17 Sep 2009
by Will Carroll
Why does a wrist injury keep a player like Brian Urlacher out for the season? The fact you need to know is that the Bears medical staff was unable to reduce (pop back into place) the bone until surgery. Even then, sources tell me that the surgeon had to use the equivalent of a medical crowbar to push it back in. This wasn't a simple dislocation; this is what happens when someone with Urlacher's build and injury history takes that much force in just the wrong way. The internal damage and the slow healing nature of this complex portion of the body combined to make it bad, but the deciding factor was Urlacher's style of play. Unlike a standard broken bone in the hand, which would have just given Urlacher a club ... err, cast to use, this bone might have been jolted from it's repositioning despite the hardware holding it in place. Think how many times one of his hits has been described as "bone jarring." Yeah, literally.
The knee is a hinge joint, much like the elbow or that hinge you see on your door across the room. It does one thing and has a structure to make sure it does only one thing. The structures around the knee that support it -- ligaments, tendons and muscles -- can be overtaxed easily on a football field, as Troy Polamalu graphically showed. As the lineman fell on the lateral (outside) of his knee, it made that hinge try to go in a direction 90 degrees off it's function. That's the classic mechanism for an MCL injury, one we've seen more and more of this season. This has made some question if we've done so much to prevent ACL injuries with conditioning and bracing that we're seeing the injuries happen to the new "weakest link" in the kinetic chain. Polamalu's style is going to hold him back here -- he's not going to be able to adjust to a large brace and he's precisely the type of guy that will try to do too much, too soon. I'm surprised we haven't heard whispers of PRP (platelet-rich plasma) injections yet, after the team's success using it on Hines Ward last season.
A rib injury is all about pain tolerance. While you'll hear about worst-case scenarios like a rib shearing and going through a lung, that almost never happens, even in the NFL. The problem is that any pain tolerance injury can have that pain level increased by exposure. McNabb, if he were to play, would have a flak jacket, inner padding, and extra protection in passing situations to protect his blind side. But he's still going to get hit. Holding McNabb out for a week should get him to a point where the healing takes away the pain. Healing is always better than management, but management is necessary when it could cost the team. We often hear that "if it was the playoffs, he'd start." In this case, if it wasn't just Week 2 he'd start, but the hope in Philly is that McNabb can miss one week and leave all this behind.
My feelings on the Official Injury Report are pretty well known. What's really beginning to burn me is how teams are gaming the "limited participant" tag. They're happy to let it hang on someone but it usually adds no new information. Cassel was at practice on Wednesday and while he didn't participate in all phases, he's the franchise quarterback -- is he ever going to need to do everything or not need some protection? Cassel looked significantly better according to media reports, though almost to a man, reporters at the Chiefs training facility said that Cassel looked likely to start at this time last week. Facing the Raiders instead of the Ravens also has a lot to do with it. Expect Cassel to get his first Chiefs start this weekend in a key game for both teams.
Ready to be confused? Anthony Gonzalez went down on Sunday without anyone touching him. Was this a return of the turf monster we remember from years past? At first, the Colts said nothing, but then leaks came out that Gonzalez had injured himself on the previous play and that when he made the inside cut, the knee just gave. That didn't match up; Gonzalez was seen jogging to and from the huddle with no problem. Reports that it was an MCL didn't match up either. He made an inside cut, which creates a lateral force, stressing the LCL, not the MCL. On Thursday, after signing a replacement, the Colts told the media that Gonzalez sprained his PCL and would miss a month. Colts fans might start thinking about Marlin Jackson, who injured his knee in much the same way last season -- untouched -- and ended his season with a torn ACL and MCL. I don't think we're getting the complete story on this odd injury. The signing of Hank Baskett is equally as odd. Bringing in a guy with a reality show and a pregnant Bunny in tow goes against the "all business" attitude of the Colts. Here's one interesting note: Peter King says that Bill Polian told him PCL on Sunday night. So they knew all along, without advanced tests.
For those of you that still believed and drafted LaDanian Tomlinson in the first round, you got to seethe as Tomlinson stood on the sideline for the end of a classic finish against the Raiders. Tomlinson's mild ankle sprain stiffened up on him, largely because he was just standing around, rather than doing something to keep it loose. Sprained ankles do tend to swell more when a player comes out, but Tomlinson said nothing to the medical staff until it was already too late. His attitude towards playing with any kind of limitation is a football catch-22: He probably protects himself from bigger injuries by coming out early, but he does come out early. Tomlinson's reputation of "soft" isn't helped by this. He'll play, of course, in Week 2, but Darren Sproles is showing that Tomlinson might end up in the Fred Taylor '08 role sooner rather than later.
The Saints had Pierre Thomas back on the practice field this week and all indications are that he'll play Sunday in his normal feature back role. Given the team's performance, some might wonder if they even need Thomas back, but some of that performance was the opposition. Drew Brees won't throw six touchdowns every week and Thomas will need to establish some kind of running game to keep the defenses a little honest. Thomas is coming back from the H1N1 MCL virus ... oh wait no, just an MCL sprain, got carried away ... and should have some issue with cuts, but not enough that I would downgrade his expected performance. He won't be overworked with Reggie Bush and Mike Bell available, so 20 carries might be the top end.
Jerod Mayo was seen at practice Thursday in a brace and on crutches. That tells us everything we need to know about his availability this weekend, but not much about anything else. There were some whispers on Tuesday that Mayo had ruptured his MCL -- and yes, we can go ahead and call the MCL the trendy injury of 2009 -- and would be done for the season. Thing is, the MCL is usually not repaired surgically and has enough secondary stabilizers -- other structures that act in redundancy of the MCL's function -- that it's not even an issue. Players often tear the ACL and MCL, but surgeons leave the MCL unrepaired. A full rupture is obviously bad, but it's likely not a season-ender. Remember, the rupture is a rumor; there's no confirmation that the injury is an MCL at all, let alone a Grade III. We'll have to watch for function rather than hoping the Pats lips will loosen.
Willie Parker isn't injured any more, but his performance last week was indicative of just how much an injury can throw you off. Between his 2008 injuries and a preseason spent rehabbing a bad hamstring, Parker just wasn't "up to speed" and had a terrible performance. Timing is one thing, but Parker ran as if he were scared of getting hit -- or scared of overstressing that hamstring. Maybe it's both, but no matter which, Parker's going to have to start running like he's healthy or he's going to be very healthy, standing on the sidelines watching Mewelde Moore.
Sure, Anquan Boldin "played" last week, but hopefully you kept him off your fantasy roster. He'll play more this week, but not 100 percent yet. Steve Breaston is also still out and very questionable for Week 2 ... Bo Scaife had what could have been a nasty knee hyperextension, but the Titans think he'll play this week. Missing practice is just a precaution ... Felix Jones has a nasty bruise on his thigh, but he'll play ... Kevin Walter was back at practice and looks to start this weekend ... Johnnie Lee Higgins is banged up enough that Javon Walker will be activated for the Raiders this week ... Desmond Clark will spend a month on the sidelines after breaking a rib in Week 1. That's not good for Greg Olsen, who was shut down even with Clark on the field ... Tavares Gooden sprained his MCL on Sunday, but was at practice on Wednesday ... Limas Sweed injured his foot. No word yet on severity.
18 comments, Last at 20 Sep 2009, 7:47am by Whatev