Monday Injury Rounds: Preseason Week 1

Making rounds on key preseason injuries, including Arian Foster, Alshon Jeffery, Kevin White, and more.

Injury Rounds

As camps began two weeks ago and the injury front was quiet, I tweeted that we were in the calm before the storm. Unlike recent seasons, we made it through OTAs and mini-camps without a major injury to a skill position player or defender. Even the usual suspects had seemed to avoid a lingering muscle strain. With the exception of Joique Bell, every player of concern (e.g. Le'veon Bell, Victor Cruz, Odell Beckham) started camp on the active roster.

So much for calm waters.

Ordinarily, I wouldn't start the Monday Injury Rounds feature until after the Week 1 games. But there's more than enough to work through this week.

arian foster | core muscle repair / groin strain | month-to-month

Here's what we know about Foster's injury: Thought to have a torn groin tendon, there was enough concern to send him to Dr. William Meyers, a sports hernia specialist. After additional testing and a direct look during surgery, Foster had a core abdominal muscle repaired. The groin tear was not as bad as feared and was not repaired. Initially felt to need 10-12 weeks or longer to recover, there are now rumors Foster could return in 4-6 weeks.

Here's what we also know about Foster: He is very prone to soft tissue injuries and aggravations of those soft tissue injuries. In recent years, he's taken an extra week or two to rehab to limit his risk of re-injury.

There has been complete silence from Foster and the Texans this week. That's not surprising. The team doesn't have to make the decision on whether to put Foster on the injured reserve list with a return designation for another few weeks.

The usual timetable for a core abdominal muscle repair -- which is the better term for the nebulous and misleading term sports hernia -- is 4-6 weeks. Depending on the muscle involved, we'll sometimes hear 3-4 weeks, sometimes 6-8 weeks. The usual timetable for a Grade 2+ groin strain (severely, but not completely torn) is 4-8 weeks.

So, on the surface, the rumored 4-6 week recovery isn't unreasonable. But given Foster's past history, the combination of injury, and the risk of aggravation when he returns, I don't see any way the Texans put Foster back into football-related activities in four weeks. I also don't believe 10-12+ weeks is likely unless Foster suffers a setback at the end of his rehab.

Here are your two keys on Foster. Obviously, if the Texans choose not to put Foster on the injured reserve-return list, the expectation is he'll return closer to 6-8 weeks than 10+. More importantly, whenever Foster returns to football related rehab work, his first 7-10 days are critical. That's when he'll be at highest risk of aggravation. I'd like to see Foster work himself back into condition slowly as he's been more likely to do recently.

Foster's surgery was August 7. Opening weekend is five weeks from that date. I think it's unlikely Foster returns then. A smooth 6-8 week recovery would get him back somewhere between Weeks 2 and 4. I think Week 3 or 4 is possible. If that's not doable, John Paulsen pointed out to me this week the Texans have a Thursday night game in Week 5 which could throw a wrench into weekly practice and game planning for Foster.

Let's not get too far ahead of ourselves here, though. The next vital piece of information is the Texans' decision about Foster's place on the active roster. I'll have more concrete thoughts on Foster's return then.

kevin white | fractured tibia | month-to-month

The Bears first told the media White was suffering from shin splints. It's a diagnosis that never made much sense for a finely conditioned football player, but when White's absence lingered into the first days of training camp and remained on PUP, it made even less sense. I referred to it as a shin injury in my PUPdates feature two weeks ago, but was reassured White was pictured without any wrap or splint and had been cleared to do some individual work. On our live Thursday show, Matt Harmon asked about White and I hedged even further, bringing up the much higher likelihood of a bone bruise, stress reaction, or stress fracture -- which are all part of the same continuum of injury. 

Friend of Footballguys Craig Zumsteg also wrote a long skeptical post on his blog about White two weeks ago.

White is still denying he has a stress fracture in his shin. Well, he's now right. After a setback last week, White's bone injury had progressed enough to require surgery to fix. He'll have a rod placed through his shin bone and will be transferred to the Reserve-PUP list to start his rookie season.

