It's a surprising fact that injuries don't go up significantly from week to week in the NFL. Fatigue is a factor and the raw numbers go up, but with a week between games and year-round conditioning, all the hullaballoo around the 18-game schedule isn't about playing longer, but merely playing more games. Talk that the NFL will insert more bye weeks doesn't work if the goal is to reduce injuries. Doing that requires a lot of hard work, a committment to doing the things that we know can reduce the incidence and severity of injuries, and a little luck.
We're never going to eliminate injuries in the NFL and I don't think we'd want to. The idea of "next man up" or the underdog, ala Matt Cassell or Jeff Hostetler, taking his shot and running with it is one of the great narratives in sport. What the goal should be is to increase availability. That's possible, if the owners will commit to it ... but they haven't. Most teams spend less on research than Dez Bryant dropped on dinner.
I'll not only be back on Sunday morning with the Med Check, but I'm filling in for a vacationing Jay Clemons on this week's Fantasy Revelations, so my availability is way up.
"Only a bruise" sounds like a great thing for Ray Rice. It's not. The key here is where the bruise is. If it's inside the knee, just ask a Mets fan how serious that can be. Intra-articular bruising is often an indicator that the joint is failing, leading to problems down the line like microfracture and even replacement. (By "down the line", I mean years, likely after retirement.) It appears that what Rice has is the much simpler external bruise. It hurts, it can linger, but it's as simple as any other bruise. Time and treatment will help it. What bothers me here is that it didn't have to happen. Rice, like many players, does not wear knee pads. Many players, especially defensive backs and receivers, will accept the risk of precisely this kind of injury for a little additional speed. There's not much study on how much, if any, gain there is in terms of speed. It's easily traced back to the popularity of Deion Sanders. Funny thing is Rice didn't always do this. At Rutgers, he wore big old-school knee and thigh pads and it didn't seem to slow him down. It appears that Rice has transitioned out of them, as there are pictures available that show him wearing thigh pads in some pictures and not in others. Perhaps the scare will be enough for Rice to consider putting them back on. Rice should be able to play this week, though he did not practice on Wednesday. At worst, he'll miss a week as a precaution.
Ryan Mathews made it through an extensive workout on Monday, but his practice is likely to be light this week. The ankle sprain remains a problem, but not one that looks to keep him out of Week 4. It's more a matter of making sure that he doesn't re-injure it in a way that causes him to lose more time. The Chargers got adequate production out of Mike Tolbert, but as I told you last week, the Chargers didn't trust him to be the full-on replacement. They used Darren Sproles and even went to an empty backfield more than usual. That pattern will continue even with Mathews back in the mix. Expect something close to a full-thirds split between the three, though if you factor in the empty back setup, it's more like quarters. Mathews will be ramped up over the next few weeks until he's back to the feature role, though it's still unclear how much the Chargers really want to have him handle.
A strain is, by definition, a tearing of muscle or tendon. I realize that what most people mean by "tear" is actually "rupture," which is a complete tearing of the muscle. I also realize that no matter how many times I say this, people are still going to confuse the terms. (Thanks to my pal Bernie Miklasz, who tried to explain this to his audience in St. Louis this week.) Steven Jackson has a Grade I strain of his groin, which is the least severe strain. That doesn't mean it's not serious and it certainly doesn't mean that it's not painful. It just means that it could have been a lot worse and the Rams will have to make sure that he doesn't make it worse by coming back too soon. Groin strains tend to be a "tolerance" problem -- players can do as much activity as they tolerate without pain and ramp them up slowly. It's just not an area that takes to manual testing very well. Ice is also an issue. Jackson will likely not practice until later in the week and will be, at best, a GTD with a reduced workload. As long as there's no setback over the next 10 days, Jackson should be back to normal.
The Lions are still hoping -- or at least putting out there -- that Jahvid Best will be available this weekend, but turf toe is a tough one to come back from. There's really no way to deal with the injury aside from pain management. There's some splinting, some special shoes, even tape jobs in the back of some Athletic Training manuals that purport to help, but the fact is that turf toe just hurts. Some players can take it, some can play with painkillers, and some just can't. That's not an indictment on any of them, but an acknowledgement that pain and recovery is very individualized. Best's style of running doesn't seem like one that would deal well with any sort of limitations and the natural adjustment, running straight ahead, doesn't suit him well. Best will be watched closely, but at most, he'll get a share of the carries. Even then, I'm down on him for the week.
