Black and Blue Report: September 24, 2009

by Will Carroll

Brian Westbrook

If there were ever a guy who symbolized why I write this column, it would be Brian Westbrook [1]. Westbrook has been one of the most productive players in the NFL when healthy. It's just that he's seldom healthy. He might well be a Hall of Fame guy with every skill you want in an NFL running back, minus the ability to stay healthy. Yes, health is a skill. There's some question as to whether this is a high ankle sprain or merely swelling near where Westbrook had a cleanout procedure this offseason. Neither is good, but swelling is much more controllable. The Eagles staff have worked with Westbrook for years and knows how to get his body to respond to treatment. If it's a high ankle sprain, there's less they can do about that, as these types of injury linger and would be more bad news on top of a chronically problematic ankle. Westbrook's very iffy, but if they have Kevin Kolb [2] under center again (see below) and LeSean McCoy behind him, then that's a ton of pressure on guys without experience.

Donovan McNabb

Donovan McNabb [3]'s rib is probably not "sticky" yet, but combined with the injury to Brian Westbrook [1], the two might be more interrelated than you think. The NFL's 16-game, 17-week schedule doesn't let you scrub a game until a playoff berth is clinched. If both Westbrook and McNabb are questionable, Andy Reid must face the proposition of trying to win with an inexperienced backfield behind an inexperienced line. Sources tell me that unless both quarterback and running back are ready to go, neither are likely to start. McNabb has made the expected progress and to play the cliche, if this was the playoffs he'd be in there. It's not, so it's doubtful that he will be. Michael Vick eligible this week, so don't be surprised to see him get some time on the field. If nothing else, the Vick sideshow will be a welcome distraction from the injury story.

Marion Barber

Quad strains are never fun, but all you need to do to understand why they're so serious for most running backs is to take a look [4] at Marion Barber [5]. Barber, like most running backs, has massive, powerful legs, which means they have thicker fibers in the muscles of their legs. Muscles, when strained, are rated on the degree of tearing. While a running back's tear isn't more or less complete than any other similarly graded strain, it is going to be a more massive tear. The churning legs necessary for acceleration and power running are precisely what is strained here, forcing Barber to the sidelines for at least a week. Barber hasn't been a quick healer in the past, so we'll have to keep a close eye on this one for signs that he'll be ready to produce. The Cowboys aren't ruling him out, but given their solid options in Tashard Choice [6] and Felix Jones [7], resting him in Week 3 makes sense.

LaDainian Tomlinson

I'm not one to reinforce the macho culture [8] of the NFL. Players should not be playing through pain, forced through ridicule and peer pressure to get back out on the field before it's medically safe. The flip side of this is that players shouldn't be damned creampuffs either. Tomlinson's ankle sprain was said to be mild, but he has shown time and again that, while he's really good when he's healthy, he doesn't deal well with injury or limitation. His good health up to 2007 might actually work against him -- I've done some work in baseball on what we've called the "Cal Ripken effect," where players that are healthy to the extreme and have never had to deal with injury simply don't know how to do so. Tomlinson's had better than a year to figure recovery out and still hasn't, so I don't think it's coming. The inevitable aches and pains of an aging running back are really going to start holding him back. The fact that he wasn't out there on Wednesday is a really bad sign.

Mike Bell

Pierre Thomas

The MCL sprain is not viral, but there is a lot of it going around the NFL. The latest is Mike Bell [9], who filled in ably for Pierre Thomas [10] while Thomas was out with the same type of sprain. Bell's habit of popping straight up after being hit exposes his legs to injury. With more and more focus on stabilizers in the knee to protect players from ACL sprains, there's some discussion in the medical community around the NFL as to whether this is a typical shift down the kinetic chain or whether the focus on the ACL may have done something to expose the MCL. Then again, it could be just dumb luck. Bell seems intent on playing, but at the same time, Thomas is much closer to a return. Given both injuries, Reggie Bush's availability, and the passing attack of the Saints so far, this could play out a number of ways come Sunday. Sources tell me that both could play, but that it's more likely that Sean Payton will keep whichever is less able inactive to heal up.

