Writers of Pro Football Prospectus 2008

07 Oct 2013

Week 5 Injury Aftermath Thread

Here's a place to discuss the biggest injuries from Week 5.

Bills Quarterback EJ Manuel -- Sprained Lateral Collateral Ligament

Browns Quarterback Brian Hoyer -- Torn ACL (IR)

The most exciting Thursday Night Football game of the season so far was also the most costly, as each side lost its starting quarterback for at least a month. EJ Manuel's LCL sprain is expected to keep him out for between four and eight weeks, putting a significant dent in a heretofore promising rookie season (-6.2% DVOA, 20th). Thaddeus Lewis is expected to start in his place. The Bills also placed rookie kicker Dustin Hopkins on injured reserve this week -- the kicking game has been the one positive (1.1% on field goals, 1.6% on kickoffs) for Buffalo's special teams (0.8%, 12th) so far.

Meanwhile, Brian Hoyer's injury ends his season and is a significant blow to the Browns. Hoyer's emergence had been slightly overstated -- his performance ranks 24th by DVOA and 25th by DYAR and the team owes at least one of its recent wins almost exclusively to its good defense (-10.3% DVOA, 8th) -- but he was comfortably better than Brandon Weeden and clearly the best option in Cleveland. This news means Weeden is expected to reclaim starting duties for the rest of 2013.

Eagles Quarterback Michael Vick -- Torn Hamstring

Eagles coach Chip Kelly described Michael Vick as “day-to-day” ahead of next week's visit to Tampa -- Vick told reporters he felt a pop during Sunday's game and sources are suggesting he will miss at least two weeks, which is at the very low end of the scale for hamstring injuries. Vick is having a good year so far -- his 5.7% passing DVOA ranks 10th this season, and his 42.1% rushing DVOA ranks seventh among quarterbacks (his 67 DYAR is second), but both of those are likely to be negatively impacted by any kind of persistent hamstring problem. Nick Foles was 16-of-25 for 197 yards and two touchdowns in relief, and would start any games Vick misses.

Jaguars Left Tackle Luke Joeckel -- Fractured Ankle (IR)

Jaguars Quarterback Blaine Gabbert -- Torn Hamstring

The Jaguars have confirmed that Joeckel fractured his ankle during the defeat to the Rams, and is out for the year. Jacksonville's offensive line already ranks second-last in Adjusted Line Yards and fourth-last in Adjusted Sack Rate, and the league's worst offense by almost every measure has now lost two left tackles in two weeks. This was always intended to be a rebuilding year; rebuilding isn't meant to involve placing your top draft pick on injured reserve in Week 5.

Quarterback Blaine Gabbert is also expected to miss significant time after reportedly hearing his hamstring pop during Sunday's game. As mentioned in the Michael Vick segment, two weeks is the very low end of the scale for the severity of hamstring tears. Chad Henne, whose -36.5% DVOA is somehow still an upgrade over Gabbert's -85.8% -- and who has thrown two of Jacksonville's three passing touchdowns this year -- will once again start in relief.

Packers Outside Linebacker Clay Matthews -- Broken Thumb

No word yet on how long Clay Matthews will be out, or even whether he'll try to play through this injury. Either way, it's expected to have a significant impact on their already league-worst (by DVOA, 47.0%) pass defense -- Matthews had around 25% of Green Bay's sacks last year, and is on the same pace this season despite already missing time with a hamstring injury. The Packers also lost backup linebacker Robert Francois for the year with a torn achilles tendon.

Bears Defensive Tackle Nate Collins -- Torn ACL

After Henry Melton's season was ended in almost identical fashion two weeks ago, backup Nate Collins has now been placed on season-ending injured reserve by the Bears. Chicago's defense has struggled at times this season, particularly against the pass (5.9% DVOA), and had been relying on turnovers to compensate for a weak pass rush (29th by Adjusted Sack Rate) even before going down to their backup-backup-defensive tackle.

