Matt's Medical Tent Talks

September 25, 2019

 

Welcome to the first edition of Matt’s Medical Tent Talk! Each week, you’ll join me, Dr. Matt, as I pop up the blue tent and breakdown all the injury information from the weekend. I know, I know, I won’t always give you the most pleasant news each week, for instance, Saquon owners, you won’t get your top three pick back, healthy, and looking like his usual self, for…at least two months *DUCKS*. BUT, what I CAN give you, is crucial injury information from the perspective of a doctor who has seen, and worked with these injuries, giving you a leg up on your league-mates, allowing you to make the start (or sit) decision that wins you your matchup! So, as with usual doctor’s appointments, take a seat, be quiet, and I’ll do all the talking.

 

 

Saquon Barkley, RB, NYG – High Ankle Sprain

Our headliner injury for week three was certainly Giants’ star running back Saquon Barkley. MRI results Monday told us what video replay already showed on Sunday, a right high ankle sprain. The classic mechanism of injury for high ankle sprains is an outward twisting of a planted foot, as the body continues in a forward direction separating the tibia and fibula, or “high” ankle, as seen with Barkley’s injury. Typical recovery timelines for high ankle sprains are 6-8 weeks depending on severity. Media reports suggest 4-8 weeks, and sure, Barkley could probably “play” at four weeks with a heavily taped ankle for stability, BUT he would not be his dynamic, elusive, always-makes-the-first-defender-miss self. A full return requires those 6-8 weeks for recovery of those, and I know some of you will say “LOOK AT HIM, HE’S A SUPERHERO. HAVE YOU SEEN HIS QUADS?!” Yes, yes I have, unfortunately, there is no speeding up the body’s healing process, so don’t expect your top pick to be back to his top form for two months. Also, what sense would it make for the Giants to rush the face of their franchise back in, what is likely to be, a developmental season for Daniel Jones? A word of caution with Saquon is that additional injury reports say that Barkley is going for a second opinion. This report worries me, as it may mean there is more to the MRI findings than just a high ankle sprain (potential fracture), which if that is the case, and he were to require surgery, Barkley would be effectively DONE for the fantasy season. 

 

 

LeSean McCoy, RB, KC – Ankle Sprain

Unlike Barkley, McCoy’s ankle is less clear. Shady suffered the original injury in week two and was questionable coming into Sunday’s matchup before leaving after a re-aggravation. Some good news post-game, though, is no one around the team, including McCoy himself, who seems very concerned about the “ankle-tweak”. Based on the lack of concern, and the ability to play just one week after the original injury, I would not be overly concerned with McCoy going forward. Considering the details available and the fact, as I said, he was able to play one week after the original injury, McCoy is likely dealing with a “low” ankle sprain. This type of ankle sprain has the same mechanism of a rolled ankle, but with more force, injuring a few Scotch-tape looking ligaments on the outside of the ankle that gives it stability. While this injury is not as severe as a high ankle sprain, poor management and returning too quickly can have consequences…like re-injury. As this is likely a low-grade sprain, I would expect this to be a day-to-day injury with practice reports being the most crucial piece of evidence going forward. That being said, I would expect more caution from the Chiefs and McCoy going into week four, as continued mismanagement could make this a season-long problem, with potential for developing chronic ankle instability. Considering the depth and firepower of the Chiefs’ offense, I wouldn’t be surprised to see McCoy miss a matchup against a beatable Lions team. 

