Monday Morning MD: Offensive line injures aplenty

Fans may think of this week as a relatively healthy one. In reality there were plenty of injuries. A plethora of offensive players were hurt, just not the ones most fantasy owners and fans are interested in. Offensive line injuries lead the way in Week 10. The trend began on Thursday when the Ravens left guard was carted off and their center limped off. Alex Lewis’ right leg was placed in a vacuum splint after being rolled up on. Though early reports indicated no fracture, by video, Lewis has a significant high ankle injury that will result in an extended absence and may still need surgery. Teammate Jeremy Zuttah was much luckier with a standard basketball type low ankle sprain. cw811xsusaaua3o The trend continued Sunday when two linemen with the last name Long (no relation) suffered apparent season ending injuries. Kyle Long of the Bears was carted off in an air splint. By video, he suffered a significant high ankle injury with possible fibula fracture and likely needs surgery. Jake Long’s twice torn left ACL was spared but video evidence of a left Achilles rupture was later confirmed by his head coach. The Vikings have now lost their third offensive tackle and their fourth consecutive game after five victories to open the season. Dolphins left tackle Brandon Albert was reported to have dislocated his wrist but finished the game in a cast. A wrist (lunate) dislocation means ligaments are torn, thus surgery is likely. Miami is on an 11-day west coast trip (played Chargers on Sunday and Rams up next) creating logistical difficulties but I hope the injury is not truly a medical dislocation. Knee injuries knocked out the Packers David Bakhtiari and Buccaneers Evan Smith. Also Packers guard T.J. Lang, by video, left with a high ankle sprain. Meanwhile, Bears Bobby Massie left with a concussion. This may seem like a good week of injures as the offensive stars stayed healthy. However, their protectors took their share of injuries. MMMD 1: Injuries to stars narrowly avoided Near miss was the theme of the day. Tom Brady avoided a hit to the knee, instead took a blow to the thigh just above. He avoided serious injury but instead will deal with a quad muscle contusion. Teammate Rob Gronkowski took one of his hardest hits ever but since Earl Thomas stayed away from the head delivering the blow, Gronk avoided concussion. cxmicpyusaewwj8 Larry Fitzgerald and Lamar Miller returned for the second half after brief absences. Jordan Howard’s coach said he hurt his ankle or Achilles. By video, Howard does not have a tendon tear. I am always happy to be reporting good news. MMMD 2: Running back news Christine Michael was active but limited with his late week hamstring issue. Doug Martin finally returned from his Week 2 hamstring injury and re-aggravation. Dion Lewis was activated off PUP with his post-ACL patella stress fracture but was not dressed this week. DeAngelo Williams had midweek knee scope and is likely out longer than the initial three-week estimate. MMMD 3: Tony Romo not active The Cowboys QB is almost three months out from his L1 back compression fracture. He has been medically cleared. No one is arguing that Dak Prescott should relinquish the starting job as the Cowboys now have the best record in the NFL. However, it was interesting that Romo was not even dressed as the back up. Even if Romo has not practiced with the first team, isn’t a rusty Romo better than Mark Sanchez who has yet to take a live snap as a Cowboy? After the game, Jerry Jones said indeed Romo would be the backup next week. After all, every 2nd stringer is one play away from being the starter.. MMMD 4: Maurkice Pouncey heroic The Steelers center tried to return last week after dislocating his thumb but lasted only one series. After thumb surgery, he is to be congratulated for not missing more time. A snapping hand injury is like a throwing hand injury for a QB. With a cast and likely pins/screws to stabilize the thumb, Pouncey played with what could have been a 4-6 week injury. There were a couple of low snaps, but that could be forgiven. Kudos to the Steelers medical staff. MMMD 5: NFL can go further for safety As the league has begun its public relations campaign, I hope it continues to go further for safety. Commercials with Dean Blandino touting 42 rules changes including the elimination of the three-man wedge ran last week. This week featured a second ad pointing out sideline video, radio communication, hand held tablets with medical records and X-ray access. These are all good advances. I remember getting multiple memos from the league saying cell phones are illegal on the sidelines. I argued they were necessary for communication to other medical personnel that may be in the locker room or with a hospital. The league now supplies all medical personnel with earpiece and radio. A simple additional change is to not have mandatory charged timeouts when checking on player health. This would have prevented the Case Keenum situation from last year. It also would have helped with the Bills at Seahawks debacle Monday night at the end of the half. When medical came onto the field to check on the down kicker, the Bills were out of timeouts, meaning he had to leave for one play. Allowing medical checks without penalty of timeout would improve safety by removing the inhibition to check a player. Of course, the league would have to police for injury faking but if medical is a priority, this change should be done. MMMD 6: Injury rundown DeSean Jackson’s rotator cuff injury kept him out even with the bye week to recover. The hope is that there is no tear. Remember, a partial tear led to surgery and injured reserve for Eric Decker earlier this season. Last week, people took note that Jimmy Graham was finally healthy after patella tendon repair. Now it seems his QB is fully healthy. Russell Wilson looks like his same old self while leading the Seahawks to a big win over the Patriots. His high ankle, knee MCL and pectoral muscle injuries seem to have finally improved. The Steelers big free agent tight end signing finally played. Ladarius Green is off PUP and had three catches. It is unusual for a free agent to end up on PUP like he did since teams perform full physicals before inking deals, but that is all behind the team now. MMMD 7: ProFootballDoc scorecard Ryan Fitzpatrick did have a mild MCL sprain. Mike Evans did return from concussion in one week as expected. Eric Wood did suffer a high ankle fracture and need surgery. Justin Pugh did have a MCL sprain. Derek Wolfe will return soon from a hairline elbow fracture. Doug Martin did beat Jacquizz Rodgers back. Jake Long does have an Achilles rupture. Kyle Long does have a high ankle injury/fracture. Alex Lewis has a significant high ankle injury. Jeremy Zuttah’s low ankle sprain is not severe. Credit Maurkice Pouncey and the Steelers medical staff for having him ready to play against the odds. Although the point of my tweets were correct about a snapping side injury for a center, he beat the odds and returned early so it will count as a mistake. This makes the previous 107-5 (95.5%) record update to 117-6 (95.1%).
Dr. David Chao
Two decades of NFL team physician experience including two Super Bowls and two Pro Bowls. Providing unique perspective to injuries and the NFL sideline/locker room. Successful orthopedic surgery and sports medicine practice in Southern California.

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