What Texas LB De’Gabriel Floyd’s diagnosis of spinal stenosis means

In early April, Texas Longhorns head coach Tom Herman revealed why freshman linebacker De’Gabriel Floyd was suffering from stingers that kept him in a non-contact jersey during practices — Floyd suffers from spinal stenosis, a congenital narrowing of the spinal canal that often produces transient spinal cord injuries like stingers.

Floyd is expected to miss the 2019 season as the medical staff continues to monitor him during his rehabilitation.

“We’re going to continue to evaluate him,” Herman said. “Probably not going to be cleared for this season, but we’re going to re-evaluate him in January and hope nine months of rehab, exercise, no hitting — I mean, the kid has been hitting that same [way] since he was eight years old playing football.”

For the rest of the spring, Floyd helped defensive coordinator Todd Orlando with his coaching duties, a role that may well continue throughout the fall.

The question is whether Floyd will ever be able to play football again. Beyond the uncertainty of what will happen during the rehabilitation process, the answer to that question hinges on the Texas medical staff and Floyd himself.

The story of Jarvis Jones is informative — once a top-50 prospect in the 2009 recruiting class, Jones suffered a neck injury as a freshman that resulted in his diagnosis of spinal stenosis, ending his brief career at USC.

”I don’t know how to describe it from a medical perspective,” said Trojans head coach Lane Kiffin following the season. “There’s a serious concern that hits or a number of hits could lead to permanent damage. Obviously, Jarvis’ safety is the No. 1 issue.”

So Jones went back to his home state of Georgia, where the Bulldogs medical staff was willing to let him play football. After sitting out the 2010 season due to transfer rules, Jones became an All-American with a monster 2011 campaign that included 19.5 tackles for loss and 13.5 sacks, followed by an even better season in 2012 that resulted in his first-round selection by the Pittsburgh Steelers in the 2013 NFL Draft.

And while Jones went to on a disappointing career in the NFL that ended with a back injury, there’s no evidence that his spinal stenosis caused him to fail.

Jones and Floyd are far the only football players with the condition — star Dallas Cowboys wide receiver Michael Irvin survived 12 years in the NFL with it, but retired after suffering from temporary paralysis in 2000 because he was advised by doctors to stop playing.

Former Baltimore Ravens linebacker Jameel McClain has spinal stenosis and suffered a spinal cord contusion in 2013, but returned to play the next season.

In 2015, Florida offensive lineman Roderick Johnson opted to retire from football based on the recommendation of team doctors and outside specialists due to spinal stenosis after suffering a stinger in a scrimmage.

In the medical community, the case of Jones indicates that there’s dissension about the risks of playing with spinal stenosis because there is less room for spinal cord movement within the spinal column, especially when compressed. Still, “congenital spinal stenosis is not a contraindication of playing football,” said Anthony Hecht in 2013. He’s the co-director of spine surgery at Mount Sinai Medical Center in New York City and serves as a spine consultant for the New York Jets and other college and professional teams.

A 2007 article in the Journal of Athletic Training said the following, which provides a little more nuance than Hecht’s brief statement:

For the clinician attempting to provide advice regarding return-to-play recommendations for athletes involved in contact sports, available management decision data are mainly experiential. Based on the available published information, it appears that catastrophic spinal cord injury is not usually associated with a prodrome or with recurrent symptoms and, furthermore, that spinal stenosis alone does not result in a high risk of future catastrophic spinal cord injury.

However, although players with spinal stenosis are not at greater risk of catastrophic spinal injuries, according to that research, they are at greater risk of cervical cord neuropraxia, essentially a stinger with more serious symptoms in multiple extremities that can often lead players to retire. Players who have suffered from cervical cord neuropraxia once are at greater risk of recurrence.

The symptoms of cervical cord neuropraxia sound like the injuries suffered by former Texas basketball standout TJ Ford, who also had spinal stenosis and experienced temporary paralysis while playing basketball on several occasions, including just after his sophomore year for the Longhorns.

Ford described the 2003 fall he took in Gregory Gym in the Players’ Tribune in 2017:

After 10 minutes, I was still numb. I stopped thinking about the NBA and started to worry about my health. Medics arrived with a stretcher to take me to the hospital.

After 20 minutes, I still had no feeling below my neck and I started to totally freak out. I suddenly began to wonder if I would ever walk again. Never mind basketball, what would life be like if I never regained feeling?

After 30 minutes, I felt tingling in my arms, legs and feet. I almost wanted to cry because I was so relieved.

After two hours, I regained feeling in the rest of my body, but I wouldn’t get back to normal for two weeks.

After a second fall that once again caused temporary paralysis during Ford’s rookie season with the Milwaukee Bucks, he opted to have fusion surgery in his neck that caused him to sit out for a season. How Ford came to that decision is notable — he met with 10 different doctors and all of them had slightly different recommendations.

When Ford returned, he struggled mentally and lost feeling in midair when he was hit on the head by Al Horford of the Atlanta Hawks. He was taken off the court on a stretcher once again and spent time seriously considering his future in basketball, but opted to continue playing until he suffered a another similar injury in 2012.

So, has Floyd suffered from cervical cord neuropraxia already? How much pain is he willing to endure to play football? How many doctors has he seen already to get opinions about his future?

Unfortunately, time off and rehab can’t correct the underlying issue here — the narrowing of his spinal column and the resulting consequences that he’s already suffered throughout his football career. “No readily acceptable corrective treatment exists for spinal stenosis,” according to the JAT article.

Floyd is a tough kid and clearly wants to continue playing football, but it’s possible that the Texas medical staff could make the same determination that the USC medical staff made about Jones nearly a decade ago.

And that means that the only real clarity right now is that Floyd’s future in football is impossible to predict.