There are so many compelling, impactful injury stories this week that I could take this slideshow out to 15 if I wanted to. Instead, we'll focus on guys like Jake Locker, Rob Gronkowski and C.J. Spiller as we start Week 5 on the NFL schedule.
One thing that I noticed Sunday, and again Monday, is that the NFL's rule against allowing medical personnel to speak with the media is working against them. A common-sense usage, such as allowing the Titans to present someone besides a former lineman-turned-coach to help explain a complex situation with a hip injury to their franchise QB. The doctor or athletic trainer would do a vastly better job than Mike Munchak, though Munchak did as good a job as I've seen a coach do.
I also think that a network would do well to get someone in studio to help explain these. If having an ex-ref like Mike Pereira around to guess at replays works, why wouldn't having someone there who could explain the injuries that are vastly more important to whether a team wins or loses? Sure, Mike Florio can read about injuries as well as anyone, but he's a lawyer, not a doctor.
CBS recently had Dr. Neal ElAttrache, one of the top sports medicine doctors in the game, on its pregame show to help explain Robert Griffin's knee situation. Unfortunately, it gave ElAttrache less time on-air than Boomer Esiason, but it's a start. Injuries are more than just a "fantasy thing." The first network that gets that will get a big in-game advantage.
For now, on to the injuries:
INJURY: unknown hip injury
OUTLOOK: expected to miss eight weeks, return possible around Week 12
Jake Locker was making the steps that some had predicted for him, solidifying the Titans from behind a rebuilt offensive line. Then, in one odd play, Locker's season was altered, if not ended. The video showed the hip being externally rotated by a hit as he fell. Locker quickly went rigid and stayed that way until he was carted off the field.
I often say that the first reaction is the truest, and Locker's was immediate. He grabbed his hip and locked his leg out. It's possible that, given how the Titans are saying there was no apparent dislocation, Locker had a self-reducing dislocation or subluxation.
It would be intensely painful, leading to his overnight hospital admission for pain management and further tests. Those tests showed no fracture, which was the major concern. A fracture either inside the pelvis or to the femoral head could be devastating, even career ending. While we still don't know what the injury is specifically, ruling out what it's not has taken some of the most dire consequences off the table.
Locker also has a minor knee sprain, a Grade II MCL sprain suffered on the same play, but that is secondary to the hip issue. While it's possible that Locker could return, it's impossible to judge how, when or how well without more info. His likely designation of IR-Return at least helps with the time frame for fantasy purposes. Locker's likely a drop in most formats except keeper leagues, and Ryan Fitzpatrick isn't a terrible pickup in deeper leagues.
(For even more info, check out Dr. Dave Siebert's article on Locker's injury.)
INJURY: post-surgical back, post-surgical forearm
OUTLOOK: expected to return in Week 6
The Rob Gronkowski story took an odd turn on Friday, as Gronkowski's "inner circle," which many took to be Gronkowski's father, pushed him not to play, according to multiple reports. The Patriots refused to acknowledge those, saying only that Gronkowski had been medically cleared to play by team doctors and by his own surgeons.
That appears to put this firmly into Derrick Rose territory, where the player is essentially refusing to play. While I understand a healthy distrust of team doctors, according to Boston.com, and a need for the player to feel a level of confidence in his return, I can also understand why a team might be a little perturbed that a player chose not to play when medically cleared. Imagine if you told your boss you just didn't think you could work today, even though a doctor said you weren't sick. It's a stretch of a metaphor, but it's clear.
The most interesting thing I've been able to glean from this drama is that Gronkowski seems more worried by his forearm than his back. Sources tell me that while the recovery from his back injury has gone exactly as Dr. Robert Watkins explained, a surgery Gronkowski has had before, that he's still worried about a re-fracture in his forearm. The infections, the re-plating and the pain of the second and third injuries have really gotten to Gronkowski. That all makes sense given the Boston.com story linked above.
The Patriots seem to have backed up expectations, moving not just to a Week 5 return but now Week 6. Tom Brady has kept the team unbeaten without Gronkowski, but there's no question the team will be better with his return. The only question left is when.
OUTLOOK: expected to play Week 5
Terrelle Pryor had something of a setback on Friday after being cleared to play on Sunday. Just hours after passing all the points of the NFL's Concussion Protocol, including sign-off by two doctors, Pryor exhibited some light sensitivity. The Raiders medical staff noted it and it was decided that Matt Flynn would get the start instead.
Pryor was not placed back into the protocol, according to multiple sources and first reported by Josh Katzowitz. He passed and was held out as a "coach's decision" rather than a medical decision, though it's clear it was medical in nature. That's semantics, and given that the Raiders made the tough decision, I'll give them credit for it.
Pryor is expected to be ready for practice and next week's games. He's under no limitations under the concussion protocol now, but the medical staff will still be watching him closely. The mild setback that he had doesn't indicate that he will or won't have more issues. Once he's playing and hopefully symptom free, he'll be back in the QB1 role and a valuable fantasy QB option given his running ability.
INJURY: strained hamstring
OUTLOOK: unclear for Week 5
It's not really a surprise that Darren McFadden is injured. It's not a surprise that once again, he's dealing with a hamstring strain. It's just disappointing. McFadden is the ultimate "if healthy" player. He's clearly talented yet is never healthy enough to exploit it, but he's still talented enough to remind everyone.
