NOTE: This column is a living document. I'll be updating as needed after team press conferences, imaging reports, Monday Night Football injuries, etc. Major changes to the content will be noted in red. I'll also be retweeting any key pieces of news and my own reaction and analysis, so make sure you're following @JeneBramel and checking my timeline on Twitter throughout the week.
Studies on NFL injuries have shown that injuries tend to peak around Week 9 or 10, then decline a bit as the season winds to a conclusion. That seemed to be the case last week when multiple injury scares to high profile offensive players proved to be minor issues.
Unfortunately, that won't be the case this week. At least one elite offensive talent was lost for the season, another is likely done for the year and we're still awaiting followup on multiple other skill players. The defensive side of the ball and offensive line weren't immune either, with multiple players likely out for multiple weeks.
injury rounds
rob gronkowski | acl / mcl | out for season
There was a glimmer of hope after seeing Gronkowski's injury live. His foot was planted on the ground when his knee was hyperextended. Sometimes, that's lessens enough of the force to prevent a catastrophic knee injury. On replay, however, it was evident that Gronkowski's knee opened up along the inside of the joint and suffered some rotational forces that would stress all structures in his knee.
This morning, an MRI has confirmed what was suspected last night -- Gronkowski has a torn ACL and MCL.
It's not known how severe the MCL sprain may be and that report doesn't rule out any meniscus or cartilage damage that often accompanies multi-ligament knee injuries. The grade of the MCL sprain is important. A higher grade MCL injury sometimes results in a delay in repairing the ACL. Many surgeons like to make sure the surrounding muscles are in condition and can support immediate rehab after surgery. Though Gronk is young and in peak condition, it's possible that his surgery may be delayed. Such a delay could impact how quickly he's able to return next year.
I asked multiple orthopedic surgeons last night whether Gronkowski's history of infection would impact their approach to repairing his ACL. All said that, since there's been no evidence of infection over the past months, Gronkowski's risk of post-surgical infection should not be much higher than baseline and that there were no obvious extra precautions to be taken.
Details aside, prepare for another offseason of injury discussion on Gronkowski. Should he be tagged with the injury-prone label at age 24? How many of these injuries are flukish, wrong place - wrong time situations and how many are due to a larger issue? Will Gronkowski return within the now common 6-7 month time frame or will he (and his family) again delay for a extra week or month to ensure he's fully healed? Will Gronkowski again start camp on the PUP list?
All are valid questions. None can be clearly answered today.
adrian peterson | foot sprain | week-to-week
Though much has been already reported about Peterson's injury, there's been nothing definitive on his diagnosis or timetable. But prepare for this injury to be season-ending. Peterson himself said that his injury was a "midfoot sprain" and that his x-rays were "pretty clear." That's concerning enough. But his description of the injury ("foot was extended" / "got rolled up" / "felt it pop a couple of times" / "couldn't push off") matched replays which showed a mechanism consistent with a Lisfranc injury.
There is a glimmer of hope here. Peterson returned to the sideline without a walking boot and I haven't been able to find a report of crutches and immobilization in the locker room after the game. That would be unusual if a player was strongly suspected of an unstable midfoot injury. And Peterson was telling anyone who'd listen that he'd be fine after the game. Not all midfoot injuries are Lisfranc sprains. If the injury is actually to the outside of his foot -- similar to what Jamaal Charles suffered this preseason -- Peterson may be able to return before the end of the season.
I think that's unlikely, however. Even the mildest midfoot sprains are difficult for a running back to play through. Even Adrian Peterson. And with just three weeks left in the regular season, it's unlikely we'll see Peterson again in 2013.
I'll update with additional details after Peterson's MRI today.
330 ET: Peterson said this afternoon that his MRI showed no ligament damage and ruled out a Lisfranc injury. There are apparently plans for a CT scan to rule out small fractures, but Peterson says he expects to play this week. I'm still skeptical, as he's reportedly going to see a foot specialist and was in a walking boot in the locker room today. If he's able to go this week despite a midfoot sprain, you can add this injury to the list of those he's had a superhuman recovery from in the past 24 months.
Wes Welker | concussion | week-to-week
Welker suffered his second concussion in three weeks yesterday. Thankfully, he didn't talk himself back onto the field for a handful of plays before exiting. We've seen players cleared for Thursday games after a Sunday concussion multiple times, but I don't expect Welker to be given a chance to pass more than one stage in the return to play protocol. Two concussions in three weeks will (and should) dictate that he takes a minimum of five days to be cleared for contact. John Fox may not rule Welker out for Week 15 in his Monday press conference, but it'll be shocking if Welker plays. In fact, I'd argue that it's much more likely that Welker sits in Week 16 than it is that he plays this Thursday.
reggie bush | calf strain | week-to-week
I was nervous about Bush yesterday morning. He'd managed only one limited practice last week in a situation that wasn't a clear case of veteran rest late in the season. That's a setup for a potential aggravation of a muscle strain and calf injuries aren't easy to play through for a back that relies on change of direction like Bush. That appears to be what happened during pregame warmups yesterday.
