Dr. David Chao
Latest NFL News

Not all ACL surgeries go smoothly. Even ones done by renowned orthopedic surgeons can go wrong.

After tearing up his knee last year, Dion Lewis flew to seek out who he thought was the best to perform the procedure but still had a serious complication. After his initial surgery, his kneecap developed a fracture from where the ACL graft was taken. He needed a second surgery with screws in his patella and missed a majority of this season.

The Divisional Round was his come back party. Lewis triumphantly scored three touchdowns in three different ways: receiving, rushing and special teams. He was a passing TD away from a historic cycle.

At the start of the season with Lewis missing, there were many questions why the Patriots could not get their star RB on the field. As I have always said, the truth comes out eventually. In fact, given the surgical complication, Lewis has made a tremendously quick recovery.

Medical staffs and especially team physicians are quick to get the blame. Their names are rarely mentioned when credit is due. When a second opinion doctor performs the surgery, their name is often announced with the obligatory proclamation that “surgery was successful”. When the team doctor does it, it is usually done in anonymity. In many ways the medical team is like offensive lineman or long snappers. Their names are often mentioned with blame but rarely with kudos.

I am glad this story has a happy ending but it serves a reminder that there is always risk in surgery and despite everyone thinking that return from ACL surgery is routine, there are definite pitfalls along the way.

Here are how the teams look from a health perspective headed into the Championship Games as well as the medical rundown.

MMMD 1: Packers injury outlook

The Jordy Nelson good news is that he has no organ damage, did travel to the game, and was on the sidelines. The bad news is he was moving very gingerly and I saw him clutching his ribs as he congratulated players on the first touchdown. Reports also said his current goal was to breathe normally again. With a week to go there is a chance, but far from a guarantee, that Nelson would play. If Green Bay gets to the Super Bowl, he would have an excellent chance of playing.

Morgan Burnett appeared to have a quad contusion. If the Packers can control swelling and maintain flexibility, he has a chance to play next week.

By video, David Bakhtiari suffered a mild right knee MCL sprain. He returned after being taped/braced. He should be fine moving straight ahead but likely will have some limitations side to side.

Slow motion showed DeVante Adams with a mild left high ankle sprain. He was taped and returned. Careful here with the swelling. I would expect a post-game boot and some missed practice but that he would try to go next week.

LaDarius Gunter appeared to have the wind knocked out of him and finished the game. I don’t seen any issues with him being 100%,

MMMD 2: Falcons injury outlook

Julio Jones left with a foot injury late in the game. The presumption is a re-aggravation of his turf toe. His coach said he could have continued but was pulled for the score. Jones will likely be limited in practice this week. This bears watching but the hope is Jones will be just fine.

Adrian Clayborn was reported to tear his biceps tendon at he elbow. Normally that is a season-ending injury that requires surgery. If Clayborn and the Falcons want to pull out all stops, he could try to play and have surgery after the season. It would be hard due to pain/swelling to play in the Championship game but he could play with some flexion and supination weakness in his elbow for the Super Bowl. Before you say this is far-fetched, ask Terrell Suggs. He played thru the second half of this season with a biceps tear.

MMMD 3: Patriots injury outlook

Chris Hogan appeared to have a thigh bruise and with good medical care should be good to go for the Championship Game.

Martellus Bennett survived a hyper-extension injury scare to finish the game and should be healthy.

Danny Ammendola continues his recovery from a high ankle sprain and another week should improve that.

MMMD 4: Steelers healthy

Big Ben is fine. The ankle scare when he was seen with a boot post-game last week is long behind us. As expected it was purely precautionary and he played and moved well.

Hope no injury news pops up as sometimes happens, but right now the big news in Pittsburgh is all about Antonio Brown’s social medial locker room post.

MMMD 5: Head coach younger than player

The Rams have a very young team but new head coach Sean McVay (age 30) is still younger than one player on his roster and the same age as two others. I am not sure what the NFL precedent is for this.

I don’t think this will be an issue. In my first eight years as a NFL team physician, there was at least one player on the team younger than me. That was an oddity but never an issue other than perhaps locker room banter.

MMMD 6: Will medical staff move with the Chargers?

Typically, the athletic training staff moves with the club. The doctors usually do not. NFL physicians all have full-time practices outside of the team that account for the majority of their income. With the move to Los Angeles, the UCSD medical sponsorship and the local team physicians will certainly change.

