Tag: injury prognosis

What Lions fans should watch in the Dallas Cowboys game on Sunday Night Football

The Lions play the Cowboys in Week 6, but first the injury-ravaged Cowboys play the Steelers on Sunday night

Lions fans get an early October treat on Sunday night. Coming off a big win over the Seahawks, we get to revel in the bye weekend by watching our next opponent, the Cowboys, play in a standalone national game vs the Steelers.

What will be especially intriguing to watch is how the Cowboys compensate for the loss of multiple significant players from last week. Making it directly relevant is these players will also likely all be out for the Lions game. I’ll run down these injuries as well as what to watch for during the game.

Micah Parsons, DE – left high ankle sprain

Parsons hurt his left high ankle last week and left the game. On video, it didn’t appear too serious but even a mild high ankle can sideline a player for longer than you might expect because of the instability it causes in the joint. What will delay his return even more is that Parsons elite game involves bending and quick cuts off the edge which require tremendous ankle strength and flexibility.

Leading up to the game this week, Parsons had three NP’s (no practices) and was ruled out. The lack of any practices along with the type of injury suggests it’s unlikely he’ll play against the Lions next week.

Demarcus Lawrence, DE – right foot Lisfranc

Like Parsons, Lawrence was hurt last week and left the game. While Parsons has an outside chance to play vs the Lions, Lawrence has no chance as he has already been placed on IR. His Lisfranc injury is expected to be a 4-8 week recovery.

Brandin Cooks, WR – knee joint infection

Cooks played the whole game last week, but after the game, had a knee injection that caused a knee infection. On Saturday October 5, Cooks was placed on IR which means he’s out for the Lions game.

The fact that Cooks was getting injections for his knee means that there is some underlying problem with the knee. This by itself could warrant some time off. Dramatically compounding the problem is the joint infection which can cause significant swelling, loss of range of motion, and full body symptoms like fever and malaise.

The joint infection requires IV antibiotics and drainage of the joint. In Cooks case, a knee scope procedure was performed to drain the infection as well as trim the meniscus. The aforementioned knee injection may have been to control pain and inflammation due to a torn meniscus. That’s a lot of things going on in a knee thus the move to IR.

WHAT TO WATCH FOR ON SUNDAY NIGHT

How will the Cowboys perform without two star edge rushers? Will they be able to generate a pass rush without them and will they increase their blitzing? Filling their void will be Marshawn Kneeland, a 2nd-round pick this year with no sacks, and Chauncey Golston, a 4th-year player with 4.5 sacks in his career.

While Brandin Cooks hasn’t been overly productive this year with just nine receptions for 91 yards, it will be interesting to see how the Cowboys adjust to his absence. In addition to star WR CeeDee Lamb, who put up 227 yards vs the Lions last year, there may be increased targets for Jalen Tolbert who has 13 receptions for 160 yards this season. Minimally utilized WR’s KaVontae Turpin and Jalen Brooks could see more action also.

Lions bye week medical status report and outlook for return

Lions bye week medical status report and outlook for return for players like Frank Ragnow, Derrick Barnes, Ifeatu Melifonwu and more

With four games in the books and entering the bye week, it’s a good time to recap where the Lions are at from a medical standpoint. Overall, despite some injuries, the Lions are in good shape coming out of the bye.

Not listed here are a couple pending concerns from the Seahawks game in Kerby Joseph and Carlton Davis (see my postgame article for details).

MAJOR LOSSES

Marcus Davenport, DE

Davenport missed game two due to a groin injury and game four due to a left elbow injury. The elbow is expected to be a season-ender.

Signed to a 1-year contract as a free agent, the Lions were hoping that Davenport would solidify the edge position opposite Aidan Hutchinson.

With Davenport out, Levi Onwuzurike, Josh Paschal, and James Houston will have increased opportunities.

Derrick Barnes, LB

This versatile LB took a direct impact on his right knee in game three, which may have caused a hyperextension, MCL sprain, and possibly more. He was placed on IR after the game.

The earliest he could return is Week 9 vs the Packers, but he’s expected to be out longer than that with the possibility it’s even a season-ender.

With Barnes out, Malcolm Rodriguez and Ben Niemann saw a big increase in snaps at the LB position against the Seahawks.

