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09 Nov 2005

Black and Blue Report: Week 10

by Will Carroll

Here's something I never expected. I did a book signing tonight for Mind Game, the Baseball Prospectus book about the Red Sox. While there, we had a couple people come by to talk baseball, to dissect last year's BP projections, to ask why I wore a White Sox jersey, and then, there was a group that had their Pro Football Prospectus books in hand, wanting to talk Colts, injuries, and my work on this column. I started writing never expecting anyone to really read it, but now I have two sports where my little niche is working? There's a thirst and hunger for the analysis of injuries in every sport. Heck, an NHL agent thought doing a hockey column would be a great idea. Maybe someday, Brian. For now, the NFL is king and while baseball fixates on finding front offices, let's get to this:

Someday, there will be an award for the player that overcomes injury and puts up the most value. We'll have to know a lot more about injuries and by then, Aaron Schatz will have developed some new stat that will factor in my new stat about injury-adjusted effectiveness. Of course, I'll have to learn to do basic math to invent a stat. So when all that occurs, maybe we'll name it the Fred Taylor Award. It's one thing to be a punch line and another to laugh last. Taylor's young, rich, and talented and if he's a bit injury-prone, so what? It's not like that's news to the Jags or to Taylor. He's already on his way to another 1000-yard season, assuming that the ankle injury that has held him back in a few games that recurred last week is as trivial as Jack Del Rio is making it out to be. I'm not sure how much to trust a man that left an axe in the dressing room, but sources tell me that Taylor's ankle is “not good, but not really that bad.� An MRI confirmed what the team thought and he'll probably hit the List at questionable. Adjust accordingly.

I'm not sure if there's an exact number of concussions one can have before there are negative effects. We simply don't know enough about them. We do know that we need more research and sadly, the NFL is giving us a number of research subjects every week, from serious to the very low grade injuries that are going unnoticed in many cases. Wayne Chrebet, the gritty gutty Jets receiver, received his ninth concussion during Sunday's game and the team placed him on injured reserve. That a guy like Chrebet can make it 11 seasons in the NFL despite his size, draft status, and college background says a lot about his determination. Let's hope he's leaving the game before serious damage sets in. He seems the type that could be a good coach or a leader in another field. Let's also hope that we can eliminate or reduce the effects of concussions in future Chrebets.

John Madden talked about the brace – though the proper term would be “cast� – on the hand of Marvin Harrison. Harrison, it is well known, has a minor wrist injury as the result of a a fall. Madden's suggestion that Harrison has refused treatment is simply ignorant and shows that Madden, a former coach and longtime analyst, is sloppy, at least when it comes to injury. The mere fact that there was a closeup as Madden spoke showing a fiberglass, formed, color-coordinated cast with proper padding should tell anyone that this is not a DIY thing Harrison picked up at Walgreens. Harrison may not want to talk about his injury or even acknowledge it, but as anyone in the Indianapolis media can tell you, John, Harrison doesn't really want to talk about anything to anyone. Madden's comments were an insult to the Indianapolis medical staff, one that's helped Harrison play through an injury with his same stellar results.

Corey Bradford left Sunday's game with the Jags with a hand injury. He attempted to play through it, managing to catch five passes, but it was the one he dropped on the last drive that everyone will remember. Sometimes, trying to play with a hand so swollen that you can't move your fingers well, especially if you're a receiver, isn't the best thing for the team. Adjusting function for injury is something that a coaching staff has to do on the fly, knowing that Bradford can't catch properly and that his backup, albeit less talented can perform that function is crucial. The “walk it off� play at all costs replaceable nature of the NFL makes it hard for any player to say “I can't.� That's the duty of the coach and if the players don't trust their coaches and trainers enough to be honest, it's time to take a hard look at the true cost of injuries. There's probably a lot more drops than just Bradford's.

One of the basic tenets of medheads is that the first thing an injured player grabs is usually what hurts. Pain makes people forget deception. James Farrior grabbed at his knee when he went down against the Packers and had a knee injury that put him on the list a couple weeks ago as well. So when Bill Cowher said Farrior had an ankle injury, it raised some eyebrows around here. Farrior seems to be having some sort of cascading breakdown, where one injury after another occurs during the normal adjustment stages of dealing with and recovering from injury. His MLB slot is crucial to the Steelers defense, so don't expect to see him out there if he's limited.

