OTA Injury Updates: Who Should (and Shouldn't) Worry You?

Which tweak, sprain, weight gain, surgery, and missed OTA practices should have you concerned before training camp

the hibernation is over

There are no lulls in the NFL offseason news cycle. National and local beat writers seamlessly transition from previews and game stories to coaching changes and free agency. The scouting combine is now a two week event. And the draft cycle runs non-stop from February to early May.

But veteran players who aren’t free agents are ignored during the winter months. They may not be around the team facilities for interviews during the combine and draft press conferences. It’s only now, with teams holding their first OTAs and minicamps, when we begin hearing from the vets.

So, after a quiet 4-5 months, late May and early June bring a flood of injury news and rehab updates.

Victor Cruz said he is 80% recovered from his patellar tendon tear. Le’Veon Bell said he still hasn’t fully recovered from a knee injury he suffered in the final week of 2014. Jordy Nelson revealed cryptic details about a hip procedure he had after the season ended.

Any number of skill position players are said to be sitting out of OTAs due to minor injury. And lots of words are written on players losing or gaining weight to improve themselves for the coming season.

What isn’t clear is whether any of these stories are meaningful.

How worried should you be about Nelson or Bell or Cruz? What does a 20 pound weight loss mean for C.J. Anderson’s outlook? Will Odell Beckham’s sore hamstring cost him as much offseason time as it did last year?

It will be tough to answer any of these questions definitively in early June. But training camp is just six weeks away.

It’s not too soon to try to read between the lines of these reports. Context is crucial. Even if the information we have is too thin to crack the code, these reports will give us a framework to work from in the early days of training camp.

Let the detective work begin.

Le’Veon Bell | knee sprain

Bell hyperextended his knee in the last week of the 2015 regular season. His injury was said to be “not anything major” and his MRI reportedly showed no ligament damage. Four weeks after missing the Steelers’ Wild Card playoff game, Bell said his knee was 85-90%.

In hindsight, that looks strange – what are the odds a minor hyperextension injury isn’t fully healed after a month?

In late May, Bell said he still wasn’t at full strength and revealed he felt he was only 50% recovered by the end of January. If you take Bell at his word here, he’s suggesting his injury needed a minimum of eight weeks to heal and still isn’t as strong as his healthy knee. And that doesn’t really jive with reports of a negative MRI. I think it is likely Bell had a significant bone bruise or a non-ACL ligament sprain (i.e. PCL or LCL). Both injuries can take four or more weeks to heal.

It’s also possible Bell has been throwing out meaningless percentages and saying nothing more than he didn’t feel great in January and he hasn’t tested himself at full football speed since Week 17. “Close to 100%” after four months may be nothing more than “check with me after my first practice.”

How Much Should You Worry Now? Not much. There are flags here, but they aren’t crimson red.
When Should You Really Start To Worry? If Bell’s camp reps are managed early, it’s time to turn to the higher power lens on the microscope.

Victor Cruz | torn patellar tendon

Nearly every week on our live Thursday night Google Hangout / podcast, Cecil Lammey asks me what to make of Cruz’ status. He’s prompted to ask because Cruz continues to make incremental progress in his long rehab. Over the past few weeks, Cruz has said he’s 70%, then 75-80%. He’s also told reporters he’s begun cutting and running routes.

But every week my answer has been the same: A torn patellar tendon is a devastating injury and until we see Cruz moving well in a live football situation, his recovery is uncertain.

That’s not to say I’m not impressed by the steady progress Cruz has made and reassured by the lack of setbacks in his rehab. But patellar tendon injuries haven’t had the recent track record of full return to form other tendon injuries – bicep, tricep, pectoral, Achilles – have had. The last 10-20% of recovery will be critical here. That’s where Cruz will (or won’t) prove he can separate from defenders and avoid compensatory injuries.

How Much Should You Worry Now? A lot. A full return to form is still far from assured.
When Should You Really Start To Worry? If Cruz says he’s nearing 100% and isn’t in pre-injury form, he may never get there.