MMMD 7: Injury rundown

Chief WR Chris Conley took a vicious penalized hit to the head, yet returned to the game. Another example of how concussions cannot be judged by video. By the eye test, he certainly should have been removed from the game but the independent doctor allowed his return after examination.

Seattle CB DeShawn Shead likely tore his ACL. Unfortunately, that means surgery and starting next season on PUP.

Seahawk Germain Ifedi by video suffered a left high ankle sprain but will have plenty of time to recover for the offseason program

Jimmy Graham has made everyone forget about his patella tendon rupture playing very well at season end.

Mike Zimmer is just being honest on Bridgewater when he says “We don’t know when Teddy will be back”. Video posts show progress in rehab but he is a long way from a full return. A knee dislocation is among the severest of injuries.

MMMD extra: ProFootballDoc scorecard

I was on vacation with the family so I did not have my usual video capabilities in the hotel but thanks to the extra cameras and playoff coverage, many great replays were shown allowing me to still provide some input.

Davonte Adams returned from left high ankle sprain. David Bakhtiari returned from a mild MCL sprain. LaDarius Gunter avoided injury from a bad looking hit. DeShawn Shead appears to have torn his ACL.

C.J. Prosise did not play as expected and neither did Jordy Nelson. Big Ben’s foot/ankle was a non-issue. Blake Martinez was limited with his MCL.

This improves the 203-10 (95.3%) record to 211-10 (95.5%)

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Dr. David Chao
Latest NFL News

Will Big Ben or Jordy Nelson play this week? How will injuries play a role in who moves on to the Conference Championships?

Ben Roethlisberger made the collective hearts of Steelers Nation stop when he showed up at a post-game press conference in a boot. He injured his right ankle/foot on the final interception with 4:34 left to go in the fourth quarter up 18 points trying to extend a play. Big Ben was rolled up on with a plantar flexion sprain to his right ankle/foot. This is not a dreaded high ankle or Lisfranc sprain. Walking boots are commonly used as a precaution to help control swelling and will likely come off shortly. The Steelers QB may even skip a practice or two, adding to the drama. Recently, Roethlisberger has played through a meniscus tear, Lisfranc sprain and separated shoulder. I am expecting he is more hurt than injured here, thus Big Ben will undoubtedly be healthy and mobile when they face the Chiefs, but whether he has Ladarius Green as a target is up in the air due to concussion symptoms.


Jordy Nelson took a helmet to the left lower postero-lateral ribs and did not return. Not only is there worry for rib fracture, there is some concern for internal organ injury. He left the field on a cart with a primary care physician (not orthopedist). If there is a fracture (and there may be more than one), it will be difficult to play in Dallas this week for not only the pain, but the risk of injury to his spleen/lung/kidney. Without a fracture, Nelson might have a chance to play with medication/rib block and a flak jacket.

In other Packer news, Ty Montgomery who had recent ankle issues and was twisted up awkwardly and limped off the field. He returned to finish the game. By video, LB Blake Martinez injured his MCL. He had a similar injury in November. He could play and run well but would have trouble cutting.

Tom Savage has a good chance to get cleared from his Week 17 concussion but would still be the back up as Brock Osweiler has already been named the Texans starter.

Danny Ammendola returned to practice for the first time since the Week 13 apparent high ankle sprain. I expect him to be near 100% given he has had six weeks to recover by the time the Patriots kickoff.

The Cowboys should be at full strength with Tyron Smith coming off a mild MCL sprain and Morris Claiborne finally returning to action after a groin avulsion injury in Week 8.

I expect both Justin Houston (knee) and Spencer Ware (ribs) to both give it a go this week for the Chiefs.

Russell Wilson shed his knee brace and looks to finally be himself after knee and ankle issues for most of the season.

Let’s hope we see all players at full strength and may the better team win.

MMMD 1: Should Matt Moore have been pulled?

The Dolphins QB took a ferocious and penalized hit to the jaw. The internet was abuzz with outrage that he was returned to the game after missing just one play and thought that he could not have been properly checked for concussion.

I took a stopwatch to the sequence of events. With the prolonged time tending to Moore on the field and the adjudication of the multiple penalties, there was exactly five minutes of elapsed time between the hit and his next snap. If play had resumed immediately, Moore would have missed a handful of plays or more. He only missed one play due to the protracted stoppage.

Typically a sideline concussion screen only takes about two minutes. If positive, a full locker room evaluation takes approximately 10 minutes. The league appointed Unaffiliated Neurotrauma Consultant (UNC) was seen taking an active role. Remember, this is a local Pittsburgh area physician (who is likely a Steelers fan) and I would find it hard to believe he was influenced by the Dolphins’ desires to keep Moore in the game.

A hit to the jaw can cause a concussion. After all, that is why mouthpieces can decrease head injury risk. However, Moore was hit with more of a rotational force to the jaw torquing his neck and thus may have escaped concussion symptoms.

I don’t know the details of how the medical decisions were made but here is another reason for transparency. Referees are questioned by a pool reporter after the game. Why not let the UNC speak as to what he saw and what the medical thinking was? This would not be a patient privacy violation as the UNC is the league observer and is not there to treat the player and thus HIPAA would not apply.

MMMD 2: Changing of the guard?

Some are proclaiming Jadeveon Clowney as the new Texans defensive leader. Certainly he played well and with a skinny J.J. Watt in street clothes on the sideline, that was an easy narrative as we are prisoners of the moment.

Don’t count Watt out yet. First, the team is just being cautious after the second disc surgery. Second, I expect a full recovery, as disc surgery does not typically end careers. Third, it is easy for a workout warrior to lose muscle mass quickly but it is also relatively easy to regain weight with the start of lifting, if you have been that big before.

Expect a double-headed monster for the Texans defense next year, not a passing of the torch.

MMMD 3: Tyrod Taylor contractual controversy?

The Buffalo QB underwent sports hernia surgery as expected. The Bills announced Taylor “elected” to have the procedure. Is that wording posturing for the looming $27.5 million March contract guarantee?

Typically core muscle surgery takes 6-8 weeks to return to play but three months to be 100%. The March date comes in between this timeline.

By contract, the team physician will be the one to determine if Taylor is healthy. This does present a potential conflict. When I was a team doctor, I avoided these situations by asking the team to never inform me about the business side. It was my job to get all players healthy as soon as possible. The best player needed to be healthy to get on the field and the worst player on the team needed to be healthy to get released to make room for roster improvement. I did not want to be influenced by factors other than my medical judgment.

I hope the Bills ownership and Taylor can get on the same page

MMMD 4: Injury rundown

Dominique Rodgers-Cromartie suffered a thigh bruise early against the Packers. With a quad contusion and stiffness, it is hard to run and play cornerback. The challenge to get and stay loose was made harder in the cold and he was thus ineffective.

Jason Pierre-Paul will return to be 100% from his sports hernia surgery but there is no rush anymore as the Giants were eliminated.

Donald Penn reportedly has a small fracture in his knee but will not need surgery.

Ryan Tannenhill did not return from his ACL/MCL sprains. The MCL heals with conservative care but do not be surprised if surgery is announced for his ACL.

Jay Cutler’s shoulder labral surgery is recovering well. Whether the Bears will keep, cut or trade their QB, they need him healthy as soon as possible for all three potential reasons.

Trevor Siemian had left shoulder surgery. He finished the season but it is not unusual to have clean up procedures. This is why the end of the season is the busiest medical time of the year.

Terrelle Pryor had finger ligament surgery and is expected to have a full recovery.

Sammy Watkins finally is having his much anticipated second Jones fracture surgery. This time, likely bone graft and a larger screw will be used. Dez Bryant and Julian Edelman had similar second surgeries last offseason and recovered well.

Matthew Stafford will not need surgery on his mallet finger. The extensor tendon heals well with immobilization.

MMMD 5: Coaches union?

Brandon Marshall said, “It’s time for our coaches to unionize. We’ve had four coaches in the hospital this year. If people understood how many hours, and what it takes to be a head coach, how many hours they put in, it would be an issue.”

Perhaps instead of a union, it could be a competition committee issue. Even if hours were limited, coaches would take work home. However, that is still better for their health than long hours at the office.

MMMD 6: Jaylon Smith back in the news

The Cowboys high second round pick says he is still recovering and wearing his ankle foot orthosis (AFO) but can run a 4.5 40-yard dash.

I appreciate Smith’s optimism but I have never seen anyone in the NFL play with an AFO. Mike Ryan, a long-time NFL athletic trainer and now sports medical analyst for NBC, concurred.

