The Seattle Seahawks and Denver Broncos are moving toward Super Bowl Sunday in a state of relatively excellent health, but two injury question marks still remain on the offensive side of the ball: Percy Harvin and Knowshon Moreno.
Harvin missed nearly all of the 2013 season after undergoing hip labrum repair surgery during the preseason. He returned briefly on two separate occasions before a hip setback—and later a postseason concussion—forced him to the sidelines once again.
Moreno, on the other hand, sustained a rib injury during the AFC Championship Game, the precise details of which are not entirely clear.
According to numerous media reports, both offensive standouts are on track to suit up on Sunday. Yet, will either feel lingering effects from prior injuries?
Let's take a closer look.
Percy Harvin (Concussion, Hip)
According to the official Seahawks injury report, Harvin practiced in full on Wednesday.
Not only does a full practice status imply Harvin is not feeling sufficient lingering hip pain to prevent him from taking part in all of his repetitions, it also means he almost certainly sits at the very end of the NFL's concussion protocol—if he hasn't completed it already.
Similar to many other concussion return-to-play protocols throughout the medical literature, the NFL and its team physicians use an exercise regimen of steadily increasing intensity to gauge a player's readiness to return to the field. Full practice participation often represents the final step in the process.
If concussion symptoms do not return with maximal activity, doctors and trainers can safely assume the full recovery of a previously concussed brain—assuming cognitive tests also demonstrate a similar return to baseline.
Conversely, the recurrence of symptoms with exercise—such as a headache—suggests the opposite.
With that in mind, the combination of optimistic media reports and Harvin's continued practice participation all but guarantees the wideout is neurologically ready for action.
As for his hip?
That still remains somewhat of a mystery.
Reports continue to suggest the hip is becoming less of an issue, and that may very well be the case.
However, running in practice—or briefly during a game—is one thing.
Repeatedly cutting away from opposing defensive backs—an action that requires strong internal and external rotation of the femur within the hip socket—is another.
Indeed, an entire game of full-speed action will put Harvin's hip through its toughest test in many weeks, as will the contact it will likely receive from opponents.
As such, as the game progresses, Seahawks faithful should pay attention to Harvin's response to that contact and his ability to cut away from opponents. His effectiveness will surely depend on both—while also serving as a very crude barometer of his hip's overall health approximately six months out from surgery.
Knowshon Moreno (Rib)
Moreno's ability to play effectively likely comes down to one simple factor: pain tolerance.
According to head coach John Fox, chest X-rays of the Broncos running back came back negative shortly after the injury occurred. In other words, no large, obvious fracture nor gross rib dislocation exists.
Furthermore, Moreno himself stated he plans to play through the injury.
Despite his recent limited practice status, nothing yet suggests that will not prove to be the case.
Along with his aforementioned negative X-rays, Moreno's mechanism of injury during the AFC Championship Game—an awkward fall onto his shoulder and side—suggests an injury such as a rib contusion or minor sternoclavicular joint sprain.
Who will have a bigger impact on Sunday?
A small fracture that escaped diagnosis on radiographic imaging also remains on the list of possibilities.
That said, if sufficiently minor, none of these injuries necessarily requires an athlete to miss time. The opposite would be true if a displaced rib or fracture threatened to puncture a vital organ or blood vessel within the chest.
As long as there isn't more to Moreno's injury than is reaching the media, good pain control—and maybe an additional protective chest guard—should allow Moreno to line up in the backfield on Sunday.
In fact, barring a crushing hit to the chest or sandwich-type impact between an opposing player and the ground, he may still be able to shoulder the lion's share of the Broncos running game.
Dr. Dave Siebert is a resident physician at the University of Washington who plans to pursue fellowship training in Primary Care (non-operative) Sports Medicine.