Dr. David Chao
Latest NFL News


After a relatively healthy Week One, the law of averages has unfortunately caught up with the NFL. Among the many injuries this week, seven prominent running backs were injured. Fans and fantasy owners of Adrian Peterson, Arian Foster, Jonathan Stewart, Doug Martin, Thomas Rawls, Ameer Abdullah and Danny Woodhead are holding their collective breaths.

Adrian Peterson is the headline injury as he could not put weight on his right leg when he was helped off the field and into the locker room. There were initial fears of ankle injury but further examination of video focused on his knee. His right knee appeared to be locked, a condition that could be caused by a bucket handle meniscus tear when knee cartilage flips and catches in an awkward position preventing full motion. I hope the early optimism is correct, but crutches and a locked knee brace is not the look of a player ready for next week. cstdebtvyaawkr0

The big concern is the high association with ACL tear, although it is possible to not tear your ligament and suffer a locked knee. I wish I had a different angle on video as my worry is the step before the ankle is pinned. I hope his season and ACL are spared but even when a locked knee “calms down” and can straighten, that doesn’t mean the problem is solved. It would not surprise me to hear Peterson needs arthroscopic surgery at a minimum. Lets hope for a small meniscus tear and a quick return.

Arian Foster was immediately ruled out with a groin injury. It is unclear if the injury is related to his hamstring issue, which he entered the game with. At the start of last season, Foster did suffer a groin injury that needed core muscle surgery. I hope his current injury is a pure groin muscle issue and not a sports hernia type injury like 2015.

Jonathan Stewart and Doug Martin exited with hamstring injuries. There is no way to tell severity or if respective teams were being cautious by removing the two players. Their returns will be likely week to week.

Thomas Rawls was coming off a high ankle type fracture and left with another lower leg injury. Coach Pete Carroll related Rawls got kicked and suffered a contusion which hopefully means he is back for next week.

Ameeer Abdullah left with a foot injury after a nifty run with several hard cuts. The good news is, by video, there was no obvious injury mechanism on that final play. The bad news is one has to worry about potential fifth metatarsal stress fracture with all those hard cuts and no definitive misstep leading to his exit. X-rays were negative but that doesn’t preclude a stress fracture. Here is hoping it is not.

Danny Woodhead injured his knee and did not return. As I indicated on twitter, I am purposefully refraining from comment or analysis here for professional reasons. I try to provide insider knowledge but can never give insider information.

I hope this unlucky group of seven running backs can dodge serious injury and all be back to top form soon.

MMMD 1: Quarterback AC joint injuries

Jimmy Garoppolo and Josh McCown both appeared to suffer AC joint sprains. The Patriots QB did not return, but the Browns QB did. The difference is severity as well as injury to throwing versus non-throwing shoulder.

The acromioclavicular (AC) joint sprain is also called a separated shoulder, but has nothing to do with the ball and socket joint. Still it can interfere with throwing mechanics and there are different grades of injury.

It will be difficult but not impossible for Garoppolo to play on a short week here but the race is on to beat Tom Brady back to action in Week 4.

McCown will undergo further evaluation on his left shoulder but the hope is he can continue to lead the Browns in RG3’s absence. After all, he did finish the game with the non-throwing shoulder injury.

MMMD 2: DeMarcus Ware breaks forearm

“Meet me at the quarterback” took on new meaning as Ware’s forearm met Von Miller’s knee. cssneptuiaetdyt Ware is reported to have an ulna fracture. I expect surgery to be announced to allow for a quicker return measured in weeks without going on injured reserve. This appears to be a similar injury to the one Thomas Davis suffered in the NFC Championship Game where he had surgery and returned for the Super Bowl. My hope is to see Ware playing in a cast as early as in 3-5 weeks.

MMDM 3: Buffalo injury worries continue

The Bills have had bad injury luck already with Shaq Lawson and Reggie Ragland. They don’t need Sammy Watkins to miss time.

Watkins had offseason foot surgery for a 5th metatarsal fracture and is reportedly dealing with foot pain. If the pain is from the bone, that is a bad sign. Jones fractures have a high rate of second surgery as happened with Dez Bryant, Julian Edelman and others recently. X-rays were reportedly negative but if symptoms continue, a bone scan or CT scan will likely be next.