A tendon transfer is not the answer either as those procedures are done to help everyday people to walk, not get around the corner to rush a QB.

I wish Smith the best and hope he can make history.

MMMD 7: ProFootballDoc scorecard

Matt McGloin was available but the Raiders played Connor Cook. Tom Savage was not cleared. Ryan Tannenhill was not ready to go. There was no way for Derek Carr to even travel to the game. Matt Forte did have a knee scope. C.J. Mosely had a calf strain and no surgery needed. JPP did not return. Tyrod Taylor and Sammy Watkins did have surgery as predicted. Jordy Nelson injured his ribs. Ty Montgomery is OK and returned. DRC had a quad contusion.

The previous 191-10 (95.0%) record is now 203-10 (95.3%).

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Danny Shimon
NFP Fresh Voices

With the conclusion of the 2016 regular season this past weekend many teams and their fans have started to gear up for the 2017 NFL Draft. While the complete and final draft order will not be finalized till after a Super Bowl Champion has been crowned the top-ten of the first round has been cemented, with the Cleveland Browns securing the top overall selection.
With College all-star games starting next week, followed by the scouting combine, and pro days a lot will change from now till draft day. Having said that here is a quick stab at what the teams selecting in the top-ten may do come April:

1. Cleveland – Myles Garrett, Texas A&M

The Browns number crunching front office sees no clear-cut franchise quarterback sitting atop of the draft and decide to go with a potential game changing pass rusher to improve their defense.
Garrett numbers were a bit down this season (8.5 sacks) as he dealt with a couple of lower-body injuries throughout the season. However, when healthy Garrett possesses the length and first step quickness off the edge, along with natural bend, that most dominant pass rushers must have.
Adding a talent like Garrett to a young defensive core that includes the likes of Jaime Collins (assuming he is resigned), Emmanuel Ogbah, Carl Nassib, and Danny Shelton will provide the Browns a good foundation to build on that side of the ball.

2. San Francisco – DeShone Kizer, Notre Dame

With a new GM and head coach tandem being hired this off-season the Niners decide to also usher in a new era at quarterback going with Notre Dames talented DeShone Kizer.
While North Carolina’s Mitch Trubisky appears to be the darling of the QB class early in the process, I feel like Kizers size, arm strength, and overall upside will shine above all others come draft time and he will be the first QB taken in this class.
While he had a up and down junior campaign in South Bend this past season (58.7 completion percentage) the tools and football makeup is there with Kizer. Despite the fact he may not be ready to start opening weekend of next season he does have a high ceiling, and is a prospect at a need position that San Francisco just can’t pass up.

3. Chicago – Jamal Adams, LSU

Another slot where the consensus pick will have a QB going is the bears at number three. However, with head coach John Fox entering a pivotal season, one in which he needs to win more games, Chicago looks to shore-up a safety position that has been a major need since Mike Brown left the team back in 2008.
In LSU safety Jamal Adams, the Bears get a physical player who will come down support the run and provide a presence in the Chicago secondary. Adams can also cover tight ends and offer over-the-top support on the defenses back-half.
Improving the secondary to go along with an underrated, and improving front seven will go a long way in helping the Bears get more wins next season.

4. Jacksonville – Jonathan Allen, Alabama

The Jaguars continue to add more talent to their defense as Alabama’s Jonathan Allen falls into their laps with the fourth pick.
Allen, considered by many one of the safest picks in this draft class, brings production and versatility from one of college football’s best defensive units. He can play multiple positions along a defensive front, and can provide pressure as both a 4-3 defensive end or inside tackle. Allen is also able to play end as a 5-technique if the Jaguars new coaching staff decides to switch to a 3-man front.
He is strong and athletic at the point-of-attack and could turn out to be a better pro than some of his highly-regarded Crimson Tide defensive predecessors.

5. Tennessee – Malik Hooker, Ohio State

The Titans get this selection from the Rams as part of the trade compensation they received from Los Angeles for the right to draft Jared Goff. With the selection, the Titans give defensive coordinator Dick LeBeau something he has been seeking since leaving the Steelers, and that is a ball hawking safety.
Hooker announced on Monday that he would be entering the draft even though he had two years of eligibility remaining and only one full season as a starter under his belt.
Hooker possesses good speed and displays tremendous range in coverage. He is also seemingly always around the football as he led the Big-Ten with seven interceptions (three of which he returned for touchdowns) last season to go along with four passes defensed and 74 tackles.