MINOR LOSSES

Frank Ragnow, C

This 2nd-team All-Pro is a major player, but he’s in the minor category because his left pec injury is not expected to be a long-term issue. He hurt the pec early in game three and missed game four.

The diagnosis is a partially-torn pec which translates to a grade 1 or 2 strain. If the strain is mild and does not involve the tendon, Ragnow could be back after the bye vs the Cowboys. Even if a longer recovery is needed, I would not expect him to be out much longer than that. He was not placed on IR which suggests an injury of less than four weeks.

To fill Ragnow’s void, Graham Glasgow moved from LG to C, and Kayode Awosika inserted at LG. Both played well against the Seahawks.

Ifeatu Melifonwu, S

A persistent ankle issue landed Melifonwu on IR before game four. The injury suffered likely in the second preseason game on August 17 was not initially expected to be a long-term issue, otherwise the Lions would have put him on IR much sooner. Melifonwu’s earliest possible return is in week nine vs the Packers.

If starters Brian Branch and Kerby Joseph stay healthy, Melifonwu’s absence is not a major problem. But if either go down, it would be valuable to have Melifonwu who made numerous splash plays in the second half of last season.

REINFORCEMENTS COMING SOON

Brodric Martin, DT

This 2023 3rd-round pick hyperextended his right knee on August 24 and was placed on IR at the 53-man cutdown. This means he could return to the team at any time now although Dan Campbell’s comments suggest he is not quite ready yet. I would expect him to start practicing sometime in the next three weeks.

With the loss of Davenport for the year, having Martin available on the defensive line will give the Lions more flexibility if they choose to play Levi Onwuzurike at the DE position.

Christian Mahogany, OG

The Lions 6th-round pick missed all of camp due to mononucleosis and started the season on NFI (non-football-injury). He is now eligible to return anytime and Dan Campbell says he is close.

His mono was likely diagnosed around July 20 and is typically a 3-4 week recovery unless there are complications like persistent splenomegaly. He was able to resume training before the start of the regular season which was a good sign.

Mahogany’s return is dependent on his strength, conditioning, and mental readiness. For a rookie who missed all of camp, the mental game might be the limiting factor.

I’m not expecting Mahogany to play much of a role this season, but any injuries to the guys ahead of him could change things in a hurry.

LONG RANGE HOPEFULS

Emmanuel Moseley, CB

After two straight ACL tears, Moseley tore his pec around August 5 this year. Assuming this was a complete rupture, expect a return around Thanksgiving if he follows the same 16-week timeline as CJ Gardner-Johnson of last year.

John Cominsky, DT/DE

An MCL tear on July 30 was complicated enough to require surgery. The initial estimated recovery was 5-6 months which would mean a return in January-February. Optimistically, the fact that Cominsky made the initial 53-man roster before being placed on IR means the Lions think there is a chance of a return this year.

Lions injury videos from the Cardinals game

Breaking down when the Lions injuries occurred and how they happened in the Week 3 win in Arizona

Unfortunately, the Lions suffered many injuries in the Cardinals game. Some were obvious at the time, some were not. Credit the players for battling through.

Here are the injury videos in chronological order. The initial injury report won’t be out until Thursday, so we’ll get more clarity then and hopefully won’t have any more surprises.

Dan Skipper 1q 14:16 right torso

Skipper might have landed on the defender’s elbow which could have caused a rib or torso contusion/strain. He was able to finish the game.

Terrion Arnold 1q 6:07 right knee

Hopefully, this is just a simple knee contusion but a mild sprain is possible. Arnold returned to the game and played well.

Ragnow 1q 1:51 left pec strain

Ragnow finished the game and was wearing a brace in the second half. See my article for more details about his outlook. 

Derrick Barnes 2q 12:07 right knee

Barnes left the game and has been placed on IR. Video suggests it could be an MCL sprain.

Sam LaPorta 2q 00:29 right low ankle sprain

Good chance LaPorta will be available on Monday but ankle won’t be fully healed.

Alim McNeill 2q 00:17 shoulder

McNeill might have hurt his left AC joint when he landed on the ground. Dan Campbell called it day-to-day.

