et al. Arthroscopic Stabilization of Posterior Shoulder Instability Is Successful in American Football Players. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2015. 31(10): 1466-1471.

White MJ, Andrews JR, Cain EL, Dugas JR, Aune KT, Fleisig GS. Return to Play After Shoulder Stabilization in National Football League Athletes.

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About Matthew Betz

I'm a sports and orthopedic physical therapist currently working in Burlington, VT. I've been a sports fan my entire life and when I became a PT, I decided to combine my two passions into one awesome hobby. My goal is to provide injury analysis and information so that you can win your next dynasty title. Follow me on twitter: @TheFantasyPT