Monday Injury Rounds: Week 4

Making rounds on this weekend's injuries, with updates on Ben Roethlisberger, Marshawn Lynch, Arian Foster, Alshon Jeffery and others

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

ben roethlisberger | Mcl sprain | week-to-week

Roethlisberger was very lucky to avoid a more serious injury yesterday. The television angles showed an obvious mechanism for an MCL sprain -- hit to the outside of the knee stretching the joint open on the inside of the knee -- but it was such a violent impact I had concerns about a bone injury similar to what we saw Danny Trevathan suffer last year. A Sunday night MRI reportedly showed the MCL sprain and a bone bruise, without any evidence of an ACL tear the team feared. 

The early timetable is 4-6 weeks, which is in line with a high grade MCL tear. Roethlisberger is not a stationary quarterback, so the Steelers will likely want to make certain his knee is fully healed and stable before bracing him up and sending him back out there.

As more interpretations of the MRI were tweeted by national and local media members, however, I'm sensing a tone that the Steelers may be more concerned about the bone bruise than the MCL sprain. That's just my speculation and it's colored by my first instinct when watching the replays. But if it proves accurate, Roethlisberger -- who has proven to recover more quickly than expected from high ankle sprains, sternoclavicular dislocations, and jaw fractures in the past -- may have difficulty returning before six weeks.

marshawn lynch | hamstring strain / calf strain / back spasms | day-to-day

Lynch was close but not ready to play on Sunday. The Seahawks were actively trying to manage another bout of back spasms in the training room and on the sideline before Lynch entered the game in the first quarter. He then left the game shortly after with a hamstring injury.

Calf strain >> back spasms >> hamstring strain ==> Textbook definition of an injury cascade.

The catchy tune about the ankle bone being connected to the knee bone, etc. is simplistic but accurate. The kinetics of your body are all interconnected. If one part of your body isn't right, you will -- consciously or subconsciously -- protect it by changing how you move. That puts more stress than usual on other parts of your body, which can then break down themselves.

Back spasms aren't new to Lynch. And the calf strain was close enough to healing to allow Lynch to make the active roster yesterday. What we don't know is whether Lynch just noticed a little bit of tightness in the hamstring or whether he has a meaningful strain of the muscle fibers. With the Seahawks already in control of the game early in the second quarter, there was little reason to push Lynch through the multiple injuries. If the Seahawks exercised caution early enough, none of these injuries may prove significant this week. Lynch also gets the benefit of an extra day and a half to recover before a home Monday night game this week.

sammy watkins | calf strain | WEEK-TO-WEEK

Watkins has been dealing with a calf injury since the preseason. I haven't seen confirmation that this week's injury was to the same calf, but it's likely to be related either as an aggravation of the previous strain or a compensation injury. As we've seen so often already this season, calf injuries are very difficult for a skill position player to recover from quickly. Alshon Jeffery, Victor Cruz, and Marshawn Lynch have all struggled to meet an optimistic timetable. While I think it's likely we'll see Watkins sooner than the Bills' Week 8 bye, he may not be right until getting that extra week of recovery time.

200 ET: Rex Ryan sounded concerned for Watkins at his Monday press conference, saying it's possible Watkins wouldn't be available this week. Prepare for a very limited week of practice and questionable tag for Week 4 at best.


FOLLOW-UP APPOINTMENTS

arian foster | groin strain / core abdominal surgery | day-to-day

I think Foster is ready to return this week. However, he's clearly thinking long term with this injury and wants to be fully reconditioned before returning. That may mean Foster chooses to rest this Sunday with an eye toward being fresh for the Texans' Week 5 Thursday divisional matchup against Indianapolis and having ten days to recover for Week 6. If Foster does choose to return this week, the Texans may try to limit his usage knowing the Thursday night matchup is just four days away. We'll know more by midweek.

alshon jeffery | hamstring strain / calf strain | week-to-week

Jeffery did not practice last week and has now missed two weeks with a hamstring strain he suffered at the end of his recovery from a mid-grade calf strain. When you see a player not practice for two weeks with a muscle strain of any kind, there's reason to worry about a mid-grade strain. Players sometimes need 3-4 weeks of recovery time before returning to practice. Regardless of the grade, Jeffery will need to do some football related activity early this week to have a chance to play in Week 4. If Jeffery does not practice at all this week, it's possible we may not see him until after the Bears' Week 7 bye.

