Monday Morning MD: Teams take different approaches to injury reporting

This season, the “probable” category for pregame injury reporting was removed. Now players need to be either eliminated entirely from the report and deemed ready to play, or placed in the “questionable” category. With the help of followers, I have gathered new injury reporting statistics. This season, approximately three out of every four (~75%) players listed as “questionable” are active league-wide, compared to just over half (~55%) in the previous year. At the halfway mark, it has become clear that teams take different approaches to injury reporting. I am not accusing any teams of manipulation or cheating; however, the numbers lead to stark contrasts. Over 90% of the “questionables” suit up for the Bengals, Panthers and Redskins. In contrast, under 50% of the same category are active for teams like the Titans, Jaguars and Seahawks. Here is a full list of teams and the percentage of “questionable” players that are ultimately activated each week through the first half of this season. RANK   TEAM   PERCENTAGE
  1. Bengals         100%
  2. Panthers         95%
  3. Redskins         91%
  4. Chargers         90%
  5. Bears               86%
  6. Buccaneers    84%
  7. Colts                84%
  8. Dolphins        80%
  9. Lions               79%
  10. Texans            79%
  11. Rams               77%
  12. Cardinals       76%
  13. Bills                 76%
  14. Jets                  75%
  15. Steelers           75%
  16. Raiders           72%
  17. Giants              71%
  18. Patriots           70%
  19. Cowboys         69%
  20. Ravens            66%
  21. Saints              65%
  22. Packers           64%
  23. Chiefs              64%
  24. Eagles              64%
  25. Falcons            60%
  26. Browns            59%
  27. 49ers                58%
  28. Broncos           54%
  29. Vikings            50%
  30. Seahawks        47%
  31. Jaguars            41%
  32. Titans               38%
Microanalysis will show many reasons for the differences. For example, the Bengals average only one player listed as “questionable” weekly but every player (a league low total of eight thru eight weeks) has been active. Some teams use the “doubtful” and “out” categories more liberally and thus have a higher percentage of “questionable” suit up. I am an injury expert, not a fantasy expert. Thus I will leave it to the fantasy gurus to interpret the significance of the mid-season findings. However, there is clearly a big difference between how the Bengals who have activated 100% of their “questionable” players and the Titans who have only suited up 38% of theirs. MMMD 1: Veteran leaders play through injury Ben Roethlisberger, Terrell Suggs and Steve Smith, Sr. all played Sunday for the AFC North lead in the Steelers at Ravens clash. None of the three were at 100%, but most players are not at this juncture of the season. All three have a history of toughness and early return from injury. Big Ben coming off knee scope and Smith dealing with a high ankle sprain will improve each week. Suggs who is putting off biceps tendon repair surgery will have to deal with elbow weakness for the rest of the year. Players will tell you that as the season marches on, 80% healthy is considered a good week. MMMD 2: Joe Flacco breaks knee brace not knee The Ravens QB scared fans when he came up hopping on one leg after an awkward slide. Fears of re-injury to his ACL or visual of a bone sticking out flashed through minds, but Flacco was fine. As he slid, his knee brace caught the turf and was mangled. cwqoarsuaaadfb6 Teams have spare knee braces, although they may not be the exact custom model for each player. The Ravens were at home but even on the road, athletic trainers pride themselves as “boy scouts” who are ready for anything. MMMD 3: More knee braces and Patriots health Even on their bye week, the Patriots made health news. Bill Belichick explained why he has the offensive line wear knee braces. Essentially every major college mandates it but it is rarely required at the professional level. A few teams like the Patriots and Cowboys insist, but players resist due to the perception restricting knee fluidity. A brace cannot prevent all injuries, but could lessen the degree of injury. Belichick also noted how his staff tries to prevent the avoidable non-contact injuries. Part of New England’s success this season may be having only three players on injured reserve versus the 19 from last season. The league average is approximately 10 IR players per season. MMMD 4: Marijuana use in NFL An ESPN survey of 226 players indicates 71% support legalization and 61% say fewer painkillers would be used if pot could be used. 22% claim they know a teammate who smoked before a game. 67% indicate the NFL testing for recreational drugs is not hard to beat. Overall, players feel marijuana is better for recovery and pain control than pills. If players are committed to this, look for the next CBA to change the rules on marijuana usage. MMMD 5: Medical sideline reporting improved With the change in the Thursday night broadcast from CBS to NBC, the medical updates are much more precise. The difference from one week to the next was noticeable. This is not a slight at the CBS sideline reporter, rather it is a compliment to the NBC sideline team that has a secret weapon. Longtime former Jaguars head athletic trainer, Mike Ryan, is on site behind the scenes providing his expertise. This is why reports now talk about specific tests and the anatomic references are all on point. Kudos to the NBC team for improving medical accuracy and the broadcast experience. The future is medical experts on broadcasts, like every network has a referee to help explain calls. MMMD 6: Injury rundown Maurkice Pouncey dislocated his right thumb and valiantly returned for one series. Look for surgery to be announced as dislocation is often associated with fracture. Unless he can move to guard or snap with his off hand, expect a 4-6 week absence. Darrius Heyward-Bey suffered a midfoot sprain. His absence will be determined by severity but will likely be weeks. By video, Allen Hurns had a left high ankle sprain but returned. His availability will depend on swelling. Victor Cruz had a low ankle sprain that should not keep him out for long if at all. Ryan Fitzpatrick injured his left knee and will get an MRI. By video, I am hoping for a minimal injury that could show a mild MCL sprain. Cody Kessler had X-rays on his right leg that were negative and should not miss time. Derek Wolfe hyperextended his right elbow and had a non-displaced coronoid process fracture. If the piece is small, he can avoid surgery and return in 4-6 weeks and possibly sooner with a brace. Justin Pugh, by video, exited with a MCL sprain. His return with a brace will depend on severity and swelling. Derrick Henry injured his calf in warm ups. Careful here, as medially, gastrocnemius muscle strains tend to linger. Sammy Watkins is out of his boot but that doesn’t meant he is ready. Being placed on IR means he is out for at least another month anyways. Mike Evans was initially cleared for concussion and later removed from the game. Hope he can return next week. Jameis Winston’s knee injury is not expected to be significant. Jamaal Charles’ menisectomy lends to a quicker recovery than the meniscus repair for C.J. Anderson. Charles has to now overcome swelling of the other knee, his IR status, age approaching 30 and a high salary cap number. Doug Martin (hamstring) should be able to beat Jacquizz Rodgers (Lisfranc midfoot sprain) back for the Buccaneers. Carlos Hyde missed another week with, by video, what seems to be an AC joint sprain. MMMD 7: ProFootballDoc scorecard Big Ben played in three weeks as expected. Terrell Suggs and Steve Smith, Sr also played. Sean Smith missed the game with left shoulder subluxation. It was time to worry on Jamaal Charles who had surgery and was placed on IR. Jameis Winston’s knee seems OK. Kwon Alexander had a stinger. Ty Montgomery sickle cell issue was only a one-week ordeal. Tyrann Mathieu did dislocate his shoulder. Barry Church is out 4-6 weeks with a forearm fracture. Corey Coleman missed six weeks with a broken hand. Referee Ed Walker tore his quad and Wade Phillips is OK but neither of these will count as this scorecard is for player predictions. The previous 96-5 (95.0%) record improves to 107-5 (95.5%).
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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