Injury Analysis: Busy Week for NFL Medical Staffs

Week 7 was a particularly busy week for NFL medical staffs. Multiple starters, including several Pro Bowlers and two former Rookie of the Year winners, suffered season-ending injuries and will not return this season.

Sam Bradford
The Rams quarterback suffered a torn anterior cruciate ligament (ACL) in his left knee after being dragged down from behind on a fourth quarter scramble. His leg cleat stuck into the turf and his knee twisted as he went out of bounds. As a result the ACL was unable to handle the stress applied from this torqueing motion and ruptured, leaving the quarterback in significant pain. This motion is one of the most common mechanisms of injury for a contact ACL injury especially in football. Bradford will require surgery to repair the torn ligament and can expect a grueling recovery process. Players like Wes Welker, Robert Griffin III, and Adrian Peterson have pushed the limits of the return to play guidelines but remain exceptions to the norm. A normal ACL recovery generally occurs in eight to nine months with full ligamentization occurring around 12 months. If Bradford adheres to these standards it's reasonable to believe he will be ready for training camp. Bradford has several factors working in his favor including his age, limited history of knee injuries, and his style of play. Bradford is more of a traditional pocket passer and won't deal with the same obstacles that face mobile quarterbacks. In the meantime the Rams will turn to Kellen Clemens and have begun looking at other existing options.

Reggie Wayne
The Indianapolis receiver is also done for the season after suffering his own torn ACL. However Wayne's injury occurred in a non-contact fashion. Wayne was attempting to catch an underthrown ball on a simple crossing route. As he decelerated his right knee stuck in the turf and twisted. This motion strains the ACL while the body is also applying an extreme amount of eccentric muscle force. As a result the ACL tears despite the lack of contact. In Wayne's case the twisting motion also resulted in a torn meniscus likely as the fibrocartilage disc was pinched between the upper and lower leg bones. Wayne will need surgery and is looking at similar timeline as Bradford. However Wayne could be in for a tougher road than Bradford given his age and the demands of his position.

Wide receiver remains a position highly dependent on a specific skill set that tends to quickly decline with age. Attributes like acceleration, speed, and separation skills all deteriorate with time particularly in the mid 30's. When declining skills are coupled with a significant injury like a torn ACL, a once productive receiver can undergo a rapid decline. For example, former Rams receiver Torry Holt had nine straight productive seasons before age and injury began to slow him down. At age 34, Holt suffered a knee injury that required surgery and the seven-time Pro Bowler never recovered. Wayne will turn 35 in November and has three additional seasons of wear-and-tear. While it's hard to count out a warrior like Wayne, he will face a more challenging road to recovery than others.

Jay Cutler
The Bears will be without Cutler for at least four weeks after he suffered a torn groin muscle. Surgery will not be required but the quarterback did reportedly hear a pop when the injury occurred. There are multiple muscles that make up the groin and they all attach to various spots on the hip and pelvis. If an isolated muscle is torn the other muscles can still perform the necessary motion though it may elicit pain. We've already seen this occur this year with Patriots receiver Danny Amendola, who has been able to play despite suffering a complete tear of his adductor longus tendon. However the Bears have not released the specifics surrounding what muscle Cutler injured making a direct comparison a bit difficult.

With a bye week scheduled for Week 8, it's possible that Cutler only misses three games. However given the requirements of the positions and the nature of the injury, don't be surprised if its closer to four or five games. Josh McCown will take over at quarterback and should benefit from an extra week of preparation. However the Bears head into Lambeau Field for a Monday night matchup against the Packers in Week 9 making it hard to have much confidence in his fantasy value.

Doug Martin
The Buccaneers are preparing for Martin to miss the remainder of the season with a torn labrum in his left shoulder. The labrum is a fibrocartilaginous ring that stabilizes the glenohumeral joint, the primary joint of the shoulder. The glenohumeral joint is a ball-and-socket joints and resembles a golf ball sitting on a tee. The head of the upper arm bone acts as the golf ball sitting in the "tee", the glenoid fossa of the scapula. The ball (humerus) can freely pivot on the tee (glenoid fossa) allowing for a large degree of motion thanks to fortification provided by the labrum and surrounding ligaments and musculature.

Unfortunately the labrum can be torn, often after the shoulder is hit with a sizeable force that jars the humeral head. Labral tears are extremely painful and can lead to chronic instability in the shoulder. Treatment for this type of injury depends on the pattern of tearing and the degree of instability. If rest and rehabilitation do not aid in recovery then arthroscopic surgery is often required.

Tampa is hoping an extended rest and vigorous rehab can allow Martin to return this season. For a guy that is nicknamed the Muscle Hamster this could be a possibility, as a key component of rehab will be increasing the strength in the muscles surrounding the shoulder. Doing so will add stability to the compromised joint and help make up for the damaged labrum. The Buccaneers plan on evaluating him in several weeks and determining his final fate. Rookie Mike James assumes the role as feature back and Brian Leonard should also see an increase in workload. Stash Martin for the immediate future but be quick to move on if the team opts to shut him down for good.

Turf Burns
Brian Cushing: The Texans linebacker will see his season prematurely end for a second straight year. After suffering a torn ACL in his left knee last season, Cushing will miss the remainder of this year with a fractured fibula and torn lateral collateral ligament (LCL). Fortunately his surgically repaired ACL remains intact and no additional work will be required.

Jermichael Finley: Finley has been shutdown indefinitely after suffering a scary injury on Sunday. The tight end suffered a spinal cord contusion and was removed from the field on a stretcher. Finley has regained all motion and feeling in his extremities. Following an injury of the magnitude, football is no longer the primary focus and insuring overall health and quality of life is fundamental. Finley will be allotted as much time as needed to make sure he can play again and no timeline has been established.

Arian Foster: The Texans will hope a much-needed week off will allow Foster to overcome a mild hamstring strain. However considering he has managed hamstring issues in the past as well as a calf strain this preseason, it would be smart to downgrade him until he proves he's close to 100 percent.

Michael Vick: The Eagles will once again turn to Vick after the speedy quarterback was sidelined for two weeks with a hamstring strain. The decision was an easy one as backup Nick Foles sustained a concussion in the team's loss to Dallas and looked erratic before the injury. Vick remains what he always has been, the best example of a high-risk, high-reward fantasy option.

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