Here's an interesting use for the bye week – Shawne Merriman dislocated his wrist during Sunday's game and had surgery early Monday to fixate the wrist with several metal pins. He'll have two weeks to recover before the Chargers next game and – wait for it – he's expected to play! The rookie leads the team with five sacks and really seems to be earning the big bonus. The wrist shouldn't affect his speed rush or even his tackling ability, which is mostly based on speed as well. It's still hard to imagine that medical science makes this possible or that psychiatry is so far behind that this isn't considered the definition of insanity.

The Jets are seeing more than their share of injuries this season – or are they? Is there such a thing as a fair share? Prediction of injuries in any sport is still more guesswork, despite some interesting work by Sig Mejdal and Nate Silver's attrition concepts at Baseball Prospectus. Football is a vast wasteland when it comes to injury projection, so I'm hoping to work out some kind of “red flag� system to help assess risk. It's an offseason project, to be sure. The latest Jet injury is Chris Baker, the starting TE, who heads to the IR and an operating table with a broken ankle. Baker had been catching more passes this season and shold be able to come back strong in 2006.

Priest Holmes is getting multiple opinions on a variety of head and shoulder injuries, yet he's likely to play this week. Someone explain to me why that's a good idea when Larry Johnson is available? The fact that Holmes is dealing with not just one condition, but enough that people are starting to use very sophisticated terms about the syndrome he's experiencing would have to be worrisome despite his continued effectiveness. Holmes is dealing with post-concussive syndrome, a brachial plexus complex injury, and some sort of spinal condition affecting his cervical spine (neck). I don't have enough information to truly be able to understand why all the Chiefs announcements are so positive and the team's information doesn't give us any clear indication as to an underlying piece of information that would have guided them this way. We're forced to sit back and wait, hoping this all turns out well for Holmes not just this week or season, but long term. There is life after football.

(Ed. note: This morning, after Will turned in his column, rumors began to come out of Kansas City that Priest Holmes is done not only for the season but possibly for this career. The main issue seems to be spinal injury, as mentioned by Will, and not the knee and hip injuries.)

Kevin Jones is feeling the pain that his fantasy owners have felt all season. Both arms are problematic for him. Ultrasound tests showed a muscle strain on one side and a nerve contusion and impingement on the other. Jones is having a hard time with taking a hit to the arm or shoulder as well as some difficulty holding onto the ball. These are both skills that are in the “must� column for running backs. Jones is practicing, though his status is questionable for Sunday's game absent marked improvement. A Jones on the sideline at least gives his owners a chance to suit someone else up.

Donnie Edwards is a procrastinator. The Chargers linebacker is going to try and make it through half an NFL season with torn cartilage in his knee. Is this possible? Yes. Edwards is asymptomatic at this point and the bye week will certainly help him recover a bit. The Chargers staff will keep a close eye on him and certainly he'll be spending a lot of time with the training staff over the next couple months. A known injury is easier to deal with than an unknown or traumatic injury. It doesn't mean that Edwards won't make the wrong step and end up on the operating table this season, just that he's got a chance to avoid it for now.

Bumps and Bruises:

As I go through the season, I'm making notes about things I'd like to research and publish in Pro Football Prospectus 2006. Don't laugh – it's not that far away. One of the things I'd like to look at is the fragility of backups. It seems that backup QBs, RBs, and especially defenders seem to have a higher injury rate. Is it the reps, the conditioning, or is stamina and the ability to regenerate from week to week part of what makes the starters the starters. … Each week, I secretly hope that Marcellus Rivers or Marcellus Wiley get injured. Not seriously, but just enough to get them in here. I have a Pulp Fiction line I just have to get in before this year's up … Marc Bulger should be back for St. Louis this week. Get him in your lineups if you still believe in the Rams attack … Darrell Jackson's out at least another two weeks and I'm not sure you'll want him even then. Wide receivers don't return to function as fast as they return to the lineup … Think of that last line before you get too excited about Torry Holt's return … J.J. Arrington is this week's tree in the forest. If he misses next Sunday's game, will anyone notice? … Mewelde Moore has been criticized in the past for the most heinous of NFL offenses, not playing while hurt. We'll see how he does next week as he tries to play with an injured wrist.

