Former Browns quarterback Tim Couch believes that Johnny Manziel should probably shut his arm down for awhile and let it settle down.
BEREA, Ohio -- The Browns' old Deuce had some sage advice for their new one: Take your time with the arm.
Former No. 1 overall pick Tim Couch, who battled elbow tendinitis throughout his NFL career, believes that Johnny Manziel's recurring elbow soreness is worrisome and that he might need to shut it down for a bit.
"When a quarterback takes some time off initially and feels good and then it flares up again, I think that's cause for a little bit of concern,'' Couch, the top pick in 1999 who's now an SEC football analyst for Fox Sports South, told Northeast Ohio Media Group.
Manziel cut his practice a half-hour short Sunday when he felt discomfort in the elbow after a deep ball to Josh Lenz. He came off the field pointing to the inside of his elbow and flexing his fingers. He rested Monday and Tuesday, but the Browns are hopeful he'll practice Wednesday and/or Thursday and play in the third preseason game Saturday night in Tampa.
The soreness was a recurrence of the "camp arm" Manziel experienced on Aug. 11, when he rested the practice before the preseason opener against the Redskins. But the Browns' medical staff determined that Sunday's flare-up wasn't serious enough to warrant an MRI.
Coach Mike Pettine stressed that the club doesn't think it's a long-term thing, and added that they won't tweak his throwing motion despite the fact they believe his 3/4 release -- between an overhand throw and sidearm toss -- is at least partly to blame.
But the fact the elbow acted up on Manziel less than two weeks after the first day off is what has Couch troubled. None of the other three quarterbacks in camp has experienced arm trouble.
"I can only address how it affected me,'' said Couch, who watched Manziel at Texas A&M and has followed his Browns career. "I haven't really watched his mechanics close enough to tell if it's something that he's doing that's causing stress on his elbow. I haven't really studied it.
"But I know for me, it was pretty bad. It was pretty severe. I missed a couple of games (in 2002) from elbow tendinitis during training camp. It was significant time off for me.''
Couch believes that his elbow soreness led to a pair of subsequent shoulder surgeries to repair a torn labrum and torn rotator cuff -- in 2005 and 2006 -- that ended his NFL career.
"For me I started changing where I was delivering the ball from because I was having so many issues with the elbow,'' he said. "I had two shoulder surgeries (to repair a torn labrum and torn rotator cuff) after that, and it all kind of started in my elbow.''
Couch emphasized that "I'm not suggesting that's going to happen with Johnny by any means, but that's kind of what happened to me and kind of the root of what started off my shoulder issues.''
Couch said if he had to do it all over again, he would have shut down his arm for a long time and let it heal completely. Instead, he sat out the first two games of the 2002 season, and then went 8-6 in the final 14 games.
"Really, the only way to heal it is to take time off and not use it, and obviously that's not going to happen for a quarterback, especially this time of year,'' he said. "So, it's just tough to get it healthy and get the inflammation down.''
Couch said he unconsciously altered his throwing motion to compensate for the elbow pain.
"I changed my release point a little, kind of trying to find different slots to the throw the ball into where it wasn't affecting my elbow as much,'' said Couch. "As a result of that, it kind of took a toll on my shoulder.''
He said he began his career with an over-the-top motion.
"Then when I started getting some elbow issues, I started dropping my arm a little bit and couldn't really get it up as high,'' he said. "I just didn't feel good. I just didn't have the usual amount of zip on the ball that I was used to having.
"Once that elbow flares up it's really hard. It affects the grip pressure and the release, and you start messing with things and tweaking things a little bit to help you try to find a place to throw the ball from a little more comfortably. That can definitely result in some other issues for sure.''
Couch emphasized that he has no idea what Manziel is feeling or how long it's been bothering him. Manziel is believed, however, to have experienced elbow soreness at other times in his career. But while Couch was diagnosed with tendinitis, Manziel's pain has been described so far only as soreness.
"I'm certainly not suggesting that (secondary injuries) are going to happen to him, but that's kind of what happened to me,'' said Couch. "You can do it without even noticing. You just kind of go out there and all of a sudden your arm is hurting so bad during practice that you just kind of alter it a little bit and the next thing you know that becomes a habit and you have to watch that.
"If I could go back and look at it again, I'd definitely not want to do that. I'd just want to take the necessary time off that's required to get myself healthy, where I could go out and throw with the mechanics and throwing motion that I was used to throwing with.''
Couch agrees with the Browns' strategy of not altering Manziel's mechanics, which vary from throw to throw.
"He's been throwing that way for a long time and he's got a lot of different releases it looks like,'' said Couch. "Sometimes he throws sidearm and other times he's over the top. It all depends on where he is in the pocket, if he's on the move, all of those kinds of things, but he uses a lot of different release points is what it looks like to me.''
Instead, Couch recommends resting it as much as possible.
"(Shutting him down) wouldn't be a bad idea if he's going to continue to have these flare-ups,'' said Couch. "This is the second one so far in camp. Once the season starts, I think it'll calm down for him since he's not going to be the starter. He won't be throwing. There's a lot less workload on his arm.''
Couch said he had to undergo constant treatment on his arm, including massage and ice to try to reduce the inflammation.
"I would take a couple of days off and then it would flare back up again,'' he said. "It was just one of those things I constantly battled and I couldn't really get under control. It's hard to take the time off and you don't want to miss time because you're obviously competing for a job and you want to be out there as much as possible.''
Fortunately for the Browns, Manziel isn't really competing for the starting job at this point and can afford to cut back on the reps. Pettine has already said he's comfortable with Manziel as the No. 2 and Josh McCown as the No. 1, even though he's not ready to declare McCown the opening-day starter.
If need be, the Browns could rest Manziel the final two preseason games and let Thad Lewis relieve McCown.
Based on the description of Manziel's condition, Dr. Bert Mandelbaum, orthopedic surgeon at the Santa Monica Orthopaedic and Sports Medicine Group in Santa Monica, Calif., said "it could be anything but I think the best clear way to describe it would be to overuse syndrome in the medial (inside) elbow.''
He said treatment "is a combination of cutting back a little bit, rest, ice, compression, elevation -- the old RICE -- and the possible the use if anti-inflammatories. I'm sure the Browns are using all kinds of modalities, ultrasound, stimulation.''
McCown said Monday "I know Johnny's in there all the time getting treatment and doing the things he can to help himself, too'' and Manziel said he ices the elbow after every practice.
Mandelbaum said, "I think the devil's in the details. Shutting a quarterback down usually comes as the consequence of a long story not a short story. With overuse syndrome, you've got to back off. You need to get this to quell. Ultimately it should respond to that and then you can move ahead.''
Mandelbaum observed that "if he didn't need an MRI, that's a good thing.''
By all accounts, Manziel's arm will be fine with a little rest, and it won't bother him once camp's over.
Couch, for one, certainly hopes that's the case.
Happy Birthday Timmy!!! Man if you could only come back to QB this team now. @timcouchtv pic.twitter.com/HA8YzdMzzY
-- JonnyO (@OzIsCTown) July 31, 2015