The Jocs and Docs Show is back with our weekly injury wrap up. Dive in as our experts give you the need to know about the major NFL injuries of the past week.
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Tony Romo – DAL – QB
Docs (Dr. Khalid)
Tony Romo rebroke his left clavicle on Thanksgiving after suffering a hit from Thomas Davis. Romo, who was now 10 weeks removed from his initial injury, instinctively rolled onto his left side and was crushed under the weight of Davis in a mechanism that puts stress directly onto the clavicle.
As soon as Romo reached for the left shoulder, the diagnosis was obvious. Romo would eventually have X-rays in the locker room, and a CT scan the next day confirmed a slight refracture of the left clavicle. At that point Romo was declared out for the year.
There were many questions surfacing after this injury. First, should Romo have had surgery after the initial break? For clavicle fractures, surgery is not always the best options. These fractures often heal very reliably without surgery if they are not grossly displaced. Romo’s decision to not undergo surgery was a legitimate path to take for this injury. Surgery is not a trivial issue. Outside of the risks of anesthesia, there are always risks of infection with placing plates and screws inside of the body. The advantages of surgery include a faster recovery and ability to begin rehab. With Romo being placed on the IR/eligible to return list, he had plenty of time to recover and rehab, surgery or not.
The other question raised was whether Romo should have waited until he was 100% before returning. This answer is more simple. Romo’s clavicle was 10 weeks removed from the initial injury. The bone does not heal to 100% until three-to-six months following initial injury but does heal enough to return to play at about six-to-eight weeks. Romo’s clavicle had a slightly elevated risk of refracturing and he happened to draw the short straw.
X-rays were inconclusive in the locker room because the bone shown on the X-ray was still remodeling. It is hard to distinguish between what is a healing old fracture and what is new injury. A CT scan (better resolution) performed the next day confirmed a slight break in the area of the original fracture. This is significant because Romo may be able to heal without surgery again. This will surely raise a few more questions, but, given the offseason, Romo should heal to 100% with or without surgery. Expect Romo to be 100% without any issues to start training camp 2016.
Jocs (Adi)
With Romo out for the year the entire offense comes into question. Darren McFadden should still get a bulk of carries and three-to-five receptions a game no matter who the QB is. If I was a Dez Bryant owner I would be very concerned. Many owners kept him through injury hoping that when Romo came back they could hit pay dirt towards the end of the season and in the playoffs. Unfortunately, these owners are now placed in a position where they are reliant on Dez.
Jerry Jones categorically denied that Bryant would be shut down for the year, so the best hope is that as the primary target on an anemic offense he can at least muster up WR2 numbers. I think he can and will.
Finally, Jason Witten, who has been a ghost recently, is not going to all of a sudden emerge as a stud. In the last several weeks he hasn’t totaled 50 yards or a receiving touchdown. Hard to see things changing now.
Allen Hurns – JAC – WR
Docs (Dr. Khalid)
Allen Hurns gave everyone a scare this week after taking a brutal blow to the head and requiring a stretcher to leave the field. Hurns was taken to the hospital to evaluate his neck. The good news was that his neck and spine were cleared and the stretcher was precautionary. The bad news is that Hurns is now in the league’s concussion protocol.
The concussion protocol is fairly extensive and generally involves the player progressing from meetings, to running and weight training, to light practice, to full practice without having symptoms after each step. The protocol usually takes about 5 days to complete, but, as we saw with Devonta Freeman last week, there is no guarantee that they will make it through with enough time to be ready for the next week.
I do not expect the fact that Hurns needed a stretcher means his concussion is more severe. The worry for neck injury should have minimal impact on his concussion. A good sign would be for Hurns to resume practice on Wednesday or Thursday. If not, find a backup plan this week.
Jocs (Adi)
Hopefully Hurns is not out for more than a week with fantasy playoffs approaching. As a reliable receiver all season it would be a shame to see his tremendous campaign go to waste. With over 750 yards and seven touchdowns so far this season, it’s easy to see that the Jaguars’ offense will miss him.