Jordy Nelson | hip surgery

In March, Mike McCarthy told reporters Nelson had a clean-out procedure on his hip after the season ended. Nelson, not surprisingly, remained evasive about his diagnosis and procedure in late May, but conceded he wasn’t fully cleared to participate in OTAs.

A clean-out procedure usually suggests removal of loose bodies, trimming up damaged cartilage, addressing bone spurs or nagging bursa sacs, and the like. Around the hip, it can also mean treating areas of impingement. It’s not clear what Nelson had done. While there are some arthritic conditions which could progress and limit him over time, the context we’ve been given so far doesn’t suggest a need to flag Nelson yet.

How Much Should You Worry Now? Very little. Nelson should be cleared for camp.
When Should You Really Start To Worry? If Nelson has a setback or isn’t cleared for contact early in camp because the hip isn’t deemed ready, there’s reason for concern.

odell beckham | hamstring strain

Last summer, Beckham struggled to return from a right hamstring strain and seemed to draw the ire of head coach Tom Coughlin for his slow recovery. In hindsight, Beckham likely had a mid-grade strain needing 6-8+ weeks to recover. When he finally did, he blew up the league.

In early June, Beckham wasn’t participating in OTAs with “soreness” in his left hamstring. A week later, there were hints Beckham would sit out minicamp, with a plan to return for training camp. It’s too soon to know how severe this strain is – the Giants could easily be taking extreme precautions with a now-veteran player they know can function at an elite level in this offense with Eli Manning.

How Much Should You Worry Now? A little. Beckham’s last hamstring injury took months to heal.
When Should You Really Start To Worry? If Beckham isn’t ready for training camp work, it implies his injury was of a higher grade. An aggravation early in camp would also be bad news.

when is a tweak more than a tweak?

If you suffer from seasonal allergies, you probably hate April, May, and June. Claritin and eye drops help, but avoiding your triggers is critical to minimize your risk.

You know where I’m going with this.

If you’re the quick twitch leg muscle of a high-performance skill position athlete, you probably fear OTAs and mini-camps. Massage and stretching help, but avoiding your triggers is critical to minimize your risk.

It’s no surprise to hear many of the league’s skill position players are missing OTA and mini-camp reps with muscle strains. Mike Evans, Marvin Jones, Dorial Green-Beckham, Kelvin Benjamin, Darren McFadden, and others sat out practices. Most have returned.

Usually, there’s no cause for concern here. There’s no reason to risk a higher grade strain by pushing through a low grade injury in May and June.

But there are a few flags to look for in these cases. Players with a pattern of injury are obviously of concern. Young players who need every possible repetition to grasp the offense and show coaches they’re capable performers are less likely to be held out for longer periods with minor strains.

I also note which players have injuries that cost them two sets of OTA practices. If you miss a handful of practices in one OTA session, there may be no reason for concern. But if you’re not ready for the next group of workouts 3-4 weeks later, it’s probably because your injury was more severe.

None of the players above are still on my list of high concern. But the first days of training camp will bring others to our attention.

worth the weight?

I have an interest in sports medicine, but I’m a pediatrician by training. I look at growth charts all day long. Parents always want to know what percentile their child’s height or weight falls?

I tell them I don’t care.

(Stay with me. I’m actually not a terrible doctor.)

The truth is I do care, but only a little.

I don’t focus entirely on the percentile line your baby is on today. If your six month old plots to the third percentile for weight, what I really want to know is where she plotted when she was two months and four months. If your baby was around the 50th percentile at two months and the 40th percentile at four months, something’s up. If your baby has been in the 3rd percentile since birth and is hitting every developmental milestone appropriately, you’ve almost certainly got a healthy little troublemaker.

It’s the trend I care about. If there’s a big change in an established trend, there’s a reason for it. And it’s usually not a good reason.

So, too, I think with NFL players.

Players establish a physical trend based on their body type. Big framed athletes gain and carry more weight than smaller framed athletes. Athletes naturally gravitate to their most effective weight. Athletes who rely – successfully – on speed over power are commonly leaner. Athletes who rely – successfully – on power over speed are commonly bulkier.

Even with ever-improving – and sometimes NFL caliber – training and nutrition regimens in college, players naturally continue to grow into their frames in their first or second NFL seasons. It’s not unusual to see players gradually gain 5-10 pounds of muscle during that time frame.