Here is hoping the pain is from the soft tissue and not related to the original bone injury.

MMMD 4: Stiffer penalty for face masking

I am not talking about an incidental tug or even instinctive grab; however, when a player is literally pulled to the ground by his face mask, that calls for a fine, ejection or even suspension.

Brandon Marshall was brought down by his face mask to prevent him from scoring and injured his knee as a result. Fortunately it was a mild MCL, but it could have been much worse. In many ways, tackling by the face mask is just as or more dangerous than a horse collar tackle.

MMMD 5: injury rundown

There were the typical early season muscle injuries. Stewart, Martin and Braxton Miller were examples of hamstring strains. No matter how in shape players are, football shape is different and we usually see these injuries more frequently early on.

Saints CB P.J. Williams was carted off on a spine board but appears to being doing better. He does not appear to have a cervical injury but rather concussion issues.

Jaguars guard Kelvin Beachum also appears to have avoided serious neck injury after he too was carted off on a spine board. He was kept in San Diego overnight for observation after a concussion.

Browns center Cam Erving was hospitalized for a bruised lung after being hit in the chest/ribs. He will likely miss at least a month. If he is placed on IR, then a choice would have to be made between him an RG3 as only one player per team can return from IR.

Lions DE Ziggy Ansah ultimately left the game after an early leg whip from friendly fire. He was seen without a boot or crutches after the game so here is hoping for a quick return.

Chargers safety Jaleel Addae was reported to have a clavicle fracture. Expect surgery and a 4-8 week return.

Seahawks WR Doug Baldwin got the wind knocked out of him and injured his knee. He will have a MRI this morning.

Vikings QB Sam Bradford’s hand was noticeably swollen but that doesn’t mean injury. The back of the hand swells easily and indeed Bradford finished the game without issue. No, the medical staff did not cut and drain his hematoma as some opined.

MMMD 6: Concussion co-chair exoneration

The co-chair of NFL Head, Neck and Spine Committee was cleared by a University of Washington panel of improperly influencing grants. A congressional subcommittee made headlines with accusations of impropriety singling out this doctor. I hope the exoneration makes similar headlines, but I doubt it will. Unfortunately, the original accusations will live forever at the top of any Google search but the clearing of his name will end up buried in the depths of the internet. Such is the world we live in today.

MMMD 7: ProFootballDoc scorecard

It was a busy week. Matt Jones did play with his AC joint injury as expected. Unfortunately, Keenan Allen did tear his ACL. Brian Cushing was confirmed with a MCL injury as was Brandon Marshall and T.J. Green. Russell Wilson was confirmed and played with a high ankle sprain. Demaryius Thomas played with his hip injury. Jimmy Garoppolo indeed has an AC sprain, not clavicle fracture. P.J. Williams and Kevin Beechum had concussions, not neck injury. Sam Bradford’s hand was not a big deal. Other analysis including Adrian Peterson is pending cross checking with MRI results.

For the time being, the 28-1 record jumps to 39-1 at 97.5% .

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Dr. David Chao
Latest NFL News


Week one of the 2016 season was relatively healthy but there still were the inevitable injuries. Despite an opening night victory, Broncos fans fretted about star WR Demaryius Thomas’ left hip and his reported second opinion.

Does a second opinion mean trouble? Not really. Getting someone other than the team doctor to evaluate a player is a mantra the NFLPA tells every agent to always do. In almost two decades in the NFL, I witnessed the second opinion rates skyrocket, even for routine injuries. It is not something that I discouraged as a team physician as transparency was important.

In this case, there are several additional reasons that Broncos fans can relax. First, Thomas injured the hip in the first quarter and finished the game. Next, he is not technically seeking another examination of his hip, rather just sending his MRI out for review.

A true second opinion would involve Thomas visiting with another doctor. That does not seem to be the case here. If the player/agent were worried, Thomas himself would have headed somewhere, especially with the extra time having played on Thursday.

The MRI is always read by an independent radiologist anyways and that doctor has usually never met or examined the player. Technically, any further impressions would constitute a third opinion.

Some still worry that the MRI would not be sent unless there was an issue. In my experience, over 50% of the time, agents would routinely request sending the MRI to a “players” doctor regardless of findings.

By video, the early game internal rotation injury did not seem significant. Thomas finished the game with four catches for 48 yards.

In any case, no surgeon operates solely based reviewing a MRI. If there was worry about a hip labral tear, the second opinion doctor would have wanted to see the player. Media and twitter speculation of surgery are very premature.

This seems to be a case of over worry. Second opinions are routine. Sending the MRI for an additional set of eyes is extremely common. In this information era, sometimes too much information creates what I think is unnecessary worry.

MMMD 1: Chargers lose game and star receiver

The Chargers were the week one surprise when they jumped out to a 21-3 lead while dominating the home team Chiefs. Then Keenan Allen went down without contact, was carted off and everything changed.

Allen was visibly distraught, but I go off injury mechanism not player reaction. We all hope his ACL was spared but several reports indicate the worst case scenario.

Head Coach Mike McCoy said ACL tear was suspected but saying further test with a MRI upon return to San Diego was needed. We can all hope for the best but physical exam is very accurate on the field and I always knew a ligament tear by feel. The MRI was done more to determine associated injury. Last year it was a kidney injury and it looks like this year a knee injury will end Allen’s season prematurely.

MMMD 2: How bad is Russell Wilson’s injury?

Seahawks fans continue to worry about their star quarterback’s ankle injury. By video, it was a high ankle sprain type mechanism, but appeared to be mild. Wilson was able to finish the game.

High ankle sprains are the dreaded type that can have a player out for multiple weeks; however, like all injuries, there are different levels of severity. Wilson was seen in a boot after the game and that is commonly used to control swelling overnight. The fact that he was putting weight on it and out at a restaurant were good signs as well. A more severe high ankle sprain would have necessitated crutches and at home ice/elevation/compression.

The worry is how much swelling there will be the next day and this will be the key. Expect Wilson to be limited in practice but I also expect/hope he will be ready for Week Two despite early reports to the contrary.

MMMD 3: Cam Newton concussion controversy

It didn’t take long for the NFL to have this years “Case Keenum” type head injury controversy. As expected, threats of fines and loss of draft picks have not changed anything. Adding a second ATC spotter makes an impossible role a little easier, yet the process is far from foolproof.

The concussion protocol continues to be confusing and the optics of the Newton situation are not good. There was an unsubstantiated report of an on field medical check, but no mention of it by Newton, no video proof, no media eyewitness accounts nor league statement confirming the on field check was done. The NFL should allow the spotters, referees & unaffiliated neurotrauma consultants to speak or release a statement on their mindset. Short of that, it just looks like the league is hiding something.

Now the NFL and NFLPA will conduct separate investigations. Lets see if the up to $150,000 fines for a first time event happen. I doubt that it will.

MMMD 4: Injury rundown

Texans LB Brian Cushing left the game with a knee injury later reported to be a MCL where he is said to miss six weeks. By video, this injury actually occurred on the very first defensive play with friendly fire and Cushing played nine more plays to finish the opening defensive series before leaving the game. This is the other knee from his previous ligament damage. I don’t believe the injury to be severe and fully expect Cushing to return well before six weeks.

Patriots TE Rob Gronkowski missed the opener with a four-week old hamstring issue. He has been at limited practice so I expect him to be close to playing, although severe strains could have a player out 8-12 weeks. Playing a road game without Gronk, Brady, Lewis, Vollmer, Solder, Ninkovich and with Chandler Jones trading sides, the minus-2 turnover ratio still didn’t keep the Patriots from winning.

Falcons WR Julio Jones re-sprained his same left ankle. Fortunately it is a low (not high) injury and he should be healthy enough to play next week.

Browns QB Robert Griffin III injured his left shoulder but finished the game. By video, he likely has a mild AC joint sprain and should not miss time.

Viking QB Teddy Bridgewater was confirmed to have a multi-ligament knee injury.

Saints CB Delvin Breaux fractured his fibula. No announcement yet but expect surgery and IR as real possibilities.

Giants WR Victor Cruz and Ravens TE Dennis Pitta overcame long odds of missing two NFL seasons and returned to play for their respective teams.

