Latest Injury News and Notes from NFL OTAs

Dave Siebert, M.D.@DaveMSiebertFeatured ColumnistMay 31, 2014

Latest Injury News and Notes from NFL OTAs

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    Tony Gutierrez/Associated Press

    Unfortunately, NFL injuries have no offseason, and it looks like 2014 will be no exception.

    Late-season injuries from last year continue to limit many players, and new injuries are popping up throughout media reports every day. Even worse, multiple players may already be looking toward 2015—not 2014.

    On the other hand, quite a few recoveries from prior conditions are proceeding quite well.

    With that in mind, let's take a look around the NFL at the latest updates on some key players.

Jairus Byrd, S, New Orleans Saints (Back)

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    Associated Press

    As CBS Sports' Will Brinson noted in March, the New Orleans Saints pulled off a "particularly impressive" move by inking free agent Jairus Byrd to a six-year contract.

    However, the deal hit a small speed bump this week when head coach Sean Payton announced—via's Mike Triplett—Byrd needed surgery to address a "disc issue" that "had been nagging him for the past month."

    Payton added that he expects Byrd will be ready for training camp. Training camps will start in roughly two months.

    Presumably—though precise medical details are not available—the former Buffalo Bill underwent a microdiscectomy to treat a herniated intervertebral disc. Herniated intervertebral discs place added pressure on nerve roots in the lower back, causing not only back pain but often leg pain—and sometimes weakness or numbness.

    During a microdiscectomy, a surgeon trims away the herniated portion of the disc using a minimally invasive technique but leaves the rest of the disc intact—as opposed to a full discectomy and spinal fusion.

    Microdiscectomies are often extremely effective at relieving the issue, and recoveries are generally relatively short compared to the more invasive procedures. If all goes well—and if the procedure addressed relatively minor symptoms, as seems to be the case—Byrd returning for training camp as Payton suggests is a definite possibility.

Jermichael Finley, TE, Free Agent (Neck)

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    Matt Ludtke/Associated Press

    One of the most frightening 24-hour periods of the 2013 NFL season belonged to free-agent tight end Jermichael Finley.

    After a hit to the head left Finley briefly paralyzed on the field—a condition known as cervical cord neurapraxia—the former Green Bay Packer developed a spinal cord contusion and later underwent spinal fusion surgery.

    Fast forward almost seven months.

    According to Mike Florio of Pro Football Talk, Finley's agent, Blake Baratz, stated his client "has received clearance from Dr. Joseph Maroon."

    In Finley's case, medical clearance probably implies he has no lingering neurological deficits, such as strength, sensation and coordination. Yet as Florio also notes, he will need to prove that to an NFL medical staff, as well. His rehab progression, neck stability and MRI images will also go under the microscope.

    Florio notes the tight end planned to make a visit this week to an undisclosed team.

    From the outside looking in, just how the medical conversations will go is anyone's guess. Yet in any case, it seems that over half a year following one of the likely scariest moments of his life, Finley is making incredible progress.

Sean Lee, LB, Dallas Cowboys (ACL, Meniscus)

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    Associated Press

    The entire NFL community felt a bit of disbelief when Dallas Cowboys linebacker Sean Lee—who has missed 15 games over the past two seasons due to injury—went down with a torn left ACL on Tuesday.

    This video shows Lee plant his left foot out and away from his body as he moves forward and leans to his right. The resulting imbalance of rotation and momentum caused his knee to twist inward—the exact motion the ACL attempts to prevent—overwhelming his ligament and causing the tear.'s Todd Archer also notes that Lee suffered a slight meniscal tear, an injury that frequently comes with an ACL sprain.'s Dan Hanzus writes Lee will undergo surgery in a few weeks—presumably to let the swelling resolve before operating.

    While it remains remotely possible for the oft-injured defensive standout to return during this season, average ACL recoveries range between eight to 10 months. For now, the smart money overwhelmingly says the Cowboys will need to look elsewhere at the linebacker position for the entirety of the 2014 season.

Eli Manning, QB, New York Giants (Ankle)

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    Ron Antonelli/Getty Images

    According to New York Giants writer Michael Eisen, Giants quarterback Eli Manning underwent arthroscopic ankle surgery last month. Eisen specifically called the operation a "debridement of the ankle."

    A debridement addresses issues such as excess scar tissue, bone spurs leading to pain and tightness or loose bodies causing inflammation. Recovery times depend largely on the amount of work done.

    By early May, Manning was already running—three weeks ahead of schedule, per Ralph Vacchiano of New York Daily News. Then, this week, Giants staff writer Dan Salomone reported he participated in OTAs.

    The Giants signal-caller probably still has a little ways to go in his rehab program, but he is already well on his way to a full return well before Week 1.

Von Miller, LB, Denver Broncos (ACL)

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    Associated Press

    Late-season ACL tears not only end an NFL player's season, but they can also threaten his availability for the following year. Denver Broncos superstar linebacker Von Miller suffered such a fate in 2013.'s Jeff Legwold reported Miller underwent an ACL reconstruction in January—the only ligament that tore as a result of the injury.

    At this point, Miller is well on his way to returning in time for Week 1. In fact, USA Today's Lindsay Jones tweeted this week that he is participating in individual drills at Broncos OTAs.

    That said, individual drills on a recovering ACL are one thing. Cutting, twisting and stressing his knee via contact are another. He likely still has another two months or more until he returns to full speed.

