November 28, 2016 - Dr. David Chao
Monday Morning MD: Solution for Thursday Night Games
Coming off the biggest Thursday with three Thanksgiving games there seems to be a renewed call to get rid of some midweek contests. Even John Madden is critical saying “it just doesn’t work”. The league is reportedly revisiting the subject to consider ending or limiting Thursday Night Football. My suggestion that I first wrote about in 2014 is simple. Add a second bye week and pair all teams playing on a Thursday with a bye. This way, there would be 11 days before and still 10 days after. Playing on four days rest and all of its problems would be eliminated. There would be no more health and safety concerns. Players like Andrew Luck who missed the Thanksgiving game with concussion could then play and improve the competitiveness of the game. There would be no need to schedule only regional matchups to avoid long flights and thus provide more compelling matchups. Teams would be able to install normal game plans and the quality of the product would improve. Teams look forward to the bye week and there are often complaints that the singular break comes too early or too late. Byes are universally acknowledged to be good for player health and recovery so why not have one in the first half of the season and another in the second? To alleviate the CBA and scheduling concerns of adding a week to the season, the league could get rid of one preseason game. The money lost doing that would be more than made up for by the TV revenue of an extra Sunday, Monday and Thursday game as well as an extra slate of games in the regular Sunday slots. Currently, it is impossible to follow all the nine or ten early games or the three to four later games and spreading 16 weeks of football over 18 weeks would barely be noticed. A second bye week was tried in 1993 but that was over two decades ago and the league only had 28 teams at the time instead of 32, so it was like four teams were on a perpetual bye already in terms of scheduling. Heck, if this happened, the league could even add a Wednesday night game and there would be no short week issues. The bottom line is, I believe players would be in favor of adding a second bye and pairing Thursday games as long as it didn’t lengthen the season. Owners will be for it as there would be more dollars to be had. Fans would get one more week of meaningful football. In the end, this is a rare opportunity for the NFL to improve safety and increase revenue at the same time. MMMD 1: Derek Carr finger dislocation Finger dislocations are commonplace in the NFL. Often players will put their own fingers back into place without even running to the sidelines to seek medical help. Most linemen tape their fingers to help prevent dislocation. Most of us have seen the gnarled finger joints of ex-players. Derek Carr’s right fifth finger dislocation brought lots of attention as it was publicly visible, resulted in a turnover, he ran off the field with pain, everyone always notices the quarterback and it was on his throwing hand. By video, it was a pinky finger dislocation without associated fracture. The PIP joint is the most common one dislocated and once reduced is stable. Carr did go to the locker room for likely X-rays, tape/splint support, medication/treatment and returned with a glove to lead the Raiders to victory. Although he will be more sore and swollen after the game, Carr will play next week against the Bills. There may be some practice time and game modification but he should still perform well. Note that Carr lined up in victory formation from the pistol, likely to avoid the pain from a direct under center snap on his top dominant hand. MMMD 2: Brady and Gronk Both Tom Brady and Rob Gronkowski started the game as expected and the Patriots were lucky to escape the Jets with a win. Gronk chest issue and presumed pneumothorax was not a problem but he did leave the game early due to a back issue after a diving attempt at a pass. He did not return and was seen after the game walking stiffly and needing to use handrails on steps. By video, this is not a recurrence of disc herniation that has necessitated previous surgery. Back spasms can be tricky and this hopefully remains a short-term setback. Brady seemed to be off his normal game throwing high several times. He was clearly bothered as the Patriots QB even supported and favored his right knee as he sat down on the bench. I don’t think this is related to the Kam Chancellor hit to the thigh from two weeks ago. In any case, I expect this to be a relatively minor issue going forward. MMMD 3: Jordan Reed plays through severe AC injury The Redskins TE returned from a grade 3 acromial clavicular joint sprain to accumulate 10 catches and two touchdowns. After going down hard on his left