Monday Injury Rounds: Week 6

Making rounds on this weekend's injuries, with updates on Jamaal Charles, Odell Beckham, 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

jamaal charles | torn acl (likely) | out for season

Charles went down with a worrisome non-contact knee injury mechanism yesterday -- knee rotating over a foot with toes pointing out -- and multiple post-game reports noted the team's concern about a torn ACL. Though Charles is having a MRI today to confirm, it's very rare for a player to get good news in this instance. The mechanism fits and sideline exams rarely miss a torn ACL. This tear is to the opposite knee than his previous torn ACL.

Interestingly, after having an ACL repaired, the risk of tearing the ACL in the healthy knee is higher than the risk of tearing the ACL in the reconstructed knee. Some of this is likely genetic and anatomic. Players who tear one ACL may have an easier to tear ligament due to connective tissue strength or a narrower area where the ligament attaches to the bone. The increased risk may also be due to subtle compensations the body makes while healing from the prior tear.

Charles successfully recovered from his previous tear -- which occurred in mid-September -- in time to play the following season. Recovering in time for opening weekend in 2016 is also possible as recoveries are currently often in the 7-9 month range. Charles will be entering his age 29 season next year, however, which won't make things any easier for him.

530 PM: Reports confirm a torn ACL for Charles this afternoon, without any additional ligament damage. Will Carroll is reporting some concern for minor cartilage damage. The ACL was expected, but it will be good news if Charles is found not to have suffered any complicating cartilage injury during surgery.

odell beckham | hamstring strain | week-to-week

Beckham was able to return to the Sunday night game after feeling a "tug" in his hamstring. Tom Coughlin told the media on Monday he hoped to have Beckham practicing this week. And the Giants have an extra day to aggressively treat and rehab before their game next Monday night. However, Beckham has yet to show himself to be a quick healer with hamstring strains.

There was no indication from Coughlin that Beckham was scheduled for imaging. If that's the case, it's a good sign this injury is expected to be minor and not limit him over multiple weeks. But stay tuned on this one. What sometimes looks to be a 1-2 week injury could become more.

justin forsett | ankle sprain | week-to-week

Forsett injured his ankle late in the fourth quarter yesterday. Though it wasn't dramatic, the injury mechanism on video is concerning for a high ankle sprain and Forsett grabbed his shin rather than lower around the ankle. Players and medical staff often don't have a good sense for how severe a low grade high ankle sprain may be until the following day when pain and swelling peak.

Expect to hear that Forsett will have a MRI early this week. Practice participation will be our guide here. If Forsett is cleared to practice by Thursday, his rehab and treatment have gone well and he'll have a chance to play in Week 6. If not, it's a strong clue Forsett needs more time to heal and we could see a multi-week absence.

500 PM: I'm now seeing reports that John Harbaugh specifically said no high ankle sprain for Forsett. While I fully acknowledge I'm missing three vital pieces of information (player report of symptoms, sideline exam, and any imaging studies), the two pieces of information we do have (video mechanism and player localizing pain immediately after injury) are telling here. This wouldn't be the first time John Harbaugh hasn't been accurate with injury information. Nearly everything he's said about Breshad Perriman has been suspect. It also wouldn't be the first time a coach has said a player didn't have a high ankle sprain when they clearly did -- see also Matt Forte, Jamaal Charles, and Julius Thomas recently to name just a few.

Regardless of the exact nature of Forsett's injury, there's still a chance he'll play this week. We'll know more by Thursday.

blake bortles | ac sprain | week-to-week

An AC sprain, or what's commonly referred to as separated shoulder, is the same injury Randall Cobb has been fighting this season. Other quarterbacks, most notably Sam Bradford and Mark Sanchez, have battled through this in the past. It's a painful injury and prone to aggravation. Bortles' reportedly has a low grade injury. Unfortunately, it's his throwing shoulder. That will severely limit his throwing this week and increases the likelihood he'll miss time to avoid a subtle change in his throwing motion and cause a compensation injury.

marques colston | ac sprain | week-to-week

Colston's shoulder injury was severe enough to need evaluation by MRI today. The Saints are usually a tough read on injuries, but the tone of beat writer reports today is not positive. Expect this to be a multiple week recovery.

I'll also be watching for status updates on T.J. Yeldon (groin strain), Ronnie Hillman (hamstring strain), Reuben Randle (hamstring strain), Tyrod Taylor (ankle injury), and Nelson Agholor (shin strain). Randle and Agholor look most likely to miss time, but Yeldon and Hillman should be considered questionable and likely to be limited in practice this week.


