Stephania Bell: Ryan Williams



Week 5 is in the books! Welcome back, Rashard Mendenhall, who played his first game since undergoing reconstructive ACL surgery in January. Add him to the list of running backs who are redefining expectations following this type of injury. Minnesota Vikings running back Adrian Peterson and Kansas City Chiefs running back Jamaal Charles have already impressed with their performances so far. Now Mendenhall has done the same with 81 yards on the ground, another 20 in receiving and a score in his first outing. Most importantly, Mendenhall's knee felt fine after the game according to Pittsburgh Steelers coach Mike Tomlin and the expectation is he will be back at it again Thursday.

[+] EnlargeRyan Williams
Jennifer Stewart/US PresswireRyan Williams is now the second starting Cardinals running back to suffer a major injury this year.
Three running backs who suffered injuries in Week 5 have already been ruled out this week, and at least one is done for the season. Arizona Cardinals running back Ryan Williams suffered a shoulder injury Thursday, which he initially tried to dismiss as nothing serious, but by Monday, he was ruled out for the season. According to the Cardinals' official website, Williams is undergoing surgery on his left shoulder Tuesday to repair a fractured coracoid process. The coracoid is a bony projection on the front of the scapula (shoulder blade) and is the attachment point for several ligaments along with portions of both the biceps and the pectoral muscles as well as the coracobrachialis (a muscle that elevates the arm and contributes to shoulder stability). The injury is very uncommon; even the Cardinals' team doctors told Williams they had not treated one in 10 years.



It's impossible not to feel for Williams, who suffered a torn patellar tendon last year during the preseason and rehabbed intensively to be ready for 2012. Williams seems to be taking the positive approach, telling the website, "[The injury] could be a good thing for my knee and my whole body, just so it could recover like it should be. ... I really believe in my heart truly that it is beneficial and it'll let my whole body do what it needs to do and then I'll be the Ryan Williams everybody has been expecting to see." We will look forward to hopefully seeing that Ryan Williams when the 2013 season starts.

In Green Bay, Packers running back Cedric Benson injured his left foot when it got twisted in a pile. Benson, who is in a protective boot, suffered a Lisfranc injury, according to ESPN's Adam Schefter. He is expected to miss at least eight weeks, perhaps the entire season if it turns out surgery is required. Benson is currently undergoing further evaluation to determine the next steps. Meanwhile, James Starks, who has yet to play in a game this season after being sidelined with turf toe, could get the start this week.

Moving south to Tennessee, Titans running back Javon Ringer went down with a gruesome-appearing knee injury, which had most assuming his season was over. According to the Tennessean, Ringer has been diagnosed with a torn MCL and is currently projected to miss four to six weeks. The timeline may change, but this is better news than a torn ACL. Ringer missed the first three weeks with an elbow infection and now has to contend with this.



There are many other teams contending with difficult injuries less than halfway through the season. Here's who we're keeping an eye on heading into Week 6.

Quarterbacks

[+] EnlargeRobert Griffin III
John McDonnell/The Washington Post /Getty ImagesRobert Griffin III is still a question mark heading into this week's action.
Robert Griffin III, Washington Redskins (concussion): Although it took a while to get a definitive diagnosis, the Redskins did confirm Sunday that Griffin suffered a concussion. According to the Washington Post, Griffin could not recall what quarter it was or what the game score was shortly after the hit that forced him out of the game. Griffin was examined by a neurologist at the stadium, then returned home. On Monday, Griffin reported feeling better and those around him, including teammate and backup quarterback Kirk Cousins, thought Griffin "appeared to be doing well." As we all know now, however, looks can be deceiving when it comes to head injuries.



Griffin is expected to undergo further testing as the week progresses to determine whether he will be eligible to return to practice and, ultimately, return to play. In addition to neurocognitive testing, which examines how the brain is processing information, players who are symptom-free at rest must undergo graded exercise testing to see if it provokes any recurrence of symptoms. To that end, Griffin was expected to undergo testing on a treadmill Tuesday, according to the Post.



