Everything that I’m about to say here shouldn’t really have to be said. But since we’re less than a week away from the NFL Draft, many people seem to prefer hype to reality. As usual, this is my chance to be a total buzzkill and bring everyone back to Earth. People love it when I do that.

The best example for today’s rant is Notre Dame LB Jaylon Smith. Smith was once in position to be a slam-dunk first round draft pick, with a good chance to be within the first 10 players to come off the board. But in the Fiesta Bowl on January 1st, Smith tore his ACL and LCL. That’s not a good combo, but it’s not exactly a death-sentence either. If Smith’s injury was limited to just those two ligaments, then his biggest obstacle might’ve simply been time, as he was unlucky to get injured so late in the season and so close to the NFL Combine. But the bigger concern now is that Smith is still dealing with nerve damage in his injured knee, and therefore cannot lift the front of his foot.

Smith’s medical team has mostly tried to downplay his nerve injury, but I’m here to tell you that nerve damage is an entirely different kettle of fish than many NFL injuries. When a bone breaks, there is generally clearly defined progress in the healing process. It’s broken, it’s healing, it’s still healing, and eventually it’s healed. Sure, there can be setbacks such as infections or later fractures if the bone is stressed again. But the healing process here is mostly a straight line. Muscle and ligament injuries such as strains and sprains are less linear, but will still frequently follow a general forward progression. But nerve injuries, no, not so much. Basically nerve damage is a just a huge question mark. Perhaps the nerve will heal on its own and sensation will return. Perhaps surgery will be needed to help this process along. But really, all bets are generally off when it comes to reliable, predictable timetables. (Note, there are timetables about nerve healing, I’m just saying that nerve injuries often vary significantly from those predictions).

For comparison, anyone remember Peyton Manning’s nerve saga? It took Manning one year, somewhere between two and four surgeries (depending on who you believe) and multiple (usually reported as four) trips to Europe for experimental procedures. And while you could view Manning as an example of a success, one could easily argue that his was a qualified success at best. Even years later, Manning was still affected by the injury, but his experience and his position allowed him to compensate in order to stay on the field. A rookie like Jaylon Smith is less likely to be able to do the same should he return at less than 100%.

I started this rambling post though to get to one point. When Smith’s medical team (in this example, Dr. Dan Cooper) says something like:

He has a very good chance of getting his nerve recovery back.

Then it’s important that we acknowledge that a different way of phrasing the exact same idea would be:

He has a chance of never getting his nerve recovery back.

In defense of Smith’s doctor, he went on to give a lot of very specific medical information that backed up his optimism, and you can read that here in this USA Today piece. Also, reporter Tom Pelissero did a great job breaking things down there and pointing out that there are no guarantees here, so I have no beef with him. My issue is that, when reduced to a blurb, this story simply gets spun as, “Smith should be fine, eventually.” In reality, we have no way of knowing that he will be fine, and we have no way of knowing exactly what timeframe he might be looking at. Given all those unknowns, I find myself frustrated to read that Smith might be a great mid- to late-round steal should he bounce back. I mean, I get it, but my point is simply that his risk is high, so let’s not get ahead of ourselves by assuming that he’ll be fine after a rookie redshirt season.

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Although, I haven’t been able to clear protocol the specialist I have met with have told me they expect a full recovery. I’m looking forward that, returning to form, having a good offseason and an even better 2016 season.

It’s notable that this piece was published December 14th, a full six weeks after Haden’s second concussion. So after six weeks, Haden still hadn’t been cleared from his concussion, and yet he’s talking about how everyone expects him to have a full recovery. Again, I can’t stress this enough, I hope that he does recover. But to throw this out there like it’s a given is just ridiculous.

It even gets a little worse, as two weeks after that quote, Browns beat writer Nate Ulrich tweeted this:

#Browns CB Joe Haden said he experienced headaches, light sensitivity, was hidden in his house for a month or two.

— Nate Ulrich (@NateUlrichABJ) December 31, 2015

Does this sound like a man who we should expect a full recovery from? Maybe this is a bias in my own memory, but Haden’s case reminds me of that of Raiders LB Nick Roach, and that one didn’t end so well.

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Such seemed to be the case with Bills RB LeSean McCoy. McCoy dealt with a lingering hamstring strain since August, but in October, he had this refreshing quote:

One thing I promised myself is I can’t go out there if I’m not 100 percent, so, if it’s this game, or next game — whenever it is, I’m rushing to get back but I’m not playing until I’m 100 percent.