Marcus Davenport 3q 6:45 left elbow

Video showed Davenport’s forearm getting chopped down while his elbow was in flexion. This could cause an elbow flexor tendon tear of the biceps or brachialis. He continued to try to play with an elbow brace but was hampered. He has been placed on IR and reportedly is out for the season.

Brian Branch 4q 6:06 concussion

Hopefully, we see Branch have a limited practice on Thursday but taking a game off might be a good idea.

Frank Ragnow injury analysis and outlook

Breaking down the medical prognosis and outlook for Lions C Frank Ragnow and his pectoral injury

A news bombshell dropped late Monday with the report of a Frank Ragnow pectoral injury suffered sometime during the Cardinals game on September 22, 2024. Ragnow played 100% of snaps without apparent issue, which made the news a surprise.

It was déjà vu for Lions fans as after game two of last year, CJ Gardner-Johnson surprise news dropped that he had torn his pec despite playing the entire game.

CJGJ ended up having surgery and missed 16 weeks. Fortunately, the pec injury and prognosis this year for Ragnow seems much more favorable.

Here’s what we know

Ragnow has a partial tear which means a grade 1 or 2 strain. The words tear and strain are synonymous medically, so the injury can also be called a pec strain.

While use of the word “tear” is terrifying albeit accurate, it isn’t a complete tear (grade 3) which would be a much bigger problem along the lines of CJGJ’s 16 week recovery.

Calling it week-to-week strongly suggests that surgery is not under consideration and the pec should heal well on its own.

Here’s what we don’t know

We don’t know the severity or location of the pec strain. Severity matters as it affects the healing time. A partial tear could technically be just a mild strain which might not be a big deal at all.

Location also matters, as complete tears of the pec almost always involve the tendon as opposed to the muscle body. Hopefully, Ragnow’s partial tear is not between the muscle-tendon junction and the tendon insertion point into the humerus, as those locations put him at risk for a complete tendon rupture.

OUTLOOK

A retrospective study (Sahota et al) done in 2020 of NFL players found 132 pec strains (grade 1 or 2) from 2000-2014. The average return-to-play for these players was 28 days. There was huge variability in return time but it gives a general idea of what to expect. Of note, ten of those players had surgery and missed significantly more time than those who did not have surgery. Ragnow presumably will not be having surgery.

Anecdotal data for non-surgical pec tears finds that Marcus Williams (2023) returned in four weeks and TJ Watt (2022) returned in nine weeks (the last week was a bye so he might have been ready at eight). TJ Watt reportedly did not tear the tendon.

As you can see, without knowledge of MRI results or other details, there is a wide range of when Ragnow might return.

I’m expecting him to miss the upcoming Monday night game vs the Seahawks, but a return after the bye for Week 6 vs the Cowboys is possible. Even with a longer recovery, he should be back in plenty of time for the stretch run and into the playoffs.

Lions Monday medical update for several players injured in Week 3 win

Lions Monday medical update for several players injured in Week 3 win, including Sam LaPorta, Alim McNeill, Derrick Barnes and more

There were some updates to Lions injuries on Monday including from Dan Campbell’s press conference. See my postgame article for my immediate thoughts with sideline videos.

I’m still here roasting away in Arizona so haven’t been able to watch the full game tape, but I’ve included some injury video here.

Marcus Davenport left elbow

This video shows his forearm getting chopped down while his elbow is in flexion. This mechanism could cause an elbow flexor muscle tear of the biceps or brachialis.

Unfortunately, Dan Campbell on Monday stated that “it looks like a season-ender”. Here is a detailed article by Jeff Risdon with options to fill Davenport’s role. 

Derrick Barnes right knee

The video looked like he took a shot directly to the right knee which can cause a hyperextension, bone bruise, and ligament sprains.

Campbell stated he’s “down for a significant amount of time” and alluded to a “ligament needing to scar in” and “once it heals, is he going to need surgery”. This strongly suggests a partial or complete knee ligament tear, possibly of the MCL based on the limited video.

While not great news, it does rule out worst-case scenarios like an ACL tear and gives hope he could be back this season.

Alim McNeill shoulder

He missed the 2nd half of the game, which was concerning. Good news was delivered Monday, though, as Campbell described the injury as “day to day”.

