Matt's Medical Tent Talks (Week 7)

October 23, 2019


“…Week 6 was probably the lightest injury week of the season! So, here’s to future injury luck…”. Those were the words of my last two sentences from last week’s article, and I AM SO SORRY. Hopefully, it brings you comfort knowing my teams have been dealt with several body blows after my uttering of those words and jinxing the fantasy world last week. If week 6 was the lightest injury week of the season, week 7 was probably the heaviest with big names from EVERY position going down. So, instead of me going off on my soapbox in this week’s intro, I want to dive right into this massive pile of injuries and give you the injury analysis YOU NEED!



Patrick Mahomes, QB, KC – Knee 

Thursday night football started this week’s injury spree as the “Madden curse” lives on! The 2018 NFL MVP, Pat Mahomes, has become a frequent flier here on Tent Talk, as he dislocated his patella (kneecap) during Thursday’s tilt and sent the football world into a panic. I described the best-case scenario on Twitter that night (@DocMiragz) which first entailed assessing the ligamentous stability around the patella. This first box has been checked off as MRI did not reveal any significant injury to the ligaments and soft tissues surrounding the patella, which is great as this MAY mean that he can stave off surgery until after the season. I say “MAY” because we are still unsure how the patella will hold up once he is re-introduced to football-specific movements. Each time Mahomes extends his knee, his patella will track laterally (outward) which is the way the patella naturally wants moves during extension. Unfortunately, this is also the same way his patella dislocated on Thursday night, so each time he extends that knee, there is that potential for dislocation again, which only increases with loading. To combat this, rehab will emphasize quadriceps strengthening to provide dynamic stability to the patella in hopes this will assist the injured ligaments to keep the patella in place. Additionally, the patella will likely be supplemented with a special knee brace that prevents it from moving into the injured direction. I see this whole “wait and see” process taking about a month before a final decision is made based on his ability to load the knee during football activities. If the knee passes, great! If he is having pain, feelings of instability, or another dislocation, his season will be over as surgery will be required. 


Prognosis: 3-4 weeks; Knee testing to determine final decision 



Matt Ryan, QB, ATL – Ankle 

After getting rolled up on in the Falcons’ embarrassing loss to the Rams on Sunday, Matt Ryan joined Pat Mahomes in the “QB’s with high ankle sprains club” (creative name I know). I’ve discussed high ankle sprains numerous times over the weeks I’ve been writing this article; pretty soon you all will know the mechanism and prognosis as well as me! But as you learn I’ll describe it again. So essentially, Ryan’s body and upper part of his leg went one way, while his ankle planted and went out, thus separating the tibia and fibula creating a high ankle sprain. As seen with Mahomes, quarterbacks are one of the positions that can potentially get away with playing on a high ankle sprain (depending on severity). Ryan should have an even better chance of playing considering he is a true pocket passer and doesn’t utilize (or have) much mobility as a part of his game. Therefore, Ryan’s ability to play will be based on pain tolerance, as the ankle will certainly not be healed come Sunday. 


Prognosis: Week-to-week; status will be based on pain tolerance which will likely make him a GTD over the next few weeks



David Johnson, RB, ARI – Back 

Add me to the list of people that were screwed over by David Johnson’s “Active” designation, only to have Chase Edmonds MASH on my bench. David Johnson continues to deal with, what can only be assumed are, back spasms. As I discussed a few weeks ago during this article, back spasms are a muscular issue that typically does not present as a long-term problem if given appropriate time for rest and recovery. This has evidently not been the case as Johnson’s symptoms continue to present and limit him. What looks worse for Johnson’s prognosis is the fact the Cardinals have now signed Alfred Morris as insurance. I would still not consider Johnson’s injury to be season threatening UNLESS we hear reports of radiating pain, numbness, or tingling which could represent additional problems. What I believe is even more concerning for Johnson’s owners is Chase Edmonds absolute dominance over the last few weeks which may lead to a timeshare once Johnson is fully healthy. Edmonds is a more pure running compared to Johnson, though Johnson has ELITE pass-catching abilities. I would be surprised to see Johnson play this week as the Cardinals SHOULD allow him a full week of rest as they do not have a bye week until week 12. 


Prognosis: Day-to-day; hard to see him active for week 8



Kerryon Johnson, RB, DET – Knee 

The Lions’ young running back injured his knee in week 7, and while we are unsure of the diagnosis, we are now sure that he will be placed on IR, effectively ending his season (won’t be eligible to return until week 16). Ty Johnson, Kerryon’s backup, should be at the top of everyone’s waiver priority as the Lion’s believed in him enough to cut CJ Anderson early in the year, and I suspect they will believe in him to shoulder a majority of the load in Kerryon’s absence, as he saw 14 touches in the Lions’ loss to the Vikings (compared to 7 for 3rd down specialist JD McKissic). 


