Monday Injury Rounds: Week 3

Discussing this week's knee injuries to Adrian Peterson and Danny Woodhead, multiple running back muscle strains, and whether Rob Gronkowski and Tyler Eifert can return soon

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.

Scroll to the bottom of this article for a quick look table of the week's most pressing injury situations and a review of the skill position players on injured reserve / PUP / NFI.


INJURY ROUNDS

Some of my medical colleagues hate me for it, but I don't believe that a good day in the clinic or urgent care can be jinxed by saying the word, "quiet." When the busy comes, it comes. And it always does.

Unfortunately, the busy came to NFL training rooms in Week 2. 

Seven running backs could miss next week with injury, with some likely to be out multiple weeks. Two quarterbacks may miss extended time with shoulder sprains. We're still waiting on the return of Jamaal Charles, Rob Gronkowski, and Tyler Eifert.

Many of this week's injuries were muscle strains. Those are difficult to grade from video and we're often misled by overly optimistic timetables from players. Even the non-soft-tissue injuries this week didn't have a clear mechanism on video. That makes the Monday press conferences and Wednesday practice reports critical. I'll have updates here throughout the day on Monday and Craig Zumsteg and I will have updates all week.

Adrian Peterson | Right knee injury | Week-to-Week / Possibly Out for Season

Peterson's mechanism was complicated and highlights how limited video study alone can be when analyzing injuries. Without knowing what the athlete is telling his medical staff, what the physical exam suggests, and what the imaging studies show, we're at a disadvantage. There were hints of a midfoot injury or high ankle sprain at first glance, then worries about Peterson's ACL and other structures after the team announced a knee injury.

Long time former NFL team orthopedic physician Dr. David Chao was concerned about a meniscus tear after a close look at the injury mechanism and noting that Peterson seemed unable to extend his knee after the injury. Mike Zimmer told reporters after the game that Peterson's knee had "calmed down." Peterson was seen leaving the locker room in an immobilizer. Both those details support Chao's argument.

If Peterson does have the type of meniscus tear that prevented full range of motion of his knee, Monday's MRI will be critical. An isolated meniscal tear could be addressed arthroscopically, with a possible return in 4-6 weeks. Unfortunately, this type of meniscus injury can be associated with ACL tears, which would obviously end Peterson's season. Former Vikings' beat reporter Tom Pelissero tweeted overnight that Peterson had minimal swelling and there is "optimism" his ACL is okay.

For now, that's educated speculation. Expect more details on Peterson's diagnosis and prognosis on Monday afternoon.

Monday Afternoon Update: Multiple sources confirm Peterson suffered a meniscus tear. Peterson is still evaluating his options. This will likely involve a trip to Dr. James Andrews, who performed Peterson's ACL repair on the other knee. If there are no other injuries to the knee and the tear is small, Peterson could choose to have the damaged portion of meniscus removed in the hope he can return in 3-4 weeks. The Vikings have a Week 6 bye, which fits into that timetable nicely. If the tear is larger or Peterson chooses to have the meniscus repaired -- which would be better for the long term health of his knee -- he could still miss the rest of the season.

Julio Jones | Right knee contusion | Day-to-Day

The immediate speculation after Jones left Sunday's game in the fourth quarter was that he'd suffered yet another aggravation of his left ankle sprain. After the game, Jones said he jammed his right knee. That's supported on video, where Jones appears to have had his right knee caught up between two defenders then driven into the turf. There was no obvious injury to his left ankle and Jones could later be seen to be flexing his right knee on the sideline. Jones' ankle held up very well yesterday. While it's likely we'll see Jones limited in practice early this week, he should be able to play through the knee injury.

Monday Afternoon Update: Adam Schefter reported today that Jones suffered a calf strain yesterday. From an aggravation of his previous ankle sprain to a jammed knee to this latest report of a calf strain, it's difficult to determine exactly how many minor injuries Jones is dealing with right now. Although each injury may be minor individually, together they raise the risk of further cascade injury. I don't expect to see Jones practice much until Friday.

Brandon Marshall | Left MCL sprain | Day-to-Day

Marshall suffered an MCL sprain on Thursday night and was able to return to the game. NFL players at all positions are often able to return to play the following week after low grade MCL sprains. Marshall will benefit from an extra three days of treatment. He'll likely be limited in practice this week but should be able to play effectively in Week 3.