Cam Newton, QB, Carolina Panthers (Ankle)

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    Ronald Martinez/Getty Images

    Carolina Panthers quarterback Cam Newton also underwent a procedure on his ankle this offseason.

    According to The Charlotte Observer's Joseph Person, Dr. Robert Anderson "tightened ligaments in Newton's left ankle."

    More than likely, a series of sprains left Newton with loose ankle ligaments—sometimes a consequence of multiple injuries to the same area. The procedure probably involved trimming out the loose area and bringing the two resulting ends together with a slight overlap for reinforcement.

    Unlike Eli Manning, Newton's surgery directly repaired one or more ligaments, leading to the longer projected recovery time.

    Yet similar to Manning, Newton is making progress and arrived at OTAs.

    Person notes that while the former Auburn Tiger "walked out to the practice fields with a noticeable limp," Newton "threw on the sideline" during and after practice.

    Make no mistake: He has a long way to go before he is planting and cutting like the Cam of 2013.

    Yet so far, so good.

Tony Romo, QB, Dallas Cowboys (Back)

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    Associated Press

    News of Tony Romo's back problems—specifically, a herniated intervertebral disc—came on rather quickly. at the end of last season. The injury ended up costing him the start in Week 17, a game the Cowboys eventually lost—along with a playoff berth.

    Romo underwent surgery soon after the news surfaced. It is not clear whether Dallas' captain underwent a microdiscectomy—like Jairus Byrd—or a full discectomy and spinal fusion.

    Either way, it looks like the January procedure did the trick.'s Todd Archer reported last week that Romo will participate in OTAs on a "pitch count" in order to not overwork his recovering back and spine.'s Lance Cartelli followed up Tuesday with reports and photos of his return to action.

    About six months later, Romo is probably nearing or at full strength, but there is little reason to risk a setback in the first week of OTAs.

    As such, unless evidence surfaces to the contrary, the aforementioned "pitch count"—ESPN's Ed Werder previously reported a plan for Romo to take approximately one-third of snaps—likely represents nothing more than an extreme safety precaution in the still-early portion of the offseason.

Quick Hits

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    Jared Wickerham/Getty Images
    • Baltimore Ravens running back Bernard Pierce is recovering from January rotator cuff surgery—or an operation on one or more of the four muscles that control most of the complex motions of the shoulder. According to Matt Zenitz of the Carroll County Times, Pierce "may be a little bit ahead of schedule maybe," according to head coach John Harbaugh—whatever that may or may not mean.
    • Buffalo Bills beat reporter Joe Buscaglia reported this week that linebacker Mario Williams underwent hip surgery earlier in the offseason. Buscaglia later noted that Williams is participating in OTAs.
    • According to Fox Sports' Mike Garafolo, Chicago Bears wide receiver Domenik Hixon announced he tore his ACL for the third time. Pro Football Talk's Mike Wilkening noted Hixon hinted on his Facebook page that the injury might mark the end of his career.
    • Earlier this year, Detroit Lions writer Tim Twentyman reported wide receiver Calvin Johnson underwent surgery on his knee and finger in January. Twentyman noted this week that Johnson is active in OTAs.
    • Ty Dunne of the Milwaukee Journal Sentinel tweeted Thursday that Green Bay Packers cornerback Casey Hayward is participating in OTAs. He battled—and may be continuing to battle—serious and recurrent hamstring issues.
    • Houston Texans linebacker Brian Cushing did not participate in the first day of OTAs, according to Brian T. Smith of the Houston Chronicle. Cushing suffered a broken fibula and torn LCL in October. There is no reason for panic yet, but a prolonged absence from offseason activities may raise serious red flags.
    •'s Mike Wells wrote this week that Indianapolis Colts wide receiver Reggie Wayne (ACL) will not likely be participating in any meaningful offseason activities just yet. He is roughly seven months out from reconstructive surgery.
    •'s Nick Underhill noted Friday that New England Patriots lineman Vince Wilfork (Achilles) and tight end Rob Gronkowski (ACL, MCL) did not participate in the first day of Patriots OTAs. It is too early to project the significance of these developments, as both Wilfork's and Gronkowski's injuries—which occurred during the 2013 season—require extensive, prolonged rehabilitation.
    • No one said it better than Fox Sports North's Brian Hall, who observed "overcoming major surgery is of little concern" to Minnesota Vikings running back Adrian Peterson. Peterson—who is coming off his second documented groin surgery—was a full participant in Vikings OTAs.
    • Philadelphia Eagles wide receiver Jeremy Maclin—who tore his ACL last year—looked "fantastic" at OTAs to head coach Chip Kelly—via Eagles writer Chris McPherson.
    • UTSanDiego's Michael Gehlken reported this week that San Diego Chargers wide receiver Malcom Floyd, who suffered a devastating neck injury similar to Jermichael Finley's—received full medical clearance.
    • Tennessee Titans quarterback Jake Locker participated in OTAs, according to Jim Wyatt of The Tennessean. He is recovering from surgery to address a Lisfranc injury—a sprain and/or fracture of the ligaments and bones of the midfoot.
    • New Washington wide receiver DeSean Jackson "appeared to tweak" his hamstring this week, according Pro Football Talk's Mike Florio. More than likely, it will prove a minor issue. However, hamstring injuries beget hamstring injuries, so fans should keep a close eye on the speedy wideout.

    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.

    Questions about players on this list? Not on this list? Send them to Dave on Twitter: