Black and Blue Report
A comprehensive look at the biggest injuries of the week.

Black and Blue Report: Week 9

by Will Carroll

I'm reading a copy of Next Man Up, the new book looking inside the NFL by way of the always publicity-hungry Baltimore Ravens. John Feinstein is a great writer and no one does the pull back the curtains type journalism better than Feinstein. I'm only about 60 pages in and what strikes me is the pure transience of most players with the exception of those very occasional "ticket to Canton" players that cannot be moved by Katrina-force winds until long after their time has come and gone. Injuries are a major portion of this, with salary cap issues and short rosters making players fungible. I wonder if this transience affects the way they're treated. I know that doctors and trainers will give their best, but at some point, are some players cast aside, because losing half a step or a portion of what will likely be a very short career makes a team look for the next man rather than at the one they have? It's an interesting conundrum – would the NFL be better off keeping more of their players healthy and returning those get injured, or does the violent nature of the game require roster churning we don't see in other sports? There's a question for next year's book. Let's get to it:

There is no good knee injury. The injury to Daunte Culpepper is the worst case scenario for both player and team. Culpepper tore not only the ACL, but the PCL and MCL as well as some associated meniscus damage. This is as bad as it sounds, one of the more severe knee injuries I've seen, short of Napoleon McCallum's life-threatening injury. Culpepper is done for the season and the course of his rehab will not only determine if he's ready for the 2006 season, but how the rest of his career will go. We're a long ways from the days where Joe Namath's knee colored his entire career, but the loss of running ability could turn Culpepper from a super-sized Michael Vick into a super-sized Byron Leftwich. That's not a bad thing, but adjustments can often go differently than you'd expect. I'm sure someone has an example of a scrambling QB that's shifted to a dropback passer,* yet Culpepper is really neither animal. His unique combination of size, mobility, and strength gives us no guidance for how this process will go. The best guess is that the Vikings will look for a solid backup in the Trent Dilfer mode, unless Brad Johnson goes from adequate backup to late-career Testaverde, while hoping that medical technology gives Culpepper a chance to be 90% of what he was.

(Ed. Note: Doug Williams in Tampa vs. Doug Williams in Washington? Steve McNair pre-2002 and post-2002? And yes, Culpepper really is listed as 24 pounds heavier than Leftwich.)

An emailer asked me about Anquan Boldin, back before the MRI showed that he had only a bone contusion in his right knee. The emailer asked “Boldin has another meniscus tear. How often is this going to happen?� That's a relatively easy question to answer and medical technology hasn't quite caught up with the problem yet. The meniscus is a small piece of cartilage that acts as a shock absorber in the knee, keeping the femur (large bone of the thigh) from bashing into the tibia (shin). Boldin had some removed last season. Note the term here: removed. The torn piece of cartilage is excised and removed, usually arthroscopically. Like most cartilage, it cannot heal and is not naturally replaced. That means it's damaged, just “clean� and not prone to clicking or “locking.� Once excised, it's gone, eventually leaving bone-on-bone contact and that's a situation that deteriorates rapidly. There has been some progress in slowing down the condition with injections of substances, such as Synvisc, a motor-oil like product that lubricates and cushions the area where the meniscus is absent. There are continued attempts to transplant or grow new cartilage, as well as the controversial microfracture surgery that's been used several times in the NFL. Boldin's future depends on a bit of luck, a bit of preventive maintenance, and hope that the experiments have some result before more careers are extinguished.

It's a good news/bad news scenario we see all too many times. A young player steps up, establishes himself as a starter or at least a contributor and promptly injures himself. Maybe it just seems that way to me since I watch injuries more than most, but it played out again with Mark Bradley of the Bears. Bradley had caught the coach's eye and had a nice game, then blew out his ACL and is done for the season. The size and speed receiver should be able to come back after surgery. He won't lose the size, and that may be enough to get the chances to regain the speed. Note that receivers and tight ends seem to take longer to recover and don't come back quite as much from ACL tears as their counterparts in the offensive backfield. Both receivers and defensive backs are so reliant on the speed and explosiveness that a healthy knee gives that this can end careers when the margin wasn't there.

Breathing – we take it for granted. In the NFL, it's mandatory and far more difficult than many would think. Imagine running like they do and being hit like they are. In many cases, the severe specialization of the NFL allows players that are in very specific condition to perform certain tasks while being “out of shape� in other ways. Add any injury that restricts breathing and things go downhill quick. Thomas Jones is fighting to keep his team in the race and Cedric Benson on the bench, so bruised ribs won't be enough to keep him out long. Jones missed overtime while trying to get air in without excruciating pain. He'll be out there on Sunday hoping to keep a DB from sticking him.

It's often said that every success will be swiftly followed by the copies, whether a successful game plan or player prototype. Derrick Brooks was the guy that scouts modeled players after but “the next Derrick Brooks� never really came. If he did, we were already looking for the next Ray Lewis, Dwight Freeney, or Tedy Bruschi. Brooks' game is predicated on speed so a hamstring injury could be major for him. The one he has, however, is not major. At least, that's what the Bucs are saying publicly, and while the evidence suggests they're telling the truth, I wonder how often coaches look at these types of things and plot a couple plays to test just how healthy that player is.

Punters are a valuable part of the team and a potent weapon, but injuries? What is going on with Philadelphia kickers and their hamstrings? Is there something they're doing or not doing? Is demon creatine or worse causing more injuries? Do the Philly kickers not join in the ineffectual pre-game stretches with the rest of the team? (And yes, most stretching I've seen in football isn't worth the ten minutes they put into it. If a team really wanted to make a difference in their injury stats, they'd get a stretching expert like Pavel Tsatsouline in there ASAP. If there is one in the league now, I'd love to know.) The Eagles originally thought that Dirk Johnson would be able to keep playing, but today they had to put him on injured reserve, ending his season.

Imagine someone with a bad shoulder, running over and over again into big, hard objects and repeatedly hitting them with that same bad shoulder. Even after coming out, this person asked to go back in, hit with that bad shoulder a while more, ending their weekend with an MRI to determine the damage. You'd call that person a freak, wouldn't you? You'd be correct – it is Jevon Kearse. Kearse's shoulder actually escaped his insane bid to keep playing after injuring the acromioclavicular joint during the first quarter Sunday. This injury normally occurs when the shoulder briefly “separates� due to tearing of ligaments inside the shoulder after collision or impact. Kearse came away without significant damage, but watch to see how effectively he can adjust to the pain.

Position changes in baseball augur an increased injury risk. The specialization in football seldom allows for such a change and when it does, the move is almost always down the "defensive spectrum." In baseball, this goes from shortstop to third base to first. In football, it goes from cornerback to free safety to strong safety. Troy Vincent lost a step to knee surgery, a mysterious procedure that was never openly discussed. Vincent took eight weeks to return and was pushed to safety when he did, so the best guess is that he had the last of his meniscus removed and the Bills thought that he'd have less wear and tear at safety rather than cornerback. It was a good move statistically, so a strained left shoulder is the last thing Vincent needs in his quest for the Pro Bowl. He timed the injury well, waiting until just before the bye week, and he may be healed up to come back in their next game.

The Texans are becoming the expansion team that couldn't, saved from ignominy only by the Browns' continued ineptitude. Is it really that hard to be an expansion team in an era of rampant free agency, salary caps, non-guaranteed contracts, and parity? Apparently so. The team continues to be hampered by poor choices and injuries. Andre Johnson, one of their few real weapons, is questionable for this week. His calf continues to have a “palpable defect� according to team sources and a setback at this stage could be a massive tear, ending his season. This leaves an opening that could be filled by Jerome Mathis, setting the stage for an eventual one-two punch that David Carr has never had.

Here's one of the more confusing stories recently – Stephen Davis, who has known knee issues, gets hit early in last Sunday's game, says he “felt scar tissue tearing� and comes back to score a couple touchdowns anyway. Afterwards, many started worrying that it was a bad sign. This one's just ignorance of the facts. Scar tissue in a surgical site, or adhesion, is not natural. It's a side effect, like the four-hour erections they tell me about every other ad on Sunday. The adhesions break and the knee is no worse the wear since they weren't supposed to be there anyway. Some even restrict motion in the knee itself or whatever joint space they occur in. It pops, you feel it, and you move on. Davis moved on for a couple tackles. If you can play this to one of your fantasy owner pals that Davis could fall apart, it's a good time to steal a runner.

Let's go to the mailbag for one question – NEinDC asks:

“The Week 8 Black & Blue report made me think of this question: what makes some muscle tears worse than others? Tebucky Jones has a torn pec, and is out for the season; meanwhile, Ray Lewis has a torn quad, but (at the time the article was written) it sounded like he might play in the next game. Are quads more resilient than pecs in general, is Jones' tear simply much more severe than Lewis', or is there some other difference? Keep up the fine work!�

Well, NE, the answer is redundancy and function. The quad is four muscles and tearing one hurts and reduces function, but it doesnt normally become non-functional. A pec is a pec and there's not much else to pick up its function. Add in function: a step slower doesn't kill Lewis, while a one-armed Tebucky is just a punch line. Remember, all writers love mailbag material. It's easier than thinking of something ourselves!

Bumps and Bruises

Want to know the best thing about having a column about football? I can talk smack nationwide. My pal Peter Osella and his Pats are facing the Colts this week and for once, I think Pete is going to end up the loser in our standing bet! … Is the sophomore slump a curse of injuries? It seems that way for Ben Roethlisberger. A posterior capsule strain in his right knee may keep him out this Sunday, but isn't considered serious, as contradictory as that sounds … Jeff Garcia may be out on Sunday. His leg may prevent him from being mobile and yes, an immobile Garcia is worse than Joey Harrington … Marcus Stroud may have been in a boot due to a mild ankle strain, but the guy hasn't missed a game during his five-year career and isn't going to miss one this week. He will be limited … Roy Williams is back at practice but just probable for Sunday. You can't blame some of the traumatic injuries on them, but at what point do all the injuries and slow recoveries get blamed on the Lions' medical staff? … Ken Hamlin was placed on the IR after his nightclub incident.


30 comments, Last at 04 Nov 2005, 9:32pm

1 Re: Black and Blue Report: Week 9

"the loss of running ability could turn Culpepper from a super-sized Michael Vick into a super-sized Byron Leftwich"

Good thing it wasn't Timmy Chang who got hurt, Will, or you wouldn't have had anyone to compare him to. :)

3 Re: Black and Blue Report: Week 9

Here's a question for Will or anyone else that I've had for a while, and this column, being injury related, seems a good place to ask it.

Suppose a player is placed on injured reserve. I know that is theoretically supposed to end their season. But is there a loophole? A player on IR still is on the payroll and counts against the cap, but the team is allowed, according to my understanding of the CBA, to reach an injury settlement with the player, pay them some mutually agreed on amount of money, and release them. Once they're released, do they become a free agent? Can they sign with another team and, assuming that their injury has healed, come back and actively play? If not, it seems like the player is being penalized unfairly--if he's healed, why should the roster decision of team A affect whether or not he can now actively play for team B? But if so, if no other team wants him, can the team that just cut them re-sign them and actively play them?

I could swear I remember the Patriots playing this game back in '01 or '02. One of their fullbacks (I think it was Fred McCrary, though it might have been Patrick Pass) was injured early in the season and placed on IR. Then they reaced an injury settlement, cut him, and (I could have sworn) resigned him to the active roster after a few weeks had passed and his injury had gotten better much faster than anticipated.

4 Re: Black and Blue Report: Week 9

Interestingly enough, Mark Bradley tore his other ACL a few years back.
I'm sure it has been asked before, but are non-contact ACL tears more likely on turf? Grossman and Bradley both suffered non-contact ACL tears on turf. The beer truck driver on New Orleans did the same thing this year on turf, I believe.
I'll be honest. My first reaction after seeing the Bradley injury was to start complaining about artificial turf.