Alex Smith, San Francisco 49ers (finger): Smith sprained the middle finger of his throwing hand late Sunday in the Niners' game against the Buffalo Bills. Coach Jim Harbaugh called Smith's finger a "concern," an uncharacteristic acknowledgment of the severity of an injury to one of his players. One wonders if that nugget was for the benefit of the upcoming opponent. There seems to be little doubt that Smith will play this week against the New York Giants in a rematch of last season's NFC Championship Game.



Running backs

Adrian Peterson, Minnesota Vikings (ankle): Peterson suffered a mild ankle sprain, which in and of itself did not appear serious. However, it was on the same side as his reconstructed knee, which does warrant a little closer attention. Nonetheless, the early impression out of Minnesota is that this will not cause Peterson to miss time.

Andre Brown, New York Giants (concussion): In what seems to be a rotation of running back and receiver injuries among the Giants, Brown suffered a concussion in Week 5. His status for this Sunday is in question.

Wide receivers

Alshon Jeffery, Chicago Bears (hand): Jeffery broke a bone in his hand and is expected to miss at least a month. On the positive side, bone healing tends to follow a fairly straightforward timetable, so the early projections of four to six weeks for Jeffery appear reasonable, further bolstered by the news that Jeffery will not need surgery.

And we're keeping an eye on:

Darrius Heyward-Bey, WR, Oakland Raiders (concussion/neck): Heyward-Bey was recently cleared for contact and was "very active in practice Monday," according to Steve Corkran of the Contra Costa Times. It looks as if Heyward-Bey could potentially return to action this week if his progress continues.

Ramses Barden (concussion) and Hakeem Nicks (foot/knee), WR, New York Giants: ESPN New York's Ohm Youngmisuk reports Barden was cleared to return to practice this week after suffering a concussion in Week 4 against the Eagles. Meanwhile, Nicks' status remains a bit of a mystery as there has been no indication from the team of the results of his knee MRI. Swelling in Nicks' knee and lingering soreness in his surgically repaired foot have kept Nicks out of the past three games. Thus far, Nicks has only practiced on Thursdays so there may not be much of an update before then this week. The Giants maintain he is day-to-day.

Jimmy Graham, TE, New Orleans Saints (ankle): Graham injured his ankle early in the Week 5 contest but did manage to eventually return to the game. He wore a walking boot as he left the stadium, and interim head coach Aaron Kromer confirmed to reporters Monday that Graham suffered an ankle sprain. Fortunately, the Saints have a bye this week, so Graham gets some extra recovery time.

Jermichael Finley, TE, Green Bay Packers (shoulder): Finley left Sunday's game early with what was called a shoulder injury, but the team has not offered any further detail. Coach Mike McCarthy told reporters Monday that Finley has "a chance" to play in Week 6.

Jahvid Best, RB, Detroit Lions (concussion): Best is expected to undergo additional testing this week to determine his readiness to be activated off the PUP list, according to ESPN's Adam Schefter. Although he is reported to be in excellent physical shape, Best will need to pass concussion-related tests to increase his activity level. Best has not played since October of last year.

Week 4 Thursday injury update

September, 27, 2012
9/27/12
10:41
PM ET


Welcome back, NFL referees! Tonight will mark their season debut in Baltimore as the Ravens host the Cleveland Browns. I have no doubt that they, like players who do not start the season on time because of contract disputes, have been maintaining their workout programs in order to be ready at the drop of a hat. But I wonder if they, like the players, will take some time to adapt to the speed of the game and will we potentially see an increased injury rate in the referees in-season this year? Something to keep an eye on.

Here's who else we're keeping an eye on in Week 4.

Quarterbacks

[+] EnlargeMatthew Stafford
AP Photo/Rick OsentoskiMatthew Stafford looks like he'll go Sunday after leaving last week's game early.
Matthew Stafford, Detroit Lions (hamstring): On Tuesday we discussed Stafford's hamstring/glute injury, which was labeled "hamstring" on the NFL official injury report Wednesday. Later that day, Dave Birkett of the Detroit Free Press tweeted that the team had revised it to a "hip" ailment. To add less clarity to the situation, consider the remarks of offensive coordinator Scott Linehan, who told reporters, "I don't really consider him injured. He's just dealing with something that's been uncomfortable ..." Based on Stafford's original remarks, this does not have the sounds of a true muscle pull but rather of an issue in the back or hip that is causing some referred pain into the gluteal or hamstring area. That leaves open a range of possibilities, but in the end the actual diagnosis may not be particularly significant, at least not yet. It will come down to functionality. Does he have enough mobility and power in the leg to function effectively, even if there is some lingering soreness? As long as that soreness does not progress into more disabling pain or weakness, then Stafford should be able to press through it. For what it's worth, he indicated he was feeling better Thursday than Wednesday.