McFadden tightened up in game and was seen on the sidelines trying to get it loose. He used a baseball to roll out the knot then got on the stationary bike, but he just couldn't get loose. The medical staff did the right thing by holding him out and kept it from getting worse. The hamstring has enough repaired damage in there that it's already weakened, so even by catching it early, the grading is difficult to read.
Look to see if McFadden can run at all early in the practice week. With Terrelle Pryor likely to return in Week 5, the workload and attention Pryor draws seems it will help McFadden.
INJURY: sprained/fractured foot
OUTLOOK: expected to play Week 5
It took a trip to London and a soggy pitch in Wembley, but Le'Veon Bell showed not only that he's back from his Lisfranc injury but that he's got talent. Bell showed no real deficits during his first taste of NFL action.
Bell did seem to avoid hard cuts, with some game-planned runs that were based on stretches rather than one-cut reads. He was able to accelerate and stop but didn't get much of a chance to show a lot of lateral motion. Even on his diving touchdown, many backs would have made a sharp inward cut to get to the goal line quicker, though his technique certainly worked.
The Steelers were clearly limiting his touches, but there were no indications postgame that Bell had anything more than normal soreness. Add in that the Steelers have the bye week to get over their jet lag, and things look positive for Bell.
Bell may well be the answer for the Steelers running game, and this may be your last chance to pick him up at a good value. The team, especially the offensive line, remains enough of a problem to make sure you don't overpay. There's also the risk of recurrence, but his first bit of game action was certainly positive.
OUTLOOK: both unclear for Week 5
The bye week made it possible that both Eddie Lacy and Jermichael Finley could avoid missing a game after suffering concussions. Lacy missed Week 3 but has cleared the concussion protocol, while it's less clear exactly where Finley is in the process. Things are normally taken at a slow pace even with the bye, but there are teams that let the athlete take a more leisurely pace on a bye.
Lacy was able to participate fully in a Monday practice, so any uncertainty about his role in Week 5 will have more to do with the emergence of Jonathan Franklin in the interim and not his concussion. Finley was not at the practice, according to ESPN, and is assumed to not be cleared. As with any concussion, it's impossible from the outside to tell exactly where someone is in the protocols and just as hard to predict any sort of timeline.
Every concussion is unique, as these two show. They were two of the more violent and egregious I've seen this season, a tough reminder that there's a lot of work to do to reduce the number of concussions we have. With each, there should have been steep fines and perhaps suspensions since both were easily preventable by the other players involved. Until the NFL gets even harsher on the clearly preventable concussions, the league is missing yet another opportunity.
Which reminds me—if you're curious in learning more about how the protocol is actually used in the NFL, check out Jene Bramel's article on the topic at Football Guys. Dr. Bramel has done some amazing journalistic work on this and he's got more to come.
INJURY: sprained ankle/knee sprain
OUTLOOK: both expected to play Week 5
Injury stacks are a real problem in the NFL, especially at the skill positions. There are few teams that can go three and four deep at any position and retain talent parity. The Bills do have three solid RBs, but Tashard Choice isn't C.J. Spiller or Fred Jackson—or else he would be higher on the depth chart.
Spiller's ankle sprain is problematic for a player with his quickness and lateral movement. Hard cuts and those ankle-breaking hops that he can toss into a run to make people miss are taken away by even a minor lingering injury. While Spiller expects to be closer by Thursday, according to the Bills' official site, he's also saying that he doesn't expect to be 100 percent. The short week is definitely going to work against him. Even if he plays, consider your options in most formats.
Jackson has a minor MCL sprain, but as Jackson said, "It's not as bad as one's I've had in the past." Experience counts, at least in terms of being able to adjust. Jackson can be a straight-ahead power runner if he needs to. Again, the short week really hurts, and Jackson is less likely to go than Spiller, though at this stage, we have to take their word for it. Choice becomes a decent flex play in very deep leagues.
Vince Wilfork: It's not a pun that Vince Wilfork is a huge loss for the Patriots. His Achilles rupture is a definite season-ender and with his size, he'll have a bit more of a challenge with his recovery. It's simple gravity and tension, though with modern techniques, he has a chance to be ready well before training camp.
Reggie Bush: Reggie Bush showed that his knee issue is one of maintenance, not function. The swelling and grinding inside Bush's knee didn't affect his speed or his lateral mobility. It's a good sign that the Lions medical staff was able to get the knee back to function quickly with only a week off. Now, they have to keep it functional without more lost time.
Larry Fitzgerald: Fitzgerald has made it through two full games and showed a bit more willingness to extend his hamstring last week. While the risk of recurrence is there, it's fair to think you can discount the injury now. Fitzgerald isn't 100 percent just yet, but he's shown that he's a must-start in all leagues, all formats. The hope now is that the rest of the team can catch up to his level somewhat.
Roddy White: White has adjusted well to his high ankle sprain's limitations. He seems to know exactly what he can and can't do. That's impressive, but what I don't see is any week-to-week improvement. Playing on the ankle until the Falcons' bye in Week 6 has always been his plan and now, he might make it. Expect an uptick in production once they come back, so he's something of a buy-low candidate right now.
Mark Sanchez: Sanchez has elected to have surgery on his injured labrum. While there's no word yet on who will do the surgery, it's likely he'll go back to Dr. James Andrews. Sanchez was designated to return, which means the Jets lose the chance to bring anyone back off IR this season. Sanchez should be able to return sometime early next year, which gives him plenty of time to audition for a backup role somewhere before the pushed-back NFL draft.