It would be fair to say that getting to the bottom of NFL injuries drives me crazy. Yes, it’s a big part of my job. And yes, the very lack of clarity that I’m complaining about is one of the biggest reasons that I even have a job. But still, there are times that I hate it simply because I never end up with any clear answers. Such is the case right now with DB Byron Maxwell and his reported shoulder injury.

Back in Week 15, Maxwell injured his shoulder. The details that came out a few days later indicated that it was an SC sprain, SC being short for sternoclavicular. This is a ligament sprain where your clavicle (or collarbone) attaches to your sternum. It’s a fairly rare injury, and depending on the details, it can be pretty severe, even life-threatening, though not in the case of Maxwell. I’m a little tempted to go on a rant pointing out that an SC sprain might be better labeled as a clavicle or chest injury than a shoulder injury, but I’ll leave that one on the shelf.

Maxwell missed the final two weeks of the season with his SC sprain. Obviously, that was at least a two-week injury, so I’ve logged it as such in my database. But Maxwell’s case gets stranger after the season ends. On March 9th, while giving Maxwell a pre-trade physical, it was reported that Maxwell’s SC sprain was still very much limiting him. Here’s a Tweet from all-things-Philly reporter Les Bowen:

Source: Maxwell went to Miami for physical, told Dolphins’ doc he couldn’t do bench press or pushups. Told Eagles he was fine at end of year

— Les Bowen (@LesBowen) March 9, 2016

And just to make matters more confusing, here’s Bowen’s follow-up Tweet:

Maxwell sprained SC joint, where collarbone meets sternum, missed last 2 games. Told Eagles he could’ve played if they’d made the playoffs

— Les Bowen (@LesBowen) March 9, 2016

So which Byron Maxwell are we to believe? Les Bowen is a reliable insider, so I have no beef with him here. I specifically used Bowen’s reports here because they are reliable and at the same time, completely inconsistent. He’s just pointing out the same murkiness that I spend my nights and weekends wading through.

As I see it, there are a few options here. Perhaps Maxwell’s injury was worse than originally reported. Maybe Maxwell wasn’t too happy about the Miami trade and he attempted to intentionally submarine the trade by raising injury concerns, (as argued by Steve DelVecchio here), though I find that pretty dubious. When sleuthing down injuries though, I find that the most likely scenario is often the one that doesn’t involve outright lying or conspiracies. In that vein, I’d guess that Maxwell’s SC sprain simply didn’t respond to treatment as well as everyone had expected, and that it is still limiting him. Unfortunately, until we get a clearer picture of exactly what’s going on, I’ll need to stay on top of this case. As it stands now, Maxwell’s return-to-play counter is at almost 2 months, and the clock is still running.

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We’re now in Week 14 of the NFL season, and in my injury world, there’s usually a noticeable shift around this time. Injuries that would’ve once been carefully rehabbed will now immediately send players to the injured reserve list, especially on teams that might not be playoff-bound. This makes sense, as there are better uses for valuable roster space than keeping a player on to rehab something like a high ankle sprain where the most optimistic outcome would be to have the player back for the final, meaningless game or two.

But beyond the medical side of things, this stretch of the season is often marked with a willingness by teams to throw in the towel and pull the plug on players that the team views as a problem. Such seems to be the case with the Bears and TE Martellus Bennett. There’s no doubt that Bennett is injured. He missed Week 12 with an unspecified rib injury. He attempted to play through the injury in Week 13, but appeared to suffer a re-aggravation of the same injury, though he was able to stay in the game. Two days later, the Bears announced that Bennett was being moved to injured reserve and would miss the last four games of the season.

To be fair, there are rib injuries that would justify this move. But those injuries would be severe enough that Bennett would likely not have played through them. If Bennett had multiple fractured ribs, the IR move might be warranted, though plenty of players only miss about two games with multiple fractured ribs, and again, we have no reason to think Bennett’s injury was that severe. Head coach John Fox had spoken about Bennett as, “day-to-day,” with the rib injury, whatever it was.

There’s a wrinkle that might help explain the move though. Dan Wiederer of the Chicago Tribune reported that Bennett had been brooding and seemed to be butting heads with John Fox. Yup, that’ll do it. I love Martellus Bennett, but the dude is a bit of an oddball, and he seemed to be a much better fit under the previous coach, Marc Trestman. Although Bennett is still under contract, it sounds like the Bears are ready to be done with him, and moving him to injured reserve with a minor rib issue would certainly be one way to accomplish that. Like a decent chunk of the cases that I write about, this move seems to be far more roster-based than injury-based, even though it uses the injured reserve designation. The good news here, at least for Bennett, is that there aren’t really any rib injuries that would spill over into the following season, so there’s no reason to think he won’t be 100% healthy in even a short few weeks.

