Monday Injury Rounds: Projecting A.J. Green's Return

Jene Bramel's Monday Injury Rounds: Projecting A.J. Green's Return Jene Bramel Published 08/05/2019

making sense of A.J. Green's recovery timeline

Even though we're likely to see high-quality video of an injury and quickly see national beat writer reports detailing severity and return to play timetables, there are always instances when follow-up reports do not match initial expectations.

That happened with Green last week. In these situations, I like to establish a timeline and see if the reports tell a sensible story.

Here's the Green timeline:

July 27: Green suffers a left ankle injury in practice. Video is limited but suspicious for a high ankle sprain.
July 27: Post-practice press conferences feature hopeful and reassuring comments from Zac Taylor and Green's teammates.
July 28: Adam Schefter reports Green's MRI showed torn ankle ligaments and suggested a 6-8 week return to play expectation.
July 28: Tom Pelissero reports Green will have a second opinion and implies surgery is under consideration.
July 30: Ian Rapoport reports Green had a minor ankle "clean out" procedure but timeline is unchanged.
July 30: Rapoport updates initial report, tweeting more was found than expected, Green now expected to miss a few games.

I had multiple questions during this first 72 hour period.

Why would Green have a clean-out procedure -- presumably to remove cartilage or bone fragments from his ankle joint -- so soon after the injury without having possible ligament stability addressed? Why would Rapoport seemingly tweet confidently after Green's surgery about an unchanged timeline only to update with a less reassuring report shortly afterward? Is a 6-8 week timetable a reasonable expectation after arthroscopic ankle surgery to address cartilage injuries?

I reached out to friends and sports medicine experts, Dr. David Chao and Dr. Jeff Budoff, who reassured me that a clean-out procedure to remove cartilage fragments or bone particles wasn't unusual. Rehab protocols for arthroscopic surgeries that do not involve repair or reconstruction or microfracture can be accomplished in 6-8 weeks if things progress smoothly.

Also, it remains notable that no national or local beat writer other than Rapoport has addressed Green's status since Schefter and Pelissero discussed the MRI result and planned specialist visit. When Green has been injured in the past, the most accurate reports have come from ESPN's Bob Holtzman, NFLN's Pelissero. While Schefter has generally been quiet on Green injuries, he's also accurate. My sense here is that the most accurate reporters have not weighed in because there's still some uncertainty.

Thankfully, the Bengals' radio team includes Dave Lapham. He's been connected to the team as a player or radio color commentator for many years and is well respected in the locker room. It can be difficult to catch Lapham's radio interviews, but he was featured on a podcast last week and discussed Green. Specifically, Lapham reported there was "no way" Green would be ready for the opener and strongly suggested the team -- sensibly -- might target the Week 4 Monday night game in Pittsburgh as a reasonable goal.

Week 4 would be 8-9 weeks after the surgical procedure and likely allow Green 7-10 days to recondition in practice if his early rehab goes smoothly.

I still think there's more detail to be reported here but I like setting Week 3 as the over-under for Green's return to practice, with Week 4 as a hopeful return date.


Injury Rounds

Andrew Luck | Calf strain | offseason | week-to-Week | Probable Week 1

There were reports of calf soreness throughout the offseason with Luck, who did not practice much this offseason and took only a few 7-on-7 reps through the first days of training camp. Luck rarely addresses his own injury status and insists the team remains quiet, too. However, Luck did tell reporters last week that he believed his injury to be a relatively minor strain. Tom Pelissero reported there are no specialist visits scheduled, no additional plans scheduled, and no discussion of surgical procedures.

It's reasonable to be concerned about this injury. It's lingered long enough -- or been aggravated -- to be considered a higher grade calf strain and although Luck was adamant scans showed no inflammation around his Achilles tendon, he did admit to feeling pain in his ankle at times. Ultimately, Luck and the team continue to say the injury would not hold him out of a regular-season game. And Luck wants to avoid any further aggravation or potential alterations in his throwing motion that might stress his surgically-repaired shoulder.

