Flyers’ Sean Couturier expected to be out 3-4 months following back revision surgery

In July, Sean Couturier chatted with general manager Chuck Fletcher about the back injury he sustained in December and asked him, “Should I be feeling this way?” The doctors gave him the go-ahead to keep rehabbing and eventually to train, but, three months later, the Flyers announced Couturier had to undergo another surgery.

Couturier underwent back revision surgery Thursday at the Carrell Clinic in Dallas. His expected recovery time is 3-4 months. The surgery was performed by Dr. Andrew Dossett, who also has operated on Denver Nuggets forward Michael Porter Jr., New York Yankees pitcher James Paxton, and Dallas Cowboys quarterback Tony Romo.

As of Saturday, Couturier still was recovering in Texas. He has been too groggy to talk with Fletcher, but was feeling hopeful before the surgery.

“I think he’s just had some concern,” Fletcher said. “And so I think, for him, there’s some relief that we’ve made a move he feels comfortable with.”

Fletcher described Couturier’s rehabilitation process as a “long road.” It’s only stretching longer, but now there’s at least some clarity, Fletcher said.

The timeline of Couturier’s situation predates him being placed on injured reserve on Dec. 30, 2021. He played his last game on Dec. 18, but at his end-of-season press conference in April, he said he started feeling pain 3-4 weeks before then. When Fletcher and Dave Scott addressed the media Jan. 26, they said they still were trying to avoid surgery. But on Feb. 11, Couturier underwent his initial back surgery and was declared out for the rest of the season.

Couturier started skating at the end of last season and continued to train and rehab over the summer. On Sept. 12, he talked to the media ahead of training camp and said that while he had some ups and downs over the summer, he had been cleared at the beginning of September to participate in training camp.

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“He feels great; he’s progressing,” Fletcher said on Sept. 12. “If anything, we’re trying to slow him down from time to time. He’s really anxious to get back, but this is the best he’s felt since pre-surgery last year, so we’re cautiously optimistic, and hopefully he’ll continue to progress.”

Couturier never took the ice under new Flyers coach John Tortorella. On Sept. 19, it was announced that he was feeling pain and was being pulled back. Couturier had originally been told the pain was part of the process when he questioned why he still wasn’t doing well months later. But it got to a point where the pain was affecting all parts of his life, not just sports.

Fletcher said they talked to specialists and gave Couturier an epidural. It provided instant relief. He went back to training and was rehab skating as of Oct. 9 — but the pain gradually came back.

“I don’t know if there was any one incident,” Fletcher said. “It’s sort of been a continuation where there’s been some good days and good weeks, and then bad days and bad weeks, but it just wasn’t right for where he should be in the return-to-play process.”

By that point, he had four or five months of persistent nerve irritation, Fletcher said, so they consulted the doctors again.

“In speaking with several specialists, it became pretty apparent that surgery was the only way to hopefully resolve this,” Fletcher said. “But I think there’s finally a little bit more clarity, and, hopefully for Sean, there’s some relief, so he can feel better. Ultimately, we’re still hopeful he can come back and play.”

It is unclear why this happened, Fletcher said. They don’t know if he didn’t heal properly, if he reinjured himself, exacerbated something, or if the original surgery didn’t work.

The process has been frustrating, according to Fletcher. Questions were raised in July why he was feeling pain but he and the team were told it was normal. Instead, 10 months after Couturier was placed on injured reserve, his rehab got extended at least three more months. If he comes back in three months, he will have been out from December 2021 to February 2023.

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When asked if he’s confident Couturier can come back this season, Fletcher huffed out a laugh but then said yes. In the meantime, they’re going to “let things play out” instead of trying to bring in a new player. They have a lot of young players they’re looking at, as well as new coaches and new systems.

The primary goal, Fletcher said, is just to give Couturier some relief. Then they’ll look to get him back on the ice.

“It’s not easy to replace Sean Couturier,” Fletcher said. “The hope is that in three to four months, he’ll be back, so we’ll just have to take it game by game and week by week. All the old clichés, but we’ll see how it plays out.”

James van Riemsdyk underwent surgery on his left index finger Friday. Dr. Robert Hotchkiss performed the surgery at the Hospital for Special Surgery in New York. Van Riemsdyk’s expected recovery time is six weeks. ... Fletcher said Cam Atkinson is week-to-week but neglected to give more details on his upper body injury or say if it could require surgery.