6. New York Jets – Leonard Fournette, LSU

Coming off a disappointing season, one in which many had them pegged to make the playoffs, the Jets are hoping to rebound next year and could look to build their team around a good defense and solid running game.
LSU Fournette is a workhorse back possessing the power, speed, and vision that can carry an offense. He can power through between the tackle runs, while also possessing the foot quickness and speed to bounce a run outside and take the edge on a defender.
With Fournette carrying the ball 25 times the Jets can help alleviate some of the deficiencies they will most likely have at the QB position next season.

7. San Diego – DeShaun Watson – Clemson

With the organizations exact location still up in the air and their future at quarterback, behind an aging Phillip Rivers, also uncertain the Chargers select Clemson’s Watson. Watson would be able to sit and learn behind Rivers, for a season or two, while providing the Chargers a future face of the franchise to sell and market to the new fan base.
Watson came into the season as a consensus top of the top QB. However, after a season in which he led the ACC with 17 interceptions some of the luster has worn off the junior signal caller. Meanwhile all he has done this season is once again lead his Clemson team back to the College Football National Championship game next week.
Watson’s dual-threat ability as both a passer and runner will add a new dimension to the Chargers offense. While also supplying the new coaching staff a talented centerpiece to build the offense around once Rivers time with the Chargers is up.

8. Carolina – Derek Barnett – Tennessee

The Panthers biggest need is along the offensive line, but without an offensive line prospect worthy of being selected in the top-ten Carolina looks to revamp an aging defensive line particularly at the end position.
Barnett could help supplant veteran Charles Johnson as he is set to be an unrestricted free agent as of this post. Barnett has posted 52 tackles for loss and 32 sacks over the last three seasons as a Volunteer. He displays the athleticism and ability to bend the corner off the edge that teams look for in pass rushers. Barnett is also a ferocious competitor who is constantly hustling all over the field.

9. Cincinnati – Reuben Foster, Alabama

With veteran Rey Maualuga getting up there in years and succumbing to injuries the last couple of season the Bengals select his heir apparent for the middle of their defense with Alabama’s Reuben Foster.
Foster is a highly aggressive, athletic, big-hitting middle linebacker with instincts for the position who can quickly diagnose, locate, and flow to the football. He has developed into a sideline-to-sideline tackling machine who can be a leader and cornerstone player for the Bengals defense for years to come.

10. Buffalo – Jabril Peppers, Michigan

The Bills select the third safety in the top ten and one many might be surprised lasted this long. Coming into the season the Wolverines do-it-all hybrid defender, and Heisman Trophy finalist, was touted as a sure-fire top-five selection. However, with some questions surrounding a positional fit for Peppers in the NFL, along with coverage limitations Peppers could find himself possibly sliding out of the top ten completely.
What he will supply the Bills, or any team selecting him, is a versatile defender who can line up in multiple spots for a defensive unit. While also providing a boost to the return game on special teams.
Whether it is at linebacker, free safety, returner, or even on offense Peppers can provide an immediate impact as a rookie next season. The key will be placing him with a coaching staff that will be creative in utilizing his abilities in a multitude of different ways.

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Dr. David Chao
Latest NFL News

To play or not to play was the theme of the week for both college football and the NFL. Leonard Fournette and Christian McCaffrey ignited debate when they decided to skip their college bowl games to prepare for the draft. Meanwhile the Cowboys and Steelers rested their stars in meaningless games as other teams played their starters.

Medically speaking, it is certainly smart to sit as it is the only way to avoid injury. McCaffrey’s teammate, Stanford QB Keller Chryst appeared to tear his ACL. Michigan’s high draft prospect TE Jake Butt tore his ACL which will affect his draft stock as there is no guarantee he will be ready for the start of the next season.

The key is what do the 32 NFL general managers think of the decision to miss bowl games. The natural question is: are they “me” guys more than “team” guys?

Sometimes the decision to miss the bowl game is clearly smart. Michigan’s Jabril Peppers was better off not playing for risk of making his hamstring injury worse and effecting his Combine as well as potentially being downgraded for not playing up to par.

