Monday Injury Rounds: Week 2

Making rounds on the Week 1 injuries, with thoughts on Keenan Allen, Russell Wilson, Demaryius Thomas, Rob Gronkowski, Julio Jones, 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.

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

This article focuses on players who were injured during the preceding week and who are still recovering from past injuries. Players who have successfully rehabbed injuries and have returned to play rarely get more than passing mention. 

That won't be the case this week.

It was great to see Victor Cruz and Jimmy Graham return to active and contributing roles. Cruz had a tremendous second half and caught a fourth quarter touchdown pass that would prove to be the game winner. Graham had an important catch on Seattle's late fourth quarter game-winning drive. Both players still need to prove they can be week-in, week-out factors, but Week 1 was a great start.

Melvin Gordon is the latest player who looks fully recovered from microfracture surgery. Jordy Nelson and Kelvin Benjamin played well despite having their snaps lightly managed in their slow returns from ACL surgery. Sammy Watkins, Dez Bryant, and Julian Edelman are back and productive after foot surgeries. 

And Arian Foster looked good in a tough matchup after a quietly strong recovery from an Achilles tendon repair.

The league's medical staffs had much to take pride in during Week 1.

Keenan Allen | Right ACL tear | Out for season

Sadly, we're just awaiting the inevitable on Allen. Multiple reports from around the team have the Chargers concerned for an ACL tear. It's a diagnosis that's easily made on the sideline exam and isn't likely to be contradicted by a normal MRI. The hope here will be that Allen hasn't suffered any additional ligament injuries, meniscus tears, or cartilage damage. If it's an isolated ACL tear, Allen's recovery timetable will fall in the standard 8-9 month range. If there's more to rehab, the start of Allen's 2017 training camp could be at risk.

Late Monday update: The Chargers confirmed Allen's torn ACL and placed him on injured reserve this afternoon. No report yet on whether Allen sustained any associated damage.

Demaryius Thomas | Left hip injury | Day-to-Day

An early Sunday national media report is rarely good. Yesterday's surprise came from Adam Schefter, who reported that Demaryius Thomas had suffered a hip injury in Thursday night's game and had an MRI that was being sent to a specialist for a second opinion. The need for a second opinion drew the most attention on Sunday morning, but getting another set of eyes on an imaging study is a common medical procedure. If Thomas later travels to a specialist to have an exam and discussion of treatment options, there's more reason to worry.

But, while it's too soon to panic over Schefter's report, the hip injury itself is a concern. Something is amiss here. You don't get second opinions from specialists for an obviously normal imaging study.

I suspect one of two injuries here. First, and probably most likely, is an injury to the soft tissues around the hip joint -- either the labrum around the socket or cartilage overlying the head of the femur. Those injuries can sometimes be managed with steroid injections and rehab but may eventually need to be addressed surgically. The other possibility is a core abdominal injury, which is sometimes described as a hip or groin condition. Watching the play on which Thomas was likely injured shows a pretty forceful internal rotation of the hip. That's more consistent with the labral/cartilage concern.

If Thomas was traveling for another exam and full consult, I'd be more worried about the potential of surgery and the end of Thomas' season. If it's truly only the images that are being shared, the Broncos and Thomas are likely just looking for reassurance that medical management and rehab are sufficient.

We'll know more in the next 48-72 hours.

Late Monday update: Thomas told reporters he has yet to hear about any additional opinions. Both the team and Thomas said they will approach his injury on a day-to-day basis and are hopeful he'll be able to practice Wednesday. I wouldn't close the book on Thomas yet this week but today's update was promising.

Russell Wilson | Right ankle injury | Week-to-Week

Wilson had his ankle stepped on by Ndamukong Suh -- or, more accurately, grazed. Unfortunately, that grazing torqued Wilson's ankle and stressed the joint in the same way high ankle sprains commonly occur. As we see every year, Wilson was limited but able to finish the game with taping and adrenaline. The extent of the sprain will be known over the next 1-2 days. If Wilson comes into the training room with significant swelling and limited range of motion, it could be a long week of rehab to get him ready to play this week. If not, many players play through low grade high ankle sprains without missing time.

Don't panic if you hear that Wilson's foot is in a boot on Monday. Mid and late week practice participation is most important here.

