By Stephania Bell, PT, MS, OCS, CSCS
Orthopedic Clinical Specialist
Certified Strength and Conditioning Specialist
RotoWire Injury Expert
RotoWire Injury Page
Trent Green's head ricocheting off the field at Arrowhead, followed by his body going limp for several minutes, was a scary sight. All imaging tests were reported as negative, meaning there was no evidence of a skull fracture, vertebral fracture or major brain bleeding, but that does not diminish the seriousness of the trauma to the brain. The brain has some ability to move within the skull, and during a concussion, it can get slammed from front to back to front again as the head and neck are whipped back and forth, resulting in headaches, dizziness, lack of concentration, and visual and balance disturbances. There is disagreement within the medical field as to when it's appropriate for players to return after such an injury. Certainly, it depends on how long it takes all symptoms to subside, but prior concussion history also plays a role. Caution is the name of the game because returning too soon can have catastrophic consequences. Green, who thankfully has not suffered a recorded concussion previously, is reportedly out for at least the next two games (three weeks as a result of the bye in Week 3), but this projection is just preliminary. His status will be evaluated based on what his symptoms are over the next few days and weeks. Don't be surprised if his return date gets extended.
Panthers' middle linebacker Dan Morgan is also out with a concussion. His was not as dramatic as Green's, but potentially equally serious as this is at least his fourth official concussion that he has sustained in the last three years. As we discussed in the Unlucky Seven, concussions have a cumulative effect. Morgan is approaching Steve Young and Wayne Chrebet numbers - and not the kind that send you to the Hall of Fame. Morgan will have to seriously evaluate how much longer he is willing to risk his future to continue in this line of work.
Cadillac Williams is dealing with back spasms in Tampa Bay. He attempted to return to practice only to have to sit out again on Thursday because of a flare-up. The problem with this injury tag is that it is non-specific. Usually we hear about an ACL tear or a high-ankle sprain where the injury name labels both the anatomy and the injury. In this instance what we get are the symptoms - muscle spasms. Muscle spasms can be caused by a variety of factors and are a reflection of the muscles tightening up in a protective manner to limit mobility. Williams' MRI was reported to be negative, as is often the case with low back problems, particularly in younger patients. It can be nearly impossible to identify the culprit with any certainty. An inflamed disc? Maybe a stiff joint in the spine? Perhaps a strain? All could result in protective muscle spasms. It doesn't require any collision contact to trigger them. The problem is that once the back locks up, there is no such thing as simply pushing through the pain. The spasms essentially render the extremities ineffective. Not good if you're a running back. The fact that he was still having spasms on Thursday makes me suspicious about his ability to be 100 percent by Sunday.
Mike Bell gets the Tough Guy of the Week award for returning to the game after sustaining a finger fracture (yes, it was broken). In fact, he didn't miss a snap since he was playing in a rotation. Luckily, portions of fingers are small enough that they can be taped up relatively easily using a "buddy" system where the broken finger is taped to an adjacent digit to keep it from moving. Although Bell is in a splint during the week, he plans to go to tape only for the game which is less bulky and will allow him more mobility. He has already demonstrated that he can handle the ball despite the finger, since he scored a touchdown after sustaining his injury last week.
Other News of Note:
Despite estimating himself at 75 percent last week, Clinton Portis (shoulder subluxation) managed to play for 10 carries, including a touchdown. He was wearing a harness for protection on his shoulder (you could see the black brace that extended midway down his left arm) but appeared to handle his workload without any adverse effects. Keep in mind that though Portis got bumped around, as is normal for a running back, he really did not take much punishment to the shoulder. He did not get pile driven into the ground, nor did he have to make a key block or tackle with the left arm. This is good in that the lack of contact enabled his shoulder to continue to improve for one more week without a serious setback. It's not so good in that we didn't see how well his shoulder would hold up to those types of challenges. The more time Portis plays this week, the more likely he is to encounter that kind of contact. Consequently, I expect his work load to be controlled. If he is able to get through another couple of weeks with minimal challenge, then we will know that his shoulder has a better likelihood of being fully healed.
Travis Henry has another foot injury. Once upon a time it was his arch, last year he dealt with a mild turf toe, this year he has another case of turf toe (pain where the big toe meets the ball of the foot as a result of injuring the fibrous tissue or capsule around the joint) and was seen sporting a walking boot. The boot is on to keep Henry from extending that painful toe. The boot has a rocker bottom, which doesn't allow the body weight to come directly over the forefoot or toes to push off. Whenever an athlete has a condition that is aggravated specifically by pushing off (such as Achilles tendinitis or turf toe), the boot can help to calm down the problem by relieving the foot of those duties. Unfortunately, that he is in a boot suggests that this condition is a little more problematic than a one or two day affair.
Brian Westbrook left Thursday's practice and sat out Friday with knee inflammation. There haven't been a lot of details reported, but knee inflammation is common for running backs who are constantly putting stress on the joint. Unless the swelling were severe enough to require draining (of which there's no indication), it sounds like the Eagles are just making sure it subsides in time for Sunday's game. Westbrook is listed as probable, and at this point, we expect him to play without major restrictions.
Steve Smith is still not practicing. The key word associated with hamstring injuries: lingering - which is exactly what his two seem to be doing. The waiting continues.
Article first appeared 9/15/06