Packers WR Jordy Nelson and Panthers WR Kelvin Benjamin took advantage of their extra recovery time with their preseason 2015 ACL tears making successful returns. Running backs Dion Lewis and Jamaal Charles who were injured mid-season did not make the opening week bell.

Texans DE J.J. Watt kept his streak of never missing a NFL game alive. As expected, he was only minimally effective and not the usual dominant player.

Seahawks TE Jimmy Graham overcame odds to suit up after patellar tendon rupture. In limited action, he produced one catch for 11 yards.

Cardinals G Evan Mathis injured his left foot, tried to continue playing but couldn’t. This may be a big blow to the offensive line.

Seahawks RB C.J. Prosise was in a cast for a wrist sprain despite no broken bones. He will have limited availability.

Jaguars RB Chris Ivory was hospitalized for a general medical issue before the game. Here is hoping he is OK and there is nothing related to his calf injury like a blood clot.

MMMD 5: Injury reporting confusion

Week one saw a big change with the new rules eliminating “probable”. With the help of medical followers, we documented that league-wide “questionable” lists more than doubled for the first week 2016 vs 2015 (82 vs 39).

With a player 99% likely to play lumped with someone who is 50-50, this surely will cause confusion. For example, Andrew Luck was described by his head coach as “absolutely” playing yet he was listed as “questionable”. I don’t see the advantage of this new reporting system where less information is given.

MMMD 6: Future expansion to London

Many speak of the travel being unfeasible for an overseas team. This weekend, the Dolphins travelled to play the Seahawks. A flight from Miami to Seattle is longer than if the Patriots were to fly to London.

With some scheduling accommodations, a London based team seems inevitable.

MMMD 7: ProFootballDoc scorecard

Thankfully, this was a relatively good injury week. Carson Wentz rib injury was not an issue. Kyle Long was reported to play through labral tear issues that likely will require surgery at season end. Teddy Bridgewater was confirmed to have a multi-ligament knee injury.

This takes the 25-1 record to 28-1 at 96.6%.

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Dr. David Chao
Latest NFL News


Media outlets reported Fred Taylor was unhappy with his NFL doctors for withholding information about his injuries. Who is he unhappy with and what really is going on here?

After analyzing the articles and Taylor’s twitter tirade, this is primarily about NFL appointed neutral doctors determining his disability benefits. “I never complain as a player or now.” The focus is not about team doctors lying about diagnoses to get the running back to play through injuries. He has not directly implicated his long-time Jaguars team doctors or Patriots medical staff. He directly criticize NFL “neutral” docs.

First off, let me be clear. It is WRONG to ever overlook injuries or withhold information from a player or patient at any time. To do so is illegal and considered malpractice which carries civil liability and is actionable by state medical boards.

Contrary to sensational media reports, Taylor makes no direct accusations against team doctors that treated him during his 13 year NFL career. His complains against league appointed “neutral” doctors in determining his post-NFL disability.

After Taylor was unhappy with being denied his “line of duty” benefits three times, he sought out his own doctor who performed 11 MRIs and a dozen X-rays. Taylor says he unknowingly played through a fractured clavicle and bilateral partial labral tears.

As much as one might suspect a player’s current team doctors might minimize injuries, when the player changes teams, the new team doctors provide quite a bit of scrutiny. Just this week, two players passing physicals for current teams failed physicals for the new team (see MMMD 5 below). If Taylor had active clavicle or shoulder issues, the Patriots doctors certainly would be incentivized to call that out on their post-Jaguars physical.

If the NFL neutral doctors are underreporting injuries to deny disability, that is certainly inappropriate and justifies Taylor’s indignation. However, lets not turn this into something along the lines of the concussion or painkiller lawsuits.

NFL neutral doctors are typically jointly appointed by the NFL and NFLPA. If there are “shady practices”, I hope the players union steps forward to help advance these claims rather than take the position that they only represent current players.

I can see why Taylor holds a medical grudge about being called “Fragile Freddy”. That certainly is not a fair nickname. Anyone who plays 13 years in this day and age has to be tough and endure to play through plenty of injuries. Retiring as the 15th all-time rusher, he deserves consideration for the Hall of Fame and a fair shot at disability benefits.