The most optimistic timetable for this injury would be in the 10-12 week range. It generally takes a lot longer. When properly healed, White should be recovered fully and expected to do well. However, while there's a chance White could be ready after spending eight regular season weeks on PUP, I think the Bears will take the time to be certain White is ready and recondition him slowly. Don't be surprised if White does not debut until 2016.

alshon jeffery | calf strain | week-to-week

John Fox told reporters after the first preseason game Jeffery had suffered a calf strain, was in a protective boot and using crutches, and was day-to-day. Even the least skeptical among us would question the last part of that statement.

It's unusual to immobilize a muscle injury. Joints and tendon injuries, absolutely. But not muscles. The calf is something of an exception, however, as you can immobilize the foot in such a way to keep the fibers of the calf muscle stretched. While players with joint sprains can be immobilized in a boot on Monday and play the following week, that's not the case with muscle injuries. If you're immobilizing a muscle, it's likely more than a minor Grade 1 strain.

That's not to say Jeffery tore a calf muscle or has a high grade injury. But I think we're closer to a Grade 2 than a Grade 1 injury based on the early facts. And calf injuries are particularly troublesome for athletes who rely on their lower bodies for explosiveness and change of direction. They're also aggravated easily. Anyone who watched Aaron Rodgers struggle through the playoffs last year saw how difficult calf strains can be.

So, while the Bears may say day-to-day and not rule Jeffery out for the second preseason game, I'm not buying it. Jeffery is week to week. And Jeffery's health is even more critical with the loss of White. Don't be shocked if Jeffery does very little for the rest of the preseason. If he's back early, great. If not, don't be too concerned over Jeffery's regular season availability until another 2-3 weeks go by without him practicing. I'm still impressed with Jeffery's ability to play through a hamstring strain last season.

c.j. spiller | knee | week-to-week

Spiller had arthroscopic knee surgery this week, but is expected to be back for Week 1. The Saints weren't specific -- and never are -- but the 3-4 week timetable suggests a minor procedure like trimming up a frayed meniscus or removing loose bone fragments. Standard estimates for those procedures are usually 2-4 weeks. It's a timetable Spiller should make and the procedure shouldn't limit him long term. However, any time a player's knee is bothersome enough to scope, there's a risk of recurrent swelling and soreness, limited and missed practice, and ineffectiveness. We'll see how Spiller progresses.

julius thomas | broken hand | week-to-week

Thomas reportedly has a broken bone on the back of his hand. The Jaguars called it a "stable" fracture and there has been no indication of surgery. Broken bones need a minimum of six weeks to heal, but players often return from these injuries in 3-4 weeks. Thomas will miss the rest of the preseason. He'll have to prove he can catch and block with whatever splint the medical team fashions for him, but a Week 1 return is reasonable.

breshad perriman | bruised knee / strained tendon | week-to-week

The Ravens initially termed Perriman's injury a bruised knee two weeks ago and called him day-to-day. It wouldn't be too unusual to have a bone bruise around the knee linger for longer than a week. Those injuries are more painful than many believe. The Ravens are now saying Perriman is also dealing with a strained tendon, but still believe him to be returning soon.

There are lots of tendinous structures around the knee and without seeing the injury on video, it's hard to speculate precisely. But the most likely combination here is a bruised patella (kneecap) and low grade strain of the patellar tendon. It may be that inflammation around the bone bruise is what's irritating the tendon and there's actually not any tearing of fibers. However, any injury to the patellar tendon is concerning. It's no surprise the Ravens are exercising caution.

This injury is difficult to put a timetable on. Bone bruises can heal slowly and the large patellar tendon sometimes recovers from inflammation slowly. Perriman will also have to go through a reconditioning period to return to football shape. I won't discount the possibility Perriman returns this week. Hopefully, he does. But don't be shocked if he's not ready until late in the preseason.

demarco murray | chipspeak | day-to-day

Eagles injuries are going to be fascinating to track this year. Chip Kelly's crew is at the leading edge of sports science. While he freely acknowledges the team's use of GPS and other biological and biomechanical markers, Kelly is ultra-secretive about what they're using and how they're applying it.

