Inside the Injury Report (Percy Harvin)
By Jene Bramel
August 24th, 2010

Percy Harvin was a valuable target for Brett Favre out of the slot and in the red zone last season, with nearly 800 yards and six touchdowns in a promising rookie season. He missed one game and many midweek practices due to headaches last season and frequently saw specialists to consider ways to both prevent and treat his headaches. Harvin began experiencing headaches again earlier this month and, in what might be the most worrisome episode yet, collapsed on the field a few minutes after looking up into the sun to field a punt.

What's the injury?

Harvin has been diagnosed with migraine headaches. He reports his first episode occurring at age 10, with many other episodes since. Harvin prefers not to talk about his condition, but his recent history suggests that his headaches have no consistent trigger and may hit him with little warning.

As many migraine sufferers can attest, Harvin's history, though severe, is not uncommon. Migraines can occur with or without a known trigger, with common triggers including fatigue, stress, certain foods, dehydration and exertion. A migraine headache may be immediately severe or build over a period of hours. Symptoms often associated with a migraine headache include nausea, vomiting, light and sound sensitivity. Most with a clear history of migraines have a family history of a headache disorder and often have their first episode during childhood.

What's the medical prognosis?

In most complicated cases of migraine, close attention to hydration, proper avoidance of known triggers and attempts to stop the headache with medication as early as possible are usually prioritized in a treatment plan. Unfortunately, Harvin's prognosis is complicated greatly by the number of hits he takes in his chosen profession. Migraine headache and concussion are relatively poorly understood medical conditions and difficult to diagnose. Post-traumatic migraine, which may or may not be what Harvin is experiencing, is an even more slippery condition to diagnose and treat.

In recent years, we've continued to learn more about concussion. Most concerning for Harvin, recent evidence suggests that even mild concussions may be associated with more severe injury than previously thought. Though much of the research defining post-traumatic migraine remains controversial, a 2005 study suggested that athletes with post-traumatic migraine may be more likely to have more neurocognitive impairments after concussion than those without.

There is some evidence that a post-traumatic migraine may not begin until hours or days after the traumatic event. Though my concerns are based entirely on speculation, if Harvin's underlying migraine syndrome is being complicated by concussion and post-traumatic migraine, his medical prognosis could be worrisome. Even without a history of post-traumatic migraine, the history of classic migraine could make the diagnosis of a future concussion extremely difficult, as many of the associated symptoms (vomiting, headache worse with exertion, light sensitivity, etc) occur with both conditions. Further complicating Harvin's picture are two bulging disks in his cervical spine that were diagnosed during an MRI last season. Associated muscle spasm and soreness from the spinal issue could also precipitate a migraine or other headache syndrome.

What's the fantasy prognosis?

Brad Childress hopes that Harvin will return to practice this week and expects him to be ready to play opening weekend, but admitted that the team understands that the condition is a day-to-day issue. Harvin has had migraines throughout his football playing career and they were apparently such a minor issue that the Vikings had no reason to consider them a serious concern during the pre-draft process. He was able to make it through 15 games last season and his collapse last week, while scary, was apparently not a sign of a more severe or progressive neurologic condition.

Still, expect the team to be extremely cautious with him should the headache continue at their current frequency. With the confounding possibility of a concussion lurking, Harvin and the team are unlikely to risk a more severe injury by pushing him to return to play before he's fully healthy. If the last 12 months are any indication, given Harvin's fearless, physical, over the middle style of play, the last episode won't be the last time we hear that Harvin is experiencing a migraine. It's hard to see him playing a full 16 game season this year and I'd be wary of drafting him as my WR3. If you do gamble on his upside, make sure you've rostered a strong WR4 and WR5 to cover yourself in case Harvin's episodes plague him throughout the season.

Questions, suggestions and comments are always welcome to bramel@footballguys.com.

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