Andre Johnson came into last Sunday's game with an ankle sprain and left it about the same. He did have a recurrence during the game, but it wasn't serious enough to keep him out long. The trainers quickly got Johnson back to a place where he could play by using a taping technique called "spatting." It's basically taping over the cleats, something that some trainers do over taping or bracing the ankles as a matter of preference. Most will do the technique as a quick preventative in this kind of situation. It's simply quicker to leave the shoe on and can keep some of the swelling down as well. Johnson's ankle appears to be susceptible to recurrence. He's a must start and will play, but this one's a bit worrying given his history and style of play.
Speaking of spatting, we also saw that this week with Pierre Thomas. Thomas was injured on an awkward tackle and looked to be in a good deal of pain, but the quick work of the medical staff got him back into a close game. It's that kind of work that often goes unnoticed by even the savviest of fans and announcers. Thomas likely wouldn't have gone back in had it not been so close or if the Saints had a better option, which tips their hand a bit. A lot of people are making a run for Chris Ivory, but look at how the Saints adjusted for the loss of Reggie Bush by going to Lance Moore. (I'd expected it to be Devery Henderson that got those looks, but in hindsight, Moore is closer to the Bush type and locks in to that role more easily.) Thomas won't practice much, but at this stage, I'd expect him to play. The Saints WRs should be better plays anyway.
We'll never know if Jason Witten's knee injury has any connection to his previous concussion, but is it that much of a reach to think that reaction time might contribute to injuries? As with Bush's injury being a cascade from previous injuries, this is one possibility that screams for more research. Too bad the NFL doesn't do that kind of thing. There's no rush to get him on the practice field this week given the bye, but this is going to be a problem for Witten in the next couple weeks. A sprained MCL, even a low grade sprain, is going to be tested for a TE. He'll need to cut and is likely to take hits. There's still no evidence that NFL players get targeted, but any weaker spot is going to be problematic. I'd imagine that the Cowboys will take it very easy on him and that he'll come back with a limited playbook in Week 5.
You can be glass half full or glass half empty with Steve Breaston. If you're a pessimist, Breaston's torn meniscus will keep him out for at least four weeks, which is a bit on the long side and makes me wonder why the Cardinals gave the guidance on the long side of the normal two to four week range. On the glass half full side, it's pretty amazing that a scope can allow Breaston to come back at all. Remember that horrible knee surgery that limited Joe Namath his entire career? It was this. Namath hobbles for years; Breaston will be back at practice in two weeks. Just amazing.
"Stinger" doesn't sound like much. It's an injury like "turf toe" where the description doesn't give any indication of the real severity or the very real pain. A stinger is actually a nerve injury where the nerve that comes out of the spine and down the arm is stretched. The head goes one way, the arm/shoulder goes the other, and there's a pain that shoots down the arm, usually with some transient weakness. There's enough slack in the nerve that it's seldom a tear, which would be a devastating injury, but the cumulative effect can be much the same. For a QB, it's the transient weakness that's the proximal issue, but it's really getting hit at all that's the problem. The Vikings are going to have to keep the heavy rushers off Favre, both to prevent more stingers and to keep that ankle healthy. I'm not sure if having the bye week this early isn't going to work against Favre. If you're unsure how serious this problem can be, Peyton Manning had surgery this offseason due to a similar problem and there have been some rumors that he's still having some issues.
Drew Brees has a mild knee sprain after a hit towards the end of Sunday's game. I can't figure out whether he was wearing a brace or not. ... Matthew Stafford isn't throwing yet, but that's not the setback some are making it out to be. He's still got a couple weeks left. ... Jake Delhomme could be back at practice later this week. Whether that means he could start on Sunday remains to be seen. ... Knowshon Moreno is out for this week and likely several more. The trade for Laurence Maroney was, I'm told, a Josh McDaniel move to get "a guy he can trust." That's harsh if Moreno's in the doghouse because of an injury. ... Fred Taylor's toe is still a problem, so look to BenJarvus Green-Ellis this week against the Fins. ... The Cards are easing Chris Wells in, so don't panic over practice reports with him this week. ... Clinton Portis' wrist is why Mike Shanahan benched Portis, but Portis says he's fine. Lots of confusion at RB, which is Job 1 for Shanahan, ... Joseph Addai's knee is no real issue. He'll get his full share of the split with Donald Brown in Week 4, though last week's ineffective running didn't help his case for keeping it. ... Cadillac Williams will try to heal up over the bye week, but it sounds like the Bucs might be transitioning him out of the feature role given the extra time instead. ... Mario Manningham suffered a concussion during Week 3, which puts his Week 4 in question. ... The Jets will be without Calvin Pace and Darrelle Revis for at least one more week. ... I wish I never had to use the term "pistol whipping" in one of these reports, but luckily, Kasim Osgood received only minor injuries.