Dr. Dan’s NFL Injury Update Week 3

Well, week 3 proved to be less injury prone for offensive players than last week’s bloody Sunday. With six teams on bye this week (Cardinals, Seahwaks, Broncos, bengals, Browns, and Rams), many injured players will be given some much needed time to rest. However, many of us will be digging deep into our benches to fill in the bye-week holes in our fantasy line-ups. An unproven back-up to a recently injured player isn’t a bad move on a bye week, so make sure you stay on top of your injury news this week.

While there weren’t as many offensive injuries this week, this unfortunately did not hold true for defensive players across the NFL. Being most people read stuff like this for fantasy football and most leagues use the team defense format, I’m going to let you get your defensive injury news somewhere else. However, I’m going to make one exception this week for a new addition to the article, the Darwin award. For those unfamiliar, a Darwin award “recognizes individuals who have supposedly contributed to human evolution by self-selecting themselves out of the gene pool via death or sterilization by their own actions.” Well, these players have self-selected themselves for injury and deserve to spend some time on the bench.

Lions’ Middle Linebacker Stephan Tulloch will be taking the award home this week. He managed to tear his ACL, and bench himself for the season, after celebrating a sack on Aaron Rodgers. Tulloch was quoted after the game “It’s unfortunate that it happened to me.” Yes, yes it is.

Doesn’t get much dumber than that.

Anyway, this week we’ll be taking a look at a sports hernia. This is the injury that is sending Minnesota Vikings TE Kyle Rudolph to the operating room this week (Do the Vikings have anyone left?), as well as Eagles center Jason Kelce. If you’re not interested in that, scroll down to the bottom for a report on all new, notable injuries from week 3 and a brief report on some older, relevant injuries.

Sports Hernia

Sports hernia, also known as “Athletic Pubalgia”, is a chronic lesion to your groin area. It occurs where two groups of muscles meet on your pubic bone. Below, you can see your abdominal muscles (your abs and your obliques) attaching to your pubic bone from above. When these muscles contract, they exert a force upward on the bone. One of these muscles, the transversus abdominus, attaches to the pubic bone at what is called the conjoint tendon. This tendon is usually somehow involved in the injury. Attaching to the pubic bone from the bottom are the adductor muscles of your leg, which you can also see below. These normally pull your leg inward and upward and exert a force downward on the pubic bone.

Screen Shot 2014-09-23 at 10.29.30 AM

Abs pull up, adductors pull down (mostly). Imbalance = sports hernia

A sports hernia results from an imbalance of these two forces on the pubic bone, the upward force from your abdominal muscles and the downward force from your adductor muscles. The result is a deep groin pain that is exacerbated by running, cutting, and bending forward (sounds like football moves). The exact injury is usually a tear in one of the muscles or a tear in one of the muscle’s connections to the pubic bone. It can also be caused by general weakness in the muscles or tendons in the area, sometimes due to a thinning out effect that can occur when the muscles are overstretched. One important thing to note is that a sports hernia is not a true hernia, meaning there is no outpouching of your intestines through the musculature. This is a good thing, because intestines should remain where they are – inside your body.

Screen Shot 2014-09-23 at 10.34.11 AMThe goal of treatment is to become pain free upon physical exertion. This can sometimes be achieved with rest and physical therapy, but for NFL players, the treatment is usually surgical. The surgery focuses on stabilizing the insertion of the muscles on the pubic bone. This usually involves stabilizing the conjoint tendon we talked about earlier. Usually a mesh is placed behind the pubic bone to help stabilize the area. An interesting implication of this surgery is that the superficial ilioinguinal nerve is removed, as it is often damaged during the surgery, which could lead to neuralgia (scarring of the nerve that leads to chronic pain) if not removed completely. Once removed, the individual has no feeling in the groin area on that side of their body. Recovery from the surgery takes from 4-6 weeks, but for a high contact sport like football, it leans more towards 6. You can expect Kelce and Rudolph back around week 9 or 10.

Notable Injuries

Quarterbacks

  • Matt Cassel – Minnesota Vikings
  • Fractured foot: Cassel fractured several bones in his foot – never an easy recovery. Not sure when he’ll be back yet, but don’t expect him back soon.
  • Backup: Teddy Bridgewater
  • Jesse McCown – Tamba Bay Buccaneers
  • Injured thumb: McCown injured his thumb on a defenseman’s facemask during a throw. He’ll be out for week 4, but he wasn’t looking that good anyway.
  • Backup: Mike Glennon

Old

  • RGIII – Washington Redskins
  • Dislocated ankle: He’ll be out until at least the week 10 bye for the Redskins. Who knows if he’ll even be starting again when he’s healthy, Cousins has proven to be quite the backup QB.
  • Carson Palmer – Arizona Cardinals
  • Nerve issues: The nerve iin Palmer’s right arm, you know, the one that throws the ball, is still doing its own thing. He’ll be week-to-week for now until that nerve starts firing again. The Cardinals seem to be doing fine without him.
  • Shaun Hill – St.Louis Rams
  • Thigh Injury: Didn’t get the start on Sunday. Austin Davis seems to be the QB for now.

