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A Doctor’s Take On Tony Romo’s Injury: No Permanent Damage, No Surgery, Should Be Fine To Play Again

Dr. David Chao gives a detailed analysis of Tony Romo’s back situation based on the information that Romo has an L1 compression fracture.

NFL: Preseason-Dallas Cowboys at Seattle Seahawks Kirby Lee-USA TODAY Sports

For a few minutes on Thursday night, the Dallas Cowboys world stood still, with Tony Romo down on the field, clutching his back. It’s worth noting, by the way, that several Seattle Seahawks stayed nearby to check on Tony and make sure he was okay. The respect was nice to see.

A few minutes later, all seemed right with the world and Tony was begging to go back in. During his post-game press conference he talked about dodging a bullet and he felt good enough that the team didn’t even bother to x-ray him.

I was a little less optimistic, which is odd to type. I told my father in a phone conversation, "you know Tony. This guy went back into a game with a punctured lung... the team needs to not take his word on this and do an x-ray to be safe."

And, two days later, with Romo still in "discomfort" ( an understatement if there ever was one), they did. The actual results weren’t disclosed, but Todd Archer reports it’s an L1 compression fracture. The L1 vertebra is the top bone of the lumbar portion of the spine, where the lumbar meets the thoracic. It’s basically the first back bone that is completely below your rib-cage.

Dr. David Chao (@profootballdoc) said that was his original gut feeling on the issue, but like many of us, including the team doctors, he was taken in by Romo’s persistent optimism and pain tolerance. "I saw the video and thought ‘compression’ but the fact that the team docs were ok without getting a precautionary x-ray led me astray. I still count it as a mistake [on my part]."

Dr. Chao has 17 years of NFL sideline experience and is a consultant for SiriusXM. He answered several questions on twitter Saturday in response to the breaking news, answering a lot of questions which are important to Cowboys fans, including reassurance that this was not related to Romo’s historical back problems.

"This was pure trauma," said Chao," the L1 fracture is away from the area of disc surgery." He did have the caveat that he was unaware of the location of the cyst surgery in 2013, but didn’t feel it was related. He also noted that the transverse process injury was a different location as well, but that there was a significant difference in the two injuries.

"Not the same bone, not the same part of bone. Tony Romo’s bone is not weak. This was football trauma." Unlike the transverse injury, however, the lumbar injury is structural. "It’s much different than in 2014. There’s risk it could get worse. No immediate return to play. He can’t take a hit for six weeks." Chao did note, however, that Romo could be throwing in two weeks time as the throwing motion doesn’t adversely affect the L1 vertebra.

"The bad news is he’s out a minimum 6 weeks. The good news is there’s no surgery required. This injury heals well on its own and there should be no long term issues."

"If Tony Romo wants to play, this will not end his career. There is no medical indication for forced retirement."

Some good news for Cowboys fans and Tony Romo, who clearly loves to play the game. Six weeks from injury would be in time for the Bengals game, but it makes more sense to get him some practice reps and ease him up to game speed over the next couple of weeks, take the bye for one more rest week, and bring him back for the home game against the Philadelphia Eagles. That would be nine and a half weeks of the outside ten weeks they said it would take to get him back healthy with a two week preparation. I would imagine the prognosis for that is much better than thrusting him back in at the minimum  six-week window, and then having him play the shortest week in the NFL against the best defense in the NFL like they did last year.

And this year, there’s actually reason to believe they’ll be okay without him, but that’s another story.