Clear enough, right? Good for him, I don’t blame him one bit. But then, two weeks later, when talking about his Week 6 status, McCoy had this to say:

Hurt or not, we need this win. So I’m out there for my teammates.

Great. So now we get to watch the Bills struggle against the Bengals in a game that the Bills will most likely lose, and we get the additional bonus of McCoy risking reinjury. Yeah, that’s awesome. The odd part to me is that the Bills are 1-1 in McCoy’s absence, so they’re not even in a drastic situation. I wouldn’t fault McCoy (or anyone) for sitting out in important games, but this isn’t even an important game! Here’s hoping McCoy doesn’t aggravate anything and that he can finish the season healthy.

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Bears WR Kevin White has had a mysterious injury since July. First it was entirely undisclosed, and later it was simply referred to as a shin injury. By reading between the lines, I speculated that the best fit, based upon what we knew, was that White had a tibia stress fracture. I wrote it up August 5th, here. Other people sort of threw around the idea of a possible stress injury, but I went bold with it by narrowing it down to one specific diagnosis. As it turns out, it was a beautiful call. Today, news came out that White has a tibia stress fracture and that he will undergo surgery and begin the season on the PUP list.

What I really love about this story is the strange turn it took yesterday. I was still pretty confident in my diagnosis, or at least as confident as you can be when you’re not a doctor or have any inside sources and you’re just working off an NFL injury database that you built yourself which might or might not spotlight your own mental illness. But yesterday, Rich Campbell of the Chicago Tribune wrote up this piece, which included these lines:

In his first public comments since the injury, White was upbeat with a good sense of humor. He was adamant there is no stress fracture in his shin.

So here was White actively denying the very thing that I thought he had. There’s no shame in admitting that I started doubting my diagnosis. But everything still fit right. Had White made his denial after actually playing on the field, I would have written this one off as a loss for me. My only consolation was that White was still ridiculously vague on what the injury really was, referring to it as, “a shin.” I love it when they do that.

Anyway, this is all just a long-form piece for me to take some credit. If you read this far, you have a really strong constitution. Nice work, you. And nice work me, I guess.

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I don’t know what that timeline is for him to be back to full speed, but yet he’s way ahead of schedule.

So Carroll knows that Mebane is way ahead of schedule, but he does not know what Mebane’s rehab timeline is? I’m not the only one that sees a problem with that, right? This is the equivalent of measuring your progress on a roadtrip without the aid of maps, GPS, or really any basic geographic knowledge. It’s like the driver saying, “I don’t know where we are or where we’re going, but we must be getting close…. we just passed an Arby’s!” In the lengthy history of players and coaches saying that someone’s rehab is, “ahead of schedule,” this one will always hold a special place in my heart. Thanks Pete!

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For once, I’m not the only skeptical one digging into how the details of an injury don’t match up with what the player is saying! In this piece by NFL.com’s Chris Wesseling, someone else points out how Steelers running back Le’Veon Bell’s words don’t quite match up. Bell hyperextended his knee at the end of the regular season. He ended up missing the following playoff game in which the Steelers lost to the Ravens. At the time of the injury, the Steelers seemed mostly optimistic about Bell’s chance to suit up the following week for that Ravens game. The injury was explained as a hyperextension without any accompanying ligament damage. I wrote about it here, backing up the opinion that, if it really was a simple hyperextension, Bell might be looking at only a very limited absence.

Now, for reasons unknown, things seem to have changed. As Wesseling does a good job of pointing out in that piece, Bell is now saying some incongruent stuff. In late January, Bell said that he was, “close to 100%.” That alone is a little suspicious for being one month removed from a knee hyperextension, but you could also just chalk that up to a player being cautious with his words or his rehab (that is, if players were ever cautious with their words). Now, nearly four months after the injury, Bell again said that he’s, “getting close to 100%.”

