Injury Report Insight: Week 4

A critical look at this week's injury report.

After Week 2's bloodbath, Week 3 seemed pretty quiet on the injury front. That's not to say that there weren't some significant injuries, as top players like Russell Wilson, Dez Bryant, and Willie Snead are now in the injury headlines. But for the most part, Week 3 brought us much more mild injuries that shouldn't result in season ending injured reserve. In addition, players like Delanie Walker, Doug Martin, Jonathan Stewart, and Sammy Watkins received some much needed rest and rehabilitation, and should hopefully be back in lineups soon.

Quarterback

Russell Wilson, MCL sprain, ankle sprain

The way Russell Wilson is piling up and playing through injuries, you'd think he was a pint-sized Ben Roethlisberger. Wilson has been playing through a right high-ankle sprain, which is no small feat given his need for mobility behind Seattle's porous offensive line. If that wasn't enough to hobble him, Week 3 brought Wilson an MCL sprain in his left knee. So far, all Seattle sources indicate that Wilson's sprain is minor and that he's expected to play through the injury. If the MCL sprain is indeed minor, it's very possible Wilson will be able to play through it. I would question how much it might limit Wilson's effectiveness this week against the Jets, but that's impossible to predict right now. For what it's worth, Wilson was able to practice in full on Wednesday, which is an impressive recovery.

Jimmy Garoppolo, AC Sprain

Jacoby Brissett, thumb sprain

Tom Brady's stand-in, Jimmy Garoppolo was unable to play in Week 3 due to an AC sprain to his throwing shoulder. In his absence, third-stringer Jacoby Brissett secured a victory, but suffered an injury of his own, spraining his throwing thumb. This early in the week, it is unclear which quarterback will start Week 4, as they both put in limited practices on Wednesday. Brissett's injury is the lesser of the two, so it sounds like he will likely be ready should Garoppolo need another week of rest. For a clearer picture, check back on this split on Friday. If Garoppolo returns to a full practice, than he's likely starting. If he remains limited, I'd expect Brissett to get the nod, though it would also be worth checking notes from beat reporters who might have specific details on how well each player is throwing.

Jay Cutler, thumb sprain

Chicago head coach John Fox is calling Jay Cutler, "day-to-day," with a sprain to the thumb of his throwing hand. Cutler was able to practice on Wednesday, but only in a limited fashion. I suspect that unless Cutler can put in a full practice on Thursday or Friday, we will see Brian Hoyer start his second game for the Bears. As with Garoppolo and Brissett, check back for details on how much throwing Cutler is doing in this week's practices.

 

Running back

Jeremy Langford, high ankle sprain

The Bears haven't confirmed that Jeremy Langford's injury is a high-ankle sprain, but Adam Schefter reported that is was an ankle sprain which was expected to sideline Langford 4-6 weeks. That sort of timeframe leaves little doubt that Langford suffered a high-ankle sprain of moderate severity at least. As long as we don't hear any future reports that Langford might need surgery, that 4-6 week estimate is reasonable for this injury. The real question here might be what sort of role Langford returns to, as all eyes are now on rookie Jordan Howard, who might run away with the starting job.

Rashad Jennings, thumb injury

We still don't have any details on what the exact injury to Rashad Jennings' left thumb is, but we know that he was held out of Week 3 due to concerns over his ability to catch passes. My sense here is that the Giants wouldn't typically rush Jennings' return, but the recent loss of Shane Vereen changes things a bit. I would tentatively expect Jennings to start this week, though I wouldn't expect him to be involved in the passing game. But again, I should stress that's just my feeling here. Since the Giants don't play until Monday night, they won't issue an official practice report until Thursday. Be sure to check up on Jennings throughout the week to get a better idea of his status.

Shane Vereen, triceps tear

As if the questions about Rashad Jennings' injured thumb weren't enough to worry about, the Giants also need to fill the role of Shane Vereen, as he suffered a triceps tear on Sunday. Mike Garafolo reported that Vereen's injury isn't necessarily season-ending.

There are new wrinkles to the IR/DFR (injured reserve, designated for return) rule this season. In previous years, the team had to basically pre-designate one player as the only one who was eligible to return from IR. This year however, any player on injured reserve can later be designated to return. So while it's true that Vereen could return, I think it is unlikely. Then again, this new rule change highlights one important limitation of my historical injury database. Triceps injuries are serious injuries and, in the past, these players rarely returned during the year. I have records of exactly two such returns. Tackle Jared Veldheer tore his triceps in the preseason of 2013 and returned after 15 weeks of rehab. Linebacker Ray Lewis returned after missing 11 weeks in 2012 (see "spray, deer-antler"). Perhaps these are outliers as to triceps tear recoveries. But under the old system, we'd rarely get a chance to judge exactly when a player was ready to return, as the team would've been unlikely to use their sole IR/DFR tag on a player with such a serious injury. With the new system, we're more likely to have clarity on exactly when a player might be able to return from what would've previously been a season-ending injury.