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The biggest thing I’ve been watching this week (besides season two of Z Nation) has been the drama of Ravens RB Justin Forsett. He injured himself in last week’s game, and everyone seems to be pretending that he’ll be just fine for this Sunday’s game against the 49ers. I’m generally a pessimistic guy when it comes to NFL injuries, and this one has been screaming danger since Sunday, at least to me.

One of the awesome things about working over at Footballguys is that I have a team of coworkers, so it’s not just me sitting here cultivating my madness. I can only be pessimistic on so many injuries before I start to wonder, “hey, is it just me? Why am I the only one?” Thankfully, I’m not the only injury guy seeing trouble with Forsett, which makes me think at least I’m not the only crazy one. Footballguys has a writer who is also a doctor, and he’s a great resource. In fact, he’s how I ended up writing over there, but I followed his work long before they hired me. His name is Dr. Jene Bramel, and you can find him here on Twitter. Worth a follow. Anyway, he wrote up some great lines about why he’s also pessimistic on Forsett, and you can find them (behind a paywall) here.

If you don’t want to pay, I’ll boil at least a little bit of it down for you. But it’s worth paying for. Anyway, the mechanism of injury (how the injury occurred), as shown on broadcast, makes it look like it’s most likely a high ankle sprain. If you read my stuff, you know that that’s often a multi-week injury. Coach John Harbaugh has stated that Forsett avoided a high ankle sprain. First of all, Harbaugh (any Harbaugh) is not known for injury honesty. Even this season, Harbaugh has already been caught in at least one injury lie. Second, take a look at this photo that Dr. Jene posted on Twitter:

When I say player reaction, here’s where Forsett grabbed — over shin, not outside of ankle. More c/w high ankle. pic.twitter.com/houRhLRxZu

— Jene Bramel (@JeneBramel) October 12, 2015

How can you look at that and not suspect a high ankle injury?

As if that wasn’t enough, Forsett did not practice on Wednesday or Thursday. He put in a limited practice on Friday, and everyone seemed to be like, “Whew, looks like he’ll be fine for Sunday!” Except me, of course.

I should admit that I have some baggage here due to my own bias. Something about this situation reminds me very much of last season when Giants RB Rashad Jennings insisted that, despite not practicing, he would be fine for Week 14 with a similar, “don’t call it a high ankle sprain,” injury. He was officially active, but he was in too much pain to do anything, and Andre Williams took the reins, handing in a 24/131/1 performance before being banished back to RBBC purgatory the following week.

Using that one, biased comparison, I’d point out that even if Justin Forsett is active on Sunday, (which people are just now Friday evening becoming less optimistic about) he might not see much/any action. Rookie Buck Allen might get the call, and on a team with an absolute depth chart vacuum, there wouldn’t even be anyone around to vulture Allen’s goal line carries.

If Forsett is active and plays a halfway decent game, I’ll apologize to him and Harbaugh personally (with a small editorial comment below of course) for ever doubting their words. Game on.

Edit, October 19th: Ah nuts. I was wrong. In week 7, Justin Forsett posted 17 carries for 62 yards and caught 7 passes for 39 yards. You win this round, Harbaugh. It appears you were honest and I was too pessimistic. I’ll get you next time! Wait, this is supposed to be an apology, not a challenge. Sorry.

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#Cowboys plan: For Dez Bryant to have surgery as soon as possible, likely today. Belief is rehab will have him ready closer to 4 than 6 wks

— Ian Rapoport (@RapSheet) September 14, 2015

On the other end of the spectrum is the reality of how quickly players actually come back from similar foot fractures. Turns out there’s a big difference between the two camps. Historically, very few players miss less than 7 weeks. In my database, I have two recent players with similar injury that returned after missing exactly 6 weeks, and neither were wide receivers. I have not been able to confirm any NFL players who returned from this exact injury at anything less than 6 weeks. Beyond that, the more reasonable RTP seems to be in the “8-12 week,” range. But it should also be noted that there are plenty of examples where players take 3 months or more to recover, and often continue to have trouble afterwards, such as WR Hakeem Nicks. Others, like WR Marvin Jones, suffered related setbacks that kept them on the shelf even longer.

If history isn’t enough for you, then you can also listen to medical experts. As Dr. Jene Bramel pointed out on Twitter, “Dr. Robert Anderson, leading foot surgeon to NFL players, quotes 6-8 week recovery after 5th metatarsal fixation.” Dr. Robert Anderson is exactly the guy we should be listening to here, and it’s notable that he doesn’t include timelines as short as four weeks as anything realistic. In fact, we have no details yet, but there’s a good chance that Bryant will have his surgery done by Dr. Anderson in the next few days.

