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

Black & Blue Report: September 23, 2008

by Will Carroll

Sometimes it's what we don't know that's informative. I know that sounds counterintuitive, but go with me for a minute. Sports medicine is often best performed by ruling things out, and while this can often lead to "garbage diagnosis" -- a broad-spectrum explanation that's more "it's gotta be something" than "this is what it is" -- if the garbage can be avoided, it can be used. Consider the protocol for an athlete having his knee tested, which is basically just a series of manual tests that rule out one thing after another. It works like that sometimes here, but our garbage diagnosis isn't tendinitis, it's risk. We're seeking the known unknown, allowing us to make more informed decisions. If the best is the enemy of the better (a phrase I learned from Aaron Schatz and find myself reciting often), then the unknown is no enemy at all. Let's get to it:

"Strain: a tearing of muscle or tendon." It's the simplest definition, but key in understanding what's happening with Brian Westbrook. It could have been much worse, such as another Lisfranc or other foot injury. It might have been a severe sprain or high ankle sprain. With strain, the most likely area is the Achilles tendon, which is the strongest tendon in the body, but something of an all-or-nothing area. When it snaps, it's fixable, but a player is done for the season. Westbrook suggested on a radio appearance that the damage was to "ligaments and tendons," so there might be more going on here that just a strain, but Andy Reid specifically said there was no ligament damage in his press conference. At this stage, there's just not enough information to know exactly what's going on, making analysis something of a wait-and-see proposition. Westbrook's practice this week (or lack thereof) might not be indicative either, as the Eagles have shown a tendency to let him rest during the week when it was his chronic knee issues slowing him. As for Donovan McNabb, he has a bruised sternum. It's a painful injury, but should heal up normally and quickly. He shouldn't have any deficits heading into Sunday.

The problem for Ben Roethlisberger isn't his shoulder, as most would have expected. It's everything else. Jim Johnson's blitz schemes overtaxed the Steelers line and ended up giving Roethlisberger a beating that looked more like a gang jumping someone than a football game. Big Ben's shoulder held up under the stress, though a late-game shot to his hand will cause him to miss practice early in the week. Roethlisberger will be ready for Monday, though he has to be thankful for the extra day's rest. He can be sure that Baltimore will be watching film closely and will try to replicate some of those blitzes.

Two touchdowns kept LaDainian Tomlinson from being a fantasy bust, but the performance wasn't there if you look deeper. The toe continues to be slowing him, preventing him from making sharp cutbacks or a quick burst when things open up. With a short week back from Monday to the Oakland game (between this paragraph and the next, can we call it the Toe Bowl?) and no bye until Week 9, Tomlinson and the Chargers medical staff will have to try to hold it at this level since it's clear that Tomlinson won't be held out if he can play at all. The split with Darren Sproles was lower than I'd expected, though the shift to more passing, even in late-and-up situations, showed that there's some understanding. If you like what you got from Tomlinson, that's what you're likely to get over at least the next couple weeks.

Darren McFadden played through turf toe last week and was productive, if not explosive. One detail that's been thrown out in some stories actually tells us a lot more than anything else. McFadden went through three pairs of cleats, seeking a comfortable level of traction due to his inability to "dig in" the front and get acceleration. With the steel plate and a numb toe, McFadden had no way to do something that comes naturally to him and because of that, couldn't use the burst he possesses. While Lane Kiffin thinks the toe will clear up, he should check the college scouting on his young runner. McFadden had a very similar injury -- a dislocated toe, injured in a bar fight -- back in his college days and it took him about six weeks to come back and even then was slowed. Turf toe doesn't heal overnight, so I'd expect McFadden to be very similarly limited next week against the Chargers, then to use the bye week to clear things up.

Completing the trilogy of "I drafted him where and he only got how many points?" we come to Adrian Peterson. He said after the game that the hamstring didn't bother him, but his totals had to bother his owners and Vikings fans. While the team was clearly giving some of his touches to Chester Taylor, there was no burst for Peterson. I won't fault him for running cautiously; with that line, I've often wondered why he doesn't "coast" sometimes and just follow them for four or five yards a touch instead of looking for the big play every time out. The downside now is that while Peterson should be healing, he's now headed into the teeth of a Titans defense that flat-out hurts people. If he can make it through next week intact, I think he's past the worst of this and can get back to establishing himself as the best running back in the game.