However they decide to label it, here's what we know: Stafford did not practice Wednesday but did return Thursday, a good sign that he is preparing to be available Sunday.



Tom Brady, New England Patriots (right shoulder): If you've missed seeing Brady's name on the injury report this year, well, he's back. And it's the same body part he was listed with when he went on that record streak of injury report appearances a few years running. He was limited at practice Wednesday but expect him to play, as always.

John Skelton, Arizona Cardinals (ankle): Skelton began limited practices last Thursday and that's how he started off this week. Still recovering from a sprained ankle, he returned to limited practice again this week. Right now it looks as if Kevin Kolb will stay under center.

Running Backs

[+] EnlargeAhmad Bradshaw
Mark L. Baer/US PresswireAhmad Bradshaw looks like he will start this week after missing the Week 3 contest.
Ahmad Bradshaw, New York Giants (neck): The Giants weren't saying much about Bradshaw's neck injury last week but he offered up some insight Thursday. The culprit, it appears, is a bulging disc. According to Ohm Youngmisuk of ESPN New York, Bradshaw experienced tingling in his hands during the Week 2 game but didn't attribute it to a specific hit. It happened a second time in the game, which is when Bradshaw decided he should get it checked out.

Tingling is a hallmark nerve symptom; when the tingling happens in both hands at the same time, it's a signal that the spinal cord is involved. The medical staff was understandably cautious when Bradshaw reported the symptoms and, after evaluating him, determined he could remain at the game, but could not return to play in the game. Bradshaw underwent a subsequent MRI, where the disc issue was detected. While disc injuries can be serious, they can also be fairly benign. It's not uncommon for bulging discs to be present and be completely asymptomatic. If there is an event that results in inflammation, it can become painful or provoke nerve tissue in the area (this is perhaps what Bradshaw was trying to explain when he referenced an "inflamed disc"). Often once the inflammation resolves, the symptoms do as well. It appears this was the case with Bradshaw.

Bradshaw has practiced fully both Wednesday and Thursday and is on track to resume his starting role Sunday against the Eagles. The Giants would not return him to play if he was at any significant risk, and his clearance to return indicates his neurological symptoms have resolved. The unknown aspect is whether these symptoms will return. There is no true predictability one way or another, however, it is not uncommon to have more than one episode once a disc injury is present. Those episodes can be weeks, months or even years apart. And in some cases, there is no recurrence.



Those who make their living at a computer are at as much, if not more, risk than professional football players for developing disc problems in their neck and back. So if everyone on a laptop is going to continue to work, Bradshaw can too. If Bradshaw's neck does turn into a recurring problem then his status may change, but until that time, he can be expected to play.

[+] EnlargeFred Jackson
Ed Mulholland/US PresswireFred Jackson might be ready to return to action for the first time since leaving during the season opener.
Fred Jackson (knee) and C.J. Spiller (shoulder), Buffalo Bills: Flash back to Sunday, Spiller clearly in pain on the ground, carted off the field with medical personnel holding his shoulders. Now it's four days later and Spiller is back in practice, albeit on a very limited basis. Quite surprising. Perhaps the reassurance he received after going through further tests was enough to encourage his rapid recovery. He is still has a ways to go before playing in a game and it would not be surprising if he is out this Sunday, but that has not yet been decided.

Jackson has made an impressive recovery of his own from a right lateral knee sprain. He returned to limited practice Wednesday but emerged seeming less than thrilled with the result. Jackson told the Buffalo News on Thursday, "I was a little sore ... a little swollen." It's not terribly surprising that Jackson's knee would respond that way to the increased activity; the question was whether he would have to scale it back further on the second day. Apparently not. There were no lingering effects into Thursday afternoon's practice and Jackson participated in most of it, according to the News. After practice, coach Chan Gailey told reporters, "I think if we make it through the next couple days and continue to improve I think [Jackson] will have the opportunity to play."

There is still plenty of time for things to change but it appears to be shaping up for Jackson to be available along with a healthy Tashard Choice, while Spiller likely rests another week.

Steven Jackson, St. Louis Rams (groin): Jackson did not practice Wednesday or Thursday, but this week isn't so much about whether he'll play or not, it's about what can be expected. Last Sunday, Jackson gained only 29 yards rushing on 11 carries, most of which were very short gains with the exception of one run for 13 yards. Jackson acknowledged the injury affected him but also said he didn't suffer any setbacks. Until we see him running full speed, there will be some question as to whether the injury is truly behind him.

Arian Foster, Houston Texans (knee): Foster took in a light practice Wednesday but was back at it in full on Thursday. So far, so good.

Darren McFadden, Oakland Raiders (shoulder): McFadden's presence here is a reminder that sometimes players appear on injury reports with very minor ailments -- bumps and bruise from a game -- because they take fewer reps in practice to preserve their bodies. Of course we all understand why there is a slight panic for fantasy owners when it's McFadden's name that appears here. While Oakland's official Thursday injury report is not in at the time of this writing, a source tells me he is participating and is "fine."



[+] EnlargeMatt Forte
Joe Camporeale/US PresswireMatt Forte could be back this week, but will fantasy owners be able to wait until Monday night for the decision?
Matt Forte, Chicago Bears (ankle): If only the Bears didn't have a Monday night game. Forte's status could very well come down to the wire, which will make this a tough decision for fantasy owners. In general, things are looking up. Forte returned to practice Wednesday and repeated the effort Thursday. His chances of returning are looking better, but hopefully there will be a better indication by Friday afternoon.

Reggie Bush, Miami Dolphins (knee): On Tuesday we highlighted Bush's knee concerns, but the real question was whether we would see him in practice. After being held out Wednesday, Bush returned to limited practice Thursday and was running well. If he can put in another good effort Friday, it appears he will play Sunday.

Willis McGahee, Denver Broncos (rib): On Tuesday, we discussed what would determine whether McGahee could play this week, and his limited participation in practice Wednesday with a bump up to full participation Thursday shows he is on track.

LeSean McCoy, Philadelphia Eagles (rib): Another running back, another rib injury. There isn't much concern here because McCoy practiced fully both Wednesday and Thursday.

Mikel Leshoure, Detroit Lions (groin): Leshoure was limited in practice because of a groin injury but keep in mind, he is coming into this season off major surgery (Achilles repair). There is no indication that his Sunday status is in jeopardy, but Friday's practice should yield better clues.

Ryan Williams, Arizona Cardinals (knee): With teammate Beanie Wells going on IR (designated for return, meaning he can return in Week 12), Williams has an opportunity to shine. He is listed on the report but put in full practice. His value is on the rise.

Evan Royster, Washington Redskins (knee): Royster strained his patellar tendon and has been held to limited practice so far this week. Roy Helu (turf toe) is now on IR, but Ryan Grant was just added to the mix so the Redskins can continue with a running back carousel.

Peyton Hillis, Kansas City Chiefs (ankle): Hillis has been in a walking boot since the game ended and has not practiced. It's not looking great for his chances to suit up this week. Teammate Jamaal Charles is not on the injury report this week, however. Kudos to Charles, who had an outstanding performance Sunday (233 rushing yards!) and showed some of the pre-injury speed on a 91-yard breakaway run. With Hillis possibly out and Charles showing improvement, he could be poised for a big week.

Wide Receivers

Calvin Johnson, Detroit Lions (ankle): Johnson has now been on the injury report each week but has never been at risk of not playing. Limited Wednesday, full practice Thursday, play Sunday.

Jeremy Maclin, Philadelphia Eagles (hip): Maclin's hip benefited from the rest in Week 3 and he claims he's much improved. Full practice both Wednesday and Thursday, and he is expected to play in the big matchup against the New York Giants on Sunday night.



