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Why Welker got head start

Brady had issues receiver didn’t

By Albert R. Breer
Globe Staff / June 4, 2010

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Wes Welker’s appearance at the Patriots’ organized team activities in Foxborough Wednesday was met with alternating elation and caution.

But without context, conclusions can’t be drawn. And while Welker’s injury, surgery, and rehabilitation have long been compared to Tom Brady’s journey a year ago, the receiver’s timetable is only loosely relatable to his quarterback’s.

According to a source with knowledge of the situation, Welker’s fight back from a torn ACL and MCL is far less complicated than Brady’s return from knee reconstruction was, because the surgeries simply weren’t the same. Both players suffered torn ACLs and MCLs in their left knee, and that really is where the similarities end.

Welker’s torn MCL happened in an area where it could heal on its own prior to surgery. Additionally, there really were no setbacks after the procedure.

According to the source, Brady’s torn MCL was in an area that kept the ligament from healing back on the bone naturally. So the MCL had to be surgically repaired, along with the ACL, as did the posterior medial capsule (a sheet of ligaments on the back of the knee).

The major difference in the injuries was the fact that Brady’s injury was a result of contact and Welker’s wasn’t.

All of this makes Brady’s recovery all the more remarkable, and illustrates that Welker may be closer to a full recovery than the public has believed.

The source said he couldn’t give a timetable on the next steps in Welker’s recovery, but said, “Clearly, it’s a great sign that he was out there able to participate at that level. It means that he’s recovering very nicely.

“Having this level of function, right now, that’s telling that he’s going to have a great chance at an excellent result.’’

After getting a full explanation of what Welker has been through — how the knee was injured, how the MCL healed, and what the receiver did Wednesday — one medical professional painted an optimistic view of where Welker stands four months after undergoing the knee reconstruction. In fact, having Welker for the team’s Sept. 12 opener against Cincinnati may not be out of the question.

“Seven months out? Yeah, it’s definitely a possibility,’’ said Dr. James Gladstone, co-chief of sports medicine at Mount Sinai Medical Center in New York, referencing the time between the surgery and the Bengals game. “That would be good for anyone to get back that quickly, sure. But if he’s doing the things you’re describing at four months, then it’s quite possible, if not likely.’’

Judging by Welker’s movement Wednesday, his progress has been significant.

According to Gladstone, the first phase of recovery includes getting swelling down, range of motion back, and muscles firing. The next phase is strengthening the knee. After that comes agility, running, cutting, and regaining knee proprioception (i.e. coordination), which is where Welker seems to be now.

Then comes playing and reacclimating to different parts of the game.

“There’s a difference between going against simulated opponents and not doing that,’’ said the source, when asked why Welker might have been pulled before seven-on-sevens and team offense work. “They may be very excited about his level of recovery, but they’re going to protect him, too. Biologically, if you’re not 100 percent with the graft, you maybe save that last little bit of simulated play until some time goes by.’’

If Welker can come back sooner rather than later, the question becomes his ability to return to form, and that’s where things are murkier.

A 2006 study by the American Journal of Sports Medicine showed that 79 percent of NFL running backs and receivers undergoing ACL surgery from 1998-2002 were able to return to the field. But the players who did return performed at just 66 percent of the level they performed at pre-injury, on average.

One thing players typically have trouble getting back, Gladstone said, is first-step quickness, which can take 18 months to return to pre-injury form.

Another, according to the doctor, is regaining full proprioception, and yet another is the mental aspect — the player’s confidence in his reconstructed knee.

“A guy can be physically ready,’’ Gladstone said, “but it’s only when they put themselves back into that competition that they figure out just how ready they are.’’

Despite all that, it’s clear that all the developments to this point have been positive, and that Welker’s appearance Wednesday was, indeed, significant.

“That means his rehabilitation is totally on course, as well as could’ve been expected,’’ said Gladstone. “I think he’s got to be comfortable practicing at that level without contact, going full steam, and then you transition to contact, and that’s where the physical and psychological come into play. Every day the knee holds up, he’s gaining confidence, but contact will be a different challenge altogether.’’

Welker, who does not plan on wearing a brace when he returns (which is not unusual for a receiver), faces different challenges at his position than a lineman or quarterback would.

And we’ll all have to wait and see those steps taken. What’s important now is that Welker has gotten through so many other steps in good shape.

“The demands he’ll have, as they relate to this injury, are great with the sudden pivot and twisting at a high speed, especially with the way he plays the position,’’ the source said. “But this is a great sign. They can be very happy with what they’re seeing.

“I wouldn’t say it’s that out of the ordinary that he’s out there. It’s what you’d hope for with an ACL reconstruction.’’

Albert R. Breer can be reached at abreer@globe.com. Follow him on Twitter @albertbreer.

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