200 ET: Adam Schefter reported Jeffery expects to play this week. That's a reassuring Monday report, but don't get excited until we see Jeffery make it through consecutive practices.

drew brees | rotator cuff contusion | week-to-week

Brees was cleared to throw on Friday then ruled out of last week's game. That's a poor prognostic indicator. Previously published research on rotator cuff injuries like Brees has note that most players have full resolution of the pain and weakness around their shoulder within 3-4 days. Others improve quickly after a cortisone shot. There is disagreement among some of the better Twitter sources on the severity of Brees' injury. To me, it's mostly semantics. The symptoms are key. Brees didn't recover quickly enough to play last week. He may have been close, but it's still possible we won't see Brees for another week or two. If Brees is practicing on Wednesday it's obviously a very good sign. If not, prepare for a multiple week absence.

andre ellington | pcl sprain | day-to-day

Bruce Arians told reporters Sunday night Ellington would return this week. The limited practice last Friday started the reconditioning process. If Ellington feels good enough to practice this Wednesday, I'll fully buy into Arians' expectation. As I've written often with Breshad Perriman, however, PCL sprains are tricky recoveries. Stiffness or looseness in the knee joint can often be slower to resolve than hoped. Practice participation will predict Ellington's availability and usage.

lesean mccoy | hamstring strain | day-to-day

McCoy looked better than I expected in Week 2, then spent lots of time on the exercise bike during the Bills' dismantling of the Dolphins yesterday and admitted he couldn't accelerate on his early first quarter runs. I don't think McCoy sounded very optimistic on Friday and the limited practice after his full Thursday practice looks like a clear concern in hindsight. Watch McCoy's practice participation closely. He likely never fully recovered.

200 ET: Rex Ryan told reporters today the team would closely evaluate McCoy this week, with his Week 4 status left to the medical staff to determine. He acknowledged McCoy was playing at much less than full strength.

demarco murray | hamstring strain | day-to-day

Murray fully practiced last Friday but wasn't able to play. The Eagles practice may have been a minor walkthrough, but the questionable tag after a midweek MRI was worrisome. Expect Murray to be limited in practice again this week. Hopefully, we'll be pleasantly surprised with a full practice on Wednesday.

eric decker | pcl sprain | week-to-week

Decker didn't practice last week and told reporters early in the week he'd not return to practice or game action until his knee had fully recovered. The early reports on Decker's injury of a low grade PCL sprain were never confirmed by the team. There were indications last week Decker was close to practicing and returning to play. We'll know more by midweek.

tevin coleman | rib fracture | week-to-week

The Falcons tried to sell optimism on Coleman last Wednesday, leaving open the possibility he could play in Week 3. Cracked ribs are not an easy injury to play through for a running back, even with kevlar and painkillers. Any movement hurts, painkiller wear off, and injuries can be aggravated. Coleman will be closer to returning this week but the strong play of Devonta Freeman yesterday could make it easier to rest Coleman another week.

chris ivory | quad strain | day-to-day

Ivory was on the active roster yesterday but didn't play. Allowed to speak to the media after the game, Ivory told reporters he felt healthy enough to play but the medical staff and coaches wanted to be cautious. That may be accurate. However, the Jets' depth chart at running back doesn't include another back like Ivory and the team could've used him if he was that close to full strength. So, Ivory probably wasn't all that close to playing. Not risking an aggravation last week gives Ivory a much better chance at being full strength this week. I think it's likely he'll return to practice midweek and prepare to play.


AROUND THE TRAINING TABLE

Victor Cruz is expected to return to practice this week with the intention of returning to play. I'd prefer seeing two weeks of reconditioning here, and I think it's unlikely he'll be cleared for a full workload if he's active in Week 4. Breshad Perriman was back to practice this week but those observing Baltimore's pregame warmup tweeted concerns he may have aggravated the injury again. Austin Seferian-Jenkins is expected to be out another 2-3 weeks with a shoulder injury. I'll also be watching for news on Dwayne Allen, Julius Thomas, Ladarius Green, and DeSean Jackson.

Eddie Lacy and Davante Adams are probable to play tonight. I'll have more on both players if there are any concerns during the game.

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.