Week 1 Injury Report: Injury-Riddled Start

Week 1's injuries began before we even kicked off with the Brock Bowers news, and they just kept on coming. Here's a look at what went down in the injury sector after the first weekend of NFL football, along with a handy injury tracker to keep tabs on all the relevant players.

Brock Bowers, TE (LV)

Injury: Knee

Projected Return: Week 3-6

A surprise addition to the injury report, Brock Bowers underwent a partial meniscectomy last week. This is a procedure where a surgeon will remove a portion of the meniscus. The smaller the trim, typically the faster a player can return. However, the one to two weeks that is being quoted for Bowers does seem fast!

A recent meta-analysis looking at partial meniscectomy found an average of nine weeks to return to sport, with other studies showing 7-9 weeks. There are individual cases of players returning after one to three weeks, but it is much faster than the average timeline, though not impossible, for several reasons. Bowers could have undergone a trim of a highly selective area and will likely have accelerated rehab protocols, which is not often seen in the broader research data. Not to mention, Bowers is in the top echelon of elite athletes, which also bodes well for a faster than average recovery. He can return in two weeks, though I would hope muscle symmetry, power, and explosiveness are similar in both limbs before he ultimately makes his return.

This is not the first time Bowers has dealt with left knee injuries, previously struggling with his left PCL. The fact that he now has a left meniscal deficit makes it more likely he’ll deal with accelerated degenerative knee changes and will be at an increased risk for further left knee injuries in the future.

A.J. Brown, WR (NE)

Injury: High Ankle Sprain

Projected Return: Week 7

Recently placed on IR and missing at least four games, A.J. Brown was confirmed to have suffered a high ankle sprain. A recent meta-analysis shows an average return after four weeks in elite athletes, while an NFL-specific study showed an average time of 27 days missed, both assuming uncomplicated high ankle sprains and no additional ligament damage. Recent reports fear Brown will miss up to six weeks, so this is one I’ll keep an eye on.

When returning, there’