On the other hand, not playing sometimes hurts. Florida State’s Dalvin Cook had a spectacular bowl game performance, which may have catapulted him to the top of the RB draft board. Meanwhile, Fournette could not respond to reclaim his top status as he had elected to sit.

NFL decisions to sit are made by the team not the individual player like in college. Weighing the potential of injury versus momentum/continuity is the playoff team’s dilemma. The Raiders clearly needed Matt McGloin to play to get more snaps but unfortunately he was injured.

If the argument is to always sit for meaningless games then the majority of the NFL would not play as most Week 17 contests had no postseason implications. In retrospect, the Cardinals probably wish they had sat David Johnson (details below).

There is precedent for NFL players to choose to skip meaningless “bowl” games. It is common for professionals to pull the injury card to skip out of the Pro Bowl. Tyler Eifert injured his ankle during the all-star game last year and needed surgery. He now says even if selected, he is never going back.

The bottom line is many things factor into a “play or sit” decision for the individual and teams. I certainly can’t argue with a player’s right to decide or a team’s necessity to strategize.

MMMD 1: Another QB concussion controversy?

Questions arose after Tom Savage was returned to play and then pulled due to concussion. It certainly looks fishy when the Texans QB is cleared and the head coach says at halftime he will play but he is re-evaluated and pulled from the game.

In reality, it is common to be fine and develop later concussion symptoms. It is routine for doctors to perform serial exams. Likely Savage had a routine re-check at halftime and doctors decided to pull him.

This is another reason that I have lobbied for more transparency. Why not let the doctors speak or at least issue a statement? Even referees are interviewed by a reporter post game. Understanding what happened would help clarify these situations and help dispel the distrust the public and media have for the NFL when it comes to concussions.

MMMD 2: Playoff QB injuries

With Savage in the concussion protocol, Brock Osweiler will be the likely Texans starter for the Wild Card round. The majority of head injuries are not cleared in one week. This will be a short week with the game on Saturday. Even if Savage was cleared late in the week, he would still miss practice snaps important for a first time starter.

Matt McGloin left the Raiders game with an apparent left AC joint sprain and later reports of trap muscle issues. It appeared that McGloin was not happy he was replaced and he was in uniform on the sidelines for the second half. It will be interesting to see if Connor Cook gets the playoff start and how much of this is coaching decision versus purely injury.

Matthew Stafford’s injury appears to be a mallet finger. I have suspected this by the type of splint but media had only reported dislocation with torn ligaments. A mallet finger is a tear to the extensor tendon at the tip of the finger and requires full-time immobilization in extension for six weeks or there is risk for surgery. Stafford can play through without long-term implications but a mallet finger injury is significantly harder to deal with than a finger dislocation as it affects his grip since he is not allowed to bend the tip of his middle finger. This could explain his declined performance post injury.

David Carr reports that brother Derek’s ankle ligament was not torn and the fracture was already healing. That may be a lay person’s interpretation but no way a bone starts to heal in three days. Also when your knee points “north” and your toes point “east”, the syndesmotic ligament is torn even before the fracture happens. Derek Carr will be back at 100%, but no way it will be in time for a potential Super Bowl appearance.

Ryan Tannenhill seems to be getting closer to playing but I think it will be beating the odds for him to be the Dolphins Wild Card round starting QB. Even if it is just a grade 2 MCL, it is a stretch to go from a cast and a crutch to playing NFL football in three weeks.

Aaron Rodgers seems to have put any worries about his calf strain and hamstring injury behind him. He moved and ran well during the Packers win to seize the NFC North crown.

Tony Romo played in a real game for the first time in over a year. He is completely healed and at no further risk for injury. What a luxury for the Cowboys to have an experienced back up like Romo.

MMMD 3: David Johnson escapes horrific injury

By video, many feared the worst for the Cardinals star RB. Fortunately, it seems to be the best-case scenario for Johnson with only a significant MCL injury with his ACL spared. He is unlikely to need surgery and should be healthy for the offseason program.

MMMD 4: Jets medical staff blamed

Muhammad Wilkerson appeared to criticize his team’s training staff for not having a plan as he returned from ankle surgery. He did acknowledge his responsibility in the process as well.

There is no question that hindsight is 20/20 and that medical staffs can look back and wish they had approached an injury differently. However, it is unusual to call out a teammate and indeed the athletic trainers are looked upon as teammates.

