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Injury Analysis: Amendola Could Have Sports Hernia

Jeff Stotts

Jeff Stotts works as a Certified Athletic Trainer (MAT, ATC, PES, CES). He won the 2011 Best Fantasy Football Article in Print from the Fantasy Sports Trade Association.

Danny Amendola
Amendola continues to limp through practice while a debate regarding the specifics of his injury persists. The receiver is dealing with a groin injury that some doctors feel is simply a groin strain while another specialist insists heís dealing with a sports hernia.

A sports hernia develops as repetitive forces placed through the trunk are rerouted into the groin and abdominal muscles, resulting in micro-tears in the muscle. As a result, the abdominal wall and inguinal canal are weakened allowing a hernia to develop and protrude through the area. The hernia causes groin and abdominal pain while limiting hip function. Surgery is often needed to return the herniated protrusion to its usual location and a surgical mesh is utilized to reinforce the area and prevent reoccurrence. The procedure has a high success rate and players are generally able to return six weeks after the surgery.

The Patriots continue to treat the injury like a moderate strain and the injury is clearly affecting Amendola. His limited participation in practice suggests heís unlikely to play this weekend and an extended absence remains probable. Donít expect him to contribute for the immediate future.

Andre Johnson and Eddie Lacy
Concussions are the hot topic in the sports medicine world as medical professionals attempt to better understand and prevent these unpredictable injuries. After years of disregarding the potential ramifications of head injuries, the NFL has recently jumped to the forefront of concussion management in an attempt to protect their players. However despite the advancements in equipment and protocol, concussions still occur. Several key offensive players, including Johnson and Lacy, were early departures from Week 2 after sustaining concussions. Before fantasy owners make a decision regarding either of these individuals, itís best to review and understand the procedure both players will be required to complete.

Any NFL player that sustains a concussion is immediately instated into the league-mandated concussion protocol. The player will first be subjected to a neurocognitive test known as ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing). Every NFL and NHL teams utilize the ImPACT Test to help provide data on a concussed athlete with a large number of MLB and NBA teams joining the ranks. Though each athlete reacts to a concussion differently, ImPACT testing allows for each individual to be properly screened.

The test is completed on a computer and analyzes the individualís current mental status through neuropsychological tests that include memory recall, immediate shape and color recognition, and matching. The results are than compared to a set of baseline information gathered prior to the start of the season. Before an athlete can resume practicing and playing, their IMPACT scores must return to or be better than their initial baseline numbers. Furthermore the individual must present no symptoms while at rest. If these check marks are met, the medical staff of each player will gradually increase their amount of exertional activity. Once the player can complete the appropriate physical activities without displaying any concussion-related symptoms, they have just one remaining step to complete. An independent neurologist will examine the individual and give the final thumbs up or thumbs down about returning to the field. This process obviously takes an extended amount of time to complete, which is why the Texans are already saying a decision regarding Johnsonís availability will not be made until the end of the week. The Packers have taken a similar approach with Lacy and said an update would come midweek.

Fortunately neither player has a history of concussions, which could help them avoid a prolonged absence. The effects of a concussion are cumulative, meaning the damage and the symptoms of each successive concussion build on one another. The more serious the damage, the more likely an individual will miss an extended period of time. On the flip side, both will be more likely to accrue more serious symptoms if another concussion occurs in the future.

The availability of both Johnson and Lacy should be determined prior to Sunday. Johnson seems to be the more likely of the two to be ready based on reports regarding early week preparation. Another factor to consider is Green Bayís Week 4 bye that could provide valuable rest for Lacy should his symptoms linger.

Maurice Jones-Drew
After declaring himself healthy and ready to play following offseason surgery to fix a Lisfranc injury, MJD has looked anything but in his first two weeks back. The entire Jacksonville offense has sputtered but Jones-Drew has been particularly inefficient. Now heís dealing with a strained tendon in his left foot that could further reduce his value. X-rays did not reveal a break to the area and no ligament damage was discovered. Thatís particularly good news given his previous problems in this same foot, but a stable foot doesnít guarantee a healthy foot. The tendon injury could easily limit the function of the joint and give MJD problems with running and cutting. While Jones-Drew is expected to play it would be wise to consider your alternatives, especially with the team traveling to Seattle to take on the vaunted Seahawks defense.

Ray Rice
Ravens fans feared the worst as the Pro Bowl running back hit the ground with a non-contact injury early during the teamís win over the Browns. Rice immediately grabbed his left hip but was able to limp off the field and into the locker room. While non-contact injuries generally end up being serious problems, it appears Rice will be ok after suffering a minor hip flexor strain.

The hip-flexor is actually a group of muscles that work together to pull the knee upward. Muscles in the group include the rectus femoris, the sartorius, and iliopsoas. When injured the athlete will often complain of tightness and pain in the area and if untreated or mismanaged can lead to lower back issues as well as groin pain. For a back like Rice whoís large muscular legs help him generate power to shed tackles and make effective cuts, preventing any further damage from occurring is key. The Baltimore medical team may provide a supportive wrap known as a hip spica but that would simply minimize the pain by reducing his available range of motion. Rice will likely be limited in practice to rest the injured area and hopes to return by the weekend. However with Bernard Pierce running well, it may be in the teamís best interest to give Rice the week off. Look for this situation to carry into the weekend until a final decision is made just prior to game-time. Rice owners that were not able to handcuff him to Pierce should begin to look for a suitable insurance policy.

Turf Burns

Steven Jackson: Jackson scored a touchdown early before leaving Week 2ís win over the Rams with a thigh contusion. The Falcons have been tight-lipped regarding the severity of the injury but are managing this on a week-to-week basis suggesting the sustained damage is significant. It should be noted Jackson has a history of quadriceps injuries dating back to 2008 that could be in play here. Add Jacquizz Rodgers in all formats.

Vernon Davis: Davis left the Monday night loss with a hamstring strain but his status for Week 3 remains in the air. The strain is considered minor but his participation in practice should serve as a strong indicator on how much it is bother him. Davis should be treated more as a receiver than as a true tight end, meaning he could easily be limited if he plays.

Larry Fitzgerald: Fitzgerald was clearly limited by his strained hamstring in Arizonaís win over Detroit, finishing with just two catches for 33 yards. He did not play in the second half but did not aggravate the existing injury. He instead removed himself from the game after becoming fatigued. He should be in uniform against New Orleans but a hamstring strain will limit his ability to stretch the field and should diminish his productivity. Scale back your expectations of Fitzgerald until heís moved past this minor strain.

Malcolm Floyd: Floyd was in the middle of a violent and scary collision Sunday that left the receiver with a neck injury. Fortunately he has feeling in his extremities and appears to have avoided a catastrophic injury. However he is out indefinitely and is slated to meet with a spine specialist.

Jeff Stotts is a Certified Athletic Trainer, MAT, PES and the Injury Analyst for You can follow him on twitter @RotoWireATC.