shoulder, Reed was seen with a sling on. However, with some treatment and medication, he returned for a big second half. The bad news is that multiple ligaments around the end of the collarbone are torn causing significant pain, presence of an obvious deformity with a visible bump and he will miss significant practice time. The good news is Reed is unlikely to miss games, although he will have to play through pain despite the help of medication. The next game is the hardest as swelling sets in post-game. Ironically once the swelling subsides, a more severe grade 3 injury looks worse but is less painful than a less severe grade 2 sprain as the end of the clavicle is riding so high it no longer rubs against the acromion to cause pain. MMMD 4: Both Justin Houston and Von Miller dominate after ACL The Sunday Night Game featured two great pass rushers recovered from ACL surgery. Von Miller had a 2014 ACL surgery and Justin Houston is only 10 months out from reconstruction. Miller had 10 tackles (9 solo) with three sacks and four tackles for loss. Houston matched those numbers with 10 tackles (10 solo) with three sacks and five tackles for loss. Miller is the NFL season sack leader and Houston might be challenging for the lead if surgery on his November knee injury wasn’t delayed until February. MMMD 5: Harvard player health study The NFLPA has funded a Harvard study on NFL player health. The report was released last week including the top 10 recommendations. The best recommendation is for the NFL and NFLPA to stop using health issues as bargaining chips in the CBA negotiations. The most obvious are that all involved should follow a code of ethics and continue to collect/study injury data. The least game-changing is the suggestion that players be supported in their right to a second opinion as that is already the case and second opinions are very routine. The most controversial recommendation is the use of “player’s medical staff” not hired or reporting to the team. I see the potential ethical concerns but in reality they are not there. Just like this study has potential bias because it was funded by the NFLPA, doesn’t mean it is biased. If Dr. James Andrews can serve as a Redskins team physician and yet be considered ethical and above reproach, so can other team doctors. Besides a system of independent doctors would be very cumbersome and result in many delays. For example, I don’t see how Derek Carr or Jordan Reed return to play with their injuries this week under such a system. Of course you can make the argument they shouldn’t have, but I think both Reed and Carr would object to that. MMMD 6: Injury rundown LeSean McCoy played well as expected despite having surgery to relocate his thumb six days ago and rushed for 103 yards with 2 touchdowns and two catches for 31 yards. https://twitter.com/ProFootballDoc/status/802987411143725056 Justin Houston, by video, suffered a mild left AC sprain when he caused the safety, but returned quickly to the game. Odell Beckham Jr. had a thumb injury that did not seem to slow him down much. Luke Willson was said to have a mild knee sprain, which was not the same side as earlier this year. 18 months ago, some feared Jason Pierre-Paul’s career was over due to the fireworks injury. Instead, on Sunday he had 3 sacks and fumble return over 40 yards for a touchdown, a first in the NFL in over four decades. By video, Jordan Richards, Patriots safety, had a mild MCL. Luckily his knee was flexed and he avoided more severe injury and returned to play. The mechanism for Danny Trevathan’s knee injury is likely to result in a right ACL tear. Martellus Bennett seemed to re-aggravated right high ankle sprain that has bothered him since Week 5 but continued to play. Derek Wolfe returned in three weeks with a brace and avoided elbow surgery for a fractured coronoid process. MMMD 7: ProFootballDoc scorecard LeSean McCoy played well despite his thumb. He performed better than Sammy Watkins who was also active. Tom Brady and Rob Gronkowski played as expected. Jordan Reed’s injury was more than just a mild AC and was announced as Grade 3 sprain. Jamison Crowder was OK with low ankle sprain and continued to play. Josh Forrest was confirmed to tear a ligament in his knee. Robert Woods does have a significant MCL and missed the game. Andrew Luck was not cleared for the Thursday game. Marshall Newhouse did have a MCL sprain. Halapoulivaati Vaitai does have a MCL sprain. Demetri Goodson unfortunately is confirmed with a multi-ligament injury with ACL tear. Derek Wolfe did avoid surgery and returned in just under a month with an elbow brace. Blake Martinez missed with a confirmed MCL strain. Kelvin Benjamin returned to the game and caught a touchdown. This slightly improves the 130-6 (95.6%) record to 145-6 (96.0%).