17 Nov 2004
interviewed by the staff of Football Outsiders
Over the past few years, Will Carroll has become the Internet's top expert on baseball injuries. He writes the Under the Knife column for Baseball Prospectus, as well as hosting the weekly syndicated program Baseball Prospectus Radio, and is the author of the book Saving the Pitcher. Before the season began, we got Will to extend his expertise into the world of football injuries. Now here we are at midseason with a whole slew of new injuries affecting the NFL playoff races, so Will is back to help us understand what's going on with everyone from Byron Leftwich to Randy Moss. (Alas, he doesn't have contacts in the front offices the way he does in baseball, so we get to hear again how secretive the NFL is with injury specifics.) The questions here were put together by the whole staff.
You'll also find Aaron returning the favor with an appearance on Baseball Prospectus Radio this weekend to discuss the NFL at midseason. BP Radio has affiliates in Indianapolis, Denver, Montreal, Vancouver, and Ft. Myers -- the Montreal affiliate streams live online at 1 pm EST on Saturday for those interested in listening.
Football Outsiders: Let's start with three major quarterbacks, each of whom has either missed time or is about to miss time with an injury, but none of whom are having any kind of surgery or anything. How long will it take these players to return to the field? What are the optimistic and pessimistic outlooks for these injuries? And are these injuries the kind of thing where you can play hurt, or where you have to be 100% healed to get back out there?
First, Steve McNair, who has missed a couple of games with a bruised sternum.
Will Carroll: McNair, like a lot of big quarterbacks, takes hits. The ability to take a hit is certainly a positive, but in a collision sport, it also raises the possiblity of a catastrophic or traumatic injury. McNair has shown the ability to play with significant pain before, so we have to assume he simply cannot play. We can also assume that, given information we have, he's closer to playing now than he was a couple weeks ago. There's simply no way he's healed, so he just needs to get to a point where he's functional. I'm not sure what that point is and I'd guess neither is McNair. It's not only scary, it's risky to have a player that you're not sure can play for one play, one quarter, or one game.
Football Outsiders: Second, Chad Pennington, who has a strained rotator cuff.
Will Carroll: This is a tough one. It's not like a baseball pitcher -- QBs don't put as much strain on their arms for a number of reasons -- but Pennington is not going to be able to throw as hard. It's simple to see that there are consequences from that fact. It's not a significant tear, should heal, and he should be back to full effectiveness in a couple weeks.
Football Outsiders: Third, Byron Leftwich, who has a strained right knee. This one is particularly interesting since the initial reports said he had a ligament tear and could miss the rest of the season, and now reports say he's only going to miss one game (two weeks; they had a bye last week).
Will Carroll: Leftwich is another player who's shown superhuman pain tolerance. The initial reports of a tear looked bad, but later MRIs seem more positive. MRIs are just a tool and notoriously difficult to read. Just Google an MRI and try to find something. Even trained radiologists often disagree. It's a partial tear and not fundamental to his game. I'd guess four weeks, but Leftwich isn't "average."
Football Outsiders: Ty Law has a broken foot suffered against Pittsburgh on Halloween. They are saying 3-5 weeks, but will the injury affect him at all when he returns?
Will Carroll: It should, but depends on the bone broken. Again, the NFL's tyranny on injury data makes this tough to judge. The most stress happens with starting and cutting, two things law will have to do. If he runs straight lines, he'll likely have no problems, but no offensive coordinator is going to let Law off easy. They'll have to protect him with a safety.
Football Outsiders: Pittsburgh linebacker Kendrell Bell missed the first seven games with a "sports hernia" and only last week returned for a few plays against Philadelphia. What the heck is a sports hernia and how does it differ from a regular old "fat guy at the office" hernia? Will Bell be back to 100% at some point this season? And how does something like this effect his future, given that he is in a contract year -- is this a one-time injury or something that may be recurring?
Will Carroll: Ha! Can I use that fat guy line? Sports hernia is one of those terms that really doesn't make much sense when the facts come out. It's a tearing of the sheath or lining that holds the groin muscles in place. While it presents like a torn groin, it's not the muscle that's torn. It's painful, but controllable and easily repaired with surgery. I don't have any experience in judging how they come back in football -- for baseball, many will remember Roy Oswalt fighting through the 2003 season with one. He had surgery in the off-season and came back 100%.
Football Outsiders: Why does something like a contusion make Corey Dillon a game time decision? Can't they just pad it up and send him out there? What can change from one day to the next that keeps them from deciding on something like this until the day of the game?
Will Carroll: Pain tolerance. What's "Probable" for one guy is "out" for another. How they can deal with the pain, adjust to reduce the pain, and the effectiveness of treatment is the deciding factor. I can remember working with a basketball player in college that had a pretty simple groin strain, but wouldn't ice. He simply couldn't handle having the cold ... ummm, down there. Ergo, he wouldn't treat his own injury. It took him a lot longer coming back. Most pitchers couldn't do what Curt Schilling did. To go back to Leftwich, I'll bet few quarterbacks could play on a broken leg. A muscle strain for a running QB is different than for a pocket QB. There's just so many factors that we know and don't know that it's amazing we know as much as we do.