Doug Martin | Right hamstring strain | Week-to-Week

Martin told reporters he'd only "tweaked" his hamstring. However, Martin immediately reached low on the back of his right thigh. His injury was early in the second quarter before Carolina moved ahead by multiple touchdowns. Expect Martin to have an MRI on Monday. There's a chance the injury is low grade and won't limit Martin in Week 3, but there are signs it could be a longer absence.

Arian Foster | Groin strain | Week-to-Week

Foster avoided a soft tissue injury throughout camp but his recent history suggested it was only a matter of time before his body broke down. After missing practice on Wednesday with a hamstring injury, I was left to wonder whether the first link in Foster's kinetic chain had broken down. And it's hard not to see this injury as yet another in a long history of cascade injuries. Head coach Adam Gase told reporters after the game his medical staff ruled Foster out immediately. There was no obvious mechanism of injury on video. This almost never ends well for Foster. Expect a multi-week absence for Foster until proven otherwise.

Monday Afternoon Update: Gase said Foster was day-to-day in his Monday press conference. That's a tough sell. Foster was ruled out immediately during yesterday's game and soft tissue injuries are rarely simple recoveries for him. Until we see Foster practice, it's hard to believe he'll be ready to play in Week 3.

Thomas Rawls | Right leg contusion | Day-to-Day

I didn't see an obvious supporting mechanism, but Pete Carroll told reporters after the game that Rawls had been kicked in the leg. Bruises to the shin are painful injuries and with Christine Michael running effectively, it's possible the Seahawks were more cautious returning Rawls to play than they otherwise would have been. The Wednesday practice report should have your attention here.

Jonathan Stewart | Hamstring strain | Week-to-Week

Stewart is another in the long line of running backs with unclear soft tissue injuries this week. Stewart's injury happened in the first quarter and he was never cleared to return. Already dealing with an ankle injury, rehabbing a low grade hamstring strain could prove difficult. I'll update after Monday's press conference and Wednesday's practice report.

Monday Afternoon Update: Ron Rivera told reporters Stewart's hamstring injury would keep him out "at least a week or two." That raises concern for more than a low grade injury. 1-2 weeks could easily become 3-4 weeks or longer here.

Doug Baldwin | Left knee injury | Day-to-Day

Baldwin was rolled up from behind while blocking for Christine Michael and had his left knee and ankle twisted underneath him. There were hints of an MCL and meniscus mechanism on video. Baldwin's return to play later in the game was reassuring but Pete Carroll told reporters Baldwin was scheduled for an MRI on Monday. There's no current indication Baldwin won't be available for Week 3, but we won't know for sure until after the MRI.

Donte Moncrief | Possible concussion | Day-to-Day

The Colts wouldn't confirm and there was some confusion among the team's beat writers about whether Moncrief was diagnosed with a concussion. The team ruled Moncrief out with a "head/neck" injury and he was seen on the sideline during the second half without his helmet. Both factors are suggestive of a concussion.

Monday Afternoon Update: Adam Schefter tweeted Moncrief was scheduled for an MRI today -- on his shoulder. There has been no update on in-game and post-game concerns for a possible head injury. Moncrief's MRI results are pending.

Ameer Abdullah | Left foot injury | Month-to-Month

Video angles on Abdullah's injury were inconclusive. While I didn't see obvious signs of a high ankle sprain or Lisfranc injury, the video didn't rule out other types of midfoot sprains or a fifth metatarsal fracture. Reports of Abdullah leaving the locker room in a walking boot aren't definitively worrisome but aren't reassuring either. Abdullah will have further imaging studies on Monday. His prognosis will be clearer then, but prepare for a multi-week absence here.

Monday Afternoon Update: There are two critical additional pieces of information on Abdullah this afternoon. First, his x-rays are reportedly negative for a fracture in the foot. That doesn't completely rule out the possibility of a fractured metatarsal, but it's a reassuring start. Abdullah's more specific imaging studies are still pending. Second, either those additional imaging studies or his physical examination -- or both -- are worrisome enough to warrant an in-person second opinion from Dr. Robert Anderson in North Carolina. Anderson is the league's go-to orthopedic surgeon for foot and ankle injuries and specializes in midfoot injuries. While Abdullah's mechanism of injury wasn't obviously scary, today's developments suggest he's suffered an injury that could keep him out multiple weeks.

