quarterback
Fracture to the throwing thumb. Late season ACL/MCL tear. Kidney laceration. Mid-grade AC sprain throwing shoulder. Surgery to address a collarbone that's been broken three times and twice in the past six months.
Such is the life of an NFL quarterback. Thankfully, none of those injuries appear to be career-threatening. If Joe Flacco's ACL/MCL rehab continues to progress as well as currently reported, none of those injury will be threaten the 2016 season either.
Here's the list of quarterback injuries I'm tracking closely in the coming months.
tony romo | left clavicle fracture
Romo has broken his left collarbone three times, including twice last season in mid-September and late November. None of the injuries were significant enough to require immediate surgery. However, after re-fracturing the collarbone shortly after returning, Romo is considering a surgical procedure to decrease the risk of future injury.
Earlier this offseason, reports had Romo leaning toward having part of his collarbone removed. The thought here may be that shortening the length of the bone at one end may reduce pain and inflammation from arthritic changes that could make it more likely for the bone to break in the future. It's now reported Romo is reconsidering and may choose to have the collarbone plated, again with the intention of "strengthening" the bone. Neither of these procedures is a failsafe, however. The need for a CT scan to assist in this week's decision-making process also suggests some concern about whether Romo's collarbone is fully healing.
Whichever procedure Romo chooses, the outlook for 2016 is the same. Romo's range of motion will be limited for multiple weeks. While he may be cleared to throw in later offseason practices and June minicamp workouts, it's unlikely he'll be cleared for contact until training camp.
running back
Most of the critical offseason storylines are at the running back positions, where multiple featured offensive talents are recovering from major injury. Le'Veon Bell's recovery remains an unknown and will evolve through the early summer. Jamaal Charles and Dion Lewis are recovering well from ACL injuries and will hopefully be cleared for training camp. And it'll be another offseason of tracking the progress of Arian Foster and hoping he can avoid soft tissue setbacks in the final stages of his rehab from an Achilles tear.
Here's the list of running back injuries I'm tracking closely in the coming months.
le'veon bell | mcl / pcl reconstruction
Like last offseason, it appears we won't get full clarity on Bell's injury or condition for some time. Last season, it became clear as the spring and summer progressed that Bell had more than a minor hyperextension injury. I wrote of my concern about a PCL sprain, but Bell and the team never shared a specific diagnosis. Since his early November injury, the team has officially discussed only the MCL tear. Jason LaCanfora reported MCL/PCL tears, with the ACL intact, but that report was never corroborated by other national media members.
Still, LaCanfora's report feels accurate. It's rare to surgically repair an isolated MCL tear and Bell's early rehab reports -- he's not yet cleared to run four months after the injury, the Steelers won't commit to any timetable for his return -- are consistent with a PCL repair. So, the MCL/PCL report is a good working diagnosis.
Unfortunately, it's not a particularly reassuring diagnosis. PCL injuries are difficult recoveries. They're often associated with other soft tissue injuries, including nerve and tendon injuries, that complicate rehab and recovery. The multi-ligament nature of Bell's reported injury may also delay his recovery. The only silver lining here is that Bell's injury hasn't been reported as a PCL/LCL injury. Posterolateral corner injuries are very difficult knee injuries to overcome.
For now, the Steelers refuse to say anything about Bell's rehab and recovery other than hinting Bell is too early in the process to reliably predict progress. As we've seen with Jamaal Charles, there's generally much more certainty with ACL rehabs. Even the Patriots have commented on Dion Lewis' progress. The next 2-3 months are critical for Bell. If all goes smoothly, a recovery within 8-9 months is possible and we could see Bell avoid the PUP list in training camp. As we've seen with Breshad Perriman -- who didn't have surgery for an isolated PCL sprain -- this rehab is tricky enough that it's still too early to predict Bell's timetable accurately.
arian foster | achilles tear
Ignore all the snarky injury-prone comments you'll hear about Foster again this offseason. While not without merit, it's sad to see Foster's career take yet another detour through a complicated rehab process. Ignore the likely discussion about how players struggle to recover from Achilles' injuries and Foster has no chance of returning to form. The conclusion -- Foster's career is over -- may prove true. But it's lazy thinking to jump to that conclusion without a fair assessment of Foster's situation.