Prognosis: Unknown diagnosis, already placed on IR (safe DROP)



Adrian Peterson, RB, WAS- Ankle

The 2nd leading active rusher in the NFL has also suffered a high ankle sprain. Peterson, 34, has a game on Thursday and it would take a miracle for him to play just four days after sustaining his injury. Sure, Peterson was the Saquon Barkley of his day when it came to returning from injuries, but those days are more than half a decade ago. It’s possible Peterson elects to play through the pain, but there is simply no fighting the mobility and agility deficits a high ankle sprain WILL cause. In addition to the high ankle sprain, and the short week, and his awful team, Peterson also gets to face the vaunted Vikings defense. Basically, there’s no circumstance I would play Peterson this week.


Prognosis: Week-to-week; IF he decides to play, will have significant limitations


Adam Thielen, WR, MIN – Hamstring 

Thielen rewarded fantasy owners with a touchdown before exiting Sunday’s game with a hamstring strain. Early reports suggest a minor hamstring strain, and both Thielen and head coach Mike Zimmer is optimistic about a quick return in week 8. The thing is, Thielen also plays on Thursday night football, and while a mild hamstring strain may only take a week to recover from, 3 full days of rest are not sufficient for a full recovery. Considering hamstring strains have the among the most frequent re-injury risks of any injury, it would be a VERY poor decision to allow Thielen to play this Thursday in-game that should not need his services to win. 


Prognosis: 1-2 weeks; Thielen is OUT for TNF



Will Fuller, WR, HOU – Hamstring 

Fuller, like Thielen, also suffered a hamstring injury, but it does not seem that he escaped with a mild injury, as Thielen did. This will be Fuller’s 4th hamstring injury over the last 3 years, though this one is not particularly surprising as hamstring injuries after ACL tears are a common occurrence. Early reports are already predicting a several week absence which tells me one of two things: either there is a significant tear in the muscle belly, OR the injury occurred near the musculotendinous junction, which has a significantly longer healing time than the same grade injury that occurs at the muscle belly. We likely won’t be privy to the exact area of injury, but these are the most likely sites based on initial prognostic reports. While Fuller is out, expect another chronic hamstring strainer, Kenny Stills, to pick up where Fuller left off…not injuring his hammy, but taking over opposite Nuk. 


Prognosis: 3-6 weeks



Delanie Walker, TE, TEN – Ankle 

After coming off ankle surgery, Delanie Walker BOOMED to start the 2019 season. Week by week though, the ankle has become more and more of a problem culminating in week 7 where he was unable to make a dent on the stat sheet, playing only 5 snaps. Walker, who has seemingly always played through injury, simply looks like he may be running out of gas (age 35). While we are unsure of the exact injury, we can assume Walker is likely to miss at least one game as head coach Mike Vrabel discussed wanting to get him in a position where he can contribute, which sounds like coach speak for “he needs a week to get healthy”. Walker’s talented backup Jonnu Smith had three catches for 64 yards in fill-in duty and looks like a good streaming option for week 8 playing against Tampa Bay in a tight end desolate waiver wire landscape. 


Prognosis: Week-to-week


The Concussed

NFL’s Concussion Protocol – Criteria for Return-to-Play
1.) Rest and Recovery – Player is prescribed rest until his signs and symptoms return to baseline.
2.) Light Aerobic Exercise – As soon as able, players will begin LIGHT exercise, for example riding a stationary bike at a low resistance.
3.) Continued Aerobic Exercise & Introduction of Strength Training – Progress aerobic activities as tolerated, and introduce strength training.
4.) Football Specific Activities – Player continues to progress aerobic and strengthening exercises as tolerated, and introduces NON-contact football activities
5.) Full Football Activity / Clearance – Player is cleared by the team physician and examined by an independent neurological consultant (INC). If INC agrees with the team physician, the player may return to full-contact practice and games.



Matt Breida, RB, SF 

Breida exited in the second half of the 49ers’ slop fest against the Redskins and was evaluated for a concussion. The good news is Breida was able to return to the game indicating no concussion-like symptoms and presented no additional injury risk, meaning he will be a go for week 8.






Ito Smith, RB, ATL

After suffering his 2nd concussion in the last month on Sunday, Ito Smith has already been ruled out for week 8, and will likely be out longer. If you recall my discussion of Sterling Shepard two weeks ago, who also suffered multiple concussions in a short time span, I detailed how compounded concussions can result in longer-lasting and more severe symptoms, and that I did not expect him back for at least one month. Shepard is looking at missing his 3rd consecutive game. Expect Ito to follow a similar timeline as the Falcons and Smith use extreme caution before returning to the field. 


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