2012 Recap and a Look Ahead to 2013

Here’s the link to my post over at FFLockerRoom.com, recapping the 2012 season and taking a look at how some key injuries will effect 2013.

http://fflockerroom.com/2013/02/05/the-season-that-was/

Enjoy!!

Championship Round Preview

Well, boys and girls, Championship weekend is upon us and we have a couple of very intriguing match ups. As you all know, I’m a huge fan of the Pats, and I couldn’t be more freaked out by an AFC championship matchup than I am now. I actually was pulling for the Broncos to win their divisional round game because I felt the Pats matched up much better against the Broncos D. Now, facing Joe Flacco and not Peyton Manning is definitely a plus, but Flacco is playing so well in the playoffs that I almost feel like he’s the hottest QB in the NFL right now. Both teams are relatively healthy considering the time of the year, with the exception of the Pats not having Rob Gronkowski and possibly Danny Woodhead. Let’s take a look at the injury situation for the AFC Championship:

Patriots (-8) vs Ravens: As I mentioned above, Woodhead suffered a sprained thumb in the Divisional round against the Texans. He’s officially listed as probable, and based on his improved participation in practice this week, he seems like a good bet to be just fine for Sunday’s game. The bigger worry with Woodhead are the touches he will lose to Shane Vereen after the monster performance he had last week. Chandler Jones appears to be relatively healthy after he suffered a slight re-aggravation of his sprained ankle against the Texans. He was a full participant in practice Friday and appears to be ready to go. Expect him to have some limitation as it’s very difficult to play full strength with any sort of ankle sprain due to the drop off in stability around the ankle, but he should be productive in bursts. 

For the Ravens, Bernard Pierce is still dealing with a sprained knee and is officially listed as questionable. Word is he will play Sunday, but I can’t see how he’s going to be close to 100%. It seems like Pierce won’t be at full strength leading up to Sunday’s game, although all signs point to him suiting up and being the change of pace back that spells Ray Rice. Other than Pierce, the Ravens enter Sunday’s basically at full strength. 

This is tough game for me to predict. I think the Pats’ offense has a definite advantage over the Ravens’ aging defense, but it always seems like the Ravens give the Pats’ O-line and Tom Brady fits with their coverage packages and blitz schemes. I expect there to be some rough patches early for the Pats’ offense, but they will make adjustments throughout the course of the game. On the other side of the ball, I think the key will be the Pats’ ability to limit big downfield plays on the outside as well as bottling up Rice on screen passes and runs outside the tackles. I think the Pats make just enough plays on D and score a bit too much for Flacco and the Baltimore O to keep up with. I think the Ravens cover, but the Pats win. Patriots 31, Ravens 27

49ers (-4) vs Falcons: This game is a bit more clearcut in my book. In terms of injuries, John Abraham is officially listed as questionable, as he was a limited participant in practice on Friday. From my vantage point, I think this was a calculated decision to allow him some rest time and avoid re-injury at all costs. I think he’s healthier this week than he was last week, as he didn’t get to play in the 2nd half. As for the 49ers, the only lingering injury issue is Justin Smith, although he looked good last week and was well protected by that bulky brace around his elbow to stabilize that triceps injury. He looked like his disruptive self last week, occupying multiple blockers many times throughout the game, so expect the Niners’ defense to be just fine against the Falcons. 

I think this game boils down to how the Falcons handle the pressure the stout Niners’ defense throws at them all day; in particular, the decisions Matt Ryan makes on his feet and if he can stay away from turning the ball over. I think he’ll do a pretty good job, but I think the Niners’ defense and the dynamic play of Colin Kaepernick will be too much. The 49ers cover and win the game outright. 49ers 35, Falcons 24.

Bouncing Back From an ACL Tear

(This article was published originally 3 years ago, some of the content has been changed from it’s previous publication)

If we learned anything from Week 16 and the Wild Card round of the playoffs, it’s that watching someone tear their ACL remains one of the most gruesome things to experience, whether it’s in person or while watching TV. Sitting at a friend’s house watching the 49ers/Seahawks game during Week 16, I knew it the second I saw it that Mario Manningham tore his ACL. I actually remember saying that I thought he tore both his ACL and MCL, mainly based on how much his knee dove in when he got his foot caught underneath his body. Same goes with watching RGIII this past weekend against the Seahawks, although initial reports say that he only has partial tears of the ACL and MCL. Maybe short of a broken bone, nothing makes me cringe more than seeing an athlete tear his ACL, partly because it almost always seems like they KNOW they just tore their ACL and that the next year of their lives just changed in an instant. Despite the improvements in surgical intervention and rehabilitation, recovery post-ACL reconstruction remains both tricky to predict and a long, arduous process.

