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Anatomy Of An Injury - Week 8

This is a weekly column that will provide you with in-depth analysis of key injuries for the week and their resultant implications on fantasy football. This information comes straight from my perspective as a Physical Therapist and Athletic Trainer for ten years. Over this time, I have seen almost all the key injuries that can happen in this violent sport on the college level and how to treat them. Hopefully, this gives you a little more insight on certain injuries and what to expect. The NFL is a quarterback driven league and the majority of injuries are quarterbacks this week. We have a couple of new injuries and a couple of old ones to recap. A few of these injuries have huge dynasty league implications.

Before I get started with the usually player recaps, I wanted to touch upon the staph infection issue that has been running rampant lately. Staph infections are bacteria that live harmlessly on many skin surfaces especially around the nose, mouth or genitals. But, when the skin is punctured or broken for any reason, staph bacteria can enter the wound and cause an infection. This is very hard to prevent, but can cause significant complications with surgery or other illnesses such as Kellen Winslow. You see it a great deal around hospitals because of the variety of germs that are brought into the hospital. I would assume that it would not be as prevalent around the NFL community because of the wealth, but obviously I was mistaken. This can reap havoc on these injuries and cause multiple games missed as with Kellen Winslow and half the Browns team, Tom Brady, and Peyton Manning.

Player: Tony Romo
Injury: Broken Pinkie
Healing Time: 4-6 Weeks
Impact On The Field: With Romo out this week, the likelihood of him playing sooner than the 4-6 week projection is minimal. The medical staff and Jerry Jones went back and forth all week with a variety of splints to protect his finger, but in the end, decided against letting him play. Because the pinkie is the finger in question and plays such a little role in throwing, it is the only reason they were even discussing letting him play. In the end, as I reported last week, the risk of his pinkie hitting someone else’s helmet and displacing the fracture was too great. If that were to occur, he would require surgery to reset the fracture and possibly miss the rest of the season. However, as each day passes and the finger heals a little more, the greater the chance he plays. Romo is chomping at the bit to play with his new toys and I would expect him to push hard to play this week. Coming off the Brad Johnson experiment, the Cowboy brass may look to push the envelope and let him play this week. Terrell Owens may be in Jason Garret’s office as you read this, begging to let Romo play.

Player: Reggie Bush
Injury: Torn Meniscus
Healing Time: 3-6 Weeks If The Injury Is Not Repaired
Impact On The Field: Reggie Bush has been dealing with periodic swelling on and off for the last year and a half. The swelling was from a small tear in his meniscus. The menisci are shock absorbing pads that are located both on the inside and outside of the knee. They enhance the congruity of the knee to allow for a more stable joint.

Because they are flexible and move with the joint, they are susceptible to tearing. A small tear does not need to be fixed if it causes nothing more than periodic swelling. Surgery is indicated when it causes pain with weight-bearing or prevents motion such as bending or straightening the knee.

In Reggie’s case, somewhere along the cuts and moves he made during his punt return, he tore his meniscus further. This is where the complexity in the injury lies. If the tear can be repaired, they stitch it up and doing this causes a limitation in motion and weight-bearing for 6 weeks. This prognosis would cost Reggie the rest of the season because of the length of time to rehab. This is why Osi Umenyora was placed on season-ending injury reserve because his injury was repaired. If the tear is removed, you will have the quicker healing time-frame as listed above.

Seeing Dr. Andrews means that they are considering his long-term future as opposed to the short-term. If the tear is removed, you lose some of the shock absorbing capability and can set the knee up for long-term wear and tear. In all cases, the physician likes to save the tissue and would repair it. Different cases call for different actions though. Activity level and age are reasons why doctors repair as opposed to remove the meniscus. If enough of the tissue remains intact, they remove the tear and he could be out only a couple of weeks.

As far as fantasy implications, there is no way to replace Reggie Bush. Pierre Thomas, Deuce McAllister, Mike Karney all combined provide nowhere near what Bush provides. The Saints may look to split the carries and become more of a straight-ahead and grind at you rushing attacks. Because they don’t have Bush as a decoy or a threat in the passing game, it should slow the others down.

Addendum: Reggie Bush’s surgery was a menisectomy. This is where they remove the torn tissue. He will be back in 2-4 weeks. The surgery was not a repair and is in no-risk of missing the season.