Danny Woodhead | Right knee sprain | Month-to-Month / Possibly Out for Season

Woodhead's injury mechanism was complicated. It's possible Woodhead suffered a relatively minor injury (MCL sprain, meniscus tear), but there was a rotational component at the end of his injury that is concerning for an ACL injury. The Chargers are waiting for the MRI to confirm their suspicions. While those suspicions weren't shared by the team, it's an ominous statement to make. Hopefully, Woodhead's injury isn't a season ender.

Monday Afternoon Update: The Chargers confirmed Woodhead suffered a torn ACL and placed him on injured reserve. There has been no discussion of associated injury. With a smooth rehab, Woodhead should be able to return for training camp next year.

Jimmy Garoppolo | Right AC sprain | Week-to-Week

Reports on the severity of Garoppolo's injury varied throughout the day on Sunday. The most recent reports were more reassuring, calling Garoppolo day-to-day after a negative x-ray. The implication here is that Garoppolo does not have a fracture. However, a mid-grade ligament sprain is often a multi-week injury for a throwing athlete. The Patriots may call Garoppolo day-to-day this week, but it's very unlikely he plays on Thursday night. Pain and stiffness will be issues throughout the week and the medical staff will not be able to harness Garoppolo's throwing shoulder without further limiting his range of motion and effectiveness. Week 4 may be at risk, too.

Josh McCown | Left AC sprain | Week-to-Week

McCown returned to Sunday's game after injuring his non-throwing shoulder. He struggled to lift his arm at all, however, and multiple writers reported the team is worried that a Monday MRI will show a higher grade injury and keep McCown out multiple weeks.

Others of note: Andy Dalton (right leg) was limping off and on after a Pittsburgh defensive lineman landed on his right shin. He was cleared to talk to the media after the game but was limping heavily. Braxton Miller (hamstring) was optimistic after the game but will have an MRI to better define his injury on Monday.


Followup Appointments

 

Rob Gronkowski | Hamstring strain | Week-to-Week

There continues to be very little optimism on Gronkowski's status. The team has essentially said he'll play when he's ready. There's a chance that the team has targeted this Thursday's game for Gronkowski's return, knowing that he'll have ten days to recover. But, other than the two weeks of very limited practice, there's been no supporting evidence for that and Adam Schefter (among others) have been hinting at a later return for over a week now.

Sammy Watkins | Foot soreness | Day-to-Day

At times on Thursday night, Watkins looked quick and comfortable in his route running. At other times, he was seen to be limping and grimacing after a quick turn or tackle. Expect Watkins to continue to be limited in practice and struggle at times during games. If the Bills don't start winning games, Watkins may decide to once again address his foot surgically.

Demaryius Thomas | Hip injury | Day-to-Day

I was surprised how well Thomas looked on Sunday. He's admitted his hip issue is chronic and limiting and observers felt he struggled in late week practices. There was a report early on Sunday that Thomas hadn't convinced the team he was healthy enough to put on the active roster. His Week 2 performance doesn't remove all concern for this season, but it's a reassuring sign Thomas will be able to play effectively through this injury again.

Jamaal Charles | ACL recovery | Day-to-Day 

Adam Schefter reported that Charles would increase his practice participation this week with the intention of playing in Week 3. Charles needs to avoid any reconditioning soft tissue injuries. Even if he's active, it's unlikely he'll see more than 15-20 snaps until he proves he's fully recovered.

Tyler Eifert | Deltoid ligament repair | Week-to-Week

Eifert continues to steadily increase his on-field work, with reports he's begun running routes with a purpose. I still believe Week 4 is the earliest we'll see him, though the Thursday night game time may play a role in his readiness. More likely, Eifert will target Week 5 and beyond for his return to play.

Chris Ivory | Medical illness | Day-to-Day

Ivory released a statement late last week. While he declined to provide any details about the condition that had him hospitalized for multiple days, the tone of his statement suggested he'd be able to return to practice this week.

Zach Ertz | Rib subluxation | Week-to-Week

It's unlikely Ertz's rib injury will have stabilized enough this week to allow him to return to play this week. There are too many major structures near that rib to risk further injury. Give him an outside shot at a Week 4 return, but it could be longer.

Markus Wheaton | Shoulder | Day-to-Day

Wheaton looked likely to return last week after full Wednesday and Thursday practices. After a Friday downgrade, Wheaton was again inactive in Week 2. The downgrade is worrisome for a setback and his Wednesday practice participation will be telling for his availability this week.

Quarterbacks Injured But on the Active Roster
Player Injury Date Player/Team Says FBGs Expects Notes
Andy Dalton Right leg injury W2 Day-to-Day Day-to-Day   
Josh McCown Left AC sprain W2 MRI pending Week-to-Week  3-4+ weeks if MRI shows high-grade sprain
Jimmy Garoppolo Right AC sprain W2 Day-to-Day W4 earliest return  
Tony Romo L1 compression fracture PS W3 6-10 WK 8-10 WK (W8+)  
Running Backs Injured But on the Active Roster
Player Injury Date Player/Team Says FBGs Expects Notes
Adrian Peterson Right knee meniscus tear W2 Week-to-Week 3-4 Wk vs 3+ Mo Timetable depends on surgical decision
Jamaal Charles Right ACL tear Mid Oct 2015 W3 return likely Limited W3 duty  
Doug Martin Right hamstring strain W2 Day-to-Day Week-to-Week Martin says "tweak"
Thomas Rawls Right leg contusion W2 Day-to-Day Day-to-Day Carroll says kicked in leg
Arian Foster Groin strain W2 Day-to-Day Week-to-Week Trainers immediately ruled him out
Jonathan Stewart Hamstring strain W2 Week-to-Week Week-to-Week  
Ameer Abdullah Left foot sprain W2 Second opinion pending Week-to-Week Worry about multi-week injury
Chris Ivory Calf strain / Medical hospitalization W1 Day-to-Day Day-to-Day Could return to practice this week
Kenneth Dixon Left knee sprain PS W3 4 WK 3-6 Wk (W4+) Has not returned to practice yet
Wide Receivers Injured But on the Active Roster
Player Injury Date Player/Team Says FBGs Expects Notes
Brandon Marshall Left MCL sprain W2 Day-to-Day Day-to-Day  
Julio Jones Right knee contusion / Calf strain W2 Day-to-Day Day-to-Day  
Sammy Watkins Foot soreness related to fracture repair W1 Day-to-Day Day-to-Day Was limited at times
Demaryius Thomas Left hip injury W1 Day-to-Day Day-to-Day More productive than expected in W2
Doug Baldwin Left knee injury W2 MRI pending Day-to-Day  
Donte Moncrief Possible concussion / Shoulder injury W2 No timetable given Day-to-Day MRI pending
Markus Wheaton Shoulder injury  After PS W3 Day-to-Day Day-to-Day W2 Friday downgrade concerning 
Braxton Miller Hamstring strain W2 Day-to-Day Week-to-Week MRI pending
Kendall Wright Aggravated hamstring strain August 1 / 29 Week-to-Week 4+ WK (W3+)  
Tight Ends Injured But on the Active Roster
Player Injury Date Player/Team Says FBGs Expects Notes
Rob Gronkowski Hamstring strain PS W2 Day-to-Day Day-to-day  
Tyler Eifert Deltoid ligament repair Late May 4-6 Months 5-6 Months (W4+)  
Zach Ertz First rib displacement W1 Week-to-Week 2-4 Weeks (W3+)  
Virgil Green Calf strain W2 Day-to-Day Week-to-Week MRI pending
Notable Quarterbacks on PUP/NFI/IR
Player Injury Date Player/Team Says FBGs Expects Notes
Teddy Bridgewater Left knee dislocation/ACL tear/+ Late August IR / 2017 9-12 Mo + (2017) Associated damage key
Robert Griffin III Left AC sprain / Coracoid fracture W1 IR / 10-12 WK 2017 Return Browns lengthened timetable last week 
Notable Running Backs on PUP/NFI/IR
Player Injury Date Player/Team Says FBGs Expects Notes
Dion Lewis Left ACL tear/? Awaiting details PUP / Undetermined Undetermined Still no details reported
Danny Woodhead Right ACL tear W2 IR / 2017 2017 Return  
Darren McFadden Right elbow fracture Early Jun 2015 NFI / 2-3 MO W6+  
Keith Marshall Left UCL sprain PS W3 IR / 3-4 WK W6+  
Notable Wide Recievers on PUP/NFI/IR
Player Injury Date Player/Team Says FBGs Expects Notes
Keenan Allen Right ACL tear W1 IR / 2017 2017 Return  
Bruce Ellington Hamstring strain PS W3 IR / 2+ MO 2017 Return  
Notable Tight Ends on PUP/NFI/IR
Player Injury Date Player/Team Says FBGs Expects Notes
Ladarius Green Ankle surgery / ? Headaches January PUP / Undetermined W6+ Steelers say ankle not ready