Sam LaPorta right low ankle sprain

Campbell described LaPorta as “day to day” which is consistent with a non-severe low ankle sprain. I’d expect him to get limited practices during the latter part of the week with a good chance of playing vs the Seahawks. The extra day before the next game on Monday night will serve him well.

Brian Branch concussion

Campbell stated he was “doing pretty good” on Monday. This suggests Branch is either asymptomatic or minimally symptomatic right now which increases the likelihood he’ll be ready next Monday.

Keep an eye on the initial injury report – a limited practice leans in; a no practice leans out.

 

Lions vs Cardinals Wednesday injury report medical breakdown

Lions vs Cardinals Wednesday injury report medical breakdown of the Detroit players dealing with injuries

Despite a rather long injury report, the Lions head into the desert in pretty good shape. Anzalone is likely going to be out and Glasgow is a question mark, but otherwise, the Lions’ starters should be intact.

See my postgame report for videos and initial impressions of injuries coming out of the Bucs game.

DETROIT LIONS

Amon-Ra St. Brown FP quad, WR

Excellent news for Amon-Ra after hobbling at least three times during the game. Video showed a definite left thigh contusion and a possible left leg groin or thigh strain.

The contusion is no concern, and with an FP, that means any possible muscle strain is very mild at worst. He’ll play with no limitations.

Graham Glasgow NP knee, OG

This was a surprise as I didn’t see any signs of a knee injury on initial watch. He was down briefly after his left arm collided with Jameson Williams but that apparently is not an issue.

A positive sign is he played 100% of snaps so hopefully this means the knee injury is mild.

Alex Anzalone NP concussion, LB

The NP suggests he is still symptomatic after taking a helmet blow from Derrick Barnes. With only three days until the game, he likely won’t have enough time to pass through the 5-stage concussion protocol.

Terrion Arnold NP illness, CB

The finger is not listed which likely means no fracture, complex dislocation, or tendon/ligament rupture.

Video suggested a left index finger injury with a dislocation being a possibility. He will play likely with a splint or buddy tape of the 2nd and 3rd fingers until it heals. Tackling and interceptions will be more challenging.

The “illness” usually is not a a concern although there are exceptions like with Christian Mahogany’s mono.

Ennis Rakestraw NP hamstring, CB

Rakestraw hurt his hamstring in pregame warm-ups. The severity is unknown but we’ll have a good idea by the end of the week depending on if he goes on IR or not.

Marcus Davenport FP groin, DE

Davenport had 3x NP last week and a doubtful designation. The FP means he will play on Sunday barring any setback.

Kerby Joseph LP back, S

Good to see Joseph’s hamstring from last week is not listed. The back is new but the LP suggests it’s mild. Joseph played the full game last Sunday with no signs of injury. I’d expect him to play on Sunday.

Isaiah Williams LP abdomen, WR

Williams was out with an ab last week and it’s a good sign he’s up to an LP now. With all the WR’s healthy ahead of him along with Tim Patrick’s emergence, there’s no rush here.

Ifeatu Melifonwu NP ankle, S

Hurt likely during the 2nd preseason game, his ankle is acting very chronic.

Notables Unlisted

Penei Sewell‘s ankle which may have been a high-ankle sprain is unlisted which is very good news. He had missed two practices last week.

Jameson Williams was hit on the head by Graham Glasgow’s arm after the 4th quarter interception and has avoided a concussion diagnosis. Also, his suspected mild left high ankle sprain from last week is off the report.

Derrick Barnes who was involved in the Alex Anzalone concussion has avoided his own concussion diagnosis.

David Montgomery was seen briefly not bearing weight on his right foot but did return to the game.

Frank Ragnow logs his 3rd straight week of being unlisted. His chronic toe has made frequent appearances over the years.

ARIZONA CARDINALS

Dante Stills LP shoulder, DT
Will Hernandez FP ankle, G
Xavier Weaver FP oblique, WR

Notables Unlisted

Jonah Williams starting RT on IR
Darius Robinson DE 1st round rookie on IR
Zay Jones WR suspended
BJ Ojulari DE on IR
Elijah Jones CB 3rd round rookie on IR

Lions vs. Buccaneers postgame medical report

Lions vs. Buccaneers postgame medical report updates on Amon-Ra St. Brown, Alex Anzalone, Terrion Arnold and more

Despite some pain on the scoreboard, this was an overall healthy game for the Lions. No long-term injuries are anticipated.

