Highlighting the Most Damaging Injuries of the NFL Offseason so Far

Dave Siebert, M.D.@DaveMSiebertFeatured ColumnistJuly 20, 2014

Highlighting the Most Damaging Injuries of the NFL Offseason so Far

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    Tony Gutierrez/Associated Press

    Offseason injury news throughout the NFL often comes in bits and pieces, based more on media reports and press conferences rather than official injury lists. As such, fans might sometimes be left wondering which injuries are troublesome and which aren't.

    In other words, a particular player's prognosis might remain a bit of a mystery for quite some time.

    Sometimes, though, it's painfully clear—literally. During the early portion of the 2014 offseason, a number of serious or season-ending injuries dotted the NFL landscape.

    With training camps opening soon, let's take a look at five of the most damaging injuries that took place this offseason, ranked from least to most concerning based on a rough composite of injury severity and potential impact if the injury on the player's respective NFL squad.

5. Jairus Byrd, S, New Orleans Saints (Back)

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    Gerald Herbert/Associated Press

    The New Orleans Saints made quite the free-agency splash this offseason by signing safety Jairus Byrd to a six-year contract. However, back surgery soon followed, somewhat dampening enthusiasm throughout the Big Easy.

    According to ESPN.com's Mike Triplett, head coach Sean Payton said Byrd underwent the procedure to address an asymptomatic disc issue:

    This is something after the doctors looked at it, and the specialists out in [Los Angeles] looked at it, [they] felt this was one scenario that would kind of take care of it rather than try to [keep managing it]...If it was during the season, you wouldn't go through the procedure. You would treat it symptomatically then.

    Payton's statement lends one to believe that Byrd's issue, presumably a bulging intervertebral disc, lies on the minor end of the severity spectrum. The surgical procedure in question, most likely a microdiscectomy, usually addresses such a problem very well.

    By removing a piece of the disc that may be bulging out of place, a surgeon can relieve pressure on the surrounding nerves. Any pain, numbness or weakness, if any existed in the first place, lets up, and the nerves recover.

    At this point, it's safe to assume Byrd—the sixth-best safety in the NFL, according to Bleacher Report's Matt Miller—will return well before meaningful preseason action.

4. Jon Beason, LB, New York Giants (Sesamoid Fracture)

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    Bill Kostroun/Associated Press

    In June, an awkward planting of the foot sent New York Giants linebacker Jon Beason—Matt Miller's 21st-ranked inside linebacker in the NFL—limping off the practice field and into the X-ray room. According to New York Daily News' Ralph Vacchiano, those X-rays revealed a sesamoid bone fracture.

    Further imaging—presumably an MRI, as X-rays do not show soft tissue detail very well—revealed a ligament tear in addition to the fracture.

    Vacchiano also mentioned Beason visited Dr. Robert Anderson, one of the premier foot and ankle specialists in the country and a true expert when it comes to sesamoid injuries, who recommended conservative treatment rather than surgery.

    The sesamoid bone plays an important biomechanical role within the foot, allowing the muscle underneath the big toe to flex with more effective strength and, therefore, help an athlete push forward off the ground with more force.

    Hopefully, conservative treatment, such as immobilization in a cast or walking boot, rest and gradual return to activity as pain tolerance allows, does the trick. If all goes well, a return to football after about three months—possibly in time for Week 1—is definitely possible.

    That said, the sesamoid bone in the foot can sometimes prove stubborn to heal, and Giants fans should keep a close eye on their defender.

3. Kiko Alonso, LB, Buffalo Bills (ACL)

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    The Buffalo Bills finished each of the last three regular seasons with a record of 6-10. Nonetheless, the team seemed ready to start making waves in the AFC East very soon.

    Rising defensive star Kiko Alonso's ACL tear from earlier this month certainly won't help that progress.

    The ACL, a crucial stabilizing ligament in the knee, often tears when the lower leg overtwists relative to the thigh. After it tears, it usually shrivels up, so to speak, within the knee and will not heal on its own, hence the need for surgery.

    According to Alonso's agent, Steve Caric, via Pro Football Talk's Josh Alper, the linebacker underwent that surgery earlier this week. Dr. James Andrews led the surgical team, a team that most likely orchestrated the replacement of Alonso's native ligament with a tissue graft.

    ACL reconstructions generally require seven or more months of rehab for an NFL athlete to return to peak condition, so Alonso returning to the field before the 2014 season comes to a close seems all but impossible.

    Matt Miller recently ranked Alonso as the sixth-best inside linebacker in the NFL, and the Bills faithful will certainly miss his presence on the field. That said, if his recovery goes as well as countless others of Dr. Andrews patients', there is no reason to expect anything less than a full recovery well before the crucial parts of the 2015 preseason get underway.

2. Sean Weatherspoon, LB, Atlanta Falcons (Achilles)

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    Kevin C. Cox/Getty Images

    Last month, Atlanta Falcons linebacker Sean Weatherspoon went down with a torn Achilles tendon—an injury on par with ACL tears or other tendon ruptures in terms of season-ending potential. Indeed, not long after the injury, the Falcons moved Weatherspoon to injured reserve, according to USA Today's Tom Pelissero.

    Why did an Achilles-tendon tear lead to such a devastating outcome?

    As the strongest tendon in the body, the Achilles also carries a large burden within the musculoskeletal system. It connects the calf to the back of the heel, transmitting the contraction of the gastrocnemius and soleus muscles to the foot, thereby pointing the toes.

    In football, the calf and Achilles allow an athlete to drive his or her toes into the ground, assisting with motions such as pushing forward or off the ground when leaping. Without an intact Achilles tendon as the connection, such motions become extremely difficult, if not impossible.

    Most of the time, an elite athlete will elect to undergo surgery to reattach the two pieces of the ruptured tendon. Surgical repair offers a lower chance of re-rupture compared to conservative rehab.

    While a the Achilles heals, it must slowly and steadily start to carry an increased workload. Placing too much demand on the tendon too early in the rehab process can lead to setbacks—sometimes serious ones.

    For Weatherspoon, who was Matt Miller's 25th-ranked 4-3 outside linebacker in the NFL, the Falcons medical and coaching staffs seem to think closing the book on his 2014 season is the safest route rather than rush him back and risk reinjury.

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

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    Perhaps the most damaging injury of the 2014 offseason—or at least the one that sent one of the biggest shockwaves throughout the NFL—belongs to Dallas Cowboys linebacker Sean Lee. Lee, the NFL's No. 8 inside linebacker according to Matt Miller, suffered a torn ACL and meniscus in May.

    Lee's injury history is extensive, and this most recent setback will cost him all of 2014. He underwent surgery in June, and the Cowboys placed him on injured reserve in July.

    Like Kiko Alonso, Lee now faces a long road of rehabilitation. The coming months will involve slowly introducing range of motion, strength training and agility exercises until his knee can support the movements necessary to play in the NFL.

    Dr. Dave Siebert is a second-year resident physician at the University of Washington who plans to pursue fellowship training in Primary Care (non-operative) Sports Medicine.