6 Re: Black and Blue Report: Week 9

I believe once a player reaches an injury settlement, he is fair game (i.e., a UFA) for all but the team who cut him. However, there is some period after which even the team that cut him may re-sign him. For instance, the Bears reached an injury settlement with Eddie Berlin in the preseason, and I recently read somewhere that they could sign him in another couple of weeks.
I'm sure others will correct me if (when?) I'm wrong.

7 Re: Black and Blue Report: Week 9

"the meniscus is a small piece of cartilage that acts as a shock absorber in the knee"

Good stuff as always Will. Small comment on the quote above though. The two menisci in the knee and articular cartilage in general are not primarily shock absorbers. Their primary two functions are to decrease the friction between the articular (joint) sufaces, i.e., lubrication, and to distribute the weight more evenly through the articular surfaces. They also provide a small measure of stability given their shape, much like a wedge placed next to a tire prevents it from rolling. They provide some shock absorption, yes, but it is very minimal, maybe 5% of the total. I think the misconception lies in the difference between weight distribution and shock absorbtion. Anyone care to guess the primary shock absorber of the knee?

8 Re: Black and Blue Report: Week 9

To my knowledge, as an outpatient physical therapist, I have never seen any research that definitively answers your turf question either way. Common perception says that there are more injuries on turf, however, I have never seen any solid evidence of that. Given FOs reliance on statistical evidence as opposed to simple observance, we'd have to say that no, it is not more likely on turf, at least until someone proves it anyway ;)

9 Re: Black and Blue Report: Week 9

"I’m sure someone has an example of a scrambling QB that’s shifted to a dropback passer"

Randall Cunningham of 1986-1992 vs. Randall Cunningham of 1998.

11 Re: Black and Blue Report: Week 9

I read this morning that T. Owens might miss the next two weeks with a sprained ankle on the leg he had fixed last year?

Any info on this?

12 Re: Black and Blue Report: Week 9

#9 beat me to it... Cunningham is the most blatant to me, since he was SO amazing in the late eighties.. and then fell off the map for that time span and then came back to help me make my fantasy football playoffs in '98!! :)

13 Re: Black and Blue Report: Week 9

Bobby Layne and Fran Tarkenton also come to mind, though like with Cunningham the decline in scrambling came over a long period.

14 Re: Black and Blue Report: Week 9


Johnson is out for the season with a groin strain, not a hamstring injury. Oh, and guess what injury that is: it's a sports hernia. Yah. One that he had surgery on in the offseason, and apparently didn't quite fix.

And yes, Owens is likely out for two weeks due to a reinjury to that ankle. Jeez.

15 Re: Black and Blue Report: Week 9

With all the trouble McNabb is having because of his injuries, is it time to consider benching him, or do they hold onto him because the Eagles aren't yet out of the division race?

16 Re: Black and Blue Report: Week 9

Here is a generic question regarding injuries.

If someone has a major injury that is not season ending, how do they compare in general physical condition to your average healthy player?

Are they in better shape because they haven't gotten smacked around for several weeks? Or are they in worse shape because of all the energy they expend on rehabing? Neither?

Thanks for your help.

17 Re: Black and Blue Report: Week 9

Sorry, my previous question should make reference to the player's condition upon returning, not upon injury as it reads.

18 Re: Black and Blue Report: Week 9

"Common perception says that there are more injuries on turf, however, I have never seen any solid evidence of that."

Our research found that over a four year period, players were injured on artificial turf at a 6 percent higher rate, compared to grass or grass-like synthetics.

Independent research by a neurosurgeon for the St. Louis Rams further corroborated the increased injury toll AND a heightened number and severity of head trauma while playing on the surfaces there.

19 Re: Black and Blue Report: Week 9

Thanks for the update on the turf issue Carl. Are there links to the research on the site anywhere?

20 Re: Black and Blue Report: Week 9


"Our research found that over a four year period..."

Can I ask what four year period?

The high rate of injuries everyone hears about was founded mostly on the old artificial turf, which was not much better than that green outdoor carpetting everyone has seen.

