Dak Prescott’s Dual Hand Injuries: Will They Affect his Play (and the Cowboy’s Playoff Push)?

In a hard-fought loss to the Chicago Bears in week 14, the Dallas Cowboy’s quarterback Dak Prescott sustained minor injuries to both hands: an unspecified injury to his right index finger (throwing arm) and a sprained left hand, per the team report.

Fortunately – given the team’s dubious position in the conference rankings – the injuries have not sidelined Prescott, and the injuries appear to be mild. However, both injuries – which are each very common – can vary greatly in severity, in some cases necessitating surgery.

Finger Injuries

In general, finger injuries separate into bone, muscle, and joint issues. With their anatomical complexity, fingers are prone to a wide variety of injuries, including bone fractures, damage to fibers in muscles or tendons (a strain), dislocations, or damage to ligaments (a sprain).

Causes and Symptoms

Given the many tasks of the fingers – from delicate, precise movements to heavy lifting and grasping – injuries are common and have numerous causes. Most often, they arise from overuse or trauma; in Prescott’s case, it was likely the latter – a jam, fall, or collision with another player.

Symptoms will depend on the exact nature of the injury, but usually include a combination of pain, stiffness, swelling, tingling, or numbness, all of which could potentially hamper Prescott’s throwing abilities.

Diagnosis

The medical provider will begin with a physical examination and review of the patient’s medical history and symptoms. If the diagnosis is not immediately apparent, x-rays can be used to check for a break while a CT scan or MRI can elucidate damage to soft tissues – e.g., tendons, ligaments, cartilage, etc.

Treatment

Most finger injuries can be treated non-surgically, as is the case for Prescott. Rest, ice, compression, and elevation are often recommended as first-line treatment along with over-the-counter pain medications. In cases where complete rest is not an option, taping or splinting might be employed to restrict movement of the finger. Indeed, multiple reporters noted Prescott taping his injured finger in the days leading up to the Rams game. Typically, injured fingers are taped to a neighboring healthy finger (i.e., “buddy taping”), which acts as a splint to support, protect, and realign the injured digit.

Surgical treatment is only required for the most serious of finger injuries, such as fractures that break through the skin, tears in tendons, or damage to ligaments. Rehabilitation and recovery will depend on the exact surgery performed but always include physical therapy.

Hand and Wrist Sprains

A sprain is the overstretching or tearing of a ligament, a fibrous tissue that connects bones within a joint. To this end, the Cowboy’s injury report – which lists Prescott as having a “hand sprain” – is very broad. This diagnosis could refer to a sprain in any joint of the hand, or a combination of multiple sprains.

Causes and Symptoms

Any movement which places a joint under a great amount of force in an awkward position can cause a sprain – e.g., twists, impacts, or unforgiving landings. Although this places athletes at a significantly heightened risk, sprains are common across all lifestyles. Swelling in the joint, bruising, weakness, stiffness, and pain upon movement are all common symptoms.

Diagnosis

Sprains fall into one of three categories (or “grades”):

• A grade one sprain – the mildest – occurs when ligaments are over stretched, but not torn. Prescott’s injury most likely falls into this category since he has remained able to play.
• A grade two sprain occurs when ligaments are partially torn, requiring splinting or casting to stabilize the joint as it heals.
• A grade three sprain occurs when a ligament is completely torn (sometimes accompanied by a “popping” noise at the time of injury), and usually requires surgery.

Milder sprains can typically be diagnosed with a physical exam and review of symptoms. However, a medical provider may recommend an x-ray, CT scan, and/or MRI in more serious cases, especially if surgery is being considered. These tools can reveal the exact location and severity of the injury and any concomitant fractures, allowing the doctor to formulate a treatment plan.

Treatment

Sprains can be treated non-surgically or surgically, depending on their severity. If pain and swelling are mild – characteristic of a low-grade sprain – the American Academy of Orthopedic Surgeons recommends trying rest, ice (15-20 minutes several times per day), compression, elevation above the heart, and pain medication as first-line treatment. If symptoms persist for more than two days, a doctor should be seen. More serious sprains may require immobilization in a splint for at least a week. During this time, the doctor may recommend certain stretches to maintain flexibility in the wrist. In certain cases, an injection may be given to relieve pain.

Fully torn ligaments will require surgery, a brief period of immobilization, and physical therapy to return strength and flexibility. All in all, full recovery may take as few as six weeks or as long as several months, depending on severity and the surgery performed.

Prescott’s Outlook

Although Prescott’s precautionary finger taping may have some Dallas fans worried, his ability to fully participate in practice following the Chicago game bodes well for recovery. Seeing as surgery was unnecessary, both injuries are likely mild and won’t prevent him from leading the playoff push provided he does not further damage either hand.

Without a doubt, these injuries came at a pivotal time in the season. The Cowboys are grappling for a playoff spot which could quickly slip out of their grasp with unfavorable results in their remaining three games against the Los Angeles Rams, Philadelphia Eagles, and Washington Redskins. Of note, 2019 has already been the most productive passing year of Prescott’s NFL tenure, having thrown for over 4,000 yards for the first time ever in his four-year pro career. Will the minor injuries affect Prescott’s prolific throwing form? Fingers crossed, no.

Citations

1. Phillips, R. (December 6, 2019). Injury Status of Dak Prescott, Vander Esch, More. Retrieved from https://www.dallascowboys.com/news/injury-status-of-dak-prescott-vander-esch-more
2. Hand Sprains and Strains (n.d.). Retrieved from https://nyulangone.org/conditions/hand-sprains-strains/diagnosis
3. Leggit, J.C. and Meko, C. (March 1, 2006). Acute Finger Injuries: Part I. Tendons and Ligaments and Part II. Fractures, Dislocations, and Thumb Injuries. Retrieved from https://www.aafp.org/afp/2006/0301/p810.html
4. Dak Prescott NFL Statistics (December 12, 2019). Retrieved from https://www.lineups.com/nfl/player-stats/dak-prescott
5. Sprains and Strains (n.d.). Retrieved from https://www.niams.nih.gov/health-topics/sprains-and-strains

Dr. John Knight

Dr. Knight is a renowned hand, wrist and upper extremity surgeon with over 25 years of experience. Dr. Knight is a Board Certified Orthopedic Surgeon and Fellowship trained. Dr Knight has appeared on CNN, The Doctors TV, Good Morning America, The Wall Street Journal, The Washington Post, Forbes, The Huffington Post, Entrepreneur, Oxygen network and more.