We learned on Sunday that Kansas City Chiefs wide receiver Tyreek Hill suffered a posterior SC (sternoclavicular) dislocation. There are two basic types of this injury: anterior (forward away from the body) and posterior (backward, toward the body). Hill suffered the latter version.
On the surface, that doesn’t sound like much, but let’s dive deeper into the anatomy and what it actually means.
As seen above, the SC joint is where your sternum and collarbone meet. Very little movement occurs here, but it is a crucial piece of how your shoulder moves.
With the type of high-grade force that we saw Hill incur, normally an A/C (acromioclavicular joint) or clavicle itself takes all the force of the injury. These injuries are typically seen in car accidents (not football games) from a blow against a steering wheel or dashboard. Most often, we see a clavicular fracture from this type of force. This was not the case today.
An S/C dislocation is a rare injury. As recent as a 2015 study, these account for about 3% of all shoulder injuries in football players. In the same study, the ratio of anterior (forward) to posterior (backward) dislocations was 9:1. So this is even rarer than the injury incidence itself.
Evaluation of this injury will show swelling in the area as well as pain with motion of the shoulder and most likely a “clunk.”
Given the location of the injury, you can imagine what is at stake once one of these happens. Structures immediately around the S/C joint are at risk for damage, including but not limited to neurovascular, as well as airway. Think trachea and aorta.
We have been told Hill avoided serious injury. Credit to both medical staffs on site for having a plan in place to take care of these injuries, including quick diagnosis and analysis of injury.
A recent example of a wide receiver with a similar injury would be Danny Amendola for the Rams in 2012. Game records show that he only missed three games (and a bye week) with a similar injury. Since we do not have all the information, it would be reckless to make an assumption at this time when it comes to Hill’s return-to-play status.
The most significant part of the injury is regaining stability at the joint. We have been told that surgical intervention isn’t needed for Hill, so that is obviously a positive.
The key will be regaining dynamic stability through rehab. This will be accomplished by putting the joint in compromising positions (pushup, grabbing, contested catching) and seeing how it reacts. Re-dislocation is a real thing, and the medical staff will be sure that the player is ready before reinitiating contact. Exercises to reinforce stability and strength in these positions will be paramount.
While we don’t know all the details, it appears that this player avoided more serious medical complications of a seemingly innocent injury. We will wait for further confirmation of procedures and clarification of the exact injury and procedures ahead.
Aaron Borgmann is the founder of Borgmann Rehab Solutions. He spent 12 years in the NFL as an assistant athletic trainer and physical therapist before joining Arrowhead Pride.