So what’s the deal here? As always, I’ll point out that I don’t know anything specific. I’m not wired in to anyone worth being wired in to. But it’s now officially fair to wonder what really happened inside Le’Veon Bell’s right knee. Perhaps the original injury was more severe than a hyperextension. Maybe the Steelers knew that at the time, or maybe they only discovered it later. Perhaps Bell has had some setbacks in his rehab. Without knowing a damn thing, I can tell you that his timeline (based on his quotes) now resembles that of a player with some decent knee ligament damage. Nothing big like an ACL tear, but perhaps something that heals on its own without surgery. Maybe an MCL, LCL, or PCL tear/sprain. We know the injury was from a direct hit by a tackling defender, so perhaps we’re looking at a deep bone bruise here. For what it’s worth, I’ve actually had that, and it sucks. Whatever it is though, we can be pretty sure that it’s not just the simple hyperextension that it was originally billed as. All of this might be a bit of a moot point though because, as long as this wasn’t something major like an ACL tear (and we have no reason to believe that it was), Bell will still be ready and running for all the offseason training camps, and in zero danger of missing any actual playing time.

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So here’s the interesting part. He sued USC over this. Turns out Toradol can cause heart attacks. The FDA warning says so right on the box. Of course, just because it can cause heart attacks doesn’t tell us if it did cause one in this particular case, which is what a lot of Armstead’s lawsuit hinges upon. In USC’s defense, the school believes that Armstead’s heart problems were caused by an underlying congenital heart condition, which was undiagnosed at the time. Armstead claims that he was not warned of the dangers of Toradol, and that he was also given too many doses at too short of intervals. I’m not here to take a side. But I do want to point out some crazy testimony that came up during this lawsuit.

According to documents obtained by Vice Sports (read the entire piece by Aaron Gordon here), USC team doctor James Tibone had this to say:

In his deposition, Tibone said he didn’t “agree with” FDA warnings about Toradol’s cardiovascular risks. He did not provide supporting evidence for his position, admitting that before and during the period he gave the drug to Armstead and other USC players he: (a) conducted no research or surveys on Toradol’s adverse effects; (b) read no peer-reviewed journal articles on the matter prior to Armstead’s heart attack; (c) did not investigate the drug beyond talking to NFL trainers he knew and having a brief, informal conversation with a friend who is a cardiovascular surgeon.

That stinks, right? There’s no way that a team doctor (or any doctor) should have the latitude to pick and choose which FDA warnings to follow and which to ignore. I should note that I wasn’t in that courtroom, so I’m just going off of widely-reported excerpts here.

I bring this all up because Amstead’s case against USC reached an undisclosed settlement on April 1. We’ll never know the details on how much Armstead received. According to this piece by the Washington Post’s Matt Bonesteel…. Okay wait a sec. Awesome name. So many career paths he could have taken with that name, and I’m not sure reporter was really the best option. Anyway, according to Bonesteel, former general manager of the St. Louis Rams, Charles Armey testified that Armstead could’ve been the next J.J. Watt. Big words, and no way to prove them, of course. But it’s conceivable that Amrstead might have received a settlement comparable to the rookie contract of other defensive linemen taken in the early rounds of the 2012 NFL draft.

What I loved here though was USC’s statement. After reaching a settlement, the school said the following:

While the university will not comment on the case, USC has always placed the health and safety of its student-athletes as its top priority.

It’s not just me, right? That statement directly contradicts the previous quote that I gave from the USC team doctor! If the health and safety of USC’s student-athletes were indeed its top priority, then shouldn’t they be more concerned with their own doctor’s admission that he chooses not to follow FDA guidelines when he doesn’t agree with them? As of now, Dr. James Tibone is still the USC football team doctor. Curious to see if that changes soon.

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Dr. Maroon says some really crazy garbage, mostly downplaying the danger of the NFL and brain injuries in general. Yes, that’s nuts, but let’s choose to ignore that right now. I’d rather focus specifically on how Dr. Maroon’s words match up with the actions of the Pittsburgh Steelers, the very team that he works with. In a previous post, I talked about how irresponsible the Steelers were during the playoff game against Baltimore. In that game, sideline medical staff allowed both Ben Roethlisberger and Heath Miller back into the game without giving them the proper NFL concussion assessment tool. Both players were checked on the sideline due to suspicion of having suffered concussions. That is a fact. Both players were allowed back into the game in far less time than the NFL concussion assessment tool takes to administer. That is also a fact. You can read about those details in that piece I wrote. In fact, it could even be said that both players continued to suffer concussion symptoms after returning to the game, though that is a judgement call. If you saw the games, it was a pretty obvious judgement call, but it’s still subjective.

