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
While I'm certain Dennis Pitta and Matt Cassel and DeAngelo Williams would strongly disagree, Sunday felt like a welcome break from the shocking number of multi-week injuries to key players in Week 1 and Week 2.
There's still much to review and consider as we prepare for Week 4, however. Let's begin with Sunday's serious injuries.
Dennis Pitta | dislocated hip | out for season
Most often, a non-contact injury that requires a cart means a catastrophic knee injury. Pitta didn’t have a mechanism for a knee injury and was immobilized on a stretcher, prompting concern for something more. Unfortunately, that something more was a second dislocation of his right hip. Pitta was taken to the hospital to get his hip back in place.
(Here’s my extended discussion of Pitta’s July 2013 hip dislocation.)
According to Ian Rapoport, Pitta will have an MRI on Monday to take a closer look at the surrounding structures – the bony hip socket, labral structures, and ligaments around the joint – to further assess the severity of the injury. Pitta will be staying in the hospital overnight in Cleveland.
It might be seen as reassuring Pitta wasn’t taken to surgery as quickly as he was with his last dislocation, but the non-contact nature of this injury is very concerning. As Dr. David Chao put it on Twitter on Sunday, “Easy out means easy to reoccur.”
Pitta’s first dislocation was career-threatening. It’s very possible this latest injury is career-ending. At minimum, it will end Pitta’s season.
t.y. Hilton | ankle sprain | day-to-day
After starting red hot with five catches for 80 yards in the first half, Hilton sprained an ankle and did not return. Chuck Pagano told reporters in the post-game press conference he didn’t believe Hilton’s injury was “too severe.”
I could not find a television angle with a clear mechanism of injury. It looked like Hilton was injured when turning back in to catch a pass late in the second quarter. He grabbed for his right ankle. I didn't see anything suspect for a high ankle injury. With luck, Pagano's classification of the injury as mild will prove accurate and Hilton will be good for Week 4.
kyle Rudolph | groin injury | week-to-week
Rudolph was limited in practice all week with an abdominal injury and left Sunday’s game with a groin injury. He’ll have an MRI on Monday. The two injuries are very likely related. According to Rudolph, “Something popped. I’ve been battling it for a while."
If what Rudolph has been battling was reported to be an abdominal injury last week and is now being called a groin injury, it’s likely that Rudolph has aggravated a core abdominal muscle strain, i.e. sports hernia. If that’s the case, expect to see Rudolph headed to Philadelphia early this week to see Dr. William Meyers to have the injury surgically repaired.
If it’s not a sports hernia, Rudolph may be dealing with a groin adductor muscle / tendon injury similar to what we’ve seen Danny Amendola and Adrian Peterson work through in recent seasons. Some might consider that injury within the family of sports hernia injuries, but it’s an injury that isn’t always repaired surgically. We’ll know more after Rudolph’s MRI.
matt cassel | multiple foot fractures | out for season
Cassel reportedly has multiple fractures in his foot. That's not very specific but the GIF to the right is as clear a mechanism as you'll see for a Lisfranc injury. I'll be shocked if that isn't the formal diagnosis today. Expect to hear that Cassel will have surgery in Charlotte with Dr. Robert Anderson this week.
In the images, you can clearly see Cassel's foot flexed while Curtis Lofton falls on his heel. That mechanism drives extreme amounts of force through the midfoot, specifically the Lisfranc complex, and separates/fractures the joint. Some Lisfranc injuries involve ligament sprains only and can be managed by keeping a player from weight bearing for 6-8 weeks. Any Lisfranc injury with associated fractures means surgery and a 6-9 month recovery timetable.
The most recent comp at the quarterback position is Matt Schaub in November 2010. He wasn't cleared to return until just before training camp in 2011.
danny woodhead | high ankle sprain w/ fracture | out for season
Woodhead has a high grade high ankle sprain involving a fracture to the outside bone of his lower leg. Injuries this extensive require surgery to stabilize and commonly take 8-12 weeks of rehab time, at minimum. Woodhead will have surgery tomorrow and is likely to go on injured reserve this week.
harry douglas | foot injury | day-to-day
On Friday, Mike Smith told reporters tests on Douglas' foot were negative. Presumably, he had a negative x-ray during the game as he was cleared to return to the bench and bear weight without crutches. Smith didn't specifically say what tests Douglas had on Friday morning, but it was likely an MRI. Whether a negative MRI means no subtle bony injury and no soft tissue injury or only that Douglas does not have a high grade soft tissue (muscle/tendon/ligament) injury is impossible to know.
Smith said Douglas would continue to receive treatment and he would have no updates until later this week.
rod streater | foot fracture | month-to-month
As of Sunday evening, there was no specific information on Streater's foot injury. Dennis Allen told reporters it was a fracture and Streater was in a boot and on crutches on the sideline. Expect a minimum of 6-8 weeks recovery time.