Posted by: Rivers McCown on 07 Oct 2013

33 comments, Last at 08 Oct 2013, 11:10pm by Andrew Potter


by Independent George :: Mon, 10/07/2013 - 2:58pm

Vick is losing two weeks for a torn hamstring?

by Andrew Potter :: Mon, 10/07/2013 - 3:05pm

There are different degrees of tear. It's most likely Grade 2, which would explain the pop and the fact he didn't immediately fall over. That would usually place him at the lower end of the recovery time, so 2-4 weeks.

by Andrew Potter :: Mon, 10/07/2013 - 4:27pm

Oh, and I'll try to be clearer about the severity of these types of injury in future. I should have mentioned the likely grade of the tear.

by Anger...rising :: Mon, 10/07/2013 - 7:26pm

Hopefully the word "strain" will be featured prominently.

by PatsFan :: Mon, 10/07/2013 - 3:05pm

So what exactly is a "torn hamstring"?

Is the muscle itself torn (in part or completely)? Is the muscle intact but one of the tendons are torn (in part or completely)?

I have the similar question re: "torn groin" (e.g. Amendola). Is it a muscle tear or a tendon tear?

Finally, what is the ultimate treatment of these things? Is it reattached in season? Left loose for the season and reattached afterwards? Never reattached?

by Andrew Potter :: Mon, 10/07/2013 - 3:33pm

As mentioned above, there are different degrees of muscle tear.

Grade 1 means it's overstretched, hurts, and needs rest, but you can walk and even possibly jog on it.

Grade 2 means the muscle fibers are damaged and need rest to heal properly. It won't be possible to jog normally, and will be painful to walk on the injured leg. Usually, it will be accompanied by a noticeable limp. This is most likely the case for both Gabbert and Vick, and Amendola as you mentioned. Importantly, this type of injury is extremely likely to persist and even get worse unless rested, as the tear widens.

Grade 3 is a major rupture of the muscle, either partial or complete, and needs surgery. The injured person won't be able to walk without crutches. It's almost certain to end a player's season, especially a running quarterback like Vick. For a recent NFL example, Terrell Suggs ruptured his Achilles tendon in April 2012, and returned to practice extremely quickly -- but that extremely quick return was still not until six months later, in mid-October.

The degrees mentioned above are applied to muscle tears. Tendon tears like Suggs or Vince Wilfork's, from what I understand, are much worse, and pretty much all are the equivalent of grade three muscle tears. I'm not a medical practitioner though, so could easily be wrong on that.

The ultimate treatment, in case of a partial or complete rupture, is surgery to reattach the muscle. If it's a total rupture of something like a hamstring or an Achilles tendon, it simply won't be possible to use the affected limb until this happens.

by PatsFan :: Mon, 10/07/2013 - 3:45pm

Re: Amendola -- the reports were that he didn't need surgery because "it" (what's "it"?) tore completely through and since the surgical treatment would have been to cut "it" loose -- thus no surgery required. So I assume this was really a blown tendon? Or would they really finish cutting a torn muscle apart as in-season treatment?

by Andrew Potter :: Mon, 10/07/2013 - 4:01pm

I've just done some more reading on Amendola's injury. The reports seem to agree that he completely ruptured his adductor longus tendon, which is attached to the muscle you use to, for example, bring your second leg into the car. Snipping that is a common treatment for persistent groin pain, so by completely rupturing it he bizarrely removed the need for surgery and cut his rehab by two weeks. That meshes with the rehab time we've seen -- the earliest he could have returned is against Atlanta, and in fact he just missed that. If he'd needed surgery, he'd have been out until at least Week 7.

I have no idea how he can make cuts without it -- I've had a tear of that exact muscle and tried to play soccer through it, and I couldn't maneuver laterally at all -- but I'll certainly go read up on it some more.

by Aaron Brooks Go... :: Mon, 10/07/2013 - 4:21pm

He should be able to do push-off cuts without it. It's the pull-along moves that he can't do.

by Independent George :: Mon, 10/07/2013 - 5:09pm

This reminds me of a scene from Firefly where Kaylee rips a bunch of wires out of the ship, and the flabbergasted (former) mechanic exclaims, "Don't we need this?!!"