Posted by: Will Carroll on 09 Nov 2005

33 comments, Last at 11 Nov 2005, 7:16am by James, London

Comments

1
by Brian (not verified) :: Wed, 11/09/2005 - 12:03pm

Would Priest Holmes post-concussive syndrome affect anything on the mental side of the game? I have a buddy who is experiencing the same thing after getting nailed by an Excursion on his bicycle, and he forgets things all the time. (mostly his wallet when we are at the bar watching the game) Football is physical, but a great deal of brains is needed as well.

2
by Kachunk (not verified) :: Wed, 11/09/2005 - 12:39pm

that injury that John Madden spoke about...wasn't that to Edgerrin James? It'd be mighty tough for Marvin to catch the ball with a cast like the one shown on his hand.

3
by NYCowboy (not verified) :: Wed, 11/09/2005 - 12:49pm

What's the deal with Julius Jones? Is he ready to go Monday night? As good as Barber has been, it'd be great to have JJ back.

4
by James, London (not verified) :: Wed, 11/09/2005 - 1:10pm

I've said this before, but the lack of attention that the NFL pays to concussions stupifies me. Concussion is always bad. Concussion is a BRAIN INJURY.

How are players allowed back on the field once this is diagnosed? If a player has taken a severe enough blow to the head to cause a concussion even through a helmet, then he should be banned from returning.

Rugby Union has this spot on. A concussed player must wait 21 days before he can play again. No discussion, no exceptions and therefore very little risk of "second impact syndrome".

If this type of compulsory injury withdrawl causes roster & salary cap problems, then frankly, the roster and salary cap rules should be amended. Does someone need to die on the field before this is addressed?

5
by Drew (not verified) :: Wed, 11/09/2005 - 1:14pm

RE: 2

No, that was Harrison. He has been catching the ball with that thing on his arm for most of the season, although I have no idea how.

6
by geoff (not verified) :: Wed, 11/09/2005 - 1:24pm

I just want to note for the record that I don't necessarily agree with this statement, based on some anecdotal evidence I have with my fantasy team this year:

Wide receivers don't return to function as fast as they return to the lineup

Maybe I'll have enough time in the offseason to look into it.

Also, any idea on Isaac Bruce? There's some talk that he'll be ready this week...

7
by Chris (not verified) :: Wed, 11/09/2005 - 1:44pm

#4

It generally depends on the severity of the concussion. Sometimes its really severe, sometimes its not. Sometimes a concussion will take a player out for a month. Othertimes, players have gotten a concussion in game and come back 2 series later.

The emphasis on winning in the NFL is huge, and concussions are much more common among QBs - the main thing that prevents a concussion is the mouthpiece, not the helmet - and QBs rarely wear their mouth pieces because it makes them harder to understand when calling plays.

While I don't necessarily know if they need to go to a 21 day system, if a player gets a concussion during the game, they shouldn't be sending him back onto the field in the same game. That's just stupid and dangerous.

8
by James, London (not verified) :: Wed, 11/09/2005 - 1:54pm

Chris,

I totally agree that the emphasis on winning is huge. The pressure on players to ignore injuries for the greater good is exactly why there should be a mandated recovery period for concussion.

As Will notes above, "Mewelde Moore has been criticized in the past for the most heinous of NFL offenses, not playing while hurt".

A mandatory spell on the sideline takes this decision away from both players and coaches.

9
by mawbrew (not verified) :: Wed, 11/09/2005 - 2:21pm

Re: 8

Isn't the diagnosis for concussion somewhat subjective? If so, and there was a mandatory recovery resulting in 2 missed games, won't there be incredible pressure on the team docs to diagnose something else?