For now, the Colts and Luck plan to rest until his calf has fully healed. He's reportedly improving over the past seven days. Whether Luck plans to return after another week of missed practice or further into the preseason remains to be seen. The length of Luck's absence isn't a huge red flag right now. Instead, you should be more concerned about Luck's status after he returns to practice. If he returns then shuts down again, our level of concern should escalate quickly.

Antonio Brown | Foot Condition | Offseason | Day-to-Day | Probable Week 1

Brown managed just one practice in pads last week and was reportedly dealing with a foot injury. Brown posted pictures of his feet on his Instagram page over the weekend, which showed a separation of the top layer of skin on the bottom of his foot and raised suspicion for possible infection. After seeing a foot specialist to remove the layer of dead skin and treat any residual issues, it's believed Brown will recover quickly and return to practice soon. Expect the team medical staff to remain cautious with Brown and try to limit any recurrences of this skin condition. Barring complications, Brown will be ready for Week 1.

Damien Williams | Hamstring strain | Early preseason | Week-to-Week | Probable Week 1

It's not uncommon for teams to remain cautious with players who are expected to see heavy regular season usage. It's uncommon for coaches to directly and negatively address the absence of a player expected to see heavy regular season usage. So, Andy Reid's comments on Williams last weekend, who has now missed a full week of early camp practices with a hamstring strain, may be notable. Reid told reporters, "’[Williams has] missed quite a bit. He’s missed a lot of plays. It’s been great for these other guys. [Carlos Hyde] has done a nice job. He’s got a lot of reps and he’s taking advantage of them.’’ The consensus local opinion is that the team would prefer Williams as their lead back, but Reid's comments may signify some frustration with Williams' recovery so far.

Derrick Henry | Left calf strain | Early preseason | Week-to-Week | Probable Week 1

Henry left practice last week and was later seen with his left leg immobilized in a walking boot. Though the boot usually suggests a foot or ankle injury, Adam Schefter reported Henry's injury as a strained calf with a two-week return timetable. There may be nothing of concern here and the Titans do not appear worried about Henry's status. But immobilizing the ankle joint for a low-grade calf strain raises some suspicion for a different or more severe injury to around the foot and ankle. If Henry's absence lingers past two weeks, it'll have my interest even further piqued.

***Zack Martin had an MRI for recurrent back pain last week. It showed "disc irritation." The Cowboys have suggested he'll rehab for a week and be reassessed. However, irritation could mean herniation of disc tissue and degenerative changes. If so, Martin may have symptoms requiring further treatment and rehab throughout the season. Dallas has dealt with similar issues with key linemen -- Tyron Smith has battled disc problems for years -- and will surely have a rehab plan to manage Martin's symptoms.

***Aaron Jones has missed multiple days of practice with hamstring tightness. His absence was termed precautionary by Matt LaFleur. Jamaal Williams has also now missed over a week of practice with a hamstring strain. For now, the Packers are telling reporters both should be back to practice soon.

Follow Up Appointments

***Todd Gurley (knee) remains on an every-other-day practice schedule. He told reporters his knee was responding as expected last week. He's firmly in the "no news is good news" category as we traverse through the preseason.

***After a few early-week beat writer reports that Sony Michel (knee) was seeing very few practice reps, the end of the week reports notably praised Michel's first teamwork, fluid change of direction, and increased reps in passing situations. Like Gurley, the early preseason returns are positive for Michel.

***Sterling Shepard has already returned to team drills in a no-contact jersey. While he hasn't been fully cleared, the team's comfort with him running routes and catching passes strongly suggests he'll be ready for Week 1.