Amon-Ra St. Brown left leg

Let’s walk through the three main videos of his injuries.

1q 00:17 – Saint’s left leg gets pulled on the tackle which could have caused a thigh strain or groin muscle strain.

 

3q 3:53 – The direct blow to the left thigh here likely caused a simple contusion and charley horse. It’s also possible the impact aggravated the previous injury.

 

4q 00:30 – His left leg gets pulled again on this tackle, possibly aggravating the initial injury. There’s a small chance of a mild MCL sprain.

We’ll see if Amon-Ra shows up on the Wednesday injury report. My guess is he’ll be listed with a groin or thigh due to a muscle strain. This wouldn’t be a long-term issue but could cause a missed game. Last year, Amon-Ra missed one game with an oblique muscle strain.

Dan Campbell, in the postgame press conference, didn’t think it was anything “long-term”.

Terrion Arnold 1q 7:00 left index finger

After the play is over, Arnold is seen looking at his left index (2nd) finger. Dislocations are common in the NFL and there’s a good chance of that here.

Arnold finished the game with a splint that used the 3rd finger as a buddy for support. Most dislocations heal within 3-6 weeks and for a CB, can be played through with protection like in this game.

Alex Anzalone 3q 00:47 concussion

Anzalone took a brutal direct blow to his right jaw from Derrick Barnes’ helmet and was officially diagnosed with a concussion.

There were no signs of fencing or loss of consciousness on video, which is good news and hopefully means a milder concussion.

Despite the concussion, there is still a pretty good chance he could play this Sunday. Watch the Wednesday report – a “limited practice” leans towards playing while a “no practice” leans not.

Jameson Williams 4q 7:44

After the interception, Jamo took a mild hit to the side of the head from Graham Glasgow’s arm. Nothing on video looked concerning and he finished the game without problems. If no concussion symptoms are reported in the next two days, he should be in the clear.

David Montgomery 4q 4:14

The video was totally obscured but he came up briefly putting no weight on the right foot/ankle. He left the game but returned later in the drive which is reassuring.

Ennis Rakestraw pregame hamstring

Dan Campbell’s postgame press conference revealed that Rakestraw pulled his hamstring in warmups which is why he was inactive. No word on severity.

NOTABLE

The three questionable players entering the game – Penei Sewell (ankle), Jameson Williams (left ankle), and Kerby Joseph (hamstring) – played the whole game and didn’t appear to suffer any aggravations.

Lions injury breakdown: Christian Mahogany outlook after mono

Lions rookie offensive lineman Christian Mahogany is sidelined after getting mono. What is his medical and football outlook?

Christian Mahogany, the Lions 6th-round-pick who mysteriously missed all of training camp and preseason, has confirmed that mononucleosis (mono) was the culprit.

 

Mono is typically caused by the Epstein-Barr virus and studies have shown that over 90% of humans have contracted it at some point in their life. Most people likely contracted it as a child and developed some immunity, which would help prevent a more severe case later in life.

If an athlete is diagnosed with mono, the main concern is enlargement of the spleen (splenomegaly), which is found in about 50% of patients. The splenomegaly can lead to splenic rupture, which is rare but life-threatening. Avoiding contact sports and even heavy lifting for three to four weeks is thus recommended as usually the spleen returns to normal in that time.

In rare cases, the splenomegaly can persist beyond four weeks, which would necessitate a longer absence. Mahogany likely has had ultrasounds of his spleen to check for this issue. Presumably since he has resumed strength training, any significant splenomegaly has resolved.

OUTLOOK

There are unlikely to be any long-term issues for Mahogany due to mono. About 10% of individuals report persistent fatigue for months but this usually resolves over time. Some may experience lingering sore joints and that could affect performance.

Mahogany has been on the NFI (non-football injury) list since the start of camp and is remaining on NFI into the season. This means he is ineligible to play or even practice the first 4 weeks of the season. The earliest he is eligible to play is October 13 vs the Cowboys, after the bye.