MMMD 1: Teddy Bridgewater dislocated knee and subsequent trade

The worst injury to date for 2016 is the Vikings QB’s knee dislocation. Details of how a non-contact injury can be so severe and my medical analysis have already been explained at Real Football Network.

What does giving up a first round pick (and more) imply for health of Bridgewater’s knee going forward? Would a team pay that price to get Sam Bradford to start for just one year? Certainly this move confirms that Bridgewater is out for 2016. It may indicate the Vikings know that the start of 2017 is not a guarantee. As Vikings GM Rick Spielman said, “no one knows how long it’s going to take Teddy to recovery”.

I knew it was bad when I saw paramedics were called and not just an ambulance. In my 17 years as a head team physician, I never called an ambulance much less 911 for a player injury. I hope Bridgewater can recover to be 100%, but that would be against the odds.

MMMD 2: Carson Wentz will be game one starter

With the Eagles trading Bradford, there was news that Carson Wentz would start when healthy. Medically you can book that Wentz will take the first Philadelphia offensive snap of 2016.

Wentz’s rib fractures may not be healed 100% but they will be healed enough to play. It would be very unusual for a rib injury to prevent play five weeks after occurrence. Teams rarely wait for full healing with players routinely playing with added protection and rib blocks.

If Wentz were an established starter, I would be 100% certain he would start. The only reasons he would not is if Eagles want to protect the rookie or feel that he missed too many practice reps with the injury.

MMMD 3: Cramp not knee dislocation

On the heels of the horrific Bridgewater injury, a video purported to “pop leg back into place” received over 100k combined retweets and likes. Instead it was just a cramp, as I indicated based on video during the college game.

Sometimes video makes injuries look bad, but they are not. Other times replay makes it look mild, but injury is severe. A trained medical eye is needed. In this case, a cramp can be very painful and it is essentially a “seizure” of the muscles. Anyone who has had a cramp knows it can be very painful, but it is far from a knee dislocation.

MMMD 4: Why is Nick Chubb playing but Jaylon Smith is not?

Visually, the two players suffered very similar injuries. Congratulations to Chubb who made a terrific collegiate return gaining 222 yards. Meanwhile, Smith was placed on the non-football injury list and has not practiced or passed his physical for the Cowboys. The big difference is the peroneal nerve injury for Smith where he still is using the AFO. Structurally, Smith’s knee should be sound. The question is when and if the nerve will return to normal.

MMMD 5: Bizarre saga of Browns cornerback continues

K’Wuan Williams was waived by Cleveland while serving a two-week suspension for not playing in a preseason game. Two independent doctors are said to have recommended surgery and now the Bears have failed him on a physical. His agent is now asking the Browns to pay for his ankle surgery. There is no doubt in my mind that the Browns will need to pay for his surgery. This is the “old maid” principle of NFL injuries. The last team to pass a player on a physical owns all of the injuries. Unless there are facts not disclosed yet, the only question here is the argument over the ensuing missed pay. How many weeks will the Browns owe the player in injury settlement? There likely will be a grievance coming unless there is agreement.

It is not uncommon for one team to pass a player and another to fail him. This week, Patriot Bryan Stork failed a Redskins physical. I wrote in detail about the famous 2014 Rodger Saffold failed Raiders free agent physical after there was agreement to terms. http://www.nationalfootballpost.com/what-happened-in-oakland/ This case is unusual as the Browns have not acknowledged the injury at all.

MMMD 6: Injury rundown

Tony Romo’s status is still in limbo, but that is good news. After a CT scan this weekend, the Cowboys QB was not placed on injured reserve yet. An IR stint would mean missing eight games. Medically, he will miss a minimum of six weeks but that could mean only four games. Hopefully staying off IR means his recovery may be closer to the six week estimate than the 10 week one.

J.J. Watt is off PUP and likely for Week 1. This would keep his playing streak of never missing a NFL game alive. Watt may play but is unlikely to be 100% until mid season as was the case with Dontari Poe of the Chiefs last season.

Josh Doctson is off PUP and on the 53 man Redskins roster. Hopefully the rest has put the Achilles tendonitis behind him, but be careful as this injury can linger.