10
by Jerry P. (not verified) :: Wed, 11/09/2005 - 2:38pm

Will, do you have information or insight into the condition of Bertrand Berry's torn pectoral muscle? Dennis Green hasn't said he's done for the season but isn't that pretty much a forgone conclusion?

11
by 10K (not verified) :: Wed, 11/09/2005 - 2:41pm

"Isn’t the diagnosis for concussion somewhat subjective?"

I've always thought the same. Moreover, doesn't a diagnosis, however subjective, require 48 hours of monitoring.

I had a concussion in the past, and besides a bad bump and some pain, the blurred vision, disorientation, and other more significant symptoms didn't occur until hours later.

12
by James, London (not verified) :: Wed, 11/09/2005 - 2:50pm

Linked is an article from the English Institute of Sport on Rugby Union & concussion. It's dated September 2003, so some of the points it raises may have been addressed.

Unsurprisingly, players have been known to conceal concussive injury in an attempt to avoid a 3 week lay-off.

13
by jimmo (not verified) :: Wed, 11/09/2005 - 2:50pm

it seems more and more likely that a Priest Holmes update is imminent...from "likely to play this week" to "retired."

14
by ToxikFetus (not verified) :: Wed, 11/09/2005 - 2:51pm

Re #4:

Is it really true that the mouthpiece prevents concussions? I've never heard that before.

It is a shame that the NFL churns through so many players' bodies, but I find this scientific analysis of injuries endlessly fascinating. Keep up the good work Will.

15
by princeton73 (not verified) :: Wed, 11/09/2005 - 3:24pm

the recognition of the severity of concussions in the NFL (unfortunately) seems to wax and wane depending upon the fame level of the player who is concussed--so when Aikman and Steve Young started talking about it, it was a big deal

That brought Al Toon and Hoge out of the woodwork, and for a while there, it was a major talking point and the NFL was really, really gonna do something about it (honest!).

But then, the interest seemed to die off

It's kind of a nasty little secret

16
by Sophandros (not verified) :: Wed, 11/09/2005 - 3:26pm

Yes, mouthpieces prevent concussion because they absorb shock.

I agree 100% with the RFU's policy, and I knew a coach in college who wouldn't let a player play for a month after a concussion.

Look, you can say what you want, but a concussion is a BRUISE ON YOUR BRAIN. Let that sink in for a second. After the first concussion, the second is more likely to happen. And the third, etc. So when "macho" guys want to hide concussions or take them lightly, even joke about them, think about Merrill Hoge and how he can't read to his kids or other guys who can't drive because the glare give them headaches or guys who are veggies right now.

17
by Capt Trips (not verified) :: Wed, 11/09/2005 - 3:53pm

you mean to tell me it's the mouthpiece (or lack of), and not the skull jarring hit and head bouncing off of the ground that does it?

Things that make you say hmmmmmmmmmm. . .

18
by Andrew (not verified) :: Wed, 11/09/2005 - 4:22pm

On the Eagles, Hank Fraley is out for the season with a shoulder injury, and Jason Short has broken his leg again.

19
by EorrFU (not verified) :: Wed, 11/09/2005 - 4:33pm

Hundreds of people have died around the world due to concussions. Aikmen retired when LaVar Arrington gave him a concussion. Beyond heart concussions, brain concussions are the second most common cause of death in proffesional sports.

20
by mawbrew (not verified) :: Wed, 11/09/2005 - 4:43pm

Re: 10

Speaking of torn pectoral muscles, this seems to be a fairly common (season ending) injury during the last few years. Why don't I recall hearing about it ten years ago? Was I just not paying attention, have they just changed the lingo, or is it really a relatively recent phenomenon?

21
by lagfish (not verified) :: Wed, 11/09/2005 - 5:14pm

Getting hit in the jaw causes many concussions, hence the recent emphasise on mouthpieces and the newish Riddell Revolution helmets that protect the jawline. Getting your head bounced off the ground will give you one too but the shock is lessened with a proper mouthpiece.

22
by footballlover (not verified) :: Wed, 11/09/2005 - 6:00pm

I think that the torn pectoral muscle may be a new diagnosis. Either that or it has been misidentified. Bertrand Berry is out for the season.

