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Injury Analysis: 2007 NFL Injury Report-Week 5

Will Carroll

Will Carroll writes about fantasy sports for RotoWire.

RotoWire Injury Report

Will Carroll
RotoWire Injury Expert

What you're seeing in the NFL is not sports medicine. It's not risk management. It's not common sense. Instead, what you're seeing is evidence. Someday, there will be a player who dies on the field or shortly after, and the management of his head injury is going to be investigated closely. They'll find that despite years of discussing head trauma, of equipment fixes, policies and conferences, that in the end, the NFL sent it's players back onto the field despite clear knowledge that players were concussed and in deficit. If you watched games on Sunday, you saw brutal hits and players coming up wobbling. Jon Kitna sat glossy-eyed on the bench, only to come back later and take more hits, perhaps because he was too groggy to slide. The paternalistic NFL is beginning to look like one of those Erin Brockovich-style corporations, the ones that should have known better and didn't just look away, they tried to convince themselves that the problem wasn't that bad anyway. If it's going to take a death, I hope it happens soon. I know it sounds callous, and I'll mourn with the athlete who falls, but he'll be a martyr who might just be the only thing that can change the criminal manner in which the NFL is handling concussions. Rant over, let's get to the injuries:

I've ranted about Kitna already, but the fact is that his "miracle" is crap. He had a concussion which does not always have immediate or consistent symptoms. Don't take my word for it - the experts in the field agree. A loss of consciousness and/or an altered state post-concussion should be accompanied by a restriction from activity. I was able to get my hands on the NFL's concussion statement in which Roger Goodell himself said in August that "Because of the unique and complex nature of the brain, our goal is to continue to have concussions managed conservatively by outstanding medical personnel in a way that clearly emphasizes player safety over competitive concerns." That could be interpreted many ways, but later in the same policy, it says this: "If an NFL player sustains a loss of consciousness, as determined by the team medical staff, he should not return to the same game or practice." So either the Lions ignored this policy or determined that Kitna did not lose consciousness, something that anyone watching TV could have seen. I'm belaboring this point, but I'll offer one more suggestion here -- make players wear their mouthguards. Jason Campbell had his custom mouthguard tucked inside his facemask all night for the Skins, much like Keith Richards tucks his cigarette up near the tuning keys of his guitar. As for Kitna, we'll see if the "touch of God" has him ready for next week, or if he experiences any post-concussive symptoms.

Jaws and Tony talked a lot about Donovan McNabb and his knee last night, but I think they only made one mistake in the discussion. At one point in the third quarter, McNabb scrambled out to his left, running out of bounds and notably limping as he stopped. Jaws quickly noted the limp, but was it that clear? Yes, the symptom could accurately be described as a limp, but the true term is compensation. As with many ACL or patellar tendon problems, McNabb experiences the most problems with high tension activity. What are high tension activities? Quick starts and quick stops. At the point where McNabb visibly showed a limp, he was trying to stop, much in the same way that he was when he initially injured the knee. Add in a bulky brace with anterior stops, and it's no wonder that we're seeing McNabb's gait change. I'm more worried about that change leading to a cascaded strain of his quad or hamstring than I am a latent problem with his post-surgical knee.

It could have been a lot worse for Andre Johnson and the Texans. After two games of putting up big numbers, he left the game and headed for an MRI. That image showed a mild (Grade I+) sprain of his posterior collateral ligament (PCL), though what we don't know is exactly how the injury occurred. Video of the play obscures the mechanism, though it looks like a rotary force rather than a hyperflexion (knee bent too much, as in heel to butt). He'll miss a week, maybe two, but what we'll have to watch for is whether there's any problem with cutting. A rotary force injury could have longer-term implications for that ability, one that's certainly a big part of Johnson's game.

Steve McNair didn't play on Sunday after he tested things out before the game, leaving the QB spot to Kyle Boller. McNair's groin has reportedly made some progress, but the Ravens haven't decided whether or not they want him back out there yet. The team not only has confidence in Boller, they're taking a longer-term view with McNair, knowing his injury history and need for mobility. With Jonathon Ogden out, the hits Boller took last week are going to inform their decision on whether or not to use McNair against an improving Cardinals defense. "Questionable" is a very proper term for McNair heading into this week's practices.

For all the worry everyone had about Eli Manning, I could have helped you avoid all the Maalox moments. My report here last week was right on. It's a good lesson to all of us to focus on results, not semantics. Manning didn't appear to have any problems last week, but he is at increased risk of re-injury with that shoulder for the remainder of the season. Add in a minor ankle sprain to his favorite target, Plaxico Burress, and you have what could be a sell-high scenario if you have one of those "it makes toast" type of guys in your league.

Maurice Jones-Drew had X-rays after Sunday's game, one in which he only gained 31 yards on 11 carries and added only one reception. Why the images? No one seems to know, and the Jags are being CIA-level secret. The x-ray tells us that they're wondering more about bone than muscle, and no known follow-up indicates that it's likely not a ligament. That it was taken after the game makes me think that something swelled up, perhaps a finger or toe, though there was no indication of that type of injury happening. My best sources are stumped on this one as well, so we'll have to wait for practice reports before learning what type of injury is attached to Jones-Drew, though I would not be surprised a bit if he's not on the report.