Football Outsiders: Michael Strahan of the Giants stuck out his arm and you could just see his pectoral muscle get ripped. Looked nasty. Will he lose a lot of strength? Will it be hard for him to lift weights and get himself into shape for next year?
Will Carroll: It is nasty looking, but tends to heal. The most devastating looking injuries actually tend to heal. Broken bones, cleanly torn muscles -- they heal, usually without complication and on a very predicatable schedule. In the short term, he'll certainly lose strength and will have to work hard to maintain balance. I think he'll be back next season.
Football Outsiders: In our preseason interview with you, we talked about how football players are less likely to be "injury prone" because their injuries are more often due to sudden movement, while baseball injuries are often due to repetitive stress. But Lions wide receiver Charles Rogers has now broken the same collarbone in two different places in successive years. Is this bad luck, an abnormally fragile bone, a bad habit of diving shoulder-first into the ground, or what?
Will Carroll: All of the above! Rogers is demonstrating something. I'm sure the Lions doctors and trainers know exactly what it is while we're left to guess. He's never -- as far as I know -- had other broken bones, taking osteoporotic concerns out. I'd certainly look at how he did it -- whether he has some technique that's misapplied. Of course, it gave more catches to Roy Williams, a guy I drafted in both my fantasy football leagues!
Football Outsiders: Speaking of Mr. Williams, he sprained his ankle October 10 against Atlanta and because he too is such an important part of the offense, Detroit has since gone back and forth between playing him one game and not playing him the next. Should the Lions let him rest his ankle for a few weeks, or should they keep trotting him out there when he can go 75 percent?
Will Carroll: The Lions have dealt with this injury very oddly. I get the sense that their roster is dictating it slightly. Ankle sprains tend to linger and get chronic. I'd much rather see a player with the elite potential of Williams -- a kid I saw play in high school -- get the rest.
Football Outsiders: So the Lions couldn't figure out if they wanted to play Williams or rest him, and Minnesota had similar problems figuring out what to do with Randy Moss and his strained hamstring. For a couple of weeks, the Vikings tried to play him, kept him active, stuck him in for a play or two and then took him off the field. Should the Vikings have dealt with the injury differently from the beginning? How much rest is needed for Moss to return to the field?
Will Carroll: I'll defer to the Vikings medical staff on this one. Hamstrings, especially for a "gazelle" like Moss, are going to be very problematic. Monday Night Football had some great shots of him running the week he injured his leg. The muscles were almost visible underneath those tight pants, straining with each stride. (Man, that's an uncomfortable sentence for a straight man ...) These players are like race cars. They're always on the edge of failure.
With Moss, I've never heard much about his fitness or off-season. That's kind of surprising. I do worry about players that are "natural talents" -- the ones that are so good, they barely have to break a sweat, worry about fundamentals, or learn the tricks. Ken Griffey is exhibit A in baseball and Moss may be the same type. As those types age, they don't do so gracefully.
Football Outsiders: Casey Hampton of the Steelers is out for the year with a torn ligament in his right knee. He's a 325-pound nose tackle. Will a guy that heavy put extra stress on the knee during rehab? How does a large man like that rehab differently from a lithe wide receiver?
Will Carroll: There's a logic that it would be harder, but it's more about the body type. I'm a normal sized guy: 6'0", 225. I'd probably be a lot better off at 180, like I was in high school. That extra fifty pounds certainly puts additional strain on my knees, hips and back. I'm betting Hampton wasn't my size when he was in high school. As with weight training, he's "trained" those muscles around the joint and he can probably carry the weight better than you or I. The rehab is only different in the different skills he'll need. Does he need to run fast? No. Explode powerfully? Yes. His rehab will be personalized, just as it is with any elite athlete.
Football Outsiders: Jonathan Ogden of the Ravens has also missed some time with a pulled hamstring. How does a hamstring injury affect an offensive lineman like Ogden differently than a wide receiver like Moss?
Get in a stance. Go on, I know you know how. Heck, even just the squat that tackles do these days. Now, explode out. Try to catch Dwight Freeney or some 260 pound, 4.4 guy barreling at your quarterback. Feel the hamstring as you do it. Yep, it's that important, at least in that initial burst. He's not taxing it step after step like a wide receiver, but he's doing it play after play at near-maximal effort.
Football Outsiders: Thomas Jones looked like a stud this year for the Bears, but then he sprained his toe. What is it about toe injuries? It sounds so minor, but then you think about it a little bit, and damn, a bad toe could really hurt. Is Jones' injury at all similar to the one Shaquille O'Neal had last year?
I used to make fun of turf toe until I got it. I tripped over my dog and, trying not to fall on it's Maltese fury, my toe "stuck" while my full body weight went over it. The ligaments did their expected crunch and ouch. There's almost nothing doctors can do unless it's fully torn and other than sad looks and pain pills, nothing alleviates it. It's a nasty injury and one that's almost always made by carpet. If you'd like to try this one at home, put a tack underneath the joint where your great toe meets your foot. Now run.
Will Carroll: No. If I had to have a major injury, I'd pick broken bone. They heal. With modern techniques like bone stimulators and new pharmaceuticals, they heal quicker and better. Absent an underlying problem like osteoporosis or tumors -- and don't laugh, these are two side effects of steroids -- these are just short-term problems.
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