Foster has been cleared for light jogging and continued plyometric work, which means there has not been any surprises through four months of rehab. Though there aren't many good running back comps for a successful return from Achilles' repair, there are many wide receiver and edge rushers who have returned to productive form within 9-12 months of their injury. So, there are reasons for optimism here.
Unfortunately, this is Arian Foster. His long history of various and significant soft tissue injuries cannot be ignored. His long history of aggravated or compensatory soft tissue injuries cannot be ignored. And his age -- he's entering his age 30 season in 2016 -- cannot be ignored.
I refuse to write off Foster altogether. He's proven he can successfully rehab from soft tissue injury and return to elite production. But his age and the totality of his soft tissue injuries are impossible to dismiss. I'm approaching Foster's 2016 as I approached Victor Cruz in 2015. Which means I'll be rooting very hard for a successful recovery, but will remain pessimistic until I see Foster staying in productive from after multiple consecutive full practices.
Best case scenario for Foster is clearance to return some time in training camp with a smooth return to full practice without soft tissue setbacks. Give him an outside chance to begin the season ready to assume a 20 touch workload, but the odds are far from even money.
wide receiver
Both Kelvin Benjamin and Jordy Nelson are well on schedule to return in advance of training camp and should join the long list of skill position players who make a full recovery from an ACL tear. Keenan Allen and Randall Cobb both had scary injuries, but neither are likely to be limited for 2016. Breshad Perriman and Steve Smith will have to prove themselves recovered, but the Ravens are optimistic for both to be ready for opening weekend. And I'm looking forward to seeing how Victor Cruz's recovery has progressed.
dez bryant | metatarsal fracture
The Cowboys and Bryant were adamant Bryant would beat all reasonable recovery estimates (10-12 weeks) after his mid-September metatarsal fracture. Bryant pushed the limits, using stem cell injections and orthotics to shave a handful of weeks off the usual estimate. Bryant wasn't effective and required another surgery on his foot in January. While under the knife, surgeons also addressed his bothersome ankle. With no meaningful games until September, Bryant should have plenty of time to rest and rehab this offseason. It's unlikely Bryant will have long term issues with the foot, but revision surgery isn't optimal.
kevin white | tibial stress fracture
White told reporters after the season he was still working to regain his former explosiveness. Whether that was a throwaway comment after the Bears elected to shut him down rather than activate him late last season, or an indication that there's still healing to be done isn't known. Chicago says White will be ready for OTAs and I see no reason to expect otherwise. But if White isn't cleared for offseason work in May, it'll be a major red flag.
tight end
Jimmy Graham joins Le'Veon Bell and Arian Foster at the top of the offseason injury concern list. Tyler Eifert's Pro Bowl injury warrants monitoring, but the usually reticent Bengals have been vocally optimistic about his recovery from a foot sprain.
jimmy graham | patellar tendon tear
Players have returned to the field and been productive after patellar tendon reconstruction. But the list is relatively short -- Morris Claiborne, Nate Allen, Jerod Mayo come to mind as players who returned to starting roles. We've yet to see a skill position player return to his formal explosiveness after this injury, though there was a little optimism surrounding Victor Cruz before calf injuries in training camp waylaid his return.
Graham's recovery is reportedly going "remarkably well" but he's not yet reached the end stages of his rehab. It's every bit of a 8-9 month recovery before he'll be cleared for contact. And the last stages of rehab will tell the tale on whether his quad strength has returned and the range of motion in his knee is sufficient to allow him to regain his former explosivity. Training camp begins just eight months after Graham's injury, making it likely we'll see the veteran tight end on the PUP list. Until we know more about the later stages of Graham's rehab, it's tough to handicap whether or not he'll be ready for Week 1.
Check back for more injury analysis throughout the offseason and follow on Twitter @JeneBramel for breaking injury news, commentary and analysis of any injury news around the NFL.