Look for Julius Thomas to build off a strong performance this Sunday, taking some of those additional targets. Allen Robinson will also see more targets and will continue to produce at a WR1 level. Blake Bortles, who has been a high-performing fantasy QB so far this season, will continue to throw at a high rate. The injury shouldn’t impair his value much at all.
Chris Johnson/Andre Ellington – ARI – RB
Docs (Dr. Khalid)
The top two Arizona RBs both suffered injuries this week knocking them out of the game. Johnson took a helmet to his knee and was seen limping off the field. He attempted to run on the sidelines but was eventually taken back to the locker room. Anytime contact is made like that, the immediate issue is a knee contusion. This is usually a pain control and swelling issue. He may have also sprained a knee ligament on that play. We just do not know what the exact injury is at this point, so guessing his status for Sunday is futile. Expect Johnson to be monitored closely this week and possibly even receive an MRI of the knee. Hopefully we see a return to practice on Thursday or Friday.
Ellington also left the game after Johnson with a foot injury. Similar to Johnson, we do not have any details regarding the injury. The most likely scenario is a mid-foot sprain or turf toe. X-rays have already likely been performed and any possible fracture would already be known. The fact we haven’t heard anything suggests a sprain. I would not be surprised to see Ellington next to Johnson in the MRI suite Monday. If significant, we may not see Ellington for a few weeks. For fantasy owners, prepare this week as if both players are not going to play Sunday, although I think Johnson probably has a better shot.
Jocs (Aman)
If both Chris Johnson and Andre Ellington don’t play this week, David Johnson will be a great waiver wire pickup. Although the rookie hasn’t been great on the ground this year, he’s provided yards through the air. On the year he’s had 249 receiving yards and four touchdowns. David Johnson has shown that he can make explosive plays, whether it be on the ground, air, or during returns. He has seven total touchdowns on the year for the Cardinals who play the seemingly broken St. Louis Rams next week.
In a pivotal Week 13 (the last game of the regular season for most leagues), David Johnson could provide the perfect waiver wire pickup needed to get that crucial win.
Jimmy Graham – SEA – TE
Docs (Dr. Khalid)
The award for most devastating injury of the week (and possibly season) goes to Jimmy Graham. Graham suffered a patellar tendon tear in the end zone towards the end of Sunday’s game against the Steelers.
The patellar tendon runs over the knee cap and essentially connects the thigh to the lower leg. This tendon is responsible for kicking the leg out. As you can imagine, a tear to this tendon is devastating for any player. This is probably one of the worst injuries an athlete can obtain. You do not need to go far to see similar examples. Victor Cruz has yet to see the field after suffering a similar injury last year. Ryan Williams and Cadillac Williams also were recent examples of the injury. We can even go as far back as Correll Buckhalter and Nate Allen.
The common thread here is that all of these players have never returned to their previous form. This injury is devastating. Graham will have surgery to repair the tendon and then will embark on a six-to-eight month recovery trek. This initial timetable is also dependent on everything going smoothly, which is a very tenuous assumption.
After this injury, there is a high risk of both rerupture of the tendon (the repaired tendon is not as strong as the original) and compensatory injuries. After recovery, players almost never have the same explosiveness or athleticism that they had pre-injury. The good news for Graham is his recovery will be easier than Cruz’s simply because he does not use the same explosive movements that Cruz does as a WR. Graham’s biggest issue will be his vertical ability.
Make no doubt Graham is fighting a Kilimanjaro-sized uphill battle, and I cannot guarantee he will be 100% in 2016.
Jocs (Adi)
Graham had been a disappointment to fantasy owners so far this year. However, we were all hoping he would come through as the Seahawks entered the playoff chase. Fortunately for the Seahawks, this injury doesn’t change much on their offense. The one benefit of not giving Graham the targets his talent dictates is that if he gets injured your offense can survive easily.
Russell Wilson’s numbers won’t change much, and nobody on the Seahawks receiving corps will all of a sudden become a WR1. Luke Willson is the next man up at the TE position for the Seahawks. However, it’s doubtful he will be worthy of a starting TE spot. So far this season he has 12 receptions, and the tight end position was not a priority in the offense to begin with.