Undoubtedly the medical staff was consulted before Wilkerson was offered an $86 million contract while he was injured this offseason. If anything, he should thank the trainers and doctors for vouching for his ability to recover.

MMMD 5: Decreased injuries with more touchbacks?

The rule change to place the ball on the 25-yard line has decreased kick-off returns but has it reduced injuries? Bill Belichick cited the Broncos Kayvon Webster’s concussion as an example of how the new rule has not worked. Sometimes injuries can happen when covering teams ease up as they see the runner kneeling down, but blockers don’t know the play is over. Full speed versus half speed will result in injury.

I am eager to see the season long statistics on this rule change. The NFL usually releases this type of injury data during the Super Bowl week health and safety press conference..

MMMD 6: Non QB Injury rundown

Vic Beasley left shoulder “popped out” but he returned to finish the game with a brace. Don’t be surprised if he needs offseason surgery similar to what he had on the right side last year.

Zaire Anderson was placed on a spine board after a head down hit. Fortunately he was released from the hospital.

Donald Penn left the game with a knee injury but returned. He will likely play against the Texans on Saturday.

C.J. Mosely was carted to the locker room but I do not expect a serious left leg injury.

Sammy Watkins injured his hip that he had surgery on in 2015. The hip does not appear to be severe but he will need to address his 5th metatarsal lingering fracture which may need a second surgery to heal properly.

Quinten Rollins was placed on a spine board for head/neck injury but early reports indicate that he will be OK.

DeMarco Murray played with a plantar plate injury this season to become the leading AFC rusher. This is essentially a turf toe injury. He will avoid surgery unless the plantar plate is retracted.

Ryan Kerrigan exited with left hand/finger injury

Ty Montgomery left the game briefly with and ankle issue but returned to be effective.

Tyrod Taylor has a groin injury and don’t be surprised if he elects to have a sports hernia surgery.

Tyler Eifert had back surgery. It has been a rough year after his ankle surgery from the Pro Bowl injury.

Tyron Smith sat out with a mild MCL from last week where the knee brace may have saved him form more severe injury.

MMMD 7: ProFootballDoc scorecard

Only a few injury first takes this week as I was on vacation with the family in the mountains and did not have my usual set up and access to all videos. David Johnson fortunately with only MCL sprain. McGloin has an AC joint sprain and trap spasm. Quinten Rollins neck was OK. Tyron Smith did have a mild MCL.

Last week’s 187-10 (94.9%) is now 191-10 (95.0%).

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Dr. David Chao
Latest NFL News

The leader of the Raiders and Titans both were announced to have suffered broken fibulas. Unfortunately by video, the injury is more than just to the bone. Both were felled by the severest form of high ankle sprain where the syndesmotic ligament (holds the fibula and tibia together) is torn before the fracture even happens.

Essentially both injuries are considered ankle fracture-dislocations where the talus (ankle bone) shifts out of place. The need for surgery is not for the fibula fracture as much as to reposition the bones due to the ligament tear.

Derek Carr was reported to be having surgery on Christmas Day, but was delayed due to holiday staffing issues and he is now reported to travel to Los Angeles for the procedure. Marcus Mariota was set to have surgery in the next few days after injury. The procedure is not an emergency and can be done in the first week or two.

The initial urgency for Carr’s surgery may have been born out of a desire to keep any slim hopes of a Super Bowl 51 return alive. Assuming the Raiders make it to the big game six weeks away, it would still be a considerable stretch to think that Carr would perform anywhere near his MVP candidate level. This is not just an issue of bone healing but one of the ligament and associated structures as well. Typically, this injury carries a six-month recovery, thus reports of earlier return seem optimistic to me. To cite the Charles Woodson or Terrell Owens early Super Bowl return from ankle fracture would be unfair comparisons as there is a dislocation component here for Carr.

The good news is that this is not a career-ending injury and both should return to essentially 100%. A good example is Darren Sproles who had a similar injury/surgery 10 years ago and continues to perform at a high level and is still known for his quick cuts as a running back. Both quarterbacks should be ready for the start of the 2017 season.

MMMD 1: Another broken leg

Tyler Lockett suffered a gruesome tibia and fibula fracture (graphic video here). Teammate Earl Thomas broke only his tibia and did not need surgery. Lockett broke both bones and likely has an open fracture with the description of blood immediately on the field.