Compare the college highlight tapes of your favorite NFL player to their 2014 NFL film and you may be shocked at the difference. I’d argue the majority of those weight gains weren’t huge changes to an established trend. Those players had likely been gaining about the same amount of weight each offseason for years.

So, not all offseason weight change stories are worrisome.

But I am always concerned about a struggling player who has decided to buck an established trend. A running back who gains 15-20 pounds in an offseason to become a better runner between the tackles or loses 5-10 pounds to become quicker to the edge is chasing a body type that probably does not fit his frame. It’s not a great recipe for success.

I’m looking at you Bishop Sankey.

on the training table

There will be lots more on these players in the coming weeks, but let’s quickly round on some ongoing injury issues as camp approaches.

Sammy Watkins: Able to participate in team drills in June and on track for training camp. Labral surgery at age 22 could impact his longevity in the league but may not impact his 2015 season.

Carson Palmer: Cleared for team drills in June a little sooner than expected and sounds very positive about his health.

Joique Bell: Had knee and Achilles cleanout procedures after the season. The Achilles tune up is the more concerning procedure and in-season struggles are possible. Still not cleared for football-related activity, conditioning in early camp is likely to be an issue.

Allen Robinson: Running routes and participating in team drills during June OTAs. No reported setbacks from last season’s surgery to repair a stress fracture in his foot.

Sam Bradford: Still gimpy and limited after a second ACL injury last summer. Bradford doesn’t rely on mobility, but he’s clearly less than 100%. Any physical limitations affecting accuracy or mental hurdles affecting decision-making in Chip Kelly’s speed offense may be tough to overcome.

Brian Quick: Was cleared to run routes and condition in June, which may be critical to avoiding muscle strains when fully cleared for contact. It’s still not certain Quick will be ready for camp or full time duty in Week 1.

DeVante Parker: Had soreness around the screw and surgical site in OTAs and elected to address the concern. Putting in a bigger screw and bone grafting to aid healing is becoming more and more common. Parker’s most realistic timetable is 10-12 weeks. He may be cleared before the regular season begins, but he’s not likely to be full strength by Week 1.

Todd Gurley: Gurley is generally ahead of schedule in his rehab from ACL surgery, but the Rams are not going to rush him. Expect him to start on PUP and prove he’s in full condition before the team risks a setback or compensatory injury.

Jordan Reed: Struggled through an episode of knee soreness in May and then had arthroscopic surgery to address the problem. It’s not clear what Reed had done and no timetable has been given. Durability remains a huge concern here.

Tyler Eifert: Bengals are still limiting his snaps after elbow and shoulder issues last year. He’s expected to be full strength for camp.

Dennis Pitta: Still trying to return to form after multiple dislocations of his hip, Pitta has yet to be cleared to practice and will likely start camp on the PUP list.

Stevan Ridley: Has been able to do some positional drills but refuses to say he’ll be ready for camp. It’ll be nine months after his surgery as camp begins, but there’s no guarantee he’ll be ready to go.

Defensive notes

Kiko Alonso, Sean Lee, and NaVorro Bowman continue to make strong progress from last year’s knee injuries. All three are participating in team drills and should be full participants in camp. Derrick Johnson’s recovery from a torn Achilles also sounds very positive.

The news isn’t as promising for Vontaze Burfict and Brandon Marshall.

There is an undercurrent of concern for Burfict, but I’m seeing some indications of hope in media reports he’ll be ready for the regular season. Don’t count on it. Microfracture recovery generally takes 8-9 months and sometimes longer. September is very optimistic here. When the always quiet Marvin Lewis says Burfict “has a long ways to go” in late May, he’s essentially saying he’s not very hopeful he’ll have Burfict available in Week 1.

Marshall had surgery to fix a Lisfranc injury in March. There’s not been too much reported on Marshall, but this is another 6-9 month recovery. Although there was a hint of optimism in last week’s report that Marshall will be cleared to run in early July, I don’t think media reports are accurately portraying how much recovery Marshall has left. Expect him to start camp on PUP. And it’s possible he’ll still be there when camp ends.

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.