Kyle Long gets Bears new deal despite a reported labral tear. This likely means he will play in a shoulder harness this season and have offseason surgery.

Neither Andrew Luck nor Keenan Allen are at significant risk for kidney re-injury. Both are hoping for a healthy 2016 after several injuries in 2015.

Is Ladarius Green’s ankle hurting or is he suffering from headaches? He is now on reserve/PUP and will miss minimum six games. Either way it is unusual for a free agent signing to be on PUP as that indicates residual medical problem from the previous season.

Dion Lewis is on reserve/PUP after ACL surgery and will have at least an additional six weeks to recover.

Will Jamaal Charles be ready week 1? The Chiefs have hinted he may not be, but clearly he is not far away or he would have been placed on PUP.

Darren McFadden was placed on NFI for his elbow fracture.

Dennis Pitta is back after finger fracture but the bigger news is his comeback from his second hip dislocation that had him out two seasons.

Tyrann Mathieu is expected to play every single play during Week 1 after ACL surgery.

Justin Houston coming off February ACL is on PUP and may be out for longer than the minimum six weeks. He would have until Week 12 to be activated.

Dion Jordan will not come back from suspension yet as he was placed on the NFI list for his knee.

Jimmy Graham’s status is up in the air after patella tendon rupture. As expected, this is a harder injury than an ACL to bounce back from.

MMMD 7: ProFootballDoc scorecard

Unfortunately, Mike Jenkins of the Cardinals did indeed tear his ACL as it seemed by video. Fortunately, A.J. Green does not have a significant injury corresponding the impressions on game tape even though he was pulled from the final preseason game.

This takes the 2016 tally sheet from 23-1 to 25-1 at 96.2%.

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Joe Messineo
NFP Fresh Voices


The Denver Broncos sent off Peyton Manning in a grand fashion by capping off his storied career off with a Super Bowl victory. Manning was a shell of himself in the game, throwing for 0 touchdowns and only 141 yards. However, a win’s a win and Manning will go down as one of top quarterbacks of all-time and ended his career with a storybook ending.

It’s no secret that the Broncos won with a fantastic defense, great game planning, and playing mistake free football. When Peyton retired, it opened the door for the next Broncos quarterback to help lead the team back to the Super Bowl. There were a few candidates available: Brock Osweiler, Colin Kaepernick, and Ryan Fitzpatrick. Instead, John Elway chose to sign Mark Sanchez and draft project quarterback Paxton Lynch.

The Broncos may have the biggest drop off in quarterback for a Super Bowl defending champion, since – well – the Broncos. History has a funny way of repeating itself. John Elway carried the Denver Broncos to a 14-2 record and beat the Atlanta Falcons in Super Bowl XXXIII in his final season. How did they fare the next year? Brian Griese was at the helm for 6-10 record for the Broncos that year.

The Broncos clearly thought Osweiler was a good enough quarterback to play for them since they offered him a contract. The Broncos reportedly offered their former quarterback a contract worth $45 million, with about $15-16 million paid per year, and a guaranteed $30 million. The biggest offer of $72 million over four years, with $37 million guaranteed came from the Texans. Since they did offer a contract, John Elway clearly wanted to bring the young quarterback back, but had a set price and wasn’t going to go over it.

Trade talks between the Broncos and 49ers picked up this offseason for Kaepernick, but talks died down before the draft. Again, this indicates that Elway was interested in bringing quarterbacks in. Ryan Fitzpatrick also was in search for a new home this season and an already-made team like the Broncos would have been a perfect fit, but the two never were reportedly talking.

John Elway must have great confidence in his defense again since he decided to defend his title with either Mark Sanchez, Trevor Siemian, or Paxton Lynch. Sanchez is the most experienced of the three, having bright spots with the Jets early in his career, but on Monday Coach Gary kubiak named Siemian the starter

Is John Elway trying to outsmart himself? Does he think any quarterback can just come and play with this Broncos team and they will still win? It’s a risk and storyline that will play out this entire season. Osweiler and Kaepernick aren’t All-Pro quarterbacks, but there was a reason why Elway was interested. Instead, he is rolling his dice with Siemian, and Sanchez if that doesn’t work out. It will be a very interesting year in Denver.