[+] EnlargePierre Garcon
John David Mercer/US PresswireIt doesn't look good for Pierre Garcon to return this week.
Pierre Garcon, Washington Redskins (foot): Judging from all the questions coming my way regarding Garcon, people are very suspicious about his injury. It's important to remember that a foot injury, even a relatively mild one (no fracture or dislocation) can be extremely incapacitating because of the load that goes through the foot with running and the shear forces it experiences when changing direction.



The Redskins have maintained that Garcon can proceed based on how the foot feels, which tells us they're not overly concerned about the injury worsening. Still, pain exists to help prevent us from doing things that would lead to further injury, and depending on the location and quality of it, it is not necessarily something that can or should be overridden. With coach Mike Shanahan telling reporters Thursday that Garcon's foot is still sore and with Garcon continuing to be limited in practice (although he is making progress according to Shanahan), it appears he could miss another week.



Hakeem Nicks, New York Giants (foot): I said it here Tuesday and I'll say it again: Expect Nicks to play in Week 4. He got the benefit of some extra rest for his sore foot last week, but returned to limited practice Thursday. He will be ready for Sunday night in Philadelphia.

Andre Johnson, Houston Texans (groin): Johnson practiced on a limited basis both days. There is reason to keep an eye on this, as Johnson suffered a groin injury in the preseason. But this has more the appearance of preserving a veteran star than anything else.

Julio Jones, Atlanta Falcons (hand): The Falcons announced that Jones suffered a laceration (cut) to his hand, which is why he left the game briefly Sunday. He has been limited in practice, likely to protect the hand and help it to heal. He is expected to play.



Kenny Britt, Tennessee Titans (ankle): According to the Tennessean, Britt described his cascade of injury after injury as "very frustrating." Britt went on to say, "It's like something I can't get right, injury after injury. The last healthy season I had was my rookie year." This has been an overarching concern with Britt for the last few years. A very serious hamstring injury derailed his season two years ago. He headed into 2011 with his quad and hamstring nagging at him, then tore his ACL later that year. During his recovery following reconstructive knee surgery, he needed a follow-up scope and an additional scope on the opposite knee. The Titans articulated their concern when he made his debut in Week 2, saying they planned to limit his touches. A week later he has yet another injury. And, although it is considered relatively minor, he has yet to practice this week. He still hopes to play, but the injury concerns will not disappear when he returns.

Greg Jennings, Green Bay Packers (groin): Jennings played in the Monday night game but we all know his performance is hardly the thing we'll remember. He did appear to be at less than full speed at times but managed to play in the game and emerge no worse for the wear. He's been limited in practice since but looks to be in line to play this weekend when the Packers host the Saints.

Dexter McCluster, Kansas City Chiefs (elbow): On Tuesday we commented on how painful McCluster's injury looked so no one would have been surprised if he was not in practice this week. But there he was on Wednesday, wearing a brace and participating only in non-contact drills but he was out there nonetheless. On Thursday, he put in another limited practice. He's surprised so far, maybe he will again on Sunday.

Julian Edelman, New England Patriots (hand): Edelman has not practiced since injuring his hand in Sunday night's game. There's not much to go on here, but two missed practices aren't encouraging for Sunday.

Tight Ends

Dustin Keller, New York Jets (hamstring): Keller has not played since Week 1 because of his injured hamstring but it looks as if things will change this Sunday. He has been practicing on a limited basis and according to ESPNewYork's Rich Cimini, coach Rex Ryan says he expects Keller to play.

Jared Cook, Tennessee Titans (shoulder): On Tuesday we said Cook would need to show he could perform well enough to play and he appears to be on his way. Cook got Wednesday off but returned to limited practice Thursday. If he can do so again Friday, there is a good chance he will return this week.

Jacob Tamme, Denver Broncos (groin): The groin can't be bothering him too much since he was able to practice fully both Wednesday and Thursday. It looks as if he'll be available in Week 4.



Other notes

New Orleans Saints WR Marques Colston does not appear on the injury report this week. He has been bothered by a case of plantar fasciitis that seemed to have limited him over the last two weeks. He played in Week 3 but had only three receptions for 40 yards. Perhaps his move off the injury report is a sign things are improving.

Don't forget to adjust your lineups! This is the first week of team byes. Both the Pittsburgh Steelers and the Indianapolis Colts are off this week so they do not appear on the NFL official injury report.

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