The point of this post today is not to point out what we already know: ACL tears are bad. But it’s to give you some insight into why exactly this small bundle of collagen fibers plays such a crucial role in an athlete’s function and what goes into the rehab process following this gruesome injury.

First question we have to answer: What is the ACL? Essentially, and very simply, the Anterior Cruciate Ligament (ACL) stops the tibia (shin bone) from gliding anteriorly (forward, towards the front of the body) on the femur (thigh bone). The significance of this knee ligament is that it provides the stability of the knee during movements such as planting-and-pushing-off, stopping quickly on a dime, cutting, and decelerating during a run/sprint. When you take this ligament away from a football player, it’s essentially taking away their burst, change of direction, and ability to accelerate/decelerate all in one pop (literally). Check out this diagram to get a visual of everything I just rambled on about:

Now that we understand the function of the ACL, our next question to answer is this: How does a person tear an ACL? Typically, the most common mechanism of injury (MOI) for an ACL tear is a twisting motion occurring at the knee while the foot is planted on the ground. This can happen with or without another player/person present, as it is quite common for an athlete to tear their ACL with no one anywhere near them (RGIII is a perfect example). What typically happens is the torsion that’s imparted on the knee places maximal strain on the ACL itself, and without the sufficient supporting joint and muscular strength to take on this force, the ACL overstretches. And with the right amount of excessive force, this leads to a partial or full tear of the ligament. Also, if the movement in question or the blow to the knee causes the knee to dive in enough, this is very commonly how people tear both the ACL and the Medial Collateral Ligament (MCL) and, potentially, medial meniscus at the same time. The MCL is the ligament that stops the knee from collapsing in when someone hits your knee from the outside. The combo platter of an ACL and MCL is typically a bit more tricky to surgically repair and rehab due to the addition of even more instability at the knee. Always remember, the more structures involved, the more difficult the rehab is.

Another common MOI with ACL tears is excessive knee hyperextension. When this happens, the femur can glide posteriorly (to the back) on a stable tibia when the foot is planted to the ground, which causes relative excessive anterior tibial motion. Think about what we said was the function of the ACL, stopping the tibia from moving anteriorly (forward) on the femur. Well, if you keep the tibia (shin bone) stable and move the femur posteriorly, it basically causes the same movement, except the femur is doing all the moving. This can also put strain on the Posterior Cruciate Ligament (PCL), which stops the tibia from moving posterior on the femur.

Ok, so we’ve gone over what the ACL is and how people tear their ACLs. Now, what goes into rehabbing this important ligament? Post surgery, the most important thing to regain is range of motion (ROM). Since a person is typically placed in a brace of some sorts (most of the time, depends on the doc) to help protect the new ligament, the knee becomes very stiff and does not move very well once the rehab process begins.

[Quick side note before we move on: When reconstructing the ACL, there are typically 3 options when deciding what type of graft to use: Your own patellar tendon, Your own hamstring tendon, or an ACL from a cadaver. Typically, cadaver grafts provide a good combination of quick recovery and great results long term, but there’s always the chance of rejection because you’re putting foreign tissue in your body and there’s increasing shift away from this now as more evidence becomes available. Patellar tendon grafts typically are super stable, but take a bit longer to heal because you’re using a tendon instead of a ligament, as tendons are not as pliable as ligaments. Also, taking a chunk of your patellar tendon can weaken your quadriceps muscle group significantly, as the patellar tendon attaches the quads to the tibia. Hamstring grafts are the last of the three options and allow the athlete to get back a bit faster than the patellar tendon choice and is arguably gaining more popularity now compared to 5-10 years ago]

While concurrently working on range of motion, initial strengthening of the quads, hamstrings, and gluts are in order, usually beginning with isometric strengthening (activating musculature without movement). In addition, it’s imperative to work on surgical scar mobility in order to allow the surrounding tissue to maintain its mobility and properly slide/glide on each other during motion.