I'll skip the easy jokes about Jeremy Shockey, New Orleans, and his groin. That's what Raiderjoe is for, after all. Shockey will miss a month as he recovers from surgery to repair a sports hernia. Shockey had been playing through it, but aggravated it last week and will need the correction. Shockey plays well through pain, so a quick recovery is reasonable and most come back very well from this surgery, even though it sounds like something that would have me laying in bed and begging for a quick death. We'll get about a week's warning when Shockey returns to practice before he plays, so if you're looking to buy low, there it is. The Saints are down to one healthy tight end, so they'll be scanning the waiver wire as well.

I'll admit I had no idea what a "spinal cord concussion" was when the term was used to describe the spinal injury to Dawan Landry. It's essentially a shock to the spinal cord, much in the same way that a brain concussion is a shock to the brain. Getting slammed by Jamal Lewis is one of those things that causes such odd injuries. This one really was a fluke of circumstance with Lewis' knee, force, and the placement and position of Landry's head. If any of those changes slightly, Landry probably just has a headache, if that. Landry has movement in all his extremities, a great sign. The Ravens think Landry will be back in weeks, which is pretty amazing given how it looked.

If one word sums up the return of Jeff Saturday, it's one you might not expect in the NFL: Woobie. Anyone who watched Peyton Manning on Sunday saw more confidence from the quarterback simply because his center was in front of him once more. From pass protection to the stretch play, Saturday's showing why the Colts rave about him, with some even discussing him as a Hall of Famer. His knee held up well, though he did have some adjustments at halftime, mostly dealing with surface issues; Saturday had limited chances to work out on the new LOS surface. The brace held up and sources say the knee was never taxed, with little swelling or pain after the game. That's a very good sign for Saturday, Manning, and the Colts.

Bumps and Bruises

It's been eight months since Philip Rivers had a pair of surgeries on a knee that was "worse than [Daunte] Culpepper's," yet no one is talking about it. They should be because his recovery is amazing ... Just me, or did Maurice Jones-Drew look absolutely gassed in the fourth quarter of the Jags' big win? That's on 19 carries ... The Seahawks think they'll have Deion Branch and Bobby Engram back when they get back from the bye ... Laurence Maroney was held out of Sunday's game not because of his shoulder injury but, according to sources, because he was rated as "less effective" than LaMont Jordan anyway ... Jon Kitna is headed for images on his sprained knee. Things look bad given the swelling in it on Monday ... Laurent Robinson will miss time with a sprained knee, though the type and severity remains unknown. He was in an immobilizer after the game, so this could be serious ... Jason Taylor will miss the Cowboys game after needing a minor surgical procedure to relieve compartment pressure. Basically, they sliced a hole in his leg so blood didn't build up and cause further damage. He'll miss -- get this -- a week ... Kevin Curtis will be back in practice this week. I'm told the Eagles think he can be back in Week 5 ... Dallas Clark has been cleared to return after a vicious helmet-to-helmet hit late in Sunday's game. He graded out fine on a concussion test ... Javon Walker played, but his hamstring "never loosened up." Look for him to be more active next week ... The Eagles are worried about L.J. Smith. He left Sunday's game with a painful back strain ... What's holding Deuce McAllister back right now? Saints sources say "conditioning" ... Yeah, that was Brett Favre limping as he left the field Monday night.


14 comments, Last at 28 Sep 2008, 9:17am

1 Re: Black & Blue Report: Week 4 2008

Not important for fantasy owners, but do you have any word on the Al Harris injury? Word is that it's a ruptured spleen, which sounds frightening and of course lends one to think of Chris Simms missing roughly two years. Would a 33-year old defensive back be able to come back from having his spleen removed? What are the dangers above and beyond Harris' football career?

2 Re: Black & Blue Report: Week 4 2008

I don't and your comp is right. I'm working on those, hope to have more by Thu at SI.

Also, working on Willie Parker. My rule is that if I can't add to the conversation, I skip it, but Parker is important enough that I feel bad saying nothing. Again, hope to have more, though he's definitely out for Week 4.

3 Re: Black & Blue Report: Week 4 2008

It doesn't sound as if Harris will be forced to retire as a result of this injury.

"Most doctors will tell a player to forgo a season just because of all the downside risk," Bechta told the Milwaukee Journal-Sentinel.

