Injury Rounds | PUPdates | July 27

Jordan Reed's surprise addition to the PUP list in Washington, a new injury for Joe Flacco, updates on Julio Jones, John Ross, and more

I'll have updates on each new injury and PUP / NFI move every evening after the NFL's official transactions are released. If you're interested in breaking analysis and discussion, follow my Twitter timeline or check out our new and exclusive Footballguys Channel on Sleeperbot, a desktop and mobile app where you can set up push notifications to get breaking news updates sent to you.

***Check the Footballguys Injury Page daily for the latest articles on injuries throughout the preseason
***Click here for July 26th analysis of Kenneth Dixon, Mike Pouncey, Reuben Foster, and others
***Click here for July 25th analysis of Andrew Luck, Teddy Bridgewater, Jaylon Smith, and others


WHY TEAMS USE THE PUP LIST

Rookies and veterans report this week for camp. After their entrance physical and conditioning test, each player will either be cleared for the active roster or moved to the PUP or NFI list. Scroll to the bottom of this article to see exactly how those lists are defined.

Don’t overreact to these designations.

Every team uses their PUP list differently. Years ago, players put on the PUP list were those unlikely to be cleared for practice in camp. Most would transition to the regular season PUP list or injured reserve. Now, nearly every team uses the PUP list as medical triage. Players who report out of shape are put on the PUP list until they pass conditioning tests. Players recovering from offseason surgery or an injury during mini-camp are also stashed on the PUP list for a few days to allow medical staff personnel to be certain they are in condition to begin taking contact.

It's usually positive when a recovering veteran starts camp on the active roster, but it’s possible that player’s reps may still be severely limited in the early weeks of camp. And while your spidey senses should be tingling with any player who is a surprise addition to the PUP list or stays on longer than expected, remember that teams will want to keep their PUP and IR-Return options open as long as possible.

Once a player takes part in a practice, those options are limited. If a player participates in a single practice rep, he's ineligible for the regular season PUP or NFI list. A setback would mean the team has only the injured reserve list to stash a player with a multi-week injury. The new IR-return rule provides added flexibility, but teams won't close any doors for themselves sooner than absolutely necessary.


JULY 26 TRANSACTIONS, NEWS, AND NOTES

JORDAN REED | TOE SPRAIN | ACTIVE-pup

Every year there are a handful of eye-opening names not cleared to practice. There were no surprises this week until today when Washington put Reed on their PUP list to start camp. Shortly afterward, beat writers were told Reed sprained his big toe and was still "dealing with pain and soreness." Reed's absence was termed precautionary and the team said he was "undergoing further evaluation" before clearance in the hopes he can avoid any "long-term issue."

Though Reed's inclusion on the PUP list was surprising, the pervasive lack of surprise among my Twitter followers was not surprising. Reed has struggled to stay healthy in recent years, battling recurrent concussion issues and a high-grade shoulder separation last year.

Washington maintains their decision was precautionary, but a big toe sprain necessitating further evaluation has to raise a red flag. And there's at least enough concern here for the team to use the Active-PUP list and keep all roster options open. The most concerning diagnosis would be a high-grade turf toe injury requiring surgical intervention and a prolonged recovery. The least concerning would be a low-grade injury and a very short absence.

There are not enough details to form an educated opinion on Reed yet. Hopefully, he's cleared to return to the active roster quickly and successfully avoids aggravation or compensatory injury. I'll have more on my Twitter timeline and on our injury page when more details are reported.

Joe Flacco | Disc inflammation

Early Wednesday evening, Baltimore beat writer Jeff Zrebiec reported Flacco was dealing with "back soreness that could limit him early in camp." At the time, Zrebiec was told Flacco could be limited early in camp but there didn't appear to be significant concern. That quickly changed later in the evening, with reports from Ian Rapoport and Tom Pelissero that Flacco was "preparing to miss 3-6 weeks with a disc issue in his back" but was without a clear timetable yet. Adam Schefter reported Flacco hurt his back lifting and had an MRI

Reading between the lines of Wednesday's Twitter storm -- which included "back soreness" and "disc issue" and a suggestion Flacco could miss as much as six weeks but is without a clear timetable -- it's reasonable to speculate that Flacco has a symptomatic disc herniation (pain, weakness) and is hopeful medical and physical therapy will calm the inflammation enough to allow him to return without surgery. Rapoport reported "at least a week or two" which would be consistent with the time needed to assess whether steroid injections and rehab would be successful. Zrebiec responded to questions about the 3-6 week timetable by saying he's heard multiple possibilities and the Ravens are "committing to a week of rest...hoping that will calm symptoms down."

