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.
INJURY ROUNDS
There appear to be no long-term skill position injuries of note this week -- if you believe what the players told reporters as they left the locker room yesterday. But there are quite a few injuries that will be re-evaluated today with additional examinations and imaging studies. It's not uncommon to find that what appeared to be a low grade muscle injury or ligament sprain has become more complicated overnight. We're also getting our first reminder of the league's return to play protocol as we track the status of a couple of the league's offensive stars this week.
reggie bush | knee
Bush was hit on the front part of his left knee yesterday, returned briefly only to leave shortly after due to what he called a "lack of explosion." The mechanism of injury was scary, but Bush had thankfully not fully planted his leg before he was hit. Similar mechanisms have resulted in ligament injuries (e.g. Fred Jackson's 2012 LCL, Adrian Peterson's 2011 ACL/MCL) and Bush is scheduled for an MRI today. He is optimistic and the initial sideline exam was reassuring enough to clear him to return to play. Hopefully, the news after today's MRI will be positive. I'll have updates when those results are released.
800 ET: Bush's MRI reportedly showed "no structural damage." Translated, that means his ACL is intact and likely also means that he has no ligament sprains. However, it does not mean that he has avoided cartilage damage that could become a nagging issue or a bone bruise around the knee. Don't expect the Lions to be forthcoming with injury information. The practice participation reports and whether they allow Bush to talk to the media midweek will provide the most useful details.
Ray Rice | hip flexor strain
Rice went down without contact on a fourth quarter run with what's been reported to be a hip flexor strain. Much was made of media reports that Rice wasn't having an MRI yesterday, but many soft tissue imaging studies are done the morning after the injury. Like any muscle strain, hip flexor injuries can be difficult for a running back to recover from quickly. Rice's timetable will depend on the grade. Although Rice was reportedly moving without much of a limp after the game, his immediate reaction to the injury could be worrisome for a Grade 1-2 injury. If that's the case, he'll be a game-time decision at best in Week 3 and could be out multiple weeks. With Bernard Pierce continuing to run effectively, the Ravens have the luxury to allow Rice an extra week to heal if necessary.
800 ET: If reports are accurate, Rice didn't have an MRI today either. That suggests that the Ravens aren't concerned enough about the strain to grade the injury. John Harbaugh said today that Rice wouldn't have to practice to play in Week 3, but the effectiveness of Pierce may affect their decision.
Andre Johnson | concussion
Eddie Lacy | concussion
Both Johnson and Lacy were diagnosed with concussions. You'll hear lots of discussion about severity this week -- all of which you can ignore. No two concussions are alike. Hits that look like they will result in long absences can be deceiving. Hits that look minor and shouldn't cause severe symptoms can also be misleading. And there are multiple hurdles for every concussed player to pass before they can be cleared for contact.
The return to play protocol includes a slow increase in exercise, a set of neurocognitive and balance tests that are compared to the player's pre-injury baseline, and an independent neurologist exam and evaluation. Each exercise step is based on a standard 24 hour test and recovery period (i.e. a player cannot progress to more strenuous exercise until he's had no symptoms for 24 hours after light exercise) and the quickest a player can be cleared to return is five days. But there is room for interpretation in each step. A player who had more severe symptoms (loss of consciousness, amnesia, prolonged headache) and who has had a previous concussion may be watched for more than 24 hours before being cleared for each successive step.
For now, all we know is that Johnson and Lacy are on the protocol and can be cleared to practice on Friday if their recovery progresses without any concerns. It's unlikely we'll be updated on their condition until much later this week.
I'll have a long form feature on concussions on the league's approach to concussions, specifics on the return to play protocol, and some recent management trends for skill position players soon.
Maurice Jones-Drew | ankle sprain
Television replays weren't conclusive on the mechanism of Jones-Drew's sprain, but I didn't see clear signs of a high ankle sprain. The results of today's MRI may provide more information. Jones-Drew told Gus Bradley that he was feeling some looseness in the joint after the game, but that shouldn't be taken as confirmation of a more severe injury. We'll know more later in the week.
800 ET: Jones-Drew's injury is being called a tendon strain after his MRI. Though the consensus is that the report is reassuring, that's not necessarily the case. A tendon is the structure that attaches a muscle to a bone. Without knowing which tendon is injured and the degree of the strain, it's impossible to know whether the injury is minor or not. I'll have more on Wednesday after the practice reports are released.
Steven Jackson | thigh
When I'm asked whether a player is injury-prone, I generally hedge my answer. A player who has had multiple injuries isn't necessarily more likely to have future injuries. However's Jackson's history -- frequent leg strains to multiple different muscles (groin x 3, quad, hamstring) -- makes me wonder whether or not there's something about his frame or tissue that predisposes him to these injuries. His recovery from these injuries, even when low grade, hasn't been inspiring either. I expect he'll be very limited in practice, listed questionable and his workload to be debated through game time next week. And that's probably the best case scenario.