 

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Dr. David Chao
Latest NFL News


Tony Romo is not too old or too fragile. The Cowboys quarterback is not injury prone. Medically, when his compression fracture heals, he will be cleared to play and will not have increased risk for long-term problems or further injury.

Sure, Romo is 36 years old, but Tom Brady is 39. Yes, the Dallas signal caller has now had his fourth fracture since 2014. However, it would be unfair to say his body is too ancient to play football. 36 may be the tail end of a football career, but medically, weak bones or osteoporosis are decades away.

The L1 vetebral body compression fracture suffered Thursday is unlikely related to his previous back issues. Disc surgery is typically performed at a much lower level (L4-5 or L5-S1). Transverse process fractures are located to the back and side (posterolateral) of the spine, while this break is located in front (anterior). Details on his previous cyst surgery are sketchy but I still don’t see the relationship to the current injury. When healed, Romo’s back will not be physiologically weaker or prone to injury.

There is not an underlying weakness in Romo’s body. Anyone who has a 300 lb defender jump forcibly on a flexed spine would suffer these same injuries. In 2014, the same year Romo suffered, transverse process spine fractures, 23 year-old Baylor QB Bryce Petty had the same injury. Certainly, the then collegiate QB’s bones were not weak. Both returned after one missed game.

Likely the two clavicle fractures and now second spine fracture does not happen out of his fragility, but there may be another reason. Romo has always been among the best at creating a big gain out of a broken play. Now, his continued desire to extend plays versus his decreased ability to avoid big hits is catching up to him.

I wrote last year that Romo has to learn to protect his left collarbone and not take similar hits. At this point, it may be time to resist his natural temptations to create something out of nothing and throw the ball away. The Cowboys clearly need him, going 1-11 last season without their star player.

With his 2014 spine fracture, he recovered quickly and missed only one game. No way a fracture heals in two weeks but a transverse process fracture doesn’t have to heal, as it is not structural. The compression fracture is structural and there is no way to rush back from this injury. No surgery or kyphoplasty will be needed. No brace or special therapy either, just time.

Romo will definitely miss the season opener and should take a minimum of six weeks to return. If hit in a similar fashion, a compression fracture can progress to a burst fracture with potential injury to the spinal cord or nerves. No one can be allowed to take that risk. Once healed, the risk of paralysis or permanent injury is no greater than normal.

Romo could resume throwing in a few weeks, but the earliest I see him playing and being exposed to a hit is six weeks. In 2007 with the Panthers, David Carr only missed a couple of weeks with his compression fracture but admitted he wasn’t at full strength until much later.

Of course Romo could decide to retire, but if he does, it won’t be because he couldn’t pass a physical or was risking further damage. No one can question his toughness. How many other people can say that they walked off the field on two separate occasions with spine fractures?

MMMD 1: Paucity or plethora of injuries?

Some journalists have gotten the erroneous impression of 2016 being a good injury year a few days ago. The reality is that injuries are near the average.

Up until this weekend, we just didn’t have as many big name stars injured. Now with Romo injured and the parade of Achilles and ACLs continuing, within a day, the chorus has now come that this may be a bad injury year including calls to modify the preseason.

MMMD 2: John Harbaugh calls to change preseason

The Ravens head coach’s preference is for no preseason games at all to avoid injury. Harbaugh states that coaches can evaluate and ready players through practice and scrimmages. He also wants to add meaningful games.

While noble to try to find a way to decrease injuries, this would not do it. Injuries happen in practice and scrimmages as well. Adding regular season games certainly would also increase injury.

My long-standing proposal has been to eliminate one preseason game and add a second bye week, keeping the total length of players time the same. Having a week’s rest early and later in the season would be positive for player health. Paring Thursday games with a bye week would eliminate playing on four days rest. An added week of televised opportunities Sunday, Sunday night, Monday night and Thursday night games would boost revenue as well.

MMMD 3: Unusual in-game injury report

Last week we discussed how pre-game injury reporting was going to become more confusing this year. Sunday night, the Bengals broke form and went out of their way to give more than the typical cursory information.