Physically, there is a good chance he could play by the Cowboys game as that will have given him about six to eight weeks of training and conditioning. But since he is a rookie who has missed a significant amount of practice, it’s his mental game that might delay his return. Hopefully, we can see him take on a limited backup role at OG sometime in October.

Lions injury breakdown: Antoine Green concussion video analysis and outlook

Lions injury breakdown: Antoine Green concussion video analysis and outlook for the wide receiver

With the recent revelation by Brad Holmes that Antoine Green was trending towards winning the X-receiver spot (detailed in the article by Jeff Risdon), let’s review the video of the injury that sidelined this Lions 2023 7th-round pick.

Green suffered a concussion in the 1st preseason game as seen below.

In the video, you can see Green get knocked forcefully down by a Giants defender. Watch his head whiplash when his fall is interrupted by Sione Vaki’s leg. It’s interesting to note that Green’s head never actually hits the ground.

Whiplash can create surprisingly extreme acceleration/deceleration forces due to the physics of the action. For example, the eponymous whip can reach speeds that break the sound barrier of 760 miles per hour. Anyone who has been snapped by a wet towel in a locker room can painfully attest to this effect.

Concussions can be caused by the brain impacting the inside of the skull. The sudden movements of a whiplash can cause this brain impact without the head actually hitting anything. While certainly possible that the initial hit by the Giants player caused the concussion, the whiplash very well may have been the actual cause.

Not only can whiplash cause concussions, but those same extreme forces can injure any part of the neck. Injuries to muscles and ligaments of the neck are likely. Much more seriously, injuries to the spine, nerves, or large blood vessels supplying the brain are possible, albeit unlikely.

The Lions waived Green just four days after the injury, which was surprising because players can usually return to practice within a few days following a concussion. In his press conference after Green’s release, Dan Campbell alluded to concerning “scans” as referenced in this article by Billy Riccette.

“Scans” is a vague term but suggests something abnormal showed up on CT or MRI. A concussion will rarely show anything concerning on these imaging tests, so an abnormal finding could mean a more serious concussion with complications or a significant injury involving the neck area.

Losing Antoine Green may turn out to be the most impactful injury of this preseason, as he was on his way to earning an important role in the WR room. Hopefully, Green can heal from his injury and fulfill the promise he showed in training camp.

Lions injury breakdown: Dan Skipper makes the 53-man roster with high ankle sprain

Lions injury breakdown: Dan Skipper makes the 53-man roster with high ankle sprain. What is his injury outlook?

Dan Skipper, the NFL’s “most eligible” offensive lineman, has made the initial 53-man roster. He was not one of the 2 players (Moseley, Martin) placed on the “designated-to-return” injured reserve list. Note that rosters are subject to change and he could be placed on I.R. at any time. Skipper is currently recovering from an injury suffered during the Lions 2nd preseason game.

MEDICAL HISTORY

August 17, 2024: Skipper appears to sprain both high ankles on the same play during the Lions 2nd preseason game vs the Chiefs.

Skipper got rolled up on, thus trapping both ankles in external rotation, which is the mechanism of a high ankle sprain. He finished the drive but was limping toward the end of the drive. He never returned to the game, although this may have been precautionary with it being a preseason game.

The ankle sprain is likely of mild severity based on the following:
-Video evidence did not show a severe deformity.
-Continued to play in the game.
-Dan Campbell after the game stated it was a “minor” ankle

SUSPECTED DIAGNOSIS

High ankle sprain – left, right, or both. Mild severity.

PROGNOSIS

-A mild high ankle can sideline a player for 2-4 weeks.
-For comparison, 2 offensive linemen for the Lions last year had similar injuries.

-Taylor Decker was hurt in week 1, finished the game, but missed the next 2 games.

-Jonah Jackson was hurt in Week 5, finished the game, but missed the next 3 games.

OUTLOOK

Expect Skipper to be available within the first 2 weeks of the season. With the season opener being 3 weeks from the date of injury, there is a decent chance Skipper will be ready for game 1. As always, return to play depends on many factors, including the severity of the injury, ability to play through the injury, player importance to the team, and game importance. No long-term issues are expected.