MALCOM FLOYD | NECK INJURY
The slow motion replay of Floyd's injury shows a mechanism of injury that is very concerning for a cervical spine injury. Thankfully, his imaging results and follow-up exams were reassuring and Floyd was able to return to San Diego with the team last night. His availability this week will depend on the strength of his neck muscles. He won't be cleared to play until he can fully protect his head and neck without pain or weakness.
FOLLOW-UP APPOINTMENTS
We also have a number of players recovering from injuries that will make news this week. For the first time this season, Rob Gronkowski isn't the most concerning name on the follow-up list.
Danny Amendola | Groin
Jay Glazer reported during yesterday's pregame show that the Patriots are still evaluating the extent of Amendola's groin injury, with some concern that the injury may be a sports hernia. Ian Rapoport, who has been very accurate with his reports on New England injuries, tweeted the same shortly after Glazer's report. A sports hernia is a generic term for a muscle tear -- it's not a true hernia -- somewhere in the lower abdomen and groin. It's not uncommon to have some difficulty in narrowing and confirming the diagnosis.
The early timetable given for Amendola was 2-6 weeks, with most reports suggesting a narrower 3-4 week frame should Amendola need surgery. There's no single sports hernia surgery, however, and most prominent surgeons quote a 3-8 week return to play expectation. There is a chance that Amendola could elect to try to rehab rather than immediately undergo surgery, but that's an unlikely recommendation for a professional athlete.
The most recent sports hernia comps are Adrian Peterson (offseason surgery) and Greg Jennings, whose told reporters he expected to return in 3-4 weeks but didn't make it back to the field for two months. Though we've seen Amendola push to return quickly from severe injuries in the past (an elbow dislocation in 2011 and sternoclavicular dislocation in 2012), he'll have a tough time making a 3-4 week rehab goal with this injury.
If the injury isn't to Amendola's core musculature and further out toward the hip, he may be able to rehab without surgery and return sooner. We'll know more after the additional specialist opinions on the injury are in.
larry fitzgerald | hamstring
In what may becoming a recurring theme for 2013, Fitzgerald joined the ranks of wide receivers who tried to play through a muscle strain at less than 100% and failed. Seen on the sideline with a leg wrap in the second half yesterday, Fitzgerald told reporters after the game that he'd "definitely" play in Week 3. When asked if he was 80% -- as Jay Glazer reported before the game yesterday -- Fitzgerald said "I wish I was." Long time readers know what I'm going to write next.
Players who return from a muscle strain before the muscle has healed are at significant risk of an aggravation. One study showed 1 in 3 NFL athletes re-injure their hamstring within the first 7-10 days of returning to play and the risk is higher if the injured muscle isn't back to 90-95% of its baseline strength. Those aggravations are often of a higher grade than the initial injury. As long as Fitzgerald continues to play before allowing his injury to heal, he's at risk of leaving games early and suffering an aggravation resulting in a much longer absence.
ROB GRONKOWSKI | BACK
We're now in Gronk range. Bill Belichick isn't going to give anyone a friendly heads-up on his tight end's weekly status, but we should get some indication from the New England practice reports and whether Gronkowski participates in the late week walkthrough. Now over 13 weeks since his microdiscectomy and nearly four months removed from his last arm surgery, Gronkowski should be well healed from both procedures. He's also been practicing in pads and reconditioning for nearly a month. If he isn't able to return, he should still be considered more day-to-day than week-to-week at his current rehab stage. Whether the Patriots plan to limit his workload in his first week back is an open question, but I think the added caution they've shown in his rehab and reconditioning suggest the team wants him in his usual role immediately.
IN THE TRAINING ROOM
Vernon Davis sat out most of the second half with a hamstring injury. His practice participation should tell us more. ... Hakeem Nicks missed only a few snaps after dislocating his finger. It doesn't appear that there are any associated fractures or ligament damage that would necessitate surgical fixation. He should play this week. ... Martellus Bennett didn't sound positive about his shoulder injury after the game, but didn't have any difficulty playing through it yesterday. The mechanism looked most consistent with an AC sprain. That's an injury that can be padded and shouldn't limit Bennett unless further testing reveals a higher grade injury. ... Dwayne Allen wasn't able to play through his hip injury yesterday. Assuming it's a hip pointer as the mechanism suggested, his availability this week will depend on how quickly the inflammation and bleeding near the bone and nerves of the area resolve. ... Brandon Myers will have an MRI exam of his ribs to better define his injury today. ... Brandon Weeden has a thumb sprain on his throwing hand and may have trouble getting ready for Week 3. ... Tyvon Branch has a broken fibula that will keep him out indefinitely (likely a minimum of 8 weeks).
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.