Who are we to believe? I can’t tell you why everyone in Dallas is so optimistic. Perhaps they have detailed information that leads them to be confident in this being only a four week injury. But without sharing that info, I have no reason to believe them. I don’t love always being the skeptical one in the room, but I feel like until a player can prove historical comps wrong, I’ll stick with history. In the case of a fifth metatarsal fracture, that history is telling me that a ballpark of, “8-12 weeks,” is probably the more likely outcome here. In my opinion, 4 weeks is entirely out of the question, and 6 weeks is probably still a little delusional. With a return being so far down the road, it’s safe to wonder if the Cowboys would consider using their IR/DFR tag for Bryant. Or maybe just plain-old IR. But the way they’re spinning this, that seems unlikely.

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Earlier today, Adam Schefter tweeted this:

Vikings’ C John Sullivan underwent a lumbar microdiscectomy Weds and has been placed on IR designated to return. Out until at least week 9.

— Adam Schefter (@AdamSchefter) September 10, 2015

As I am apt to do, I immediately disagreed. Not with the story… Shefter doesn’t get too many wrong. But with the Vikings use of the DFR (designated for return) tag. Teams only get one of those per year, and it seemed odd to me that the Vikings would burn theirs here. What stood out to me was that a lumbar microdiscectomy rehab doesn’t seem to mesh well with having a player return during the season. I always point out that I have zero medical background, so I relied on the internets to do some digging. Sure enough, the always-useful Medscape put an RTP at no less than three months. Even better, a study published in the American Journal of Sports Medicine showed that professional athletes return to play from this exact same surgery in an average of 5.8 months. To be fair, there’s a little difference between those two sources, as the study showed about 50% of the players returning at the three month mark. As an interesting aside, I also found a study that focused on how many NFL linemen (offensive and defensive) return to play after this surgery. By that, I mean how many come back, EVER. It’s about 86%. But the numbers I was finding weren’t exactly unanimous in this 3 month outlook. Footballguys’ Dr. Jene Bramel passed this one along, which shows an RTP of 6-8 weeks as a possibility.

With all the dispute here, it’s worth taking a look at my database to get some historical perspective. I’ll have to point out first that back surgeries are one of those areas where I can’t always be certain that I’m comparing apples to apples. A lot of times, the only details you can find are that a player had, “back surgery.” Details like the ones Shefter included are rare. But I have some examples. And I can safely include others where it was known that it was back surgery to correct a herniated disc, which is what Sullivan’s was.

The two best-case ones I have on record are T Eben Britton who missed 5 weeks in 2011, and C Barrett Jones who missed just over 2 months in 2014. Both were detailed only as “minor” back surgeries to fix a herniated disc, so I’m hesitant to include them. But I’d be lying if I threw them out just to fit my argument, so there’s that. Aside from those two, I have six players that fall right in line with the, “3+ months,” that I was reading. One of those, WR Kevin Walter, even goes on the PUP list to start the season, but is unable to ever get back onto the roster. The worst-case scenario was G Eric Steinbach who had surgery in August of 2011 (at the age of 31) and never played another down again.

So where does this leave us? I’m not entirely positive. If we start with that 3 month timeline and project it forward, we’d be looking at Sullivan returning for a December 10th, Week 14 game. It’s hard for me to believe that a team would use their sole DFR designation on a non-QB that they’re not expecting to return until December at the earliest. That leaves me to consider the possibility that I don’t know what I’m talking about. I’m not always right with these things, as evidenced by my stance that Pittsburgh wouldn’t use their IR/DFR on Maurkice Pouncey, which they immediately did. Of course, we won’t know who was right about either Sullivan or Pouncey until they actually come back off the shelf and play. But, as it stands now, I feel like I must be missing something on the Sullivan case. Perhaps the team has details that lead them to believe he’ll be back sooner. If so, I just wish they’d show their math.

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MCL Sprain/Tear RTP

Because of my callous dismissal of MCL sprains, I was surprised to see that the Tampa Bay Times was saying that Dotson could miss, “as much as 10 weeks,” with this injury. It’s not even that this 10 weeks estimate is incorrect, it just surprised me because it was so severe. Typical media reports tend to revolve around the best-case-scenario rehabs, and hardly ever take into account the more pessimistic possibilities. Without knowing anything about Dotson’s specific injury (aside from the fact that it’s an MCL sprain of course) I would’ve expected the media to sort of parrot something in the, “two to four weeks,” ballpark. Other sources went with, “six to ten weeks.” Indeed, Dotson himself said that he hopes to be back in six weeks. Still, that’s odd. Not necessarily wrong, but odd.