If Flacco is dealing with a disc herniation and it doesn't respond to therapy, the worst case scenario is surgery and a 2-3 month absence. However, that's another level of speculation entirely and there's no current indication the Ravens are concerned. For now, it's best to consider Flacco week to week.

I'll have more on Flacco when additional details and context are reported.

Julio Jones | Bunionectomy | Active Roster

As expected, Jones passed his entrance physical and was cleared to the active roster. Dan Quinn told local reporters Jones would be limited in practice early in camp.

MIKE POUNCEY | HIP INJURY / STEM CELL INJECTION | APRIL | DECISION PENDING

Pouncey has been a VIP in these updates while we waited for the Dolphins to make a formal decision on his status. Today, one beat writer reported Pouncey passed his entrance physical and the team would allow him to do individual drills as camp begins. Miami opened camp and began practicing on Wednesday, placing a number of players on the PUP and NFI lists. Pouncey's status looks official and it's a great sign for his recovery. There would be no reason for the Dolphins to limit options on a critical player who already experienced at least two setbacks with this injury over the past 12 months.

Jamaal Charles | Meniscus surgeries | November 2016 | Active Roster

Vance Joseph told reporters today Charles is fully cleared to practice. The Broncos will work him into team drills slowly and see how his knee responds to football-related activity in pads.

Reshad Jones | unreported injury | Active - NFI

Jones was an unexpected addition to Miami's NFI list today. He reportedly "tweaked something running on his own." There doesn't appear to be significant concern from the Dolphins.

gio bernard | left acl reconstruction | November 2016 | active roster (reported, not official)
Tyler eifert | microdiscectomy | december 2016 | active roster (reported, not official)

John Ross | shoulder labrum repair | march 2017 | active roster

The Bengals have apparently elected not to place Ross on their NFI list. Rookies have already reported and taken their conditioning test in Cincinnati. Geoff Hobson says Ross won't make his practice debut for a couple of weeks. It's odd for the team to not use the NFI list but it should be considered a sign that Ross' rehab has progressed without concern.

Hobson also speculates good news for Bernard and Eifert, noting that "all indications are [Bernard and Eifert] could be available when training camp opens and won't have to start the summer on any restricted lists." Hobson also expects the Bengals to work both veteran offensive players slowly.

Sammie Coates Jr | Arthroscopic Knee Surgery | Active-PUP (reported, not official)

Coates underwent arthroscopic knee surgery last week and may not return until mid-August.


DECIPHERING THE ALPHABET SOUP OF INJURY LISTS

Players not ready for camp practices are placed on one of two lists – Physically Unable to Perform (PUP) or Non-Football Injury/Illness (NFI).

Physically Unable to Perform

Active/PUP – Preseason only list. Once a player participates in any part of a scheduled training camp practice, they are ineligible for this list. Players can be activated from this list at any time. This list is commonly used for veterans still recovering from injury and those who fail conditioning tests before camp begins.

Reserve/PUP – Regular season only list. Players still on Active/PUP at the end of camp are eligible to move to Reserve/PUP. Players cannot practice with the team until after Week 6. Teams then have six weeks to evaluate the player before moving to the active roster or to season-ending injured reserve.

Non-Football Injury / Illness

Active/NFI – Preseason only list. Once a player participates in any part of a scheduled training camp practice, they are ineligible for this list. Players can be activated from this list at any time. Only veterans with a non-football related injury or rookies injured before the NFL draft are eligible for this list.

Reserve/NFI – Regular season only list. Players converted from the Active/NFI list to the Reserve/NFI list are out for the entire season.

Injured Reserve – Return Designation

Each NFL team can return two players to the active roster from injured reserve. Teams are not forced to designate this player at the time of the move to injured reserve. Players designated to return can begin practicing six weeks after being placed on injured reserve and are eligible to return to the active roster eight weeks after being placed on injured reserve. This rule allows a team to continually evaluate the rehab and recovery of their injured players and provides roster flexibility should teams have multiple key injuries early in the season.

Check back for more injury analysis throughout training camp and follow on Twitter @JeneBramel for breaking injury news, commentary, and analysis of injury news around the NFL.