 

 

T.Y. Hilton, WR, IND – Quadriceps Strain

Hilton is another player who aggravated a previous injury on Sunday after already having a pretty solid fantasy day. Hilton was unable to continue in Sunday’s tilt against the Falcons after having a flare-up to his quadriceps muscle. After the game, Hilton told media that the team medical staff did not want him going back out there and risk fully tearing the muscle. Smart. Trying to gauge the severity of Hilton’s injury is difficult as we are not privy to imaging results or physical examination. But, following standard muscle strains, if only a grade one strain, Hilton is likely looking at a 1-3 week timeline. Similar to McCoy, practice reports will be the key as we try to decipher the true severity of the injury. Also similar to McCoy, poor management can lead to season-long problems, if not a full tear if severely mismanaged. Rehab will focus on the classic R.I.C.E. method to calm down symptoms before Hilton works his way back to practice, but return should be progressive, and not rushed, to prevent another aggravation. I think Hilton is another candidate to miss week four action to ensure a full recovery for the rest of the season. 

 

 

Julian Edelman & Josh Gordon, WR’s, NE – Ribs/Hip/Finger

Wide receiver news that ISN’T Antonio Brown coming out of New England!? That is correct. And though it is injury news to the team’s top two wide-outs, it is GOOD news. We’ll start out with Edelman who left Sunday’s game and did not return with a rib injury. After having x-rays, it was found that there was no major damage or fractures, which is great for owners of Brady’s favorite target and should not keep him from any game action, though a few rest days at practice would not be unexpected. Edelman will likely be playing through some pain, but, as long as there are no fractures that would put him at risk for a more severe injury, he can be started with confidence in week four. As for “Flash” Gordon, he amassed a solid stat-line after going into the medical tent on multiple occasions Sunday (hip/finger). Gordon went to the tent after coming down hard on his left hip in the first half before returning, and then in the third quarter seemed to dislocate a finger before returning with his fingers taped together. All told, neither injury concerns me, though we’ll keep an eye on the hip injury to make sure it isn’t anything more than a painful bruise. Gordon has a tough matchup with Buffalo’s Tre’Davious White in a week four battle of 3-0 AFC East teams. 

 

 

Jimmy Graham, TE, GB – Groin/Quadriceps

Perennially banged up Jimmy Graham is back at it again. After attempting to tough out a groin injury on Sunday, Graham wound up being limited by a quadriceps injury as well. Groin injuries in athletes can typically be classified as “Athletic Groin Pain” as there is usually an injury to one, or more, of three areas near the groin, those being the hip flexor muscles, adductor muscles, and/or abdominals. Regardless of the injury site, the problem is typically managed similarly and can be considered a week-to-week injury. Even if this was Graham’s only injury, I would consider him a longshot to play on a short week (vs. Eagles on TNF), but with the addition of a quad strain as well, I would be shocked to see number 80 suit up on Thursday night. For what it is worth, Graham practiced in a limited fashion on Tuesday. 

 

 

Cam Newton, QB, CAR – Foot

After the team’s continuous denials that Cam’s preseason foot injury was contributing to his early-season struggles, we learned Tuesday that there is fear that Newton is dealing with a Lis Franc injury. A Lis Franc injury is caused by compression and shearing forces of bones and ligaments in the midfoot. There are two options for the management of this condition: conservative treatment or surgery. Current reports suggest that the Panthers will go with the conservative route to start, which carries a likely timeline of 6 weeks before a potential return, and at that point who knows if Cam even gets his job back. If conservative treatment were to fail, surgery would be the last resort and Cam would be out for the rest of the season. Will this be the end of Superman?

 

 

Vance McDonald, TE, PIT – Shoulder

Vance McDonald (Shoulder) – No information has been released regarding his shoulder injury, with inconclusive video replay. It was reported Tuesday afternoon that McDonald was seen in a sling at the team facility, and late Tuesday night, it was reported the Steelers were trading for Nick Vannett, which puts McDonald’s season-long prospects in serious doubt. We will monitor this injury throughout the week as more details are available. 

 

Players requiring additional information 

 

Ito Smith (Concussion Protocol) – All concussions are different and individualized. Will monitor practice reports for progression through protocol. 

 

Mark Andrews (Foot) – Late week addition to injury report with unknown foot issue in week three. Played majority of snaps on Sunday, will monitor to see if the injury lingers. 

 

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