Week 14 wasted no time making its injury impact felt. Both quarterbacks suffered injuries Thursday yet both continued to play. The returns of Ben Roethlisberger and Colt McCoy have been the topic of much discussion in recent days, for different reasons.
Roethlisberger suffered a high ankle sprain, an injury that typically sidelines players for multiple weeks, yet he managed to return to complete the game once it was determined no fracture was present. The adrenaline might have helped him get through Thursday night, but what about the Pittsburgh Steelers' next contest, a Monday night matchup against the San Francisco 49ers? Given Roethlisberger's history of beating the odds and managing to suit up even in the presence of significant injury, it's impossible to rule him out. Still, it's difficult to imagine him being able to perform effectively, given the nature of what's ailing him. Sam Bradford also suffered a left high ankle sprain, and was sidelined for two games because of his inability to step into throws and move out of the pocket. After Bradford returned, he suffered a setback that again resulted in missed time, and even though he played Monday night, it's clear he is not fully recovered.
Cleveland Browns quarterback McCoy took a shot to the head from Steelers linebacker James Harrison, which left him momentarily flat on his back. Harrison has since been suspended for one game by the NFL, and the circumstances surrounding McCoy's return to the game (he missed just a few plays following the hit) have become the subject of an investigation. The Browns maintain McCoy was evaluated on the sideline before being allowed to return and that his concussion-like symptoms appeared later (McCoy has since been diagnosed with a concussion). Members of both the NFLPA and the NFL are expected to meet with members of the Browns' medical staff this week to clarify exactly what happened following the hit and how decisions about return to play were made. In an email response to The Associated Press, league spokesman Greg Aiello said the purpose of the meeting "is to examine procedures and identify areas for further discussion with other medical experts, Commissioner Goodell and the union."
Perhaps the most notable aspect of this incident so far is that we are seeing the first suspension of a player based on a hit to the head (a punishment directed in part by this particular player's history of similar hits) and an investigation into the circumstances surrounding an in-game medical decision. A couple of years ago, this incident likely would have been just another play in the game. While there still is a long way to go in terms of understanding how to best manage and protect against these injuries, the fact that they are gaining attention and being discussed is, in itself, a sign of progress.
After Thursday night ...
... The injuries continued to mount. Particularly brutal was the injury suffered by Dallas Cowboys running back DeMarco Murray, whose legs got trapped awkwardly underneath him as he was tackled. The right leg got the worst of it, as Murray suffered a fractured ankle and a high ankle sprain. As reported by ESPN Dallas, Murray will need surgery, confirming the obvious conclusion that his season is over. It's hard not to feel for Murray, who had provided a spark in the running game after Felix Jones was sidelined with his own high ankle sprain in October. Murray tweeted that he'll be back "a better football player," but we will have to wait until 2012 to see proof of that. With Murray out, Jones now resumes the starting role in Dallas. The Cowboys also signed Sammy Morris on Tuesday as insurance.
• The Green Bay Packers also lost one of their key offensive weapons for what it appears will be the remainder of the regular season. Greg Jennings sustained a sprained medial collateral ligament, and his obvious pain had everyone concerned. Following an MRI on Monday, the team projected his absence at two to three weeks (the standard timetable for MCL sprains ranges from two to six weeks), suggesting a mild to moderate sprain. Coach Mike McCarthy seemed to intimate at his news conference Monday that Jennings would not return for the regular season. "I would think it would be safe to say he'd be back for the playoffs," McCarthy said. Meanwhile, running back James Starks missed Week 14 because of his knee and ankle injuries, but he might return this week if he can return to practice. Rookie Brandon Saine saw some playing time in Starks' absence but left the game early with a concussion. Saine will have to receive medical clearance in order to return.
• The Minnesota Vikings are sounding as if they expect to have Adrian Peterson on the field in Week 15, but we'd like to see him run without a limp before penciling him into the lineup. Peterson made further progress last week, doing some individual drills. Still, Peterson rated himself at only 80 percent, although he was willing to try to "gallop" if necessary. It was a good move to rest him this past week, and that rest might well be what allows him to go in Week 15. Stay tuned.
