Monday Injury Debriefing

By Jene Bramel on October 8, 2012 • ( 0 )

Robert Griffin III has more than a “mild” concussion.
(Photo by Keith Allison)

Robert Griffin III left yesterday’s game with a concussion. The team first said that he was “shaken up” then called the injury a “mild” concussion. While I’d prefer that teams report these injuries as head injuries and not qualify the severity of concussion to eliminate any misunderstanding and concern that they may not be taking the condition seriously, this situation is not as frustrating as the Eagles reporting that Michael Vick had dirt in his eye while clearly being evaluated for a head injury last season.

Still, it’s important to note that Griffin’s concussion should not be considered low grade or “mild.” Though Griffin was not knocked out on the field, the amnesia he had when questioned (did not know the score or quarter) is considered a significant neurologic symptoms – even if it quickly clears. While I’ll stop short of saying that Griffin will not be cleared for contact in time to play in Week 6, his progression through the league’s return to play algorithm will have to be very smooth if he hopes to return this week.

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Television angles of Jimmy Graham’s ankle injury show a mechanism of injury consistent with a high ankle sprain. It’s impossible to make a diagnosis on the strength of a TV replay, but I still think it’s worth noting. Receivers have been able to return in 1-2 weeks after low-mid grade high ankle sprains – Andre Johnson comes to mind two seasons ago – and Graham will have the benefit of the bye week to get treatment. Though questionable, a Week 7 return is possible.

Mike Reiss reported that Rob Gronkowski was playing through a potentially significant hip condition before yesterday’s game. We’re not likely to get any additional information from the New England locker room, so it’s pointless to speculate whether it’s a chronic condition like a hip flexor strain or labral tear or potentially a cascade injury related to the high ankle sprain that required offseason surgery. While he doesn’t appear to be as explosive as usual, it’s hard to ignore that Gronkowski felt well enough to all 94 snaps yesterday.

As recently as five seasons ago, a ACL reconstruction carried with it a 12-18 month prognosis for a return to full health. With the impressive recoveries of Adrian Peterson, Jamaal Charles and Rashard Mendenhall, it’s clear that the prognosis has improved to 9-12 months. Arguably, a very smooth rehabilitation without setbacks could have a player back in 8-9 months. Mendenhall made the Pittsburgh plan to ease him back on the active roster for the first month of the season rather than keeping him on the PUP list (which would have kept him out of practice) look brilliant yesterday. He changed direction and accelerated comfortably and post-game reports suggested that Mendenhall finished the game without any swelling or soreness. It’s tremendous news for Mendenhall and a Pittsburgh rushing offense that struggled during the early weeks.

Cedric Benson was in a walking boot after his foot injury yesterday, but said he thinks he avoided a Lisfranc injury. We’ll see. The weight of the tackling defender was on Benson’s heel driving the ball of his foot into the ground, which is one possible mechanism of a severe midfoot injury. X-rays showed no structural damage, which likely rules out a broken bone in the foot, but an x-ray isn’t a definite study for soft tissue injuries of the midfoot. I expect we’ll hear that he had an MRI scheduled today, with more information to follow.

I promised more on Danny Amendola yesterday after Jay Glazer reported that his SC dislocation was a posterior rather than anterior dislocation. Studies suggest that anterior dislocations outnumber posterior dislocations by a factor of at least 20:1, and Glazer reported that the St. Louis medical staff was calling around the league to find out if any other orthopedists had treated a similar injury. However, two very important things are working in Amendola’s favor. Posterior dislocations, where the collarbone is pushed back into an area where your trachea, lungs and big blood vessels live, are often associated with severe injuries and can be very difficult to reduce. Neither issue seems to have been the case for Amendola, who had no associated injury and, though I’d imagine the sphincter tone of the surgeons in the operating room was higher than usual, a smooth reduction. I still feel six weeks is optimistic, but eight weeks is reasonable despite the more unusual type of dislocation and the uncharted waters associated with it.

Adam Schefter reported that Jahvid Best will be tested this week to determine whether he can be cleared for contact in anticipation of coming off the PUP list and playing in Week 7. Again, don’t buy into the late preseason report that one year after his most recent concussion was some kind of scientific threshold. Best will return when he no longer has any neurologic symptoms – and not before.

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Jermichael Finley injured his shoulder. Trainers appeared to be examining him for a stinger or AC joint sprain and Finley said that he expected to be okay for Week 6 after the game. D’Qwell Jackson and Matt Cassel both with concussions yesterday and will be re-evaluated throughout the week. Troy Polamalu re-aggravated his calf injury. It looked to be a non-contact injury, which raises suspicion for an Achilles’ issue. The Steelers are only saying that Polamalu will not play this Thursday, but expect him to be out for an extended period.