Thomas Rawls, fibula fracture

After dealing with what the Seahawks initially thought was a leg bruise, Thomas Rawls has now been diagnosed with a hairline fibula fracture. Pete Carroll, ever the injury optimist, said that Rawls would be out, "a few weeks." Our own Dr. Jene Bramel estimated Rawls' return at around 6 weeks, which I find to be in-line with historical comparisons. The fastest return from a hairline fibula fracture was from tight end Brandon Bostick, who in 2014 returned one month after suffering what was originally thought to be a bruise. It's notable that Bostick was slowly eased back into the offensive rotation, and that he played special teams only for that first game back. Like with most injuries, we'll have a better idea of when Rawls might return when we see that he's practicing and cleared for contact. For now though, my best guess is that he's out until about Week 6 at the earliest.

Arian Foster, groin injury

The starting running back job in Miami is wide open for Arian Foster, but he's been ruled out for Thursday's game with a groin injury, likely a muscle strain. This is understandable given Foster's extensive groin injury history and Miami's short week. In the meantime, Miami will continue to roll with their puzzling running back committee featuring, "anyone-but-Jay-Ajayi." Due to Foster's injury history, it's safe to assume that he is out until he returns to full practices, which is at least another week away.

Doug Martin, hamstring strain

Doug Martin missed Week 3 with a hamstring strain, and has not practiced since. Initial estimates were that Martin would miss three weeks. While that might be an accurate estimate, the team's schedule offers us a better idea of possible return, as the Buccaneers have a Week 6 bye. It is unlikely that they would rush Martin back to play in Week 5, even if his rehab was going well. Look for him to return in Week 7 at the earliest. Martin did not practice on Wednesday, so it's almost certain that he will miss this weekend.

Jonathan Stewart, hamstring strain

Jonathan Stewart will remain inactive due to a hamstring strain he suffered in Week 2. Coach Ron Rivera said Stewart could miss 2-4 weeks, which isn't a bad early estimate on a hamstring strain. From my perspective, I'm just happy to hear a coach say anything other than, "day-to-day." As Dr. Jene pointed out in his Monday injury piece, the Panthers have a Week 7 bye. As with Doug Martin, I wouldn't expect the Panthers to rush Stewart back before a bye. There's a legitimate chance that Stewart recovers closer to the lower end of that range and returns in Week 5 or 6, but I wouldn't bet on it. 

Jamaal Charles, ACL

You'd be forgiven for feeling like you're reading recycled blurbs every week on Jamaal Charles because that's exactly the case. Since the start of the season, Charles has been close to returning, but something has been holding him back. If there's any silver lining here it's that Andy Reid has largely avoided the drama of the game-time-decision, and we've always had clarity early in the week as to Charles' status. This week appears to be the same as last, with Charles getting in only a limited practice on Wednesday. The Chiefs have a Week 5 bye, and I think it's safe to assume that Charles' first real shot at playing might be after the bye, in Week 6.

Kenneth Dixon, MCL sprain

Ravens fans received some good news Wednesday morning when Ian Rapoport tweeted that running back Kenneth Dixon might return to practice this week. Dixon has been out since the end of the preseason with an MCL sprain, and it appears he's making steady and significant progress towards a return. Many writers, including Peter King, feel that Dixon has a good chance of becoming the workhorse back after he returns. This would be a huge help for fantasy owners, as the current Ravens backfield is both crowded and ineffective. Dixon did indeed return to practice on Wednesday, but only as a limited participant. I would expect that Dixon would be held out until he's had a week of full practices, so be sure to check back on his reports.

Ryan Mathews, ankle

According to the NFL's Ian Rapoport, Ryan Mathews' ankle, "stiffened," before his Week 3 game, resulting in him getting very little playing time. Presumably, this is the same ankle that bothered Mathews during the preseason. Without more details, it's tough to speculate as to how long his rehab might take. Luckily for Mathews, the Eagles have a bye week to get healthy.