To my lay perspective, I'm kind of at a loss as to how you can play a professional sport with a completely ruptured anything.

by In_Belichick_We... :: Tue, 10/08/2013 - 8:47am

According to Troy Brown, there is only one thing you can do for a torn groin: Ask somebody very nicely if they will massage it for you.

by Jon Goldman (not verified) :: Mon, 10/07/2013 - 3:09pm

Ugh. The Bears may end up starting a UDFA at DT.

by tuluse :: Mon, 10/07/2013 - 3:53pm

Yeah, Stephen Paea missed the game against the Saints meaning the top 3 tackles were all out of the game.

by Chip :: Tue, 10/08/2013 - 12:54am

At this point, I'd rather have all the injuries at the same position rather than a few first line guys across multiple positions. Better off with an an UDFA starting at DT (with Wooton at 3Tech) than down say Lance Briggs and Jennings. Or Peppers and Tillman.

by tuluse :: Tue, 10/08/2013 - 11:25am

Given that Peppers hasn't been doing so well, I wonder if moving him to DT would be prudent this year.

by TomC :: Tue, 10/08/2013 - 12:43pm

Peppers had a great game on Sunday, so I wouldn't mess with him right now.

by Andrew Potter :: Mon, 10/07/2013 - 5:32pm

The Jaguars website has confirmed that Gabbert's hamstring injury is Grade 2. He's considered "week to week", according to Gus Bradley.

by DA (not verified) :: Mon, 10/07/2013 - 5:32pm

I don't see how Matthews could be out many if any weeks at all with just a thumb. GB's D I do think is being undervalued so far:

Game 1: Predictably Destroyed by 100x better Coaching staff of SF

Game 2: Shut Out Wash in 1st Half, before Classic McCarthy/Capers foot off gas strategy in 2nd Half

Game 3: Forces/Recovers 4 Turnovers, hold Cincy under 300 yards and 4-11 on 3rd Down

Game 4: Pretty much Shut down Detroit. Predictably give up a Gabrage time TD

by Andrew Potter :: Mon, 10/07/2013 - 5:44pm

Schefter's reporting that he's expected to miss at least four weeks. I've seen others suggest there's a chance it could be season-ending, though that's speculative. It all depends what other damage there is and whether he'll need surgery.

by DA (not verified) :: Mon, 10/07/2013 - 5:47pm

A source also says Josh Gordon is available for a 2nd Round pick. Every team in the league should be lining up to give a 2nd for Gordon

by herewegobrowniesherewego (not verified) :: Mon, 10/07/2013 - 6:10pm

Not if he ends up failing a drug test after he gets traded, they shouldn't.

The rumors about Gordon being possibly traded have been around since the start of the season; the Eagles, Skins, and now Niners supposedly have the inside track.

Supposedly the Skins were interested in Greg Little recently, as well.

by DA (not verified) :: Mon, 10/07/2013 - 6:33pm

It would still be worth trading for Gordon. Other than the Julio Jones/AJ Green/Dez Brant trio, Gordon is the Best Young WR in the league and perhaps only a little bit behind those 3.

by herewegobrowniesherewego (not verified) :: Mon, 10/07/2013 - 6:40pm

It would be a good low-risk move for SF, since they already have so much depth and barring a collapse would only be giving back a late 2nd.

I'm surprised the Browns would accept a pick that late for him, when they got a 1st for T-Rich, though (and it sounds like the trade will not happen.) It's no secret that Banner/Lombardi are no fan of his past off-the-field problems, though, so you never know.

by akn :: Tue, 10/08/2013 - 8:06pm

It's being reported that Matthews suffered a Bennett's fracture, which a fracture at the base of the thumb. It's the most common type of thumb fracture, and it usually occurs when an axial force hits a partially flexed thumb (usually in something like a fist fight).