The first phase of the rehab process is predicated on achieving 3 major milestones: 1- Regain proper quad muscle activation; 2-Decrease and minimize post-operative swelling; 3- Regain full range of motion, particularly full knee extension (straightening out the knee). Achievement of these three milestones is crucial before progressing to the next stage of rehab.

Following these initial phases in addition to the athlete being cleared by their orthopaedic surgeon, there’s a progression from isometric strengthening to isotonic, which involves moving resistance as muscle length changes. This progresses from mat exercises to sitting exercises to standing exercises, all based on achieving milestones before moving on to the next phase.

Once this phase is reached, we move on to dynamic movements, in straight lines first, then adding lateral and diagonal motions to help rebuild stability around the knee. This goes on until the individual is ready to do sport-specific exercises, which is the last step before return to play.

Last important question we need to answer is what is the prognosis for recovery from this terrible injury? This varies depending on the individual and whether multiple structures were involved, but as Adrian Peterson showed us, timetables can be thrown out the window when it comes to world class athletes. BUT, in general, prognosis for return to sport can be anywhere from 6 months to 12 months, depending on complications, past injury history, and response to rehabilitation. But as you’ve probably heard many times, a player in any sport is typically not back to their “prior level of function” until the second year following reconstruction.

This is by no means a set rule for all cases, but it takes time for an athlete to feel comfortable back on the field again, competing at the highest levels, without thinking about how to move and whether their knee with hold up to these enormous demands placed on it. One of the more difficult things for an elite athlete following this type of injury is getting back to moving instinctively, which is where a lot of the variability in return to sport comes from. Some get this back faster than others.

What does this mean for someone like Breshad Perriman. According to Ian Rappaport from NFL.com, he saw Dr. James Andrews today to determine the next step in his recovery process

#Ravens WR Breshad Perriman’s scope from James Andrews is tomorrow. That will determine if he needs a reconstruction. 1st visit was today.

— Ian Rapoport (@RapSheet) June 13, 2016

This is the tricky part of suffering a partial tear vs a full tear. With partial tears, due diligence needs to be performed in order to determine the severity and extent of the damage before jumping into making a decision on reconstruction vs conservative rehabilitation. The likelihood of Perriman going the conservative route, in my opinion, is slim. If he does, they’d take the rehab process on a week to week basis, determine his response to treatment, and ultimately see if he can get back on the field and perform at a high level while they give the ligament time to heal.

However, this road could still ultimately lead to reconstruction if conservative rehabilitation does not get the job done, which will end up costing him time on the back side. The one positive from attempting to rehab first would be that Perriman would be extremely strong and mobile going into the surgery, as PREhab has been shown to improve outcomes post-operatively. Regardless, and very unfortunately, I don’t think we’re seeing Perriman at all this year, which means we’re looking increased involvement of both Kamar Aiken and Mike Wallace this season barring a free agent signing.

Thanks for reading kids! Much more to come to help you get ready for the 2016-17 season.

Terrell Suggs’ Torn Biceps: Can He Play Through It??

Word came out today that Terrell Suggs suffered a tear to his biceps tendon on Sunday. There are a couple of things to consider when deciding whether he can play through this injury or not:

1. Which tendon did he tear, long head or short head of the biceps tendon? Long head tear would be the more serious one as it is a larger participant in function and a greater force generator.

2. What is the severity of the tear? Tears of muscle are graded, so if you hear he suffered a grade 3 (near to complete tear), then he’s more than likely not playing through it. But a grade 1 or grade 2 tear can be played through depending on whether he can tolerate a pretty darn significant amount of pain.

3. What’s the likelihood of imparting further damage on the muscle? Location of the tear: musculotendinous junction (where the muscle blends into the tendon), osseotendinous junction (where the tendon attaches to bone), or somewhere in the muscle belly itself. After an MRI is done and location of the tear is found, they’ll determine the likelihood of him more seriously damaging the muscle.

So, as you can see, the results of the MRI and of his second opinion will go a long way in determining if Suggs will play through this injury. With the Ravens still in the thick of things and lock for the playoffs, you better believe if he gets the OK, he’ll probably be out there. Let’s wait until we hear more information before we rush to judgment.

Ravens/Browns Update & Other News

First off, quick update for tomorrow’s game between the Ravens and Browns. Not a ton going on fantasy wise, but let’s do a quick run through:

Ravens:

Basically, not a damn thing. Ladarius Webb had a minor little thing, but he’s probable and will play. Roll out everyone you normally would. And for what it’s worth, I think Joe Flacco throws 3 TDs, all to RBs/WRs (I think Dennis Pitta gets shut out since the Browns are very solid against TEs this year).

