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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
What a crazy Monday it's been. After a Sunday full of significant injuries to major skill position players, today was devoted to clarifying the many incorrect initial reports and unexpected imaging results that followed. There's still much to be learned about Jimmy Graham, Randall Cobb, Cecil Shorts and others, but expect most of this week's injured players to miss multiple weeks.
jimmy graham | foot | week-to-week
Graham's injury was originally reported to be a leg or ankle condition, but the mechanism of injury looked more like a foot injury on replay. We learned this afternoon that Graham had an MRI of the foot, but results are yet to be reported. There's a wide range of possible diagnoses, from metatarsal fractures to muscle / tendon strains to plantar plate and fascia injuries. Any of those injuries could cost Graham multiple weeks. Chris Mortensen hears there is some optimism about the injury, but the general sense has been that Graham could miss some time after the Saints' Week 7 bye. This situation is eerily similar to last season when an ankle injury Graham suffered heading into the bye week was still very much an unknown for the two weeks leading up to his next game. I'll have more this week as the story develops.
randall cobb | fractured fibula | 6-8 weeks
Earlier today, I tweeted a picture of the mechanism of Cobb's injury. The most dramatic part of that image was the hyperextension of Cobb's right knee, which prompted me to speculate on the potential of a PCL or LCL injury -- similar to the injuries we've seen sustained by Fred Jackson and Robert Griffin III III in recent years. But that image also shows stress on the outside part of Cobb's ankle. Later in the day, multiple media sources tweeted that Cobb had fractured his fibula.
It's hard to know exactly which part of the bone fractured. The hyperextension could have put enough stress on the upper part of the fibula, but those injuries are often associated with ligament and nerve issues. Hopefully, though the hyperextension was more impressive, it's the stress near the ankle that caused the injury. That would be an injury much lower on the fibula and not associated with a high likelihood of any additional damage.
There's been disagreement about how much time Cobb may miss. I think the estimates of 6-8 weeks are likely to prove accurate. It's early, however. We've seen some wide receivers return in six weeks, but others, like Vincent Brown last year, took longer to recover. I've seen speculation that Cobb could be back in as little as four weeks, but I think it's very unlikely that he will return sooner than six.
demarco murray | mcl sprain | week-to-week
Murray reportedly has a low grade MCL sprain and could be back as soon as Week 8. There's a wide range of possibilities with ligament sprains around the knee, however. Return to play is based on how quickly the inflammation around the ligament heals and how quickly the player feels his knee joint is stable again. Sometimes that's a matter of days, other times it may take 2-4 weeks. For a skill position player that stresses the knee often to cut and change direction, bet on a minimum of two weeks' recovery time.
Danny amendola | concussion / multiple groin injuries | week-to-week
For the umpteenth weekend in a row, a media member slipped a huge bit of breaking news into the late Saturday night, early Sunday morning news cycle. This weekend, it was Albert Breer noting that Amendola has injuries to the hip adductors on both sides of his body. Breer reported that Amendola has a full adductor tear on one side -- the injury we've known about for a month -- as well as a near full tear on the other side. What we don't know is how long the partial tear has been there.
As I detailed earlier this year, many athletes choose not to have surgery for a completely torn adductor muscle because there's enough redundancy in the other muscles in the area that players often notice no decrease in leg strength. But the partial tear is another issue. For now, it's a pain tolerance issue. If the tear becomes complete, however, Amendola could be looking at another 4-6 weeks of rehab time. It's still worrisome to me that Amendola had at least one specialist worried about a sports hernia condition around the time of the original injury. That concern was reported by Breer and this latest report could be a related issue.
The uncertainty surrounding Amendola's groin injury didn't get as much run as it deserved on Sunday morning and Amendola continued to look good on the field. The ticking clock in Amendola's groin may be muffled now by the concussion he suffered during yesterday's game. He'll be put through the return to play protocol. Though it appeared Amendola lost consciousness briefly, that won't necessarily prevent him from gaining clearance for this week's game. But it is yet another reason to be concerned about Amendola making it through the rest of the season without missing additional time.
james jones | pcl sprain | week-to-week
Jones was leg-whipped by Courtney Upshaw at the end of a play yesterday and left the locker room with an ice bag on his shin. While he may have a shin contusion (similar to that of Andre Johnson recently), his MRI showed a sprain of his PCL. That can be a devastating injury if nearby structures are damaged -- it's the injury that slowed Shawne Merriman well before his Achilles tear -- but Jones, like others in recent years, apparently has an isolated, low grade injury. Mike McCarthy wouldn't rule Jones out this week, but even low grade PCL sprains can be difficult to recover from quickly. I think Week 8 (or later) is a much more realistic expectation for Jones.
cecil shorts | shoulder sprain | week-to-week
Shorts was driven into the ground onto his shoulder yesterday. That's a classic mechanism for an AC sprain. There was some speculation for a rib fracture near his sternum late Sunday night, but Shorts tweeted that his injury was to the AC joint today.
Though this injury is often referred to as a separated shoulder, don't confuse it with a shoulder dislocation. Shorts' shoulder stayed in the socket. The injury is to a complex of ligaments that hold the collarbone and top of the shoulder blade in place. Like any other sprain, the degree of damage to the ligaments will determine how quickly Shorts can return.