It's the same type of injury that ended Jay Cutler's season two years ago, but it appears to be a less severe form. A Bennett's fracture requires reduction and stabilization right away because there are several ligaments/tendons that pull the fracture pieces apart. If the parts are displaced less than 3mm (and some other conditions are met), then you can simply put a couple of percutaneous pins (through the skin, not requiring open surgery) in for a month and and cast it for about 6 weeks. Given that linebackers can play without use of a thumb, he'll likely be able to come back in 4-5 weeks with soft cast, but it may take longer. You don't want to mess with the possibility of permanent thumb dysfunction.

If the damage is more extensive, like Cutler's, it requires open reduction and fixation, meaning several more weeks to recover. Cutler took advantage of a newer innovation in the treatment of this type of fracture. On the surgical table, they put a sterile football in his hand before inserting the hardware, optimizing the reduction for his career as a QB. This kind of technique had only recently been used with pitchers and tennis players--I'm not aware if it was ever done for a QB before then.

BTW, I am a doctor, but not in orthopedics or sports medicine.

by Andrew Potter :: Tue, 10/08/2013 - 11:10pm

I'd been hoping you'd contribute in this thread. This is great information. Thanks for it.

by Arkaein :: Mon, 10/07/2013 - 7:10pm

Regarding Matthews' thumb, the word is that if he needs surgery he would be out for at least a month. If they can just cast it I'd assume that he'd play through the injury.

Regarding your other points, I think the pass D issues in game #1 had less to do with bad coaching (remember, GB did take a 4th quarter lead in that game, and played excellent run D throughout), and more to do with the secondary missing it's best safety in Morgan Burnett, and a very good CB in Casey Hayward, due to injuries.

Burnett is finally back, and should allow the CBs to play more aggressively. Once Hayward comes back the defensive backfield should be comfortably above average.

At least, that is if GB can actually field a completely healthy backfield, and not lose Matthews for an extended time. Hayward should be close to recovering from his bad hamstring, but the D looked it's healthiest at the start of the Detroit game, and they promptly lost 3 LBs to injury.

If GB can actually get healthy at some point they could have a formidable defense. Their D-line is extremely deep, and they are potentially very deep at CB. None of the injuries so far to defensive players look to be season ending, except for Francois (a backup).

by Andrew Potter :: Mon, 10/07/2013 - 5:40pm

Panthers have also lost their starting LG Amini Silatolu for the year with an ACL injury.

by panthersnbraves :: Tue, 10/08/2013 - 9:55am

bringing their already weak O line one more issue.

by In_Belichick_We... :: Tue, 10/08/2013 - 8:49am

Any word on Tommy Kelly's knee injury?

by Andrew Potter :: Tue, 10/08/2013 - 11:32am

Getting any useful information like that from the Patriots is not easy, but the few indications I've seen give me the impression that it isn't anything serious. I doubt we'll know for sure until the participation reports are released.

by foxlies (not verified) :: Tue, 10/08/2013 - 8:51am

independent george; i agree; the amount of injury these guys play with each week is unreal;I always cringe when some stupid ex player posing as an expert analyst criticizes rules vs. high hits;we[partly cause economics of sports have gotten so far out of line but admittedly due to complexity] can fix a joint or even replace it;but repeated head trauma is different.So sick of hearing 'he just got his bell rung'...nflalternative.com

by foxlies (not verified) :: Tue, 10/08/2013 - 8:52am

independent george; i agree; the amount of injury these guys play with each week is unreal;I always cringe when some stupid ex player posing as an expert analyst criticizes rules vs. high hits;we[partly cause economics of sports have gotten so far out of line but admittedly due to complexity] can fix a joint or even replace it;but repeated head trauma is different.So sick of hearing 'he just got his bell rung'...nflalternative.com

by Andrew Potter :: Tue, 10/08/2013 - 12:14pm

Owen Daniels is expected to miss between four and eight weeks with a fractured fibula. Garrett Graham will replace him in the lineup.