Tevin Coleman, ankle

Isaiah Crowell, knee

Matt Forte, knee

I'm not really a fan of lumping a bunch of injured players together like this, but the truth is I simply have nothing particularly useful to say about any of them. None of the three appeared to be injured in their Week 3 games, yet they were all limited at Wednesday's practices. It's likely that they are all just being given a little much-needed rest. But this is a situation where owners will still need to check back later in the week to follow-up. Sort of a fantasy football version of, "trust, but verify," if you will.

wide receiver

Dez Bryant, tibial plateau fracture

Now this is a story! Dez Bryant suffered a knee injury in Week 3, but was able to return to the game. In the days following the game, there were reports that Bryant would undergo an MRI exam, but nobody, even owner Jerry Jones, could sufficiently explain exactly what was going on. Now there is a story from The Dallas Morning News that Dez Bryant missed his scheduled Tuesday MRI and couldn't get the exam until Wednesday. That same source also reports that Bryant has been fined for missing his scheduled appointment on Tuesday.

Even without that drama, this is still an interesting story, as Bryant's injury was reported by ESPN's reliable Todd Archer as a tibial plateau fracture. In that piece, coach Jason Garrett calls the injury a, "day-to-day, week-to-week," injury. He goes on to say that he's had other players with this injury who missed no time at all, though he doesn't name those players. From Garrett's comments, we're led to believe that Bryant could possibly play soon, perhaps as soon as this weekend.

While we might never have some of the important details, such as the size and location of the fracture, I can tell you that from a historical perspective, this is not a minor injury. Adam Hayward and Nate Burleson both landed on injured reserve with similar injuries, missing the last 5 and last 10 games of their respective seasons. Danny Trevathan is a better example, as he had a similar injury during the 2014 preseason. He was given an initial estimate of 6-8 weeks, and returned after missing 7 weeks. In the case of Trevathan, he did not require surgery. Early reports are that Dez Bryant won't require surgery either.

I can't tell you why there seems to be such a large disconnect between my numbers and what the Cowboys are saying. Perhaps Jason Garrett is entirely correct that he's seen players miss no time with this injury. Perhaps there are details about Bryant's injury that make it far less severe than those examples I'm comparing it to. I think it's important to note that the Cowboys initially gave what I felt were ridiculously optimistic return-to-play estimates for both Dez Bryant and Tony Romo last season. I suspect that we're seeing a similar trend this week with the latest timelines for Bryant. But for right now, it's only that... a suspicion.

Michael Floyd, concussion

Michael Floyd was able to put in a limited practice on Wednesday after suffering a concussion in Week 3. The good news here is that Floyd was cleared for football activities. The bad news is that he's not out of the woods yet, as he still needs to be cleared by a neurologist on Thursday before returning to full practice. It's early in the week, but Floyd's rehab is trending in the right direction, and there's a good chance he's able to suit up this weekend. 

Willie Snead, toe sprain

After being a Monday night game time decision, Willie Snead was ultimately declared inactive due to a toe injury. According to ESPN's Mike Triplett, "Snead said his toe was injured when it got caught in the turf and rolled up when he was tackled." As always, I'll point out that I'm not a doctor, but what Snead described there is a classic mechanism for what we colloquially refer to as turf toe. Turf toe injuries can linger and sap a player's effectiveness and explosion, though it's a promising sign that Snead was able to put in a limited practice on Wednesday. Hopefully the Saints are simply being conservative, and Snead will be a full-go for Sunday's shootout with the Chargers.

Sammy Watkins, foot injury

Sammy Watkins did not practice on Wednesday due to ongoing soreness in his surgically-repaired foot, and that's never a great way to start the week. The NFL's reporter Mike Garafolo stated that Watkins would test his foot on Wednesday or Thursday to see whether he had a shot to play this weekend. As of Wednesday night, we have no word on whether that has happened yet or what the results were, so we'll just have to wait patiently.

DeSean Jackson, ankle injury

DeSean Jackson appears to be dealing with a lingering ankle injury. He was listed with an unspecified ankle injury on the practice reports leading up to Week 3, but was removed from those injury reports on the Friday before Week 3's game. Jackson seemed fine in his game against the Giants, but perhaps he tweaked the troublesome ankle, as he was held out of Wednesday's practice. Either he is being conservative with a minor injury or he's just getting a day of rest, but be sure to follow up on his Thursday and Friday practices for better information.

Julio Jones, calf injury

It's hard to know how much concern we should have for Julio Jones' health going forward. Both Jones and the Falcons medical staff felt that Jones was healthy enough to play in the Week 3 Monday night game. But Jones' stat line of 1 reception for 16 yards could be seen as a sign that he was far from full health. With that in mind, it's promising that Jones was able to put in a limited practice on Wednesday. Perhaps his low stats were more a result of scheme and coverage, and he has his calf injury well under control. Hopefully he can get in at least one full practice this week, which would signal that he's not in any danger of missing Week 4.