"The conservative answer now from the original (diagnosis), I believe from Dr (John) Gray, is to shut it down. But nothing is imminent as of yet."

5 Re: Black & Blue Report: Week 4 2008

I had my spleen removed about 10 years ago. Once he has recovered from the surgery (abdominal surgery truly sucks) there should be no real reason not to play football, except that his conditioning may be lacking and he isn't really a spring chicken. Long term health affects outside of football would be that his immune system will be somewhat comprimised going forward, so he would be more susceptible to infection, and general illness. Nothing an annual flu shot can't help counteract.

7 Re: Black & Blue Report: Week 4 2008

Oddly, Steelers safety Ryan Clark had his spleen removed last year. He's a DB who's not quite as old, but not exactly a rookie. He looks like he's at the top of his game this year. He's 28, which isn't exactly as old as Harris, but it's a data point.

4 Re: Black & Blue Report: Week 4 2008

The Eagles are a good team with a scary lack of depth at the skill positions. I can't think of another squad whose success is so dependent on the health of 2 injury-prone players. Yea, you say, what about Brady. Well sure, but until this season he wasn't injury-prone. The Eagles came into the season riding on the same two guys who have had a history of injury. I hope they can hold up, for the sake of the NFC East being the best division in the history of the league.

6 Re: Black & Blue Report: Week 4 2008

This canard again? McNabb's been knocked out of games enough to demonstrate pretty adequately that a replacement-level quarterback (Feely, Garcia) can succeed in his place. Hell, Feely nearly took down the then-undefeated Patriots last year. Can't recall a specific case of both McNabb and Westbrook being out, but I'm sure it's happened.

I'd credit their success more to things like a talented, healthy offensive line and good scheming on both sides of the ball.

11 Re: Black & Blue Report: Week 4 2008


The Eagles just won a game against a fairly good team while having seven of their eleven offensive starters at least limited by injury. WR Curtis, OG Andrews: out, RB Westbrook, RB Hunt: out by early 2nd quarter, TE Smith: out by 4th quarter, QB McNabb: injured in 1st half and missed two series, WR Brown: played sparingly in first game back from injury. (Yes, that is every skill position.)

There is no scary lack of depth. Take any team in the league and remove their elite QB and top RB and they will look much worse by comparison. (Anyone want to try to win a Super Bowl with David Carr?)

8 Re: Black & Blue Report: Week 4 2008

Is there any word on the marvelous Mr Hester?

Is he better/ likely to be better/ still the same/ check back with me in six weeks/ call the paramedics we need a crash cart?

Any thoughts or news?


9 Re: Black & Blue Report: Week 4 2008

It's been eight months since Philip Rivers had a pair of surgeries on a knee that was "worse than [Daunte] Culpepper's," yet no one is talking about it.

Reports from San Diego are that his offseason rehab was the most insane and intense that the trainers and doctors have EVER seen. An article from the San Diego Union Tribune sometime in the spring (looking for it, can't find any articles in that timeframe though there surely were a few) mentioned him getting up at 5AM every day for rehab, starting on the first day they doctors let him do it. He slept with a machine that bent his knee back and forth all night for a time, from what I heard.

If I find the articles I'll link them.

10 Re: Black & Blue Report: Week 4 2008

Well, the best links I can find now are:

Combined, that has a lot of info on his recovery process and how fast it was. Unfortunately, I can't substantiate my other claims with these, but having read just about every piece written on the Chargers between late January and July, all I can say is I remember reading about an absolutely insane daily rehab schedule. Within the last few weeks, I have read about the impressions of trainers and doctors.

14 Re: Black & Blue Report: Week 4 2008

Long term health affects outside of football would be that his immune system will be somewhat comprimised going forward, so he would be more susceptible to infection, and general illness. Nothing an annual flu shot can't help counteract.

So, what you're saying is that this would be fatal if Harris played for Cleveland?

I wouldn't worry about the Chris Simms comparison. Simms was a quarterback for a coach who never particularly liked him trying to come back from an injury that directly affected his throwing motion. There were also reports during this offseason that the team doctors and whoever else he was seeing didn't really go about his rehab right, and that he eventually went to some other specialist who got him on the right track. Forget the injury, the real question is whether or not you think Al Harris will still be a viable option at cornerback next year, splenectomy or no.