Todays artificial turf is far better. Penn State does studies on artificial turf (and turfgrass). These studies test frictional forces (how much grip) and weight tests which see how much the turf gives during a collision (prevent head injuries).

The artificial turfs being tested are different blade widths, lengths, and materials.

I am not disputing your results, only interested in when it was done. 6% increase is not that much more. How many total injuries? How was "injured" defined (just major injuries, anytime a player missed game time as a result)??

Without any doubt, the artificial turfs of today (and future) are quite grasslike.

22 Re: Black and Blue Report: Week 9

Is the "demon creatine" reference a joke? Did you know creatine improves athletic performance, acts as a nootropic, has been shown in longitudinal studies to have no negative side-effcts and prevents outbreaks of herpes? Look on medline:
Ness SR, McCarty MF. Does supplemental creatine prevent herpes recurrences?Med Hypotheses. 2001 Sep;57(3):310-2.

And in terms of preventing injuries the key is the use of dynamic warm-up protocols pre-game. Stretching before athletic activity actully weakens the stretched muscles and increases the odds of injuries. Click the link for a pretty good recent article.

23 Re: Black and Blue Report: Week 9

Does anyone know whether Kearse's shoulder seperation was a full on grade II sublaxation? To expand a little on Will's explanation, a grade II seperation occurs when acromioclavicular joint damage results in the joint space expanding beyond 50% its normal boundaries and are incredibly painful.

24 Re: Black and Blue Report: Week 9


You must know about the Joseph Valentine Research center...good place, atleast for alittle while longer. Then, the new law school, and no more Valentine....research going to the farm, I think.

25 Re: Black and Blue Report: Week 9

Craig B:

The Decline for Cunningham was immediate after his second major injury in 1993, when his rushing was literally cut in half. 500-650 yards rushing per year and one exception 950 yard year 1986 to 1990 + 1992. 1993 rushing at the same rate, injured again. 1994 290 yards, similar rate in 1995 through a handful of games and in 1997. 1998 130 yards, similar rate in a handful of games in 1999.

I think the second injury gave him a big wake-up call.

26 Re: Black and Blue Report: Week 9 is reporting that Big Ben is out for the Packers game, and could be out through the first Browns game.

27 Re: Black and Blue Report: Week 9

Good for Culpepper that he got an additional guarantee of five million dollars prior to the season; the Javon Walker scenarios are really, really, ugly to see.

The Vikings will have some very interesting decisions to make as they start to rebuild their entire front office and coaching staff the day after the season ends. It'll likely be 2007 before they have a good idea of whether Culpepper makes it back, and even prior to the injury he was an enigma. Was a healthy Culppepper, on average, closer to the 2004 verion, or the 2005 version? I thought it would have been interesting to see a Moss-less Culpepper play on a team with a good defense and running game, and now that may never happen.

Perhaps if the Vikins decide to not devote that much cap space for 18 months to a rehabbing QB (if Culpepper decides to not be helpful in that regard), he'll end up with a club that doesn't need 28 points every Sunday to be competitive. Then again, if new personnel management and coaching changes the Vikings' identity sufficiently, maybe Culpepper will help out on the cap space prior to the 2007 season.

28 Re: Black and Blue Report: Week 9

Why is the Javon Walker thing ugly to see? Not t be too trite, but the guy was a first round draft pick. Am I supposed to be sad that a millionaire didn't make more millions? Chances are he will come back and as a veteran in the league will still get millions. I'm sorry, but I'm never going to be that sad that a team didn't go out of their way to give a guy tens of millions of dollars when the guy is pretty well off already.

29 Re: Black and Blue Report: Week 9

Has anyone heard anything about Darrell Jackson? I haven't seen an update on his condition since he had surgery, and I tried the Seahawks website and the Seattle page on I'd like to find out if he's at all close to returning and how much of a contribution he can be expected to make if/when he does come back.

30 Re: Black and Blue Report: Week 9

Gee whiz, call me crazy Sean, but I hate to see somebody's earning potential greatly harmed by injury, and I'm happy that Culpepper cashed to some degree before he shredded his knee.