FOLLOW-UP APPOINTMENTS

ANDREW LUCK | SHOULDER BRUISE | WEEK-TO-WEEK

Luck was all smiles on Monday after what was reportedly a full practice and throwing session. He was also allowed to address the media. While it's still unclear exactly what is ailing Luck, I think it's a good sign he's been cleared to throw. The key again this week will be how Luck's shoulder responds to the increased workload. If he's more sore or relatively weak tomorrow, his practice participation will tell the story. For now, the Colts have again waived Josh Johnson -- presumably after observing Luck's throwing session. Tentatively expect him to return this week.

marshawn lynch | hamstring strain | week-to-week

I don't believe there's any funny business with Lynch. His hamstring injury was a cascade from calf and back conditions, which was a known risk. Teams don't order MRI exams on players for reassurance alone. They were worried enough about Lynch's hamstring to want to define the extent of the injury. Then, Pete Carroll acknowledged the MRI showed tissue damage. At minimum, that means Lynch's strain is somewhere in the significant low grade to mild mid grade range. And that's a 2-4 week injury.

I think we'll see Lynch return to some limited practice work this week as he reconditions. But don't be surprised if he's not cleared for a full gameday workload until Week 7. If his absence stretches into the middle of next week, it's possible the Seahawks could hold him out through the Week 9 bye. For now, I think that's unlikely.

julio jones | hamstring strain | week-to-week

Jones felt his hamstring tighten again during practice last week, but felt good enough to play. He was clearly in less than peak physical condition, yet somehow managed to play 63 of 70 snaps. While he said he felt good after getting post-game treatment, playing yesterday was risky. It'll be even moreso if he goes on Thursday night on a twice tweaked, now fatigued muscle. Don't expect to see Jones practice this week, but the early expectation is he'll play. Cross your fingers he doesn't aggravate his injury and miss multiple weeks.

dez bryant | metatarsal fracture | week-to-week

Bryant reportedly had a stem cell injection last week. That's not something you do for a player healing well enough to return in two weeks. A return in 4-6 weeks was always a nearly impossible feat to pull off, and now it's even more unlikely. I still believe 8-10 weeks is the most sensible time frame, but I fully expect to hear the Cowboys talk about a possible Week 7 return this week.

alshon jeffery | hamstring strain | week-to-week

Wednesday practice participation is huge for Jeffery, who missed last Friday's practice after multiple weeks of consecutive limited workouts. One of two things happened. Either Jeffery was rested on Friday with the Bears knowing he was close to returning but unwilling to risk another aggravation or Jeffery suffered a setback during Thursday's limited practice. If Jeffery misses Wednesday's practice, it's a terrible prognostic sign for this month.

ben roethlisberger | MCL sprain | week-to-week

Roethlisberger continues to make good progress from his knee sprain and could be close to returning. Watch for the team to allow him to do more movement in drills this week. If so, he may well meet -- or beat -- the once very optimistic four week estimate.

steve smith | back fractures | week-to-week

Like Roethlisberger, Smith is notorious for playing through injury and beating even the most optimistic estimates. Still, four fractures in the back -- whether spinal bones or spine-rib joint injuries -- will be very tough to recover from in two plus weeks. It's a difficult area to pain manage and keep from significant muscle spasm. Smith's practice participation will guide us this week.

karlos williams | concussion | week-to-week

Whenever a player isn't advanced through the return to play protocol within seven days, there should be concern about lingering symptoms and a continued deliberate and cautious period of observation before clearance. Rex Ryan was optimistic in his Monday press conference, however, and it looks likely Williams will return to practice on Wednesday.


AROUND THE TRAINING TABLE

LeSean McCoy (hamstring) is unlikely to return until after the Bills' Week 8 bye. Davante Adams (ankle) continues to recover and is questionable to return to practice this week. Sammy Watkins (calf) was able to do some pre-game work on Sunday and could be close to returning if he's able to recondition in practice this week without a setback. DeSean Jackson and Stevie Johnson are working to return this week from hamstring injuries. Jordan Reed remains in the concussion protocol and still needs to prove his MCL sprain has healed enough to play. Austin Seferian-Jenkins (shoulder) likely has at least one more week of recovery before he's cleared for contact. Crockett Gilmore (calf) has yet to return to practice and will need a week of reconditioning. And, though he's not yet been put on the active roster and won't be on the injury report, there are reports Martavis Bryant has a multiple week recovery ahead for a knee injury suffered in practice last 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.