Late Monday update: Pete Carroll confirmed Wilson suffered an ankle sprain. Wilson was reportedly seen in a walking boot last night but Carroll told reporters today that Wilson was walking around normally. That's likely a bit of a stretch. Wilson will be limited in practice this week and the team was already searching for bodies to assist with practice reps. I still believe the next 24 hours are most critical. If Wilson is able to do something in practice Wednesday or Thursday, he'll have a good shot at playing effectively this week. If not, he's likely to be very limited if he's able to go at all.

Robert Griffin III | Left AC sprain | Day-to-Day

Griffin told the local media he'd suffered a sprained shoulder in the locker room. It's Griffin's non-throwing shoulder, which significantly increases the likelihood he'll be able to play through the injury with minimal limitation. However, Griffin suffered the injury by putting himself in harm's way unnecessarily once again. If he continues to take hits like this, he won't last much longer. 

Late Monday update: Griffin's injury is more than a sprained AC joint. He also has a fracture of the coracoid process of the scapula, which is the medical term for a small part of the shoulder blade near the collarbone. It's not a major structural bone, but it's one that will complicate what's likely a mid-grade shoulder sprain. It's possible for an injury like this to heal in 4-6 weeks but the Browns aren't ready to put an optimistic timetable on his return yet. They've placed Griffin on injured reserve and will re-evaluate him in 6-8 weeks before deciding whether or not they'll return him to the active roster.

Chris Ivory | Calf strain / Medical hospitalization | Day-to-Day

Ivory was a game-time decision entering the weekend after being limited in practice all week. Unfortunately, Ivory was never able to test his fitness in pregame warmups after being hospitalized with a medical issue before the game. The Jaguars public relations staff didn't elaborate on Ivory's condition and there are too many possibilities to list here. Multiple media reports would later suggest that Ivory's Week 2 status is dependent on the results of his medical workup. Those results won't be known until mid-week.

Late Monday update: Ivory remains in the hospital awaiting the results of medical testing. While not impossible, it's unlikely he'll be able to play this week.

Zach Ertz | Displaced First Rib | Week-to-Week

Late Monday update: The Eagles reported that Ertz suffered a displaced first rib during yesterday's game. This injury is in a similar location to the sternoclavicular dislocations suffered by Ben Roethlisberger and Danny Amendola some years ago. The concern with these injuries is that instability in the bony structures in this area puts major blood vessels and nerves at risk. The SC dislocations of Roethlisberger and Amendola were multiple week recoveries. Ertz won't play this week and should be considered doubtful to return in Week 3.

...

I'm also in the process of further reviewing video on Dwayne Allen, T.Y. Hilton (arm), and Mohamed Sanu (ankle). More on these situations later this week.


Followup Appointments

We have some big names on the followup list this week.

Sammy Watkins | Foot soreness | Day-to-Day

Late Monday update: Multiple media members this morning confirmed what Adam Schefter hinted at yesterday -- Watkins is dealing with ongoing soreness in his surgically repaired foot. Prior to the team's afternoon press conference, some reports suggested Watkins would need to be shut down for an extended period of time. Later it was reported Watkins had x-rays that showed no new injury around the foot and that his surgeon did not feel further exploration or revision was a necessary option. Rex Ryan hinted in his afternoon press conference that the issue may be one of pain tolerance. Watkins would later talk to reporters and said his foot was "tired" rather than painful and just wanted the injury checked out to be sure.

What's it all mean?

Imaging studies aren't done unless there's some level of concern. Watkins can deflect concern if he likes, but he initiated the imaging process. It's possible he just needed some reassurance after a full first game back. But the area around the screw fixation seems to be bothering him enough to worry him during and after play. These metatarsal fractures are often complicated by further stress reaction and screw failure, so there's reason to worry. Watkins played through similar issues last year. It's hard to handicap the odds Watkins will miss one week or multiple weeks during this season, but the risk has gone up significantly with the need for a Week 1 imaging study.

Rob Gronkowski | Hamstring strain | Day-to-Day

After having fans and fantasy owners bracing for a dreaded Sunday night game-time decision, Gronkowski didn't go with the Patriots to Arizona. In hindsight, that's not too surprising. Gronkowski remained limited in practice last week after not doing much in practice for 2-3 weeks. Gronkowski strained his hamstring in mid-August. The 3-4 week length of recovery means the injury is either a mid-grade strain or was aggravated at some point in the past ten days.

This week's practice participation will be critical. The optimistic line has Gronkowski participating in limited fashion for another week and continue to recondition in advance of a Week 2 return. The less optimistic line would include at least one DNP this week and would raise suspicion that Gronkowski aggravated his muscle strain late last week.