Wide Receivers

  • Harry Douglas – Atlanta Falcons
  • Left foot injury: Douglas came in as Roddy White’s backup on Thursday, and after scoring a touchdown on the Falcons’ first drive, left the game shortly after with a foot injury. His MRI was negative, but with White’s return likely Douglas moves back to WR3 on the Falcons even if he is healthy.
  • TY Hilton – Indianapolis Colts
  • Ankle injury: Hilton had 5 catches for 80 yards before he left Sundays game with an injured ankle. The Colts were on a roll and were probably just being cautious when they decided not to put him back in the game. Expect him out there for week 4.
  • Eric Decker – New York Jets
  • Hamstring: Decker’s hamstring has been bothering him since preseason, and he had only one catch in Monday night’s game before leaving with another aggravation of the injury. Consider him day-to-day for week 4 (and probably 5 and 6, this injury seems to be lingering). Geno Smith seems to prefer throwing to the opposing cornerbacks rather than his wide receivers anyway.
  • Brandon Marshall – Chicago Bears
  • Right ankle injury: Marshall’s injury doesn’t seem to be affecting his play too much. After being briefly sidelined during Monday night’s game, he went out and caught a touchdown pass that was brought back. He’ll probably continue to be listed as questionable then start in week 4, much like this week.

Old

  • Tavon Austin – St.Louis Rams
  • Knee sprain (MCL): Should be back after the week 4 bye.

Running Backs

  • Danny Woodhead – San Diego Chargers
  • High ankles sprain + fractured fibula: That’s it for Woodhead this year. If he was on your bench, drop him.
  • Arian Foster – Houston Texans
  • Hamstring Injury: The Texans worked Foster too hard in those first two games, and this is what they get for it. They could have used him in their loss to the Giants. Foster is currently listed as day-to-day, but this injury has been bothering him for a while.
  • Backup: Alfred Blue
  • Bernard Pierce – Baltimore Ravens
  • Thigh Injury: Wish I could be more specific here, but when everyone lists it as a thigh injury I can’t just make something up to sound like I know more. It looks like he’ll be back for week 4 anyway.

Old

  • Jamaal Charles – Kansas City Chiefs
  • High ankle sprain – Looks like the sprain wasn’t so bad and after taking a rest this past Sunday he should be good to go in week 4 versus the Pats.
  • Mark Ingram – New Orleans Saints
  • Broken hand: Coach Peyton has called Ingram “week-to-week”, so maybe we’ll see Ingram back on the field prior to his expected week 6 or week 7 return. He’ll still be on the bench for week 4 though.
  • Ryan Mathews – San Diego Chargers
  • Sprained MCL: Looks like another 3-4 weeks before Mathews return. With Woodhead out, Donald Brown will no doubt be the Chargers’ lead back.
  • Knowshon Moreno – Miami Dolphins
  • Dislocated Elbow: Moreno is hoping to be back by week 6 In the mean time, Lamar Miller will continue to get the majority of the carries.
  • Doug Martin – Tampa Bay Buccaneers
  • Knee injury: Martin should be good to go in week 4. With Bobby Rainey forgetting his job is to hold on to the football while running it, the Bucs will be glad to have him back.
  • Maurice Jones-Drew – Oakland Raiders
  • Hand Injury: MJD returned to practice last week but did not play Sunday. He may be healthy enough to get some snaps in week 4.
  • Deangelo Williams – Carolina Panthers
  • Thigh Injury: Sounds like Williams will be back for week 4 against the Steelers after sitting out on Sunday. This is good, because both backup RBs Mike Tolbert and Jonathan Stewart were injured this week.
  • Ben Tate – Cleveland Browns
  • Knee: Bye week this week, so we’ll see if he returns for week 5. West and Crowell have proved an effective combo so far in his absence, however, Tate will be the lead back upon return.

Tight Ends

  • Kyle Rudolph – Minnesota Vikings
  • Sports hernia: Rudolph was limited last week with a strain in his abdomen. Now he has a sports hernia, which is an extension of his previous strain. Surgery will require about a 6 week recovery.
  • Backup: Two TEs who have a combined 16 catches in the NFL. Stay away.
  • Dennis Pitta – Baltimore Ravens
  • Dislocated right hip + fracture :Repeat of training camp 2013 here. He’s already been operated and will be out for the year (and possibly his career after two of these).
  • Backup: Owen Daniels

Old

  • Jordan Reed – Washington Redskins
  • Hamstring: With a Thursday night game this week, it’s unlikely that Reed’s status will have changed much since sitting out this Sunday. Keep an eye out for an official report, but I would expect the Redskins to bench him for one more week.
  • Backup: Niles Paul
  • Vernon Davis – San Francisco 49ers
  • Knee/ankle injuries: The 49ers are expecting Davis back for week 4 against the 3-0 Eagles. As always, look for an official report later in the week.

Defenses: too many injuries to list.

 

Good luck with the first big bye week of the season – I know I’m not looking forward to it.

Dr. Dan

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