INJURED PLAYERS ON ACTIVE ROSTER

Quarterbacks Injured | On the Active Roster
Player
Team
Injury
Date
Player/Team Says
FBG Expects
Notes
Andrew Luck Ind Left calf strain Offseason Week-to-Week Week-to-Week Probable Week 1
Alex Smith Was Right leg fracture / Post-surgical infection November 2018 Active - PUP Unlikely to Return to NFL Expect Inseason PUP or IR
Robert Griffin III III Bal Right thumb fracture Early preseason 4-8 Weeks Week-to-Week Doubtful Week 1
Running Backs Injured | On the Active Roster
Player
Team
Injury
Date
Player/Team Says
FBG Expects
Notes
LAR
Left knee inflammation
Chronic
Active Roster Limited practice Probable Week 1
NE
Knee inflammation
Chronic
Active Roster Limited practice Probable Week 1
KC
Hamstring strain
Early preseason
Week-to-Week Week-to-Week Probable Week 1
Ten
Left calf strain
Early preseason
Week-to-Week Week-to-Week Probable Week 1
GB
Hamstring strain
Early preseason
Day-to-Day Week-to-Week Probable Week 1
GB
Hamstring strain
Early preseason
Day-to-Day Week-to-Week Probable Week 1
SF
Right ACL reconstruction
September 2018
Active - PUP Week-to-Week Probable Week 1
Cle
Hamstring strain
Early preseason
Day-to-Day Week-to-Week Probable Week 1
Was
Right ACL reconstruction
December 2018
Active - NFI Inseason return possible Doubtful Week 1
Cin
Right ACL reconstruction
September 2018
Active - NFI Week-to-Week Doubtful Week 1
Wide Receivers Injured | On the Active Roster
Player
Team
Injury
Date
Player/Team Says
FBG Expects
Notes
Antonio Brown Oak Foot condition Early preseason Day-to-Day Week-to-Week Probable Week 1
Julio Jones Atl Foot soreness June 2019 Active Roster Limited practice Probable Week 1
A.J. Green Cin --Left ankle-- Early preseason 6-8 Weeks Week 4+ return Out Week 1
John Ross Cin Hamstring tightness Early preseason Day-to-Day Week-to-Week Probable Week 1
Julian Edelman NE Left thumb fracture June 2019 4-6 Weeks Likely return during camp Probable Week 1
Demaryius Thomas NE Left Achilles repair December 2018 Active - PUP Week-to-Week Doubtful Week 1
DaeSean Hamilton Den Hamstring strain Early preseason Day-to-Day Week-to-Week Probable Week 1
Sterling Shepard NYG Left thumb fracture Early preseason 4-6 Weeks Limited practice Probable Week 1
D.K. Metcalf Sea Oblique strain Early preseason Day-to-Day Week-to-Week Probable Week 1
Andy Isabella Ari Knee injury Early preseason Day-to-Day Week-to-Week Probable Week 1
Parris Campbell Ind Hamstring strain Early preseason Day-to-Day Week-to-Week Probable Week 1
Marquise Brown Bal Left Lisfranc joint reconstruction January 2019 Active Roster Limited practice Questionable Week 1
Marqise Lee Jac Left ACL reconstruction / PCL repair August 2018 Active - PUP May return during camp Questionable Week 1
A.J. Brown Ten Left leg injury Early preseason Day-to-Day Day-to-Day Probable Week 1
Jakeem Grant Mia Right hamstring injury Early preseason Day-to-Day Week-to-Week Questionable Week 1
Tight Ends Injured | On the Active Roster
Player
Team
Injury
Date
Player/Team Says
FBG Expects
Notes
Jack Doyle Ind Hip labrum repair February 2019 Active Roster Limited practice Probable Week 1
Charles Clay Ari Knee soreness Chronic Active - PUP Week-to-Week Probable Week 1
Tyler Kroft Buf Right foot fracture fixation revision May 2019 Active - PUP Week-to-Week Questionable Week 1
Dawson Knox Buf Hamstring strain Early preseason Day-to-Day Week-to-Week Probable Week 1
Josh Oliver Jac Hamstring strain Early preseason Week-to-Week Week-to-Week Questionable Week 1
