Lions injury breakdown: DJ Reader quad tendon tear and what his activation off PUP list signifies

Breaking down the medical outlook for Lions DJ Reader now that he’s been activated from his torn quad tendon ahead of Week 1

DJ Reader, who has yet to practice this preseason, was removed from the PUP (physically unable to perform) list today which allows him to start the individual drills that Dan Campbell forecasted last week. The Lions did have the option of keeping him on the PUP list into the regular season which would have made him ineligible to play the first 4 games of the season.

Keeping Reader on PUP would have freed up a roster spot at the 53-man cutdown this coming Tuesday. By removing him from PUP now, it suggests the Lions feel Reader’s rehab is going well enough to start ramping up to play in a game. He is available to play as early as Week 1, but there there are a few reasons why this should not be the expectation.

RELEVANT MEDICAL HISTORY

-June 2024: Knee scope, which is often a sign of cartilage damage. This likely affected his rehab.

-December 16, 2023: Tore right quad tendon requiring surgery. This is typically about a 9 month recovery so the start of this season was always in question.

-2022: Knee injury, missed 6 games.

-2020: Tore left quad tendon in game 5. Returned for the start of next season.

QUAD TENDON PROGNOSIS

A quad tendon tear carries durability concerns even after fully healed. Here are some recent case reports of quad tendon tears:

-Anthony Walker 2022: injured in game 3, returned 1st game next season, played 12 games before a knee injury ended his season.

-Gerald McCoy 2020: injured in preseason, returned 1st game next season but hurt opposite knee in that 1st game and never played again.

-Mike McGlinchey 2021: injured in game 8, returned 1st game next season, played all 17 games.

-Dontari Poe 2019: injured in game 11, returned 1st game next season, played 7 games before being released and never played again.

-Beau Allen: injured in 2020, never played again.

A retrospective study in 2004 of NFL players found 14 quad tendon tears over the previous 10 years. Only 50% returned to play in the NFL and the average games played for those who returned was 40.

OUTLOOK

I would not expect DJ Reader to be ready for Week 1, but today’s removal from the PUP list implies he likely will be ready by Week 5. Last year, the Lions had a similar situation with Emmanuel Moseley, who was also coming off a long-term injury (ACL), also had a knee scope during rehab, and also was removed from the PUP list late in preseason (August 23). Moseley did not end up playing in a game until Week 5.

Durability this season and beyond is a concern due to the bilateral quad tendon tears, possible knee cartilage damage, and age (30), so the Lions might be wise to load-manage him either through snap counts or games off if they hope to have him healthy into the playoffs.