Player: Carson Palmer
Injury: Unknown (My Opinion, Questionable Tommy John Injury)
Healing Time: Week To Week; Possibly A Year
Impact On The Field: As I mentioned last week, Carson’s elbow injury has been very secretive. Again, there are only a few things that cause swelling in the elbow, bursitis or something that requires surgical intervention. It was reported last week that he saw the Mets team doctor who provided information that was unexpected. The fear is that he has torn his Ulnar Collateral Ligament, otherwise known as the “Tommy John”. There is a good chance he requires surgical intervention and his status for the beginning of next year could be in doubt if they further delay the procedure.

Player: Tom Brady
Injury: ACL Reconstruction; 2nd Surgery To Clean Out Infection
Healing Time: 10 Months
Impact On The Field: Oh boy. Could this be the beginning of the end? First, major reconstructive surgery on a 31-year-old was required. Second, a staph infection needed to be cleaned out. This is not a good scenario. Peyton Manning required a second surgery to clean out an infection this past off-season. That slowed him down for an extra 4-6 weeks. Brady had a major surgery to stabilize his knee and this certainly, will slow down his progress on rehab. Brady was never much of a scrambler, but his footwork such a big part of his ability to avoid the rush and stand in the packet to deliver the ball. The impact of these surgeries will limit his ability early-on to maneuver within the pocket adeptly.

The medical side of me says that he will not be the same for a while next season. But, this is Tom Brady we are talking about. I can’t see how anyone can predict how this injury will affect his innate ability to see the field and deliver the ball so quickly. Only time will tell with this injury. Chris Mortensen reported on Sunday that there is a chance that the infection disrupted the hardware that was placed in the knee and that it may need to be removed. If so, this is the worst case scenario.

Player: Jeremy Shockey
Injury: Sports Hernia
Healing Time: Already Back, But Should Be Limited For Another Month
Impact On The Field: This guy can’t stay healthy. He injured his groin back in training camp and because the injury is so hard to diagnose, was misdiagnosed as a groin strain. When in reality, it was a sports hernia that was causing his pain. A groin strain and a sports hernia are virtually in the same spot, which makes it very difficult to accurately assess. I have had surgeons tell me that MRI’s and other imaging do not correctly diagnose the injury. So, rehab is very conservative using your typical stretching, strengthening and icing techniques to allow it to heal. If it does not heal, then you need to investigate further.

Shockey came out this weekend and verbally ripped the organization. I can understand his frustration, but because of the nature of the injury, there is no way to treat it any differently. He will heal and in time will be fine, but will experience nagging pain along the way. Being from the New York area and knowing about his lack of working-out with his team, I may be a bit skeptical and say, “This is why you condition with your strength and conditioning coach and not with the University of Miami alumni.”

Player: Brodie Croyle
Injury: Torn MCL
Healing Time: Season-Ending
Impact On The Field: The skill position players in KC will rejoice. Although, not much better, Damon Huard does look for Dwayne Bowe and Tony Gonzalez quite a bit more than aforementioned quarterback. Brodie Croyle’s torn MCL must have been of the Grade 3 variety. This means that it was a complete tear. They lock the knee in a brace for a period of time and allow the ligament to scar over and heal. Because of the severity of the tear, this will prevent him from rejoining the team this season. There are no long-term implications and he will be back throwing inaccurate passes next season.

Player: Willie Parker
Injury: MCL Sprain
Healing Time: 2 Weeks From Now
Impact On The Field: Willie Parker re-injured his knee in practice last week. He re-stretched it and that caused extra swelling and pain. The MCL connects the inside of the lower leg to the inside of the upper leg. He should be week to week assuming he does not aggravate it this week. Mewelde Moore has been very solid in his place, but I am a bit skeptical because he has gone up a bit of a soft schedule in Cincy and a banged up Jax defense. Willie Parker should be back this week splitting carries with Moore.

Player: Jay Cutler
Injury: Hand/Finger Sprain
Healing Time: Day To Day
Impact On The Field: The x-rays came back negative last night on Jay’s injury. He threw a few wobbly balls and looked like he was in pain. This injury should be sore for a few days, but with Denver on bye, this should be a non-factor. He will be back to his gun-slinging ways in 2 weeks.