Frank Gore had a great performance on Sunday given what he was dealing with off the field, and while I'm no Niners fan, I'm becoming more and more of a Frank Gore fan. Yes, he's an injury risk, but he's someone that's easy to root for as well. There are reports out that Gore suffered a muscle strain during the game, but sources tell me it was cramping. One of the problems Gore was having had to do with the turf, but not what you'd expect. Gore was complaining of "slippage," as if his cleats weren't catching on the fake grass. That made his muscles work harder and got his legs into some non-standard positions, which could have been a contributor to the cramping. It shouldn't be a problem going forward. The Niners are also keeping an eye on Darrell Jackson. The new WR had some mild back spasms, and we'll need to watch the practice reports to see if they were transient.

There's some question heading into this week's practice on how much progress Chad Pennington made in getting back into the game. Given that this is a high ankle sprain, it shouldn't surprise people to hear that the answer is "not much." Sources tell me that Pennington has a reduction in swelling, but that the ankle is still painful and that he's still having problems with weight bearing. How does that jibe with the fact that he was active last week? There's a big difference between being able to play and being able to play effectively. Pennington was nothing more than an emergency QB last week and would have been even more hobbled that he was in Week 1, but with the proper bracing, he could have played without significant chance of exacerbating the injury. We'll see if Pennington gets into practice more this week, but early indications are that Kellen Clemens will get another start this week, against the Dolphins.

The Jets also got bad news on Justin Miller, their kick returner. They don't have a full report yet on how bad the damage to the knee is, but the Newark Star-Ledger says it's "as bad as it gets." That could mean an ACL or perhaps a multi-structure injury that would be terrible for a speed player like Miller. Hopefully we'll have more information soon, but losing Miller would be a downgrade for the Jets DST for upcoming weeks.

I heard one scout call Tarvaris Jackson a "mini McNair" late last season. If so, the only similarity I see is that they both have groin injuries heading into the week. Jackson was terrible before getting injured and with Kelly Holcomb available, and this might be the time to see whether Holcomb's better suited to win with this team than Jackson. If you combine performance with projection and assume that the NFC North remains winnable due to its overall mediocrity (and yes, I still say the Lions are the best of the division), then we'll test two NFL adages soon. One is that you don't lose a starting job due to injury and the other is that a head coach should always avoid a QB controversy. Jackson's scheduled to practice this week, so watch to see if he's limited and who's getting most of the first team snaps.

The Colts got the win, but their LB corps was clearly downgraded by injuries. That left Bob Sanders up in the box, often spying (legally!) on Vince Young. Next week against the Texans, the Colts should get both Freddy Keiaho and Rob Morris back. The Colts showed that the system is still the thing in the Dungy version of the Cover-2, with Sanders and Tyjuan Hagler getting the funneled weak-side tackles that the defense pushes. The bigger concern is what many are perceiving as a change in the Colts rush. We don't have hurry numbers yet, but one scout says that he's seeing Dwight Freeney taking another step back, though accounting for him is altering the offensive schemes.

It's one thing to see a player get carted off the field, but quite another to have them back on the sidelines later in the game trying to talk their way back onto the field. That's what happened with James Harrison. The Steelers staff smartly kept him out of the game, knowing that his initial symptoms could "rebound", in the words of one spinal surgeon I spoke to about this, but who did not treat Harrison. X-rays were negative and assuming that Harrison shows no deficits heading into practice this week, he should be fine to play and be at no real increased risk for re-injury. If anything, it shows just how fine the line is between this type of situation and the one Kevin Everett is in.

So how did I miss the call on Josh McCown last week? Sources tell me that it was confidence, not injury, that pushed McCown back into the starter role for the Raiders. Simply put, despite a sore foot and broken finger, the Raiders coaching staff felt that McCown gave them a better chance to win than Daunte Culpepper did. Absent McCown being knocked off the field, it appears that Culpepper's chance to put up meaningful fantasy totals is small. McCown is expected to start again in Week 3 and beyond, at least until JaMarcus Russell learns the playbook. Looking at the Raiders schedule, there's no natural place to put Russell in other than this week's easy matchup against Cleveland, but it's obviously too soon.

Bumps and Bruises: Tom Jackson was the only one of ESPN's eight experts to pick the Redskins on Monday. That man knows his stuff ... Brian Dawkins is a hitting machine, so when he laid on the grass for a bit after a hit, I thought "concussion." Instead, it was a simple stinger, which hurts, but isn't serious in isolation ... Deuce McAllister left Sunday's game with a swollen eye. The official line is that it was caused by a helmet, but sources tell me it was a finger poke, one the Saints feel was intentional ... Marc Bulger is reporting he has sore ribs after taking six sacks. Yes, he misses Orlando Pace already ... Looking for a possible waiver wire pickup? Kevin Jones (foot) looks ready to play in very limited action next week, and Tatum Bell has looked awful ... Someone check on Danni Boatwright. The Chiefs are even worse than I expected.

[Carroll is the author of several books, including Juice: The Real Story of Baseballís Drug Problems and Saving the Pitcher, writes the "Under the Knife" column for Baseball Prospectus and comes to us after serving as the injury expert for the short-lived The Fantasy Show on ESPN last season.]

Article first appeared 9/18/07