Now given that recent history, let’s dig into what Dr. Maroon said. Here’s a quote that stood out to me (1:51 mark):

The worst thing that can happen with a concussion is to go back in if you’re still suffering the lingering effects, because the brain is more vulnerable at that time.

Doesn’t that sound exactly like what unfolded with Roethlisberger and Miller? Didn’t they both go back in while still suffering lingering effects? If nothing else, they were not properly checked using the very tool the NFL has created to assess possible concussions.

Dr. Maroon follows this up with this little gem (2:10 mark):

… if you do have a concussion, or any symptoms of a concussion, you get out of the sport until the brain has a chance to heal.

Again, isn’t this exactly what the Steelers did not do with Roethlisberger and Miller? Weren’t Roethlisberger and Miller sent right back in after suffering what staff suspected might have been a concussion?

I’m not trying to tear into the Steelers in particular. Both the Seahawks and the Patriots had similar irregularities during the postseason. But at least their team doctors didn’t go on television to tell me that everything was peachy. In Dr. Maroon’s defense, I do not know if he was present on the sideline or had any part in treating the particular cases I outlined above. But even if he was not present or involved, he is still the team neurosurgeon, and one would think that the sideline medical staff answers to him on all concussion matters. The fact that the NFL Network would overlook this recent history and hypocrisy to have Dr. Maroon give us his expert opinion only tells us (yet again) how out of touch the NFL is on safety issues. No surprise there, I guess.

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Holy crap! 49er’s linebacker Chris Borland just announced his retirement at age 24, one year into his NFL career. ESPN’s Mark Fainaru-Wada and Steve Fainaru reported it here, and that is easily the best injury-related piece you’ll read this month. I can’t recommend it enough.

Chris Borland was already on my injury radar, as I wrote this about him pre-draft, and, even after his huge rookie season, I was planning on revisiting his ongoing health concerns. My concerns were all in regards to his shoulder injury history though, nothing to do with the concussion concerns which led Borland to call it quits.

That piece has plenty of great, honest, intelligent quotes from Borland, all of which outline how seriously he took this decision. For my money, the best was this thought he had after playing through what he thinks was a concussion:

What am I doing? Is this how I’m going to live my adult life, banging my head, especially with what I’ve learned and knew about the dangers?

Before anyone gets all stupid macho and throws around jock-talk about, “passion,” or, “dedication,” they should really read the piece. Borland is an intelligent man who thought this through and researched the hell out of it before making his decision. Any players that react poorly to Borland’s decision in the following days might want to consider that perhaps Borland knows something that they do not.

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It’s always interesting (to me at least) to see all the spin control from injured college players as we get closer to the NFL draft. Typically, the players (or more accurately, their agents) jump at any chance to downplay a college injury history and present the player as 100% healthy. Of course, this is often not the case. As a Pats fan, first round 2014 pick, defensive end Dominique Easley comes to mind as someone who was far from being finished with his history of knee injuries.

With all of that in mind, I thought it was odd to read about Georgia RB Todd Gurley and how his injury history is playing out in this year’s draft. Gurley tore his ACL back in November, and at this year’s NFL combine, he refused to let doctors examine his surgically-repaired left knee. Originally, this looked suspicious to me, and plenty of other crackpot bloggers. But the picture became clearer when Dr. James Andrews (bow down everybody) went into detail with ESPN’s Chris Mortensen. Good piece, and Dr. Andrews (or DrJA, as I call him… we’re tight) is usually pretty forthcoming about details. Sure enough, he drops a little knowledge bomb in that interview that really stood out. Andrews claims that Gurley is probably about six weeks ahead of schedule in his recovery. Nothing special there, as all NFL surgeries are instantly reported as successful and all players are somehow, inexplicably ahead of schedule. Except Andrews actually shows his work and tells us exactly why he feels Gurley is ahead of scheudle:

Gurley’s quad muscle is way ahead of what you would expect even at this stage and that’s vital to a good recovery, as you know

I can’t tell you how significant that quad strength is. I can’t tell you whether Gurley is actually ahead of schedule, or by how much. But it’s incredibly rare to get details like that to support medical opinions, so I will defer to Dr. Andrews and believe this one. I wouldn’t be surprised if it was the most transparent medical information to come out of this year’s draft. Nice to finally get a little signal to go with the noise. Thanks DrJA! Now please tell us what the hell is up with Julius Thomas’ ankle!

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