This article is part of our Injury Analysis series.
Condition Critical
By Stephania Bell, PT, MS, OCS, CSCS
Orthopedic Clinical Specialist
Certified Strength and Conditioning Specialist
RotoWire Injury Expert
RotoWire Injury Page
Painful Play
Greg Jones tore his left ACL (anterior cruciate ligament) when his lower leg collided with a Tampa Bay helmet while his foot was planted. The result was a rapid shear of the femur (thigh) on the tibia (leg) resulting in a torn ACL. It was evident when watching the replay that Jones had suffered a serious injury as his lower leg went completely floppy while he fell to the ground. It is less common to see the ACL torn this way, as it is often a non-contact deceleration/pivot type of injury. However, when the contact is head-on like that, either of the cruciate (meaning cross-shaped) ligaments of the knee is vulnerable. Jones has been through the ACL rehab before with his right knee while at Florida State so he is well prepared for what lies ahead. If Jones is trying to find the silver lining in all of this, one benefit of the injury happening so early is that he should be ready for action this time next year.
Quad Squad
Ahman Green is gradually returning from his ruptured right quadriceps tendon. The good news is that he has fared well during his limited preseason outings. Bear in mind however that we haven't seen much in the way of power or explosiveness. While some of that can blamed on Green's offensive line, one of the concerns after an injury such as this is whether the player will return with power. The quadriceps muscle (also called the quad and so named because it is comprised of four separate muscles) is the large muscle on the front of the thigh, the one that is largely responsible for speed and explosiveness when running. After a tendon rupture, the leg has to be immobilized for a period of time, and it tends to get quite stiff. During rehabilitation, the stiffness decreases as the leg is put through increasingly vigorous workouts. Due to the nature of the healing process though, strength has to be increased in a very gradual manner so that the tendon is progressively exposed to further stress. As a result, it may take some time to see Green rise to breakaway speed or even to play full games. Watch his performance over the first few weeks for clues.
Sinorice Moss has been noticeably absent from the Giants practices and preseason play with a quad strain. His attempts to return have resulted in pain. No one wants to see Moss's strain turn into a chronic problem throughout the season, or a rupture like Green suffered, so the Giants are being cautious. This injury may result in very limited play for Moss during the early part of the season.
The PUP Tent
A few stars of recent years have found themselves starting the season on the PUP list - not quite IR, at least not yet, but it doesn't sound optimistic.
To no one's surprise, Curtis Martin is on this list. Nothing has really changed regarding his knee situation. It remains to be seen whether he will be able to return to play at all this year.
Priest Holmes is still recovering from the head and neck trauma that he sustained last year after a helmet-to-helmet contact. Holmes had expressed his intent to return but has not yet been cleared for even non-contact practice. His was one of the most serious injuries from last year and is an example of why helmet-to-helmet collisions are so dangerous. The helmet protects the skull, and more importantly, the brain inside. The force of the helmet-to-helmet collision can rattle the brain (concussion) and compress or shear the neck. The body's nervous system is like a sophisticated computer network that drives everything we do. Think of the brain as the big server and the spinal cord as the cable "nerve" network that transports all of the data to the smaller nerves that branch out to the limbs. The uppermost portion of the spinal cord contains more nerves so an injury there causes potentially more damage. If the spinal cord suffers enough damage, paralysis can result (Remember the Detroit Lions' Mike Utley in '91?). Holmes reportedly sustained a bruise to the cord, which means the nerves were traumatized but theoretically he could return to full function. Two critical points should be made: The nerve heals very slowly, and, it is essential that the nerve tissue is not re-injured while healing. Consequently, medical personnel are limiting Holmes, potentially forever, with long-term safety in mind.
Other News of Note:
David Givens is still nursing a sore hamstring (What wideout isn't?) but is expected back for the season opener. The only concern would be whether he can be really up to full speed within a relatively short time frame.
Darrell Jackson is reportedly doing straight ahead running on the treadmill. Clearly, on the treadmill one can only run straight ahead - but the treadmill also provides an even surface (no divots like a grass field might have) and allows the pace to be very controlled. As we discussed early in the preseason, Jackson has had several arthroscopic surgeries on his knee and has had issues with persistent swelling and aggravation. Although it is a good sign that he is doing impact activities, he is still quite removed from wide receiver activities. Again, speed work, agility and cutting maneuvers are far more stressful on the knee - but are a must for playing his position effectively. His current activity would suggest that he appears to be a few weeks away from returning, but the Seahawks maintain that they hope to have him for September 10th. Keep in mind that they have pushed back his return date multiple times already.
The mystery around Adam Vinatieri's ankle injury has been solved. The Indianapolis Star reported that Vinatieri did indeed suffer a sprain (ligament injury) to his left, or plant, foot. However, as is common with these types of injuries, one of the bones to which the ligament attaches sustained a small chip as a result. The main point of all this is that the bone chip in and of itself is not the big deal here. The ligament injury is the primary problem for Vinatieri in terms of limiting his ankle. The injured ligament (the calcaneocuboid ligament) attaches the large bone at the base of the ankle (the calcaneus which is the one that forms the heel) to a bone of the mid-foot (the cuboid). The fact that the force of the ligament sprain was enough to create a small chip tells us that the ligament injury was significant - hence all the time off for Vinatieri recently. Joint stability is important because if Vinatieri's plant leg is not solid, it will ultimately weaken the drive through his kicking leg. Moderate sprains usually take 4-6 weeks to recover but the ankle can be reinforced to some degree with taping or bracing. The Colts say that he is targeted to return for the season opener but until we see him perform, we won't know how fully recovered he is.
We only have to look at Mike Vanderjagt's performance this week to see what happens when a kicker is trying to come back from injury. Vanderjagt's groin injury still appears to be a problem as he missed two field goals - both with the same odd trajectory - that he normally would have made with his eyes closed. Although it has not been stated that his performance was related to his injury, you have to consider that the misses came in overtime, after he had made a field goal, an extra point, and handled a kick-off to open the second half. Even if he did not appear to be in obvious pain, the fatigue of a still recovering groin muscle could have been responsible for the misses. He does not appear ready for the start of the season.
Article first appeared 9/1/06
