Dr. Kenton Fibel weighs in on Texan WR injury and challenges returning from Hamstring injury.
Article Link: The NFL’s most frustrating injury. What to know about the hamstring, Nico Collins and recovery (msn.com)
Houston Texans and Nico Collins face uncertainty of hamstring injury (houstonchronicle.com)
The Houston Texans’ receiver took off down the field late in the first quarter of Sunday’s 23-20 victory over the Buffalo Bills. Collins blew past defensive backs Rasul Douglas and Cole Bishop, showcasing high-end speed to get open deep and catch a C.J. Stroud 67-yard touchdown pass.
But something seemed off as Collins, the NFL’s leader in receiving yards, crossed the goal line for his season’s third score. Collins straightened his posture after catching the ball, slowed on his way to the end zone and stiffened when he got there.
The receiver did his best to show nothing was amiss. He tossed the ball into the stands and high-fived fans in celebration. Yet after a choreographed handshake with fellow wideout Tank Dell, Collins couldn’t hide it anymore. The receiver was ruled out of the game shortly after halftime with a hamstring injury: an all-too-common ailment that can be hellish for football players. Coach DeMeco Ryans said postgame that Collins “felt his hammy grab” and he’d be evaluated “day-to-day.”
The hamstring is a collection of three unique muscles on the rear side of the leg connected by tendons to bones in one’s pelvis, knee and lower leg. The conjunction of muscles means that hamstring injuries are not uniform in their location, ranging from anywhere from the gluteal region to down by the knee.
A strain occurs when muscle tissue is overstretched, possibly to the point of tearing. That can often happen in the hamstring when there’s a sudden knee extension or hip flexion according to Dr. Kenton Fibel, a sports medicine specialist at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles. Fibel said the nature of football’s physical movements breeds an environment ripe for hamstring injuries. 
“There’s no doubt that they’re more commonly seen in sports that have more of this quick, rapid acceleration as well as quick changing direction and reaction,” said Fibel, the medical director for the NHL’s Anaheim Ducks. “That’s why we see it more commonly in soccer players or American football players, and that’s why you’re seeing it probably more in your skill position players.”
Fibel said that Collins’ rapidly lengthening timeline likely came as the team got more information about the injury. The grabbing sensation Collins felt is synonymous with a common strain. But between physical exams and imaging studies done following the game, the team likely got more understanding of the injury’s severity and realized Collins needed appropriate time to heal and not risk re-injury.
Unlike other lower-extremity injuries common in football, hamstring injuries are almost always non-operative and must heal on their own. There’s been improvements in rehabilitation processes to prevent re-injury. But because there’s no procedure to streamline initial recovery, patience is paramount in the process of preventing any further damage.
“You can’t speed up time when it comes to tissue healing,” Fibel said. “That’s the biggest challenge with these. It’s acknowledging and being better at understanding the severity of the injury so that you can have a better understanding of the timeline that it’s likely going to take so you can return them and not have as high of a risk of re-injury.”
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