Murray has practiced intermittently since camp began. There were hydration concerns and a possible viral illness early in camp, but Murray has repeatedly said he's 100% healthy. The beat writers are putting the Woodward and Bernstein press on Kelly, trying to determine precisely why Murray is missing practice.

That has lead to a fun new kind of EaglesSpeak:

Murray: (I'm not injured. I don't know why I'm not practicing.) "I just do what I'm told." -- August 3rd / 4th

Murray: "I think there's a difference between getting the reps you need and getting too many reps." -- August 13

Kelly: "Murray is coming along...We're trying to get him acclimated. He carried the ball more than anybody last year, so we are trying to get him integrated into what we are doing." -- August 14

Duce Staley, Eagles' RB coach: "Don't put weight into Murray's practice schedule. It doesn't have anything to do with last year's workload."

While fascinating to see the interplay and contradictions, don't read much into this. The Eagles are managing Murray's workload in camp to limit his chance of a preseason injury. Maybe he's getting a few more veteran work days and maybe the Eagles' flow of information on their hydration parameters is confusing. But veteran days off are now a staple of NFL practice weeks -- preseason and inseason. As long as Murray is taking some reps each week and we see him in preseason game action by Week 3, get some popcorn and enjoy the Chip Kelly show. I think it's just a taste of what may be coming.

knile davis | knee sprain | week-to-week

On video review, there are mechanisms for a high ankle sprain, MCL sprain, and ACL sprain. The Chiefs are calling Davis' injury a knee sprain and one that isn't expected to be serious. That makes the most likely injury a low-mid grade MCL sprain, but without more specifics and a report of a negative MRI for ACL injury, it's too soon to conclude with certainty. If it is an isolated MCL sprain, Davis' return could be in 1-2 weeks or 4+ weeks depending on the rate of healing and how stable Davis feels his knee is when cutting. We may know more in the next 1-2 days.

Around the Training Table

Victor Cruz continues to progress from his patellar tendon injury. He reportedly looked good in a handful of reps during shared team practices with the Bengals last week. Cruz didn't play in the Giants' first preseason game, but is on track to play Week 1. Whether he'll have the same short-area explosiveness and separation skills as before his injury remains to be seen.

Devante Parker had an early timetable of around eight weeks. It's no surprise we've passed that mark and Parker still isn't practicing. Most athletes need 10-12 weeks to return from the screw revision surgery Parker had. The Dolphins continue to be optimistic about Parker's Week 1 availability, but I don't see Parker having a major impact until he's been able to fully practice for two weeks without a setback.

Kenny Stills is still recovering from what was a mid-high grade calf strain. He's reportedly getting close to returning. If he makes it through the reconditioning period without a setback, he could be in full form by Week 1.

Rueben Randle is battling knee tendinitis from what he feels was practicing on a different surface. Regardless of the explanation, patellar tendinitis needs time to cool off. Randle was trying to work through the soreness but limped off the practice field again this weekend. He may need a week or more off to limit his risk of lingering issues or a compensation injury elsewhere.

offensive line and defensive updates

Demar Dotson (RT - TB), Jeff Allen (RT - KC), and Phil Loadholt (RT - MIN) all left their preseason games with injury. Allen reportedly has an isolated MCL sprain. He could return during the preseason but ought to be ready for Week 1. Dotson likely has a MCL sprain, but is still awaiting testing to be certain there are no other injuries. Loadholt tore his Achilles and will be out for the year. Matt Bitonti will update his offensive line rankings for us soon with adjustments for these and other injuries and depth chart changes.

E.J. Gaines will miss the season after having surgery to fix a Lisfranc injury.

Landon Collins (MCL), Johnathan Cyprien (broken hand), Sean Weatherspoon (hamstring strain), and Kiko Alonso (concussion) will miss more time this preseason, but all are expected to be ready for Week 1.

Check back for more injury analysis throughout training camp and the regular season. Also, follow on Twitter @JeneBramel for breaking injury news, commentary and analysis of this injury and others around the NFL.