Take a look at that RTP chart again. Do you see how few people need six or more weeks to come back from this injury? I’ll be the first to admit that Dotson certainly knows more about his exact injury than I do, and that he has his reasons for shooting for that six week return. But I don’t get it. Even oft-injured G/T Roger Saffold missed only seven weeks with a severe (grade 3) MCL sprain in 2012. Saffold followed that up by missing only four weeks with another MCL sprain (of unknown severity) in 2013. So why the pessimistic mention of ten weeks as a possibility? I don’t know. Perhaps the team is being overly cautious. Perhaps they’re planning a roster move such as injured reserve with designation to return, and they’re simply working backwards based on when he’d first be eligible to return. Or maybe there is something really messed up with Dotson’s knee. I’m not saying that we’re not getting the whole truth… yet. I’m just saying that this one stood out to me.

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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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What’s the deal with Bears WR Kevin White’s shin? That’s what you should be asking yourself this week. For those of you who dare not follow July NFL “news,” something is way fishy with White’s shin. Or at least the bears are calling it his shin. I don’t even know anymore. In case you haven’t been following it, the Bears haven’t allowed Kevin White to run in almost seven weeks now. They’ve been very secretive about the exact injury, but by reading between the lines one can tell that White has basically had to stay off his feet for more than six weeks. In an interview today, head coach John Fox tried to give us new information about the injury while simultaneously not giving us any new information:

“He’s got a shin. You can call it splints, call it whatever you want.”

As always, let’s be clear. I know nothing specific here. I have zero sources. But I log NFL injuries all day. Six weeks for shin splints seems odd to me. Maybe not wrong, but odd. I mean, yes, a team could conceivably be that conservative with a player. But this is a first round pick… a rookie that needs to learn the system. Sitting on his butt for six plus weeks is not the usual rehab for shin splints. Unless…. wait, that’s too crazy. No, I shouldn’t. Okay, fine. Here’s an odd connect-the-dots thought I had. You know what sort of rehab is typically six weeks and requires you to stay off your feet? Fractures. Leg or ankle or foot fractures would all have a pretty similar looking rehab, at least up until now. Fractures might be a bit (or even a lot) more severe, but still, that six week figure is a staple of fracture rehabs.

So let’s take another look, and now we’ll just assume that John Fox is telling at least a partial truth. Here we are, looking up, “shin splints,” online, and what do we find? This. WebMD, in describing shin splints, says that shin splints can be caused by:

Stress fractures, which are tiny breaks in the lower leg bones.

That’s weird, because didn’t I just mention fractures? Okay, yeah, I have zero proof that lower leg stress fractures are what is sidelining Kevin White, and that the Bears are only sort of telling the full truth. But do you have any better ideas?

Update, August 15th: Nailed it! Read my less-than-humble summary here if you like.

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Michael Floyd will miss roughly six weeks I’m told with three broken fingers on left hand. Big, big part of the AZ offense. Injured today

— Jason La Canfora (@JasonLaCanfora) August 5, 2015

Now, about two hours later, a different report disputes that and says that Floyds fingers were dislocated rather than fractured, and that he should be out for about a month:

Source confirmed Floyd suffered dislocated fingers. He’ll miss around a month

— Kent Somers (@kentsomers) August 6, 2015

Sounds good enough, right? Nope. About a month for dislocated fingers, even three of them at a hand-heavy skills position like WR, seems really pessimistic to me. Luckily, I have a database to back me up on this hunch. You know how many weeks most players with dislocated fingers miss? Did you guess zero, because that’s the overwhelming answer. I have 10 finger dislocations in my database, and 7 of them miss zero time. In fact, dislocated fingers are so common that there are probably plenty of them that I don’t even have records on them. The most severe one I can find was LB Sean Weatherspoon who missed two preseason games with a similar injury in 2013.

Given that discrepancy, I’m not sure what to make of Floyd’s injury. Maybe we’ll hear a different diagnosis once the dust settles. Or maybe we’ll see Floyd come back much sooner than people are currently anticipating. I’m curious to see which way this goes, as it simply doesn’t make sense so far.

Update: After the dust settled, it was clarified that the injury was more severe than originally stated. In fact, it was downright gruesome. The three fingers on his left hand weren’t just dislocated, but actually punctured through the palm of his hand! Yeah, that makes more sense for that estimate. Unsurprisingly, my database has exactly zero examples of fingers being dislocated and poking through the palm. At least I’ll have one ready for next time, right?

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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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