• The Philadelphia Eagles saw the returns of Michael Vick and Jeremy Maclin in Week 14. While Vick managed to get through the entire game (even though he could be seen lying on a treatment table getting worked on at one point while the defense was on the field), Maclin did not fare so well. His hamstring tightened up on him, according to coach Andy Reid, and Riley Cooper took Maclin's place for much of the second half. Until Maclin shows he has recovered enough to get through a full game without incident, it's going to be hard to have confidence.
• Tennessee Titans quarterback Matt Hasselbeck suffered a calf injury Sunday, and it was not known immediately how severe the injury was. Jake Locker took over for the remainder of the game (with the exception of a single play in the fourth quarter that Hasselbeck handled), and Hasselbeck is now being called day-to-day. Calf strains are typically slow to heal, even when minor, and will limit a quarterback's ability to push off as well as his all-around mobility. It will be no surprise if Locker gets the start this week.
• New Orleans Saints tight end Jimmy Graham showed some toughness playing through major back spasms Sunday. Fantasy owners knew something wasn't right when Graham left the pregame warmups early and headed into the locker room. He came out to join his team for the game and managed to garner 55 yards. Graham, during an appearance "Rome is Burning" on Tuesday, called the spasms "crippling" but said it would take more than spasms to keep him out of a game. He also noted he had undergone an MRI and everything was "fine." He sure sounds like someone who is planning on being out there again in Week 15.
• From last Tuesday: Things are not looking good for running back Darren McFadden. Despite all the positive-speak initially from coach Hue Jackson, his latest remarks have a different tone suggesting progress is not being made as expected. McFadden has already missed more than a month because of a midfoot sprain and his absence is expected to continue. Steve Corkran of the Contra Costa Times reported via Twitter that Raiders coach Hue Jackson does not expect McFadden to miss the rest of the season. Well, neither did we. In fact, it had not been a real thought until Jackson introduced it as a possibility. Jackson also noted that there was no timetable for McFadden's return. Those two comments cause concern as to what the real status of McFadden and his foot is going forward. After the initial MRI, Jackson said there was no major structural damage and hinted at a speedy recovery. While the structure of the midfoot is complex and pain or inflammation in the area, even in the absence of major disruption to the anatomy, can be severely limiting, the slow progress of McFadden after such early optimism is frustrating. At this point it is difficult to have confidence in McFadden's status, especially as long as he is absent from the practice field.
This Tuesday: Things still don't look good. The poor outlook noted at the start of last week has become grimmer as another week has passed with no obvious signs of progress from McFadden. If anything, there is less clarity about McFadden's injury than ever. On Sunday, CBS analyst Phil Simms commented that McFadden was dealing with a Lisfranc injury. Steve Corkran of the Contra Costa Times best captures the semantics issue around the term "Lisfranc" and coach Hue Jackson's response as it relates to McFadden in his Monday post on the topic.
In an attempt to interpret the cause of the confusion, it should be noted that the term Lisfranc is an anatomical description of a region of the foot, specifically a complex joint comprising the bones and ligaments that connect the midfoot to the forefoot. An injury in this area could technically be called a midfoot sprain or a Lisfranc injury, and both would be correct. Injuries range from minor ligament tearing involving a single joint to multijoint severe injuries including fracture and dislocation. The latter type require surgery to fix; the former do not.
As Lisfranc injuries have become more common in the NFL and have led to season-ending surgeries for some (Ronnie Brown, Dwight Freeney and most recently Matt Schaub), when the term is used, the implication is that the athlete has suffered the most severe, season-ending variety. That degree of injury does not always result. Since the Raiders insist McFadden does not need surgery, it would appear that his injury is of the less severe type and that, perhaps, is why the term "Lisfranc" was avoided. For any injury to the midfoot, it is important that full healing occur in order to restore normal gait and prevent future problems, which can render the recovery process slow. In McFadden's case, his recovery appears to be taking longer than the Raiders initially projected it would, adding to the frustration of all looking from the outside in. At this point, despite Jackson's statement that he expects McFadden to return, it's hard to imagine a full-strength McFadden resurfacing within the next three weeks.