Jonnu Smith Ten Left MCL sprain December 2018 Active - PUP Week-to-Week Questionable Week 1
Garrett Celek SF Back surgery Offseason Active - PUP Likely inseason PUP Doubtful Week 1
Offensive Linemen Injured | On the Active Roster
Tackles
Team
Injury
Date
Player/Team Says
FBG Expects
Notes
Russell Okung LAC Pulmonary embolism June 2019 Active - NFI Could return during camp Questionable Week 1
Cam Robinson Jac Left ACL reconstruction September 2018 Active - PUP Could return during camp Questionable Week 1
Kelvin Beachum NYJ Ankle injury Early preseason Day-to-Day Week-to-Week Probable Week 1
LaAdrian Waddle Buf Quadriceps strain Early preseason Likely injured reserve Injured reserve 2020 return
Kaleb McGary Atl Cardiac ablation Early preseason 6-8 Weeks Likely early season return Questionable Week 1
Donovan Smith TB Achilles injury Early preseason Day-to-Day Week-to-Week Probable Week 1
Jonah Williams Cin Labrum repair June 2019 Active - PUP Likely inseason PUP Out Week 1
Guards
Team
Injury
Date
Player/Team Says
FBG Expects
Notes
Zack Martin Dal Disc irritation Early preseason Day-to-Day Week-to-Week Probable Week 1
Marshall Yanda Bal Foot / ankle soreness Early preseason Day-to-Day Day-to-Day Probable Week 1
Josh Garnett SF Recurrent finger dislocation Early preseason 3-4 Weeks Week-to-Week Probable Week 1
Alex Redmond Cin Shoulder surgery ? Offseason Active - PUP Could return during camp Four game PED suspension
Centers
Team
Injury
Date
Player/Team Says
FBG Expects
Notes
Weston Richburg SF Knee surgery Offseason Active - PUP Likely return during camp Questionable Week 1
Mitch Morse Buf Concussion Early preseason Week-to-Week Week-to-Week Questionable Week 1
Defensive Players Injured | On the Active Roster
Edge Rushers
Team
Injury
Date
Player/Team Says
FBG Expects
Notes
Demarcus Lawrence Dal Shoulder labrum repair April 2019 Active - PUP May return during camp Questionable Week 1
Dee Ford SF Knee tendinitis Chronic Day-to-Day Day-to-Day Probable Week 1
Trey Flowers Det Shoulder surgery Offseason Active - PUP Likely return during camp Probable Week 1
Ezekiel Ansah Sea Shoulder labrum repair Offseason Week-to-Week Week-to-Week Questionable Week 1
Montez Sweat Was Calf contusion Early preseason Day-to-Day Day-to-Day Probable Week 1
Jabaal Sheard Ind Knee injury Early preseason Awaiting information Week-to-Week Questionable Week 1
Jason Pierre-Paul TB Neck fracture May 2019 Active - NFI Likely inseason PUP Out Week 1
Defensive Linemen
Team
Injury
Date
Player/Team Says
FBG Expects
Notes
Jurrell Casey Ten MCL sprain December 2018 Active - PUP Likely return during camp Probable Week 1
Damon Harrison Det Conditioning Early offseason Active - NFI Likely return during camp Probable Week 1
Sheldon Rankins NO Achilles repair January 2019 Active - PUP Likely inseason PUP Doubtful Week 1
L.J. Collier Sea Ankle injury Early offseason Week-to-Week Week-to-Week Doubtful Week 1
Tyrone Crawford Dal Hip surgery Offseason Active - PUP Likely return during camp Questionable Week 1
Jeffery Simmons Ten ACL reconstruction February 2019 Active - NFI Likely inseason NFI Out Week 1
Linebackers
Team
Injury
Date
Player/Team Says
FBG Expects
Notes
Lavonte David TB Knee meniscectomy Early preseason Week-to-Week 3-6 Weeks Questionable Week 1
Nigel Bradham Phi Toe injury Early preseason Day-to-Day Week-to-Week Probable Week 1
Kamu Grugier-Hill Phi MCL sprain Early preseason 6-8 Weeks Early season return Questionable Week 1
Haason Reddick
Photos provided by Imagn Images
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