Either way, expect Gronkowski to be listed questionable on Friday. The Patriots are home, which means we won't be on Gronk Travel Watch 2.0, but have an early Sunday start. If Gronk is a game-time decision, we'll at least know whether he's active in advance of lineup lock.

Julio Jones | Aggravated left low ankle sprain | Day-to-Day

Jones had a second violent inversion of his left ankle on Sunday. While Jones looked healthy earlier in the game and never had a high ankle variety of ankle sprain, it takes time for any ligament sprain to heal and another stress to the joint can easily aggravate an injury. Jones struggled through the remainder of the game but minimized his injury in the locker room after the game. I expect Jones to be limited in practice but play in Week 2. He may have some limitations and will again be at risk of aggravation.

Andrew Luck | Shoulder soreness | Observation

Luck looked tremendous on Sunday, so let's consider this a mostly intellectual discussion.

Will Carroll, who's well plugged into the Indianapolis sports market, reported last week that Luck was dealing with some fraying of the labrum in his throwing shoulder. Carroll was careful to note that a frayed labrum is often symptomatic and I confirmed with friend of Footballguys and RotoViz contributor Dr. Jeff Budoff that many overhand throwers have some labral changes that do not affect the throwing motion.

Luck looks fine now and there's no immediate concern about his effectiveness -- so don't take my next sentences out of context. Carroll also reported that Luck suffered a shoulder subluxation last year. That's not a new revelation. But it suggests the possibility that Luck's labral issues may be connected to some residual instability in his shoulder. And the Colts kept Luck from throwing -- in front of the local media -- twice last week. I'm not saying Luck has peaked in 2016. But it's worth watching Luck carefully to be sure he remains accurate and aggressive with his throws.

Jamaal Charles | Right ACL tear | Day-to-Day

Enough time has passed now that it's safe to assume Charles' delay in return -- and it is a delay in return as most players in recent seasons have returned in less than 12 months after ACL repair -- is not related to a new injury. The Chiefs continue to list Charles as a knee injury on the practice reports and there should have been a report about a setback or compensatory injury by now. With each passing week Charles isn't recovered enough to play effectively, the level of concern that he'll not be able to return to full form increases. 

We're not there yet, but it would be very nice to see Charles cleared for contact and preparing to rotate with Spencer Ware very soon.

DeVante Parker | Hamstring strain | Day-to-Day

Parker was able to test his injury during pregame warmups on Sunday but was never close to playing. The Dolphins haven't been pleased with his recurrent injuries and Parker undoubtedly is feeling pressure to return. Hopefully, Parker builds on last week's limited Friday practice and makes it through consecutive sessions without another setback. He's likely at least a week from seeing meaningful playing time.


In the process of updating this week's table after Monday's breaking news....

Quarterbacks Injured But on the Active Roster
Player Injury Date Player/Team Says FBGs Expects Notes
Russell Wilson Right high ankle sprain W1 Day-to-Day  Day-to-day Midweek practices key to W2 potential
Andrew Luck Right shoulder soreness Chronic Day-to-Day Day-to-day  
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
Jamaal Charles Right ACL tear Mid Oct 2015 Off PUP / No contact Week-to-Week  
Chris Ivory Calf strain / Medical hospitalization W1 Day-to-Day Week-to-Week Awaiting details on medical issue
Kenneth Dixon Left knee sprain PS W3 4 WK 3-6 Wk (W4+)  
Wide Receivers Injured But on the Active Roster
Player Injury Date Player/Team Says FBGs Expects Notes
Sammy Watkins Foot soreness related to fracture repair W1 Day-to-Day Day-to-day Could struggle or require rest
Demaryius Thomas Left hip injury W1 Day-to-Day Day-to-day Reassuring update, watch for more details
Julio Jones Aggravated left low ankle sprain PS W3 / W1 Day-to-Day Day-to-day  
Steve Smith Right Achilles tear Early November Week-to-Week Week-to-week  
DeVante Parker Hamstring strain PS W4 Week-to-Week Day-to-day Possible aggravation
Markus Wheaton Shoulder injury  After PS W3 Day-to-Day Day-to-Day  
Danny Amendola Ankle / Knee surgery Offseason Week-to-Week Week-to-Week  
Josh Doctson Left Achilles tendinitis Mid May Day-to-Day Day-to-day Returned to play W1
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+)  
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 Injured Reserve Chance to return 8 Wks  
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
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

I'll be updating this feature throughout the day. Footballguys Insiders will get a full update from Craig Zumsteg with additional fantasy perspectives on Wednesday and 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.