Matt Hasselbeck

Matt Hasselbeck [11] might have the same injury as McNabb, but it's far from the same thing. Taking a big hit in his exposed back could have been a lot worse given his history, but a fractured rib is no picnic either. Hasselbeck's back is the bigger concern, because the body will naturally guard an injury. It does this by tightening the muscles in that area, which can lead to what trainers call the "pain/spasm cycle." Pain leads to guarding, which leads to spasm, which leads to more pain. It is possible to break the cycle, but at its core this is a physical problem causing pain and masking that will open the body to more injury. I think it's unlikely that Hasselbeck will play, although the Seahawks appear ready to give him every chance to prove he can. Hasselbeck's fight to be seen as tough after last year's injury will play strongly into this decision.

Wes Welker

It's very hard to say anything with certainty about Wes Welker [13]. His knee problem presents as an inflammation issue that can be controlled, but that control comes and goes with usage. He was out for a few days in camp, then again after playing and looking normal in Week 1. This looks and acts a lot like Brian Westbrook [1]'s injury in 2006, where holding him out early in the season allowed the Eagles staff to get ahead of the issue and allowed him to play relatively normally for the rest of the season. Welker likely has some sort of cartilage injury, although I could find no record of a previous knee surgery. If this is his first issue, it must be more serious than just a meniscus tear, which could be fixed and have him back in the lineup in a matter of weeks. With Julian Edelman playing the role of Welker 2.0, the team has an adequate replacement. There's more going on here and not enough information to make an informed judgment yet. Welker was out of practice Wednesday, but this is the type of injury where practice is just going to cause inflammation, so that isn't an accurate gauge of his current condition.

Jason Smith

Jason Brown

First round pick Jason Smith left Sunday's game with a sprained knee, while center Jason Brown [14] also sprained his knee. Both are linemen, share a name and suffer from the same injury, but that's about it. The Rams are keeping the nature of the injuries under tight wrap, but both are thought to be MCL injuries -- who'd have guessed that this season? Smith's is more severe, making him likely to miss a game, maybe two, but he won't need surgery. This indicates a Grade II sprain. Brown's is less severe and he's more likely to play. The demands of the two positions are different; with the center needs less lateral motion, but is at higher risk of a collateral ligament sprain, since those occur when hit from the side. Centers in the middle, so almost everything happens to their sides. At left tackle, Jason Smith needs more quickness, more lateral motion, and more quick lateral motion. Like the center, the tackle also needs to push, but he's going to be more taxed with footwork than a center would be. It's amazing how similar injuries to similar players end up with very different scenarios once you understand the game of football and how it's played.

Bumps and Bruises:

Adrian Peterson [15] may be on the injury report, but his back soreness is no big deal. The worst that could happen here is that Chester Taylor [16] gets a bit more of the workload ... Frank Gore [17] had two big runs and a mild ankle sprain in Week 2. He'll be ready to go on Sunday ... The Bengals are watching Cedric Benson [18]'s ankle closely. He's expected to practice fully on Thursday, so watch for that ... Kurt Warner [19]'s shoulder injury is exceptionally minor: It was more to do with saving his record and making sure it didn't get worse. He'll be ready Sunday without limitations ... There's a report from the Pittsburgh Post-Gazette that Santonio Holmes [20] has a cast on his wrist. We'll have to watch this one ... Kevin Walter [21] continues to be limited by his hamstring strain. He seemed close last week, but there seems to have been some setback ... If you're a Mets fan, you'll recognize Antonio Bryant [22]'s injury, a bone bruise inside his knee. If you're not a Mets fan, congratulations. Bryant's very iffy for this week ... Troy Williamson [23] hits IR after tearing his labrum ... It's very unlikely that Domenik Hixon [24] will play this week ... Chaz Schilens [25] won't be back for Week 3, but Week 4 is looking like a possibility. If you're looking for some wide receiver help or are desperate, grabbing Schilens early might not be a bad idea ... It doesn't appear that Bo Scaife [26] will be ready to go for Week 3 due to continuing issue with his knee ... Nick Hardwick [27] had surgery on his ankle and will miss around 8 weeks ... The Texans will lose Chester Pitts [28] for the season. He's on IR and will have microfracture surgery ... Justin Tuck [29]'s shoulder is going to keep him out at least one week, perhaps two. He has a small labrum tear ... Aaron Kampman [30] showed up to Wednesday's practice with a club-like cast on his hand.

I'll be doing the Sunday Morning Twitter feed again this week, so please join me @injuryexpert [31].