Monday Injury Rounds: Week 5

Making rounds on this weekend's injuries, with updates on Steve Smith, Andrew Luck, Marshawn Lynch, 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

Leading into Monday Night Football, it's thankfully been a quiet week for new injuries. Cecil Shorts (dislocated shoulder) and Stevie Johnson (hamstring strain) will be questionable at best for Week 5. Jordan Reed will be in the concussion protocol, and the Washington medical staff may choose to take extra care in clearing him for contact given his previous history of a concussion with prolonged symptoms.

1030 PM (Sunday): Lance Dunbar was ruled out of Sunday night's game with a non-contact knee injury. I'll update with more information as it's released, but the mechanism was concerning for ACL and MCL injury.

Before we get to the long list of followup concerns, however, let's check in on the back injury suffered by Steve Smith last Thursday night.

STEVE SMITH | BACK fractures | week-to-week

There are confusing reports about Smith's injury. John Harbaugh called them microfractures, there was Twitter speculation the injuries were transverse process fractures, then Ian Rapoport reported the injury as four separate rib fractures. I'm always interested in accurate specifics on injuries, but let's not get bogged down in the details here. Smith has a painful set of bony injuries in his back. Any of these injuries are often associated with muscle spasm.

These injuries will take multiple weeks to heal but Smith's return will be based on pain tolerance. It's reasonable to give Smith the benefit of the doubt given his history of playing through pain, but he'll need a minimum of two weeks to heal and get enough range of motion back to play. Week 6 is likely the earliest we'll see Smith return.


FOLLOW-UP APPOINTMENTS

andrew luck | shoulder bruise | week-to-week

Luck had a midweek MRI that reportedly showed a shoulder bruise. It's not clear exactly what Luck's injury is. It's possible Luck has a muscle or joint contusion similar to what Drew Brees dealt with recently or something outside the joint similar to what Randall Cobb has been dealing with since the preseason. It's also possible, though unlikely given the report of a bruise on MRI, Luck has a muscle strain of some sort.

Without knowing specifics it's hard to know how concerned to be with Luck this week. As of last Friday, Adam Schefter tweeted things were trending positively. But the Colts' decision to declare Luck inactive raises a worry that he has lingering weakness or pain restricting his range of motion in his throwing shoulder. Hopefully, the Colts just chose to be very cautious with their franchise player and were targeting this week's Thursday night divisional matchup with Houston. That would give Luck an extra 4-5 days of rehab and recovery and also leave ten days for him to rest the shoulder before Week 6. 

We'll know more on Monday, when Indianapolis' first injury report is released.

130 PM: Local Indianapolis media member Chris Hagan tweeted this afternoon that Luck's injury was a shoulder subluxation. If accurate, Luck's shoulder came partway out of the socket and went back in before dislocating. It's an injury that would involve ligament stretching and, in a worst case scenario, a labral tear which could leave Luck prone to further subluxations and possibly dislocations in the future.

Hagan further tweeted that Luck saw multiple orthopedic doctors last week after the MRI, presumably to look at the images and examine and determine the stability of his shoulder. Those visits and second opinions must have been reassuring, as Ian Rapoport has tweeted the team expects Luck back on Thursday night. The Colts have also released Josh Johnson, who they signed as an injury hedge late last week.

Shoulder subluxations can cause chronic instability of the shoulder and predispose to dislocations. Some subluxations are more concerning than others and a smooth and effective rehab for Luck will be critical. For now, Rapoport's latest tweet is a good sign for Luck returning this week. But we heard similar "trending positive" reports from Adam Schefter late last week. I'll update again with any meaningful information after today's practice report.

marshawn lynch | hamstring strain | week-to-week

As I wrote last week, players don't have MRIs for reassurance. They have them to evaluate an injury concern. It was clear the Seahawks were concerned about Lynch's hamstring strain early last week and Pete Carroll's admissions that "there were findings" on the MRI is worrisome. It's possible Lynch has only a very low grade muscle strain, but the lack of practice last week argues otherwise. With Lynch also recently dealing with a calf strain and back spasms, I expect the Seahawks to hold Lynch out until he's fully recovered. Consider Lynch a game time decision -- at best -- this week.

alshon jeffery | hamstring strain | week-to-week

The Bears have been more cautious with Jeffery than they were with his calf strain. Though Jeffery missed more time with the calf strain before returning to practice than he has with this hamstring strain, he was back in live game action after just one week of practice and football-related conditioning. The Bears have now given Jeffery a full week without practice and a full week of limited drills while he reconditions. He's still well within that critical 10-14 day period where players are at highest risk of aggravating a muscle strain, but the pace of his reconditioning is reassuring. Jeffery's midweek practice participation will tell us more.

lesean mccoy | hamstring strain | week-to-week

On Sunday morning, Mike Garafolo reported McCoy has a tear in his hamstring muscle in a new location and will be out 3-4 weeks. That means McCoy has had two mid-grade hamstring strains in the past eight weeks. Don't expect to see him again until after the Bills' Week 8 bye.


AROUND THE TRAINING TABLE

Ben Roethlisberger was on the sideline without crutches on Thursday night. That means the staff was willing to allow him to bear weight on the knee joint bruised in Week 3. It's too early to adjust Roethlisberger's recovery timetable, but it gives him a better chance to return in four weeks than I originally expected.

Andre Ellington has been slowly reconditioning in practice over the past two weeks. He told reporters he wasn't yet full strength at the end of last week, but he'll have a good chance to return in Week 5. Tevin Coleman is likely close to beginning the reconditioning phase of his recovery, after fully resting his broken rib for two weeks. Joique Bell continues to struggle to get into football shape. Achilles and knee injuries held him out until late in the preseason and he's now been sidelined for more than a week with an ankle injury.

Sammy Watkins remains in the rehab and recovery phase with a calf injury. We've seen how difficult it is for players to recover quickly and effectively from calf strains. It's likely the Bills will continue to bring Watkins back slowly. His absence could easily last another 2-3 weeks. Davante Adams likely has a high ankle sprain he's already aggravated once. Expect the Packers to be conservative and hold him out at least one more week. DeSean Jackson hasn't yet returned to practice and could need at least one week of reconditioning before he returns to play. The Ravens continue to minimize the mutliple setbacks requiring imaging studies and arthroscopic surgery to re-evaluate the slow healing PCL sprain of Breshad Perriman. While John Harbaugh has said Perriman could return any day, this latest setback showed Perriman's PCL hasn't yet healed. Realistically, that puts Perriman a minimum of 2-3 weeks from returning. At the current rate of healing, you can consider Perriman's absence indefinite until we see him put in a full practice.

Julius Thomas hasn't yet been cleared for contact. His tendon repair needs another week to heal. Dwayne Allen was closer to returning this week after two limited practices and could get enough range of motion back this week to make the active roster in Week 5. Austin Seferian-Jenkins is likely another 2-3 weeks from returning from his shoulder injury.

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.