This fracture is very unstable and requires early surgery. Fortunately the Seahawks were in Seattle, otherwise Lockett would have needed surgery before flying home.

Despite how horrific the injury seems, this is not a career-ending injury. Many others, including Patriots fullback James Develin last season, have made full recoveries. This is a similar injury to NBA’s Paul George and UFC’s Anderson Silva who both have returned to their sport. Lockett may not be ready for the start of the season as there is typically a 6-9 month recovery.

MMMD 2: Earl Thomas returning

Thomas likely suffered a non-displaced isolated tibia fracture and thus did not need surgery. He contemplated retirement at the time.

Medically, this was not an injury that ends careers. I would not begrudge any athlete who chooses to retire as I agree one needs to be “all in” to play effectively.

Fortunately for us as fans, Thomas has decided to return next season. Since he tweeted retirement thoughts on his twitter account immediately after the injury, it was appropriate that he used twitter to announce his return.

MMMD 3: Play or sit?

Christian McCaffrey and Leonard Fournette started much discussion with their decision to skip bowl games to prepare for the draft. Skipping games is a precedent that already exists in the NFL. Many players choose to miss the Pro Bowl. Tyler Eifert hurt his ankle there last year and needed surgery, which affected his season. He would not go back if asked.

Now the discussion of play or sit turns to the teams that have clinched post-season spots. For example, should the Cowboys sit their stars for rest and/or injury protection or keep momentum going? Does the season-ending injuries to Carr and Mariota make it more likely we see Tony Romo over Dak Prescott to finish the regular season?

MMMD 4: Return to play decisions

A.J. Green is unhappy he was not allowed to play. He made the trip to Houston for the Christmas Eve game with the expectation to suit up, while other injured players stayed behind.

Green was pulled from a team meeting and informed of the ownerships decision to not risk further injury and he subsequently flew home. The decision was based on fear that the tendon portion of the hamstring injury had not fully healed and further damage might mean surgery.

Return to play is always decided by a unanimous vote between the player, medical staff and the team. It is clearly within the ownerships rights to withhold the player, but perhaps communication of that intent prior to travelling to the game would prevent any hard feelings.

MMMD 5: Team doctors care for more than players

Todd Bowles was treated for kidney stones and gall bladder issues. With Gary Kubiak (complex migraine) and Mike Zimmer (retinal detachment), that marks the third head coach to be hospitalized this season which is a higher rate than for players.

Line Judge Sarah Thomas was knocked down and taken to the locker room. She did return to finish the Vikings at Packers game.

Head coaches and all team staff are cared for by team physicians. In fact, coaches’ physicals is a big part of a team doctor’s job. On game days, the home team medical staff is responsible for providing care to the game officials.

MMMD 6: Injury rundown

Aaron Rodgers left the game briefly with a stinger. This should not be a major deal if the Packers protection holds up. The calf injury seems to have progressed nicely.

Ryan Tannehill came out of his cast which is certainly good news. Still with the partial ACL/MCL injury, he may not be ready to go for the wildcard round.

Jay Ajayi fell on his left shoulder in overtime suffering a likely AC joint sprain that is hopefully mild and won’t have him missing time.

Carlos Hyde injured his knee and will be done for the season. MCL sprains do not typically need surgery and he will be healthy for the off-season program.

Justin Houston sat out, proving again that even though players return well from ACL surgery, the second season back is the fully healthy one.

Robert Griffin III left with a concussion but the Browns notched their first victory.

Jordan Reed did not play with his grade 3 AC separation which is usually a six week injury.

Ryan Matthews is reported to have a herniated disc in his neck. Even if he needs surgery, return from single level cervical discectomy/fusion is reliable in the NFL.

Derek Wolfe left with a neck injury that has plagued him in second half of this season.

Kayvon Webster was blind-sided, but riding off in the passenger seat of the cart is a great sign that his spine was OK. Of course his head injury will need evaluation.

MMMD 7: ProFootballDoc scorecard

Unfortunately the significant injuries to Derek Carr, Marcus Mariota and Tyler Lockett were easily seen on video. Will Gholston did dislocate his elbow missing this week. Kayvon Webster suffered a concussion but was spared neck or back injury. Earl Thomas will play in 2017 as expected.

The previous 181-10 (94.8%) record now improves slightly to 187-10, a 94.9% accuracy rate.

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