Mohamed Sanu, shoulder injury

If you take my advice on Julio Jones and check the later practice reports for the Falcons, keep an eye on Mohamed Sanu. He suffered an unspecified shoulder injury in Week 3, but the Falcons don't seem to have any concern that he'll miss Week 4. Even a week of limited practices will probably result in Sanu starting this weekend. Obviously, a downgrade to a missed practice would be alarming and would indicate a serious injury, but that doesn't seem to be the case here thus far.

Eric Decker, shoulder injury

In contrast to Mohamed Sanu, it sounds like Eric Decker's shoulder injury has his team very concerned. Decker was playing through an unspecified shoulder injury, but Todd Bowles said that Decker aggravated the injury in Week 3 and that it is now worse than it was previously. Without having any specific details, I suspect that Decker is dealing with either an AC sprain or a shoulder labrum injury. Both are common among NFL players, including wide receivers. Both could be effectively played through if they were minor enough. And both could easily be further aggravated when attempting to play through them. It's been reported that Decker is getting an MRI, which would also fit with either an AC sprain or a labrum injury. Hopefully we hear some good news soon, but there's too little information here for me to dig any further.

T.Y. Hilton, knee injury

T.Y Hilton showed up on the injury report last week with a knee injury, and despite limited and missed practices, played an outstanding game on Sunday. Due to this history, we shouldn't be alarmed to see that Hilton was held out of Wednesday practice. Should he not return to practice in at least a limited fashion, then we'll be allowed to worry. But for now, don't sweat this one.

Josh Doctson, Achilles

Washington rookie Josh Doctson has been having problems with his Achilles since May, yet the team has insisted that this is not a, "long-term," injury. Doctson had limited practice all last week, but was ultimately held out of Sunday's game. Doctson was held out of Wednesday practice. ESPN's John Keim reported that Doctson hasn't suffered any further damage, but that this is an issue of pain management. Given the lack of progress in Doctson's now nearly five month rehab, I think it's a very real possibility that Washington puts Doctson back on the shelf for an extended period, perhaps even the rest of the season. Obviously, that's simply my opinion, so we should wait for more information before jumping to conclusions.

tight end

Rob Gronkowski, hamstring strain

Rob Gronkowski was only able to put in a limited practice on Wednesday, but there shouldn't be any concern there. There are no reports of Gronkowski suffering a re-aggravation or setback, so we can reasonably expect him to continue to take on more snaps this week.

Tyler Eifert, ankle surgery

There was some enthusiasm when it was reported Tyler Eifert had returned to practice after his offseason ankle surgery. While Eifert might well return in Week 5, he is listed as doubtful for Week 4, and can safely be ruled out.

Julius Thomas, elbow injury

Julius Thomas wasn't shown to have suffered any injury in Week 3, so it's a little odd that he sat out Wednesday's practice with an unspecified elbow injury. This is likely nothing, but as always, it's well worth checking back later in the week in order to be sure.

Eric Ebron, ankle injury

Eric Ebron has been dealing with an ankle injury off and on since late August. He has played effectively through the injury thus far, so it's not necessarily concerning that Ebron missed Wednesday's practice. As long as this isn't a setback or a new, more severe injury, we can expect Ebron to play this weekend. Even a limited practice session from Ebron would help to alleviate the concerns of fantasy owners.

Vance McDonald, hip injury

Although we don't have any details on the exact nature of the hip injury that sidelined Vance McDonald in his Week 3 game, it sounds like it wasn't a minor injury. Coach Chip Kelly has already said that McDonald might not play this week, which is always surprising to hear so early in the week. McDonald did not practice on Wednesday. For McDonald's sake, I hope the injury is something like a hip pointer rather than a more serious hip labrum injury. Both would warrant Kelly's pessimism, but a hip pointer would be the much less severe injury.

Delanie Walker, hamstring strain

Antonio Gates, hamstring strain

Virgil Green, calf strain

Delanie Walker, Antonio Gates, and Virgil Green were all inactive for Week 3. Furthermore, all three tight ends missed Wednesday's practice. Unless any of them can make it back for at least a limited practice this week, it's safe to assume they will all be held out of Week 4. Of the three, I'm the most pessimistic about Antonio Gates, as Michael Gehlkin, who has a great track record on Chargers injuries, tweeted last week that Gates, "wasn't close, " to playing in Week 3.

 


For more of my NFL injury thoughts and opinions, be sure to follow me on Twitter. I will try to answer all questions and am always happy to add my two cents to any injury conversation.