Uncertainty has surrounded the injury, which will keep Tannehill out for his fifth consecutive game Sunday, and the Dolphins have a return date of Nov. 25 at Indianapolis in mind.
With the help of ESPN injury analyst Stephania Bell and former San Diego Chargers team doctor and sports medical analyst David Chao, an orthopaedic surgeon, here's an explanation of Tannehill’s injury. Is playing through it the right move? Is that return date realistic?
What’s Tannehill’s injury?
It has been diagnosed as a right shoulder capsule injury. Tannehill admitted he didn’t know what that was until the doctors told him. Many of us might share the same feeling. It’s not a part of the shoulder that commonly gets injured, such as the rotator cuff or AC joint.
Bell defines the capsule as “a fibrous tissue around the joint. It helps contain the bony elements of the joint and it provides stability.” The capsule, which connects the upper arm bone to the shoulder socket, can become overstretched or suffer a tear after repeated overhead activities or trauma.
In Tannehill’s case, it is likely the latter -- more specifically, being hit by Bengals defensive end Carlos Dunlap from behind in the middle of his throwing motion during the teams' Oct. 7 contest.
It doesn't hurt Tannehill to walk around, but he said it does give him pain when he makes an overhead motion, such as throwing.
Is it smart to fight through it?
Tannehill spoke Wednesday about how frustrating mentally and physically it has been for him to deal with an injury as uncertain as this one. He’s a tough guy, and he’s been trying to play through something that hasn’t responded well.
When asked if the injury is better than it was a month ago, Tannehill initially responded: “it’s got to be” before saying that he felt it would be a “little better” when throwing again. There’s clearly still uncertainty.
He’s not throwing this week after coach Adam Gase said: “We haven’t had the jump that he was looking for. That’s why we’re kind of taking a step back and saying, ‘All right, let’s go [rest].’”
Tannehill added: “We’re resting again, trying to just get it to heal up because every time the arm goes through that motion, it stresses that capsule. That’s the goal right now is just to let that thing tighten back down, heal up and then get back into throwing during the bye.”
Tannehill’s words indicate that he has at least a partial tear of the capsule, Chao said.
The Dolphins' treatment plan includes hours of Tannehill working to strengthen the muscles around the capsule, such as the rotator cuff, to lessen stress on the capsule. Then they simply have to wait.
“While the capsule has some potential to heal, it depends on the size and location of the tear,” Bell said. “There is potential for some capsular injuries to heal, but not necessarily all of them.”
Tannehill has accepted that he won’t be 100 percent this season. But he’s confident he’ll play again in 2018, and he hopes it is later this month.
“Yeah, I think it’s going to be playing through pain the rest of the year,” Tannehill said.
He’s convinced that once he can make all the NFL throws, he’ll be able to fight through the pain.
It's an injury that Tannehill admits can be made worse, but most likely only if he's hit by a defender in a similar manner to how he first injured it.
Chao agrees on the unpredictability of the injury and, after hearing Tannehill’s comments and looking at the timeline, believes that he isn’t close to coming back.
“It certainly concerns me that he’s in pain when he throws,” Chao said. “If his pain is from the capsule, the answer is no, he shouldn’t play through it. If the pain is something secondary that is not going to be made worse, then OK, maybe you can fight through it. But usually when it’s pain in your throwing shoulder, you can’t make all the throws, not even speaking to overcoming that pain.”
Tannehill joked that the best plan for recovery is the only thing he doesn’t have in the middle of a Dolphins playoff run: time.
“The throwing motion is so complex and quick. Imagine doing something and every time you do something, you get a sharp pain,” Bell said. “It’s reflective and prohibits your motion. It hurts, and your body tries to compensate around it. It affects your ability as a thrower even if you decide you’re going to play through it. It’s less about toughness and more a natural reflex.”
"I think it's going to be playing through pain the rest of the year."Dolphins QB Ryan Tannehill, on his shoulder injury
Is the Dolphins’ Nov. 25 return date realistic?
Tannehill says he’s “all in on Indy,” which is two-and-a-half weeks away.
The simple answer is that return date is possible, but it likely falls somewhere between ambitious and overly optimistic. December seems more likely than November at this point.
Tannehill admitted that he “wasn’t close” to making NFL throws this week.
“This injury is unpredictable. The recovery is unpredictable. There isn’t a defined timetable of X weeks. Without knowing the extent or location of capsular injury, it’s even tougher to narrow down,” Chao said. “You can’t count on anything. Even the doctors who are working on him, they don’t know for sure when he’ll play.”
One thing to watch is if Tannehill does get close to a return, will he change his throwing motion to compensate for the injury? He says the pain typically happens at an “overhead” position. So certainly this is a multilayered situation.
“There are a few possible scenarios,” Bell said. “One, that it’s too painful to throw and he’s never able to be functional again to throw this season and he can’t return. Scenario two is he comes back, takes a certain hit, falls a certain way or the consecutive throws become problematic enough that he’s not able to sustain for the rest of the season. And the third scenario is that he comes back and he’s fine. He’s uncomfortable, but he’s effective and serviceable for the remaining of the season.”
“Even if he’s able to finish out the rest of the season, he might not feel himself and could need an offseason procedure like a scope (arthroscopic surgery).”
Tannehill said he's talked to multiple doctors and “no one said surgery."
Typically, surgery is the last option for quarterbacks on their throwing shoulders. Both analysts said the Dolphins and Tannehill are taking the “sensible” plan in avoiding surgery right now.
Tannehill likely feels the pressure to get back on the field in what seems to be a defining season for him with the Dolphins franchise. He will miss his 25th of the Dolphins' last 30 games on Sunday, and he still wants to prove his worth as Miami’s answer to its longstanding franchise quarterback question.