Browns:

Trent Richardson is officially forever probable, but his knee is good to go. He has a tough match up this week, so I could see why any Richardson-owner would be hesitant, but I think he sneaks in a late TD, possibly on a screen pass, which Brandon Weeden will be checking down to all night. I’d still play him.

Joshua Cribbs is also probable with a sprained knee, but I don’t like him at all this week. Weeden really is not very good, and the Ravens pass rush is going to throw different looks at the rookie QB. Cribbs really didn’t look 100% this past week anyways. I’d sit him.

Mohamed Massaquoi is officially out. I’m so, so sorry if you were relying on him (your chances to win this season aren’t good if you’re relying on guys like him), but he’s not going to suit up tomorrow.

I honestly don’t like anyone on the Browns tomorrow except for Richardson. Baltimore is dominant at home and is coming off an emotional win against the Pats, which I think will cause a bit of a let down early on, but come on, it’s the freakin Browns.

Other News:

Ahmad Bradshaw: Full participant in practice Wednesday, he looks like a go. I think he’ll be ok, even though he’s in more of a time share now than he probably thought he would be. But if you’ve been waiting on him, play him. He seems ready to go

Arian Foster/Andre Johnson: Get used to these guys being limited on Wednesdays. Reports are they’re going to be “limited” participants because the Texans are going to use Wednesdays as rest days. Play both.

Roy Helu/Beanie Wells: I combined these two because they were both placed on IR today with turf toes, effectively keeping them out until November. Both were pretty big disappointments thus far, so thank your lucky stars. However, Ryan Williams’s stock shot through the roof.

Jeremy Maclin: He practiced today, which is good. I still think he’s toughing this hip pointer out, because he doesn’t seem right at all. I just think he’s gutting through this injury and being a good solider, but if he was on my team, I’d sit him until he demonstrates he can play a whole game.

Matthew Stafford: Reports say he didn’t practice, but did do some things on the side and was moving around well. It seems like the Lions are just being cautious, but this is one of those cases where the end of the week will tell the story. Wait until Friday, but make sure you have a serviceable backup just in case (Ryan Fitzpatrick is available in a ton of leagues, and the Pats aren’t exactly world beaters against throwing teams).

Titus Young: He didn’t practice today with an undisclosed knee injury. I don’t remember hearing anything about this over the weekend, so just monitor and adjust accordingly.

Hakeem Nicks: He had his scheduled “non-practice” on Wednesday, as the Giants’ plan was to have Nicks practice on Thursday for the first time. Post-surgical soreness is pretty normal, so here’s hoping that 10 days of rest and rehab went a long way for him. I think he’s dress and play, and I’m expecting him to look a lot more fresh this week.

Reggie Bush/Matt Forte/Fred Jackson: They were no practice/practice/practice today, respectively. I’m lumping them together because all three scream “TOO SOON” to me.

• Jackson was very honest, saying there were a lot of things that didn’t feel quite right, even though some things felt good. I   think he doesn’t play and I’m in total agreement with that.
• Forte seems like he’s on pace to play, and he will have the extra day since they play Monday. My gut is that he tries to go, but I have Michael Bush is one league and I’m confidently playing him regardless of what comes out.
• I can’t imagine Bush playing this week after he JUST injured his knee. I know they were happy that nothing was structurally damaged in his knee, but he reportedly still has a lot of stiffness and swelling in the knee, which is never a good sign. It’s typically 7-10 days before swelling really clears out of the joint space. I’d sit him this week, go with Daniel Thomas or Lamar Miller if you picked them up, I just don’t like ol’ Reg this week.

CJ Spiller: Reports are he’s going to make a strong push to play this week, and it seems like he’s progressing well. From an injury standpoint, I don’t necessarily think he will damage the shoulder any more than it already is, but there will be pain associated with it when he gets hit. My one concern is if he gets tackled and goes down shoulder first, because that’s a very common mechanism for AC joint separations. I’d probably err on the side of sitting him this week regardless of what news comes out.

Ok boys and girls, as more news comes out, I’ll post more information. Friday’s practices will tell us a lot about these guys. Keep checking the waiver wire for more gems.