I agree with a concussion being a serious injury, but there should not be a rule requiring days out as teams would just do a different diagnosis. A player should decide whether or not to go. If he decides to go he should sign a waiver.

I noticed one serious injury missing, Terrell Owen's brain (maybe it was missed because that is a 33, almost 34 year old injury) and his ability to get a longterm contract.

Love the article. Keep it up.

23
by Jen (not verified) :: Wed, 11/09/2005 - 6:18pm

It appears that the Priest is done for the year :- (

24
by Patrick (not verified) :: Wed, 11/09/2005 - 6:56pm

On the local morning show I heard that Priest may be retiring as soon as tomorrow due to a lump on his spine. He's in Miami getting a 3rd opinion they said. They said their source on the retirement speculation was a family member, but I'm still not sure about the whole thing. It would be a shame to see one of the true standup guys in the NFL go out like this. It definetely seems like LJ is going to get his chance to be the man in KC this year no matter what happens to Priest in the long term.

25
by footballlover (not verified) :: Wed, 11/09/2005 - 9:12pm

I heard the same thing. I hate to see Priest retire. He is such a good guy. I guess age does catchup with you. Best of luck to LJ this year and next and best of luck to PH if he does retire.

26
by little red tractor (not verified) :: Wed, 11/09/2005 - 10:06pm

Apparently, some feel that the decision to retire is dependent on whether Vermeil returns. If he does, Holmes goes. If not, he stays.

27
by michael (not verified) :: Thu, 11/10/2005 - 1:40am

Re: the concussions discussion.

Not only is a concussion a serious injury, it can have serious negative effect on play. Merrill Hoge not only suffers ongoing symptoms, but has spoken about watching his old film and seeing himself drop passes or miss a block or choose the wrong hole, and then realizing that he had no memory of the game due to concussion. So the whole "play through it" mentality may not only have long-term health consequences, it may hurt the team.

The torn pec might be more common now due to the increased fitness and "cut" quality of many NFL players.

28
by DavidH (not verified) :: Thu, 11/10/2005 - 2:34pm

Do Holmes and Vermeil not get along? I haven't heard anything like that before.

29
by MCS (not verified) :: Thu, 11/10/2005 - 2:42pm

I thought it was the exact opposite. I thought that PH was getting so many carries over the more effective LJ because of Vermeil's loyalty to him.

30
by Andrew (not verified) :: Thu, 11/10/2005 - 3:53pm

The immortal Duane Starks has been placed on injured reserve with a shoulder injury.

31
by Mike (not verified) :: Thu, 11/10/2005 - 4:11pm

This NCAA related but does anyone have any info. on Northwestern and whether they have any key injuries?

32
by JACO (not verified) :: Fri, 11/11/2005 - 6:23am

RE: 14, 17, & Concussions

Inside the human skull, there are thousands of tiny little bumps, some of which are sharper than others. A concussion occurs ANY time your brain hits the inside of your skull. Wearing a mouthpiece can certainly alleviate some of the concussions that occur, because some of them result from your lower mandible being slammed upwards into the rest of your jaw. Some of the new more high-tech mouthpieces absorb much more of the shock, and are a way better investment for anyone than the basic team issued mouthpieces at any level of football or rugby.

According to at least one study by Riddell (see the link in my 'website'), up to 70% of concussions are caused by a severe blow to the front of head, side of head, or mandible area. So basically, any remotely strong blow to the head will result in a concussion, also known as mild traumatic brain injury (MTBI). The varying degrees of these make it often very difficult to diagnose, especially since many of the effects will not be seen immediately. Because of this, any kind of mandatory minimum layoff from games/practices would not really be a good idea, because in some very mild cases, a player can recover from a concussion within the hour, and in other instances they might never recover.

33
by James, London (not verified) :: Fri, 11/11/2005 - 7:16am

JACO, I would argue that it is exactly because the severity of a concussion is difficult to diagnose and because the symptoms of concussion can be delayed, that a mandatory minimum lay-off is a good idea.