Inky Johnson’s Incredible Football Injury Journey: From Tragedy to Inspiration

This article is a summary of the YouTube video ‘Inky Johnson’s RARE Football Injury Explained – From TRAGEDY to INSPIRATION’ by Brian Sutterer MD

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Inky Johnson suffers severe arm injury, inspires others without restoration.

Key Insights

  • Inky Johnson suffered a life-threatening injury during a football game, where he ruptured a subclavian artery in his chest, causing internal bleeding.
  • The injury resulted in the paralysis and atrophy of his right arm.
  • The subclavian artery supplies blood to the arm and is located close to the brachial plexus nerves, which control muscle function and sensation in the arm and chest.
  • Johnson's injury was a severe type of peripheral nerve injury, possibly caused by a combination of impact and traction on the nerves due to the helmet hitting his shoulder.
  • The subclavian artery's blood flow is crucial for the brachial plexus nerves, and a tear in the artery can lead to ischemic damage and further contribute to nerve injury.
  • There are different classifications for nerve injuries, with neuropraxia being the mildest and neurotomesis being the most severe.
  • Johnson embraces his condition and uses it to inspire and help others.
  • Doctors can attempt to repair nerves or perform nerve grafts, but in Johnson's case, they were unable to restore function to his arm.
  • The video provides a medical perspective on the anatomy and injuries related to stingers, spinal cord injuries, and brachial plexus injuries.

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Transcript

Doctors rush in, head boy says, “Hey ma’am, gotta rush him back to surgery, he’s about to die.” And he says to me, “You ruptured a subclavian artery in your chest, you’re bleeding internally. If we don’t perform this surgery tonight, I guarantee you, you won’t be here no more.”

Inky Johnson was able to rise up from a life-threatening and tragic injury to become one of the most inspiring former athletes in the world today. In today’s video, we’re gonna take a look at the medical side of what exactly happened to Johnson.

Welcome back, everybody. I’m Dr. Brian Suter, and this is your number one source for learning about the unique medical side of the world of sports.

This was the play where Johnson got hurt back in 2006, and on first review, it honestly looks like a play that we’ve seen countless of times throughout the course of a football season. In these situations, we usually worry about head-to-head contact, but here in this case, the Air Force player’s helmet went directly into the right upper shoulder of Johnson as he was coming in to make this tackle.

The feared severity was apparent as Johnson was carted off the field, but whenever we see a player carted off like this, we’re of course thinking more often about the health of the nerves or the spinal cord, but in Johnson’s case, the injury was actually a lot more severe.

As Johnson said later on, he actually blacked out, losing consciousness from this hit, and after the initial shock wore off, everything sort of localized in his right arm and his right hand, but the most immediate concern here was actually that Johnson had an injury to the subclavian artery, which is one of the branches we’ll look at here in a minute that comes off of the aorta and supplies blood down to the arm.

After doctors repaired the artery, then it became more apparent about the severity of the brachial plexus injury that Johnson had suffered, leaving him with the atrophied and paralyzed arm he has today.

A lot of people are of course familiar with a stinger, which is a transient injury to one of the peripheral nerves after it’s left the spinal cord, and typically these are what occur on an impact like this, but Johnson’s injury was the most severe type of peripheral nerve injury that we can see in this sort of whole constellation of what you might consider a stinger.

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Here in the anatomy tool, I’ve highlighted the brachial plexus and the subclavian artery. The first thing you can appreciate is how close the subclavian artery lies in proximity to the brachial plexus. If we rotate the model around here, of course, the spinal cord is traveling down the vertebral column and then the spinal nerves branch off to eventually come together to form the brachial plexus.

The brachial plexus is this collection of nerves that sits kind of right in this area, just outside of our neck and kind of in the upper portion of our shoulder. Those brachial plexus nerves go on to control the muscle function and sensation throughout the arm and a little bit in the chest.

When most athletes have a stinger, it’s by definition a temporary transient injury to these nerves that resolves, it goes away. Usually this is from some sort of direct trauma causing compression of these nerves, or it can be from some traction where somebody gets their neck pulled in the opposite direction, stretching those nerves.

When we look back here at the hit that Johnson took, it was likely a combination of the impact from the helmet hitting directly onto where those nerves live, potentially causing some traction as it tended to pull the shoulder downward, stretching those nerves, tearing those nerves, but then also is probably contributed by the damage to the artery because that artery supplies those nerves as well.

In this hit, it’s not so much just purely the impact from the helmet as it is the action of the helmet forcing the shoulder down into this depression, which is gonna put more traction and pull on those brachial plexus nerves, potentially tearing them as much as it could cause direct trauma.

The other contributing part to this is that the brachial plexus nerves need blood flow. And the majority of that blood flow comes from this subclavian artery. The subclavian artery here is a branch off of the aorta coming from the heart, and it continues on to deliver blood down to the rest of the arm. When that artery is torn, you’re gonna get ischemic damage, meaning death of those nerve tissues because they don’t have adequate blood flow, which can further contribute to the possible nerve injury that we saw with Johnson.

Now, if we wanna take this to a whole nother level, of course, in medicine, we have classifications for everything, and it’s the same with different types of nerve injuries. The most mild is called neuropraxia, where basically there’s just some damage to the myelin that sort of goes around to protect the actual axon, which is the yellow here. That’s kind of the wire of the nerve. Nerves are sort of insulated by this myelin that helps them to conduct their electrical signal. So in neuropraxia, there’s just some transient injury to that myelin, but the actual wire is still intact.

The next level of severity is something called axonotomesis, where now that actual wire, this yellow part here, the nerve, has been cut. But what’s important is that the casing or the protection around the nerve, thinking of it as like the insulation around the wire, is still intact, but you’ve cut the metal on the inside. These both have very good potential to heal, but it’s the third kind, neurotomesis, where there’s actually been complete transection of both the axon coming through the middle and also that outer, what we call epineurium, that sort of provides the pathway for that axon to hopefully regrow.

So when we talk about these severe brachial plexus injuries, we’re usually talking about some sort of neurotomesis, where those nerves have been completely severed from either traction, compression, or being directly cut.

What I think is one of the most admirable things about Inky today is that he doesn’t try to hide his appearance with this atrophied arm. Over time, when you lose the nerve innervation to the muscles, the muscles basically atrophy away. They shrink up, they become smaller, and they just sort of wither away. They don’t have that constant nerve signal supplying them to keep them robust. And so what we see here with Inky Johnson today is just a completely thin atrophied arm because of the loss of that innervation.

The brachial plexus also controls the activation of the pectoralis muscles in the chest. And so you can also see that muscle atrophy in the pec muscle here with Inky. But Inky doesn’t try to hide this or cover it up. Rather, he embraces what’s happened to him and uses it as an example to help others in their lives.

With some of these brachial plexus injuries, doctors can try to repair those nerves or do different nerve grafts to try to give different nerve control to other muscles that might be functioning better. But unfortunately, in the case of Johnson, they just weren’t able to get that function back.

Johnson’s story continues to inspire others. And hopefully, this more kind of anatomical, medical look at what happened helps you guys kind of learn a little bit more about our neurovascular anatomy and what we can kind of see in some of these injuries that we talk about with things like stingers, spinal cord injuries, and brachial plexus injuries.

That’s it for the video, everybody. Let me know as always any questions or comments down below. And until next time, we’ll see you later. Bye.

This article is a summary of the YouTube video ‘Inky Johnson’s RARE Football Injury Explained – From TRAGEDY to INSPIRATION’ by Brian Sutterer MD