Ben Roethlisberger – PIT – QB
Docs (Dr. Khalid)
Ben Roethlisberger also joined the league’s concussion protocol club this week after suffering a hit to the head on the Steelers’ last drive. Everything we discussed for Allen Hurns also applies to Roethlisberger at this point. The interesting aspect of Roethlisberger’s injury is whether or not there was a failure to spot the initial injury. Roethlisberger seemed to play about eight-to-nine plays after the hit and was taken to the locker room after the drive ended. With the recent mishandling of Case Keenum, the NFL will probably look into this incident as well. Although, I believe this injury is not as blatant as that of Keenum, for which the NFL acquitted all involved parties. The NFL needs to re-examine its protocol to prevent these instances from happening.
Jocs (Adi)
One thing is for sure, and that is we already have a large sample size of how the Pittsburgh offense fares without Big Ben. It’s not always a pretty picture.
However, players like Martavis Bryant and Antonio Brown still retain must-start statuses simply because the lack of replacement options at this point in the year. With Big Ben playing, Brown has averaged 136.7 ypg compared to 58.8 ypg without him. So be prepared for disappointment.
Starting RB DeAngelo Williams is still a must-start as he will get a bulk of the carries and several catches out of the backfield. Heath Miller will become a boom-or-bust TE selection. Finally, any other WR which was previously tempting (Markus Wheaton) when Big Ben started now becomes much riskier.
Steelers’ fans and Big Ben owners need to monitor the concussion protocol and hope that Roethlisberger starts practicing towards the latter part of the week.
Rob Gronkowski – NE – TE
Docs (Dr. Khalid)
I can’t believe I am sitting here typing out an injury report on Rob Gronkowski’s previously-repaired right knee. Let’s get straight to the good news. Gronkowski took a hit to the front of the leg and essentially had a hyperextension-type injury with the leg not planted. The fact that his foot was not on the ground means everything. The force of the hit can be dissipated through the air and not through his ligaments, making the chances of major ligament damage less likely.
The biggest concern here is that Gronkowski has previously had the ACL/MCL repaired in the same knee. Reports from the locker room suggest that the injury is not as bad as originally feared. I usually tend to believe these reports, as manual physical exams can be very telling. MRIs, which will be performed Monday, are usually just confirming what the staff already knows. Combined with the video, there is a good amount of hope that Gronkowski avoided a major injury here.
My best guess off of video would be a knee contusion and possible knee sprain of either the PCL, LCL or both. If that is the case, Gronkowski could miss anywhere from one-to-four weeks, but the injury will not threaten his entire season or playoffs. If very minor, we may even see him next week. Fantasy football players are not out of the woods. With so little time left this year, a multi-week injury could be devastating
Jocs (Aman)
Gronkowski is obviously an important cog in the Patriots’ offense as well as an important piece of many fantasy teams. Not only does Gronk provide mismatches at the TE position each week, he produces as if he’s a WR1.
Gronkowski is considered by many one of the most valuable players in fantasy football, and if he’s out extended time, Scott Chandler will be the man to fill that role. After Gronkowski’s injury, Chandler immediately filed into Gronkowski’s position and caught a reception. He hasn’t provided the Patriots much in terms of receptions, but has seen a few touchdowns this season. Chandler also saw 11 targets, 33% of his total on the season, against the Broncos.
The Patriots still have a litany of weapons, and Tom Brady is well. We will also see the return of Danny Amendola for the fantasy playoffs. I don’t see the offense taking a big step back in the absence of Gronkowski. If you’re looking at the waiver wire, Chandler is the pickup this week.
The views of this show are strictly our own personal opinions and are in no way affiliated with any institution or any of our employers. All medical knowledge expressed is solely based off our own knowledge and no private patient information was obtained or used to formulate these opinions.
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Asad Khalid, M.D., Jie Chen, M.D., and Rob Williams, M.D. are orthopedic surgeons and sports maniacs at heart. Aman Khalid and Aditya Patel are law students and former “athletes.” Follow the show @jocsanddocs and listen to them on iTunes.