All teams are required in-game is to give a body part and a status. When A.J. Green injured his knee, the team released more than that. Instead of the usual “knee – questionable (or out)”, the Bengals tweeted Green’s right knee as “reported as not serious”.

This helped calm fans worry. After the game, Green said he “banged knees”. I bet fans wish all teams would be this forthcoming with injury information.

MMMD 4: Achilles tears continue

Ben Watson TE Ravens tore his Achilles tendon. Brandon Oliver RB Chargers had a classic eccentric load Achilles rupture as well that was well documented with HD video. This is another example of how obvious some diagnoses are off publicly available images.

Achilles tears continue to be the second most common season ending injury to ACL tears. As players get bigger/faster/stronger, the size of the Achilles remains essentially the same. It is the strong muscle that overcomes the tendon to cause a tear.

MMMD 5: Preseason injury rundown

Bengals RB Cedric Peerman has a forearm fracture that will need surgery and is likely to be 6-12 weeks for return, making him an IR candidate and possible return.

The fear by video is Cardinals DB Mike Jenkins has an ACL tear. I hope my eyes deceive me here.

Ravens RB Kenneth Dixon has a mild MCL sprain. While media have said 4-6 weeks for return, I am hoping for 2-4 weeks.

Colts G Jack Mewhort does not have an ACL tear despite initial reports to that effect but will still miss some time.

Bears backup QB Connor Shaw has a tibia and fibula fracture and likely had immediate rodding surgery.

Steelers OT Marcus Gilbert hyperextended his elbow and is seeking a second opinion. As a lineman he should be ok for the season to play with a brace. By video, Steelers DE Cam Heyward had a mild high ankle sprain. Being seen in a boot but putting full weight on it is a good sign for Week 1 appearance.

Redskins RB Keith Marshall has a strained elbow and I fear ligament damage, but won’t need surgery and will return in weeks. LB Ryan Kerrigan has a groin strain. RB Matt Jones has a previous mild AC sprain and I expect a Week 1 return.

Tyler Eifert just started jogging and is targeting a Week 4-6 return and may be a PUP candidate.

Falcons S Keanu Neal will miss 3-4 with a “clean up” knee scope.

Rams WR Pharoh Cooper is said to be out several weeks. By video, he suffered a left AC joint sprain on a spectacular catch Saturday vs Broncos.

Texans LT Duane Brown with a torn quad is not expected to he ready for season and likely will be on PUP. Meanwhile C Nick Martin had ankle surgery and his season is over.

Patriots TE Rob Gronkowski is back practicing.

Bears OT Kyle Long has a torn labrum. Offensive lineman can play with a shoulder harness, unless the labral tear is in the more unusual posterior location.

Ravens WR Breshad Perriman is finally practicing.

Chiefs LB Tamba Hali is off PUP now.

Packers WR Jordy Nelson has been off PUP but is only doing individual drills and not full go yet.

MMMD 6: Eddie Lacy cutting his hair?

Hair is considered part of the body. Although tacking a player from behind by grabbing his hair is just as dangerous as a horse collar tackle, it is not illegal.

After just such a tackle, Lacy is considering cutting his hair. The Packers running back is not worried about the pain of losing some hair but rather the safety of his legs.

In this era of health and safety, I am surprised the competition committee has not outlawed pulling a player down from behind by any means, including hair.

MMMD 7: ProFootballDoc scorecard

One can never be perfect and I will definitely call my initial Tony Romo assessment a mistake. I didn’t see the injury when it happened as I was at the 15th annual Taste at the Cove fundraiser. Although when I saw the injury video the next morning, it had me worried about compression fracture. However; by then it was reported that Romo did not have X-rays at the stadium. I read too much into the fact that team doctors did not get films at the game. Dallas has a spine surgeon as one of it’s regular team doctors. I am right about it not being related to previous injuries, but the bottom line is this is an error in video diagnosis.

Brandon Oliver’s Achilles rupture was fairly easy and a classic example for the eccentric load injury.

Connor Shaw does indeed have a tibia and fibula fracture and had immediate surgery with a rod.

Ravens RB Kenneth Dixon did indeed have a MCL sprain.

These take the previous 20-0 record to 23-1 or 95.8%.

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