It's not clear whether Bush's calf strain is of a higher grade after yesterday's events and Bush refused to talk to the media after the game. At minimum, we'll see Bush limited in practice again this week. Consider him a game-time decision unless he's able to handle consecutive practices this week. If he doesn't practice at all, prepare for him to be termed a GTD for Week 16, too.
eddie lacy | ankle | day-to-day
Lacy's mechanism of injury was most consistent with a low ankle sprain and he was able to return to the game, though limited, in the second half. His availability this week will depend on much swelling affects his range of motion and ability to cut. Expect him to be limited early in the week, with his late week practices key to his playing time in Week 15.
keenan allen | shoulder | day-to-day
Allen returned to play yesterday after aggravating a shoulder injury that has reportedly been bothering him since October. His mechanism of injury and the nagging nature of this injury is consistent with a low-mid grade AC sprain. That's an injury that a wide receiver can play through, but it won't be surprising to see Allen miss some practice time or sit a few snaps in any given week if he lands on the shoulder.
maurice jones-drew | hamstring | week-to-week
Jones-Drew's hamstring injury was initially reported as a cramp, but is now believed to be at least a significant low grade strain. He's hopeful he can return to practice by Friday and the extra days of rehab and treatment after last Thursday's game will help, but he's a game-time decision pending his practice participation.
jonathan stewart | knee | week-to-week
Stewart will have an MRI today to define his injury. First reports were that Stewart had suffered only a contusion, but there are now concerns of a more serious injury. The mechanism on replay was most worrisome for an MCL sprain, but it's possible more ligaments, including the ACL, or cartilage structures are also involved.
330 ET: Ron Rivera told reporters today that Stewart has a torn MCL but no ACL damage. He'll miss this week's game and be re-evaluated in 10 days.
FOLLOW-UP APPOINTMENTS
AARON RODGERS | FRACTURED COLLARBONE | WEEK-TO-WEEK
Rodgers is now a little over five weeks removed from his collarbone fracture. Last week, he said he had regained strength and full range of motion without pain in the shoulder and was cleared to throw in practice. He also said that the Green Bay medical staff wasn't comfortable with the results of his imaging studies last week, implying that there hadn't been enough healing to clear him for contact.
That last hurdle is based on a risk-reward assessment. Rodgers' collarbone will not fully heal for weeks, but will be more stable and resistant to injury with each passing week. Some orthopedic surgeons consider 6-8 weeks post-injury as the earliest window to clear a player in Rodgers' situation. Rodgers will be at six weeks this Sunday. So, he'll have to be able to make a persuasive case to the conservative Green Bay medical staff that it's worth taking the risk of a more severe injury to play this week.
And his case got a huge boost yesterday with the Packers' win and Lions' loss. With Green Bay now just a half game out of the division lead and a playoff spot, the potential reward for Rodgers' return is much higher than his interest and pride in finishing out the season.
Last week, I thought it was 80-20 that Rodgers would be shut down for the season. While I'm still not confident that he'll be cleared to return, it's very unlikely that he'll be placed on injured reserve anytime soon and his odds of returning in Week 15 (or Week 16) are much better.
jay cutler | high ankle sprain / groin strain | day-to-day
Cutler is very close to returning. He was able to run on the treadmill and participate in limited drills last week. The Bears are being more cautious than they were earlier in the year, but I foresee Cutler taking more practice reps this week and pushing to play.
percy harvin | hip | week-to-week
Harvin had a cortisone shot two weeks ago and hasn't yet been cleared for practice. Best case scenario is limited practice and limited snaps this week, but it's hard to see Harvin see meaningful game action until Week 16. It's now more likely that Harvin will be on a snap count until the NFL playoffs begin.
rashad jennings | concussion | week-to-week
jordan reed | concussion | week-to-week
Both Jennings and Reed advanced to the mid-stages of the return to play protocol for their respective teams last week but were not cleared for contact in time to play. Jennings, who was placed on IR in Jacksonville late last season, and Reed, who has had three concussions since college and experienced a setback in symptoms in Week 13 after two weeks in the protocol, both have mitigating factors for their return. Based on last week's practice reports, I think it's more likely both players return than not this week. However, if they haven't been cleared for contact in time for Wednesday's practice, prepare for their absence to stretch at least one more week.
randall cobb | leg | week-to-week
Cobb's outlook brightened with yesterday's Green Bay victory, but he remains a long shot to return in the next two weeks. He said late last week that he's not been cleared to run yet and he's likely at least two weeks from returning once he hits that stage of his rehab process. Limited reps in Week 16 or 17 are theoretically possible, but Cobb is now unlikely to return until the playoffs, should the Packers make it that far.
I'll be updating this feature throughout the day. Footballguys Insiders will get a full update with additional fantasy perspectives on Wednesday, with analysis of the week's game-time decisions early Sunday morning. Follow me on Twitter @JeneBramel for breaking injury news and analysis throughout the week.