FOLLOW-UP APPOINTMENTS
Jamaal Charles, Arian Foster, Vernon Davis, DeAngelo Williams, Bernard Pierce and Maurice Jones-Drew were all inactive on Sunday. A.J. Green, DeSean Jackson, Keenan Allen and Jordan Cameron played through painful injuries, some more effectively than others.
I imagine many of you scrolled past Sunday's new injuries to check up on the status of the long list of previously injured players.
jamaal charles | high ankle sprain / bone bruise | day-to-day
Charles was very close to playing on Sunday. He was able to get through consecutive limited practices on Thursday and Friday, flew with the team to Miami and was quick and only slightly favoring his left ankle in pregame warmups. The Chiefs elected to deactivate him and continue to ride Knile Davis, however, and the decision paid off in their win over the Dolphins.
Despite this tweet from Ian Rapoport...
As for #Chiefs RB Jamaal Charles, he’s a game-time decision. It’s more of a bruise than a high-ankle sprain, though. Gives him a real chance
— Ian Rapoport (@RapSheet) September 21, 2014
...I still think it's likely that Charles' primary issue is the ankle sprain. I wrote yesterday about the differences in grades of high ankle sprains and the differences in how players heal. Giving Charles the added recovery time and protecting him from any hits or cuts that may have aggravated his injury on Sunday gives Charles a much better chance of returning to play in Week 4 and not suffering the same fate that C.J. Spiller and Roddy White did a year ago.
Expect Charles to return in Week 4. His usage may be less than usual, though that may due more to the strong play of Davis than Charles' ankle injury.
arian foster | hamstring strain | week-to-week
Foster has never recovered quickly from muscle strains and often aggravates them if he tries to return too soon. I'm certain that weighed heavily into the decision to deactivate him on Sunday. Foster was allowed to test the hamstring in pregame warmups, including multiple 40-yard sprints from one side of an end zone to the other. Those sprints were observed by beat writers, who noted no clear limitation in Foster's gait.
Three limited practices and a strenous pregame workout bodes well for Foster's Week 4 availability. But it's very hard to be optimistic when Foster misses time due to a muscle strain. Until we see him practice fully this week or hear the team confirm he'll play in Week 4, however, Foster shouldn't be trusted to return.
a.j. green | toe sprain | day-to-day
jordan cameron | ac sprain | day-to-day
Both Green and Cameron were active and played extensively on Sunday. Green had a very productive day, Cameron managed only one reception on three targets. Neither looked to be full strength. On the bright side, however, both Green and Cameron will have two weeks of recovery and intensive treatment to ready themselves to return after their team's Week 4 bye.
keenan allen | groin strain | day-to-day
I thought Allen looked healthy on Sunday. He made quick movements off the line, beat press coverage without difficulty and looked to come out of his breaks well. He showed no ill effects after slipping on an early route and didn't look stiff in his first routes after halftime. How he feels Monday morning will determine how much practice he'll have this week and whether the groin injury is behind him.
desean jackson | ac sprain | day-to-day
Jackson was very much a game-time decision on Sunday but a mix of adrenaline, padding, pain management and desire for revenge against his old team got him through the entire game. Seen wincing at times, Jackson took a couple of glancing blows to his left shoulder, but didn't not miss many snaps. He'll likely miss practice and won't be 100% in Week 4, but he's less likely to be a game-time decision this week.
vernon davis | bone bruise ankle | week-to-week
Davis was on crutches on Thursday and struggled through individual drills on Friday. Consider him 50-50 to play in Week 4. Bone bruises don't heal quickly, especially in areas responsible for weight bearing.
marvin jones | fractured foot | week-to-week
It's always dangerous to trust what Marvin Lewis and the Bengals tell the media about player injuries.
Marvin Jones, Burkhead, Sean Porter all expected back after bye according to ML.
— Paul Dehner Jr. (@pauldehnerjr) September 21, 2014
Week 5 was always the target for his return. While optimistic, Jones has been meeting each of his rehab goals. Barring a setback as he works back into football shape, he looks likely to return after the Cincinnati bye week.
maurice jones-drew | hand | week-to-week
It's still unclear exactly what Jones-Drew's injury is. It's been enough to keep him out of action for ten days, however, so it's best to consider him week-to-week until he gets a full practice in.
deangelo williams | quad strain | week-to-week
bernard pierce | quad strain | week-to-week
Both the Panthers and Ravens were hopeful their running backs could play Sunday. But it was evident after each team elevated a running back off the practice squad that neither had a good chance to play. Watch their practice participation this week for more information on their status.
AROUND THE TRAINING TABLE
Demaryius Thomas reportedly fought through a bothersome foot injury on Sunday. He'll have two weeks to recover as the Broncos have a Week 4 bye. ... DeAngelo Hall ruptured his Achilles and is done for the season. ... Stephen Tulloch will have an MRI to rule out a severe knee sprain on Monday. ... Tyvon Branch will be out multiple weeks with a foot fracture.
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.