We've seen players with low grade AC sprains return to play the following week and play effectively. A.J. Green last season is the most recent example. But higher grade injuries can take 2-4 weeks to heal. The extent of Shorts' injury hasn't been reported. Though he left the locker room in a sling last night, there's still a chance he has just a low grade sprain.
matt schaub | leg injury | week-to-week
Schaub told reporters he might be able to play this week. Given the mechanism of his injury -- which was worrisome for a mid-high grade high ankle sprain and possibly a fibular fracture -- he's more likely to be out multiple weeks than return this week.
FOLLOW-UP APPOINTMENTS
Oh, hello, Mr. Gronkowski. Welcome back to this section of the column. Have a seat over there. Again.
rob gronkowski | arm | week-to-week
The reports on Gronkowski get more interesting by the week. Saturday, it was reported that Gronkowski (a) has yet to be cleared by both Dr. James Andrews and Dr. Jesse Jupiter (the noted arm surgeon who did Gronkowski's most recent revision in May, (b) may have nerve-related arm weakness after his prolonged infection and (c) may have had the original surgery to shorten his recovery time rather than out of medical necessity.
That left me with multiple questions.
1/ Why is Gronkowski's medical team comfortable allowing him to practice in pads over the past four weeks and take contact in practice over the past two weeks if there's serious concern about his arm holding up in a game?
2/ If there's really concern about the strength of Gronkowski's bone and/or a worry about nerve-related weakness, why has he been cleared to practice at all?
3/ Now that we're nearly five months into the healing process since Gronkowski's last revision, what could possibly change in the next 1-2 weeks to reassure Gronkowski's doctors (or Gronkowski or his family)?
I know what you're thinking in regard to the first question. There's no comparison between the contact a player experiences in a game and what they see in practice. And I agree. But Gronkowski's second injury happened when he fell and landed just right on his injured arm. He's had a much longer recovery time in the current instance, but if there is any concern for a re-injury with contact why is he cleared to practice in pads?
I checked in with my orthopedic contacts on questions 2 and 3. Each of them had the same questions. One told me that the concern about nerve weakness is a non-starter. If there was weakness in a major nerve in the forearm, Gronkowski wouldn't have been cleared to practice, much less take contact. All of them told me that it's possible that Gronkowski's arm has yet to fully heal on followup imaging studies. If that's the case, it's highly unlikely that it heals before the season ends. None of them could think of a bone issue that persists through five months that would resolve within the next month.
Essentially, that means that Gronkowski is medically ready to play now or he won't be for an indefinite period. And that statement doesn't fit with allowing Gronkowski to practice for a month, yet not gaining clearance from two noted orthopedic surgeons.
I fully realize that's the most frustrating answer I can give. But that's the scoop I'm getting. Consider Gronkowski week to week, but as I wrote two weeks ago, the trend is growing more concerning by the day.
CALVIN JOHNSON | KNEE | DAY-TO-DAY
I'm not sure which Monday press conference I look forward to less -- the monosyllabic responses of Bill Belichick or the intentionally misleading and vague Jim Schwartz. At least we're getting media members to give us some specifics on the New England injuries. There's nothing of value coming out of Detroit.
Here's what we know (I think):
Johnson injured his knee two weeks ago. It's a different injury than he struggled through last season. Johnson needed at least ten days for the swelling to resolve enough to allow him to run well enough to play. After looking extremely limited on Sunday and playing just a handful of snaps, Johnson was reportedly sore.
I was reassured on Sunday after Johnson was deemed healthy enough to play. That seemed to suggest that he was not dealing with a condition that might later necessitate surgery and a multi-week absence. But without a clear diagnosis or an improved appearance on the field, that can no longer be assumed. If Johnson does have a condition that could be treated surgically, we're getting nearer the Detroit Week 9 bye. Regardless of the approach, given the current rate of recovery, we may not see Johnson at full strength until Week 10.
percy harvin | hip labrum surgery | week-to-week
Harvin was never likely to return to practice then play in Week 7. But he's far enough along in his rehab that a strong week or two of practice could prompt the Seahawks to activate him anytime between Week 8 and 10. I still think Harvin's return will be later than he, and now the team, may be hinting, but it seems to be a lock that we'll see him before the Week 12 bye.
david wilson | herniated cervical disc | week-to-week
There is good news and bad news on Wilson today. The good news is that Dr. Robert Watkins did not recommend surgery for Wilson's spinal stenosis and associated herniated disc today. The bad news is that there's no guarantee Wilson will avoid surgery this year or that the underlying spinal stenosis won't eventually shorten his career.
For now, Wilson will try to rehab through the disc herniation, a process that could take at least another 3-4 weeks. With the Giants bye week coming in Week 9, don't expect to see Wilson until at least Week 10. If rehab isn't successful, Wilson could decide to have surgery at any point in the next few weeks.
larry fitzgerald | hamstring strains | week-to-week
Fitzgerald looked strong on his long touchdown run on Sunday but was reportedly in serious pain after the game and having difficulty walking. Before the game, there were reports that Fitzgerald had strains in two different areas of the same hamstring. After the game, there was a report that both hamstrings were strained. It's hard to know which of those reports are accurate, but it's clear that Fitzgerald is risking both major complications -- a more significant reaggravation and / or cascade injury -- by continuing to play through his original strain. It's not too early to consider Fitzgerald a game-time decision, at best, this week.
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.
