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Injury Analysis: Wide Receivers on the Shelf

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.

Marvin Jones
The Cincinnati receiving corps took a hit when it was revealed Jones suffered a broken foot during practice over the weekend. Jones fractured the fifth metatarsal in his left foot and underwent surgery Monday to have a pin inserted into the area. The Bengals are optimistic that Jones will miss a few weeks with a chance to return following the team's Week 4 bye. However fifth metatarsal fractures are rarely as straightforward as they appear with multiple complications possible.

Anatomically, the metatarsals are the long bones of the foot that sit between the bones of the midfoot and the bones of the toes. The fifth metatarsal is located on the outside of the foot, below the pinkie toe, and serves as an attachment site for several muscles. These muscles make the bone susceptible to fractures when the ankle is forced inward, like when landing awkwardly on the turf or another player's foot.

In these types of injury, recovery and treatment is dependent primarily on the where the break is located. The most serious of the fractures is the Jones fracture, when the break occurs near the base of the bone. The blood flow to this area is very poor and this fracture takes a prolonged period to heal, often requiring surgery to repair. Individuals who suffer Jones fractures can experience a delayed union or nonunion of the bone, meaning the two bone pieces require a longer period of time to connect or in some cases do not unite at all.

Regardless of location, the inherent risk of re-injury remains high until the bony union is 100 percent and, even then, the risk of hardware failure remains. Hardware failure often depends on the size of the screw with most surgeons now opting for larger pins and screws.

Jones isn't the first NFL receiver to endure the injury with Julio Jones and Hakeem Nicks each breaking their metatarsals in recent years. Both players failed to bounce back quickly with Nicks battling lingering soreness for months after surgery. Julio Jones has twice fractured his fifth metatarsal, including last year when he missed 10 games. Running back Ahmad Bradshaw's experience was even worse as he underwent multiple surgeries on his foot after the surgical hardware failed.

Despite the Bengals' positive outlook Jones could be a candidate for the PUP list, sidelining him for the first six games. In his absence the Bengals will turn to Mohamed Sanu to help ease the burden of Andy Dalton and AJ Green. Jones' value takes an obvious hit and even stashing him at this point is a risk.

Jordy Nelson
The Packers were without their best receiver as Nelson missed the team's preseason opener with a hamstring injury. The team considers him day-to-day but Nelson's past could factor into his recovery. Nelson missed four games during the 2012 season with a hamstring strain that aggravated off-and-on throughout the year. Hamstring injuries and aggravations are commonplace in the NFL and wide receivers are notoriously vulnerable.

The hamstring muscle group is extremely important for wide outs and defensive backs. They help control the explosive movement in the lower extremity that is required to run routes with speed and precision while also aiding in decelerating in and out of cuts.

However the velocity of these movements and the need to quickly alter speeds is demanding to the muscle tissue. In the legs, power generated by the hips substantially increases as a player begins to sprint down field. The hamstrings extend the hip and flex the knee all while controlling the opposite motion eccentrically. This delicate balance is easily thrown off resulting in muscle failure and straining of the muscle tissue.

A strain can occur in either the muscle belly or the tendon. Following an injury, the body's natural defense almost immediately sends specialized types of cells to begin the healing process and regenerate new muscle fibers. The newly developed scar tissue is haphazardly laid down, limiting the strength of the new tissue. Athletes and medical professionals can begin rehab exercises designed to properly load the healing muscles in a way the healing muscle stronger and more durable. However even in the best cases, the newly formed tissue remains vulnerable to re-injury. Scar tissue can be easily disrupted and as a result hamstring injuries often become chronic and lingering injuries.

Though he did return for Tuesday's practice, Nelson's previous hamstring issues increase his inherent injury risk. Miles Austin, Michael Floyd, and Andre Johnson are all receivers that have battled reoccurring hamstring issues, yo-yoing in-and-out of the lineup. For Nelson taking the appropriate amount of time to heal now will be beneficial for his long-term health and help him avoid joining this list. However his past still makes it hard for me to invest in him as an elite wide receiver.

Turf Burns

Drew Brees:
The former Super Bowl MVP continues to miss time with a strained oblique. Despite reports that he is progressing in rehab, he will not play Friday in the team's preseason game against the Titans. I wouldn't get worried just yet and give Brees just a little more time to work his way back. Oblique strains can be fickle and the Saints are understandably treating him conservatively.

Rob Gronkowski: The Patriots remain tight-lipped about Gronk's status but the Pro Bowl tight end has yet to participate in contact drills. The situation is starting to look eerily similar to last year when New England dodged questions regarding the state of his back, before finally placing him on the PUP list to start the year. The recovery from an ACL repair isn't as long as it used to be but Gronkowski still needs time to get back to 100 percent. Tread carefully here.

DeSean Jackson: The Redskins' big offseason acquisition was back in action Monday after missing time with an ankle injury. Keep an eye on his performance over the next few days to get a better idea if the injury is truly a thing of the past.

Cam Newton: Newton is inching toward a full return and plans on playing Sunday in Carolina's preseason outing against Kansas City. He has begun performing reads that require him to run on his surgically repaired ankle, though the team wisely controlled the conditions. I'll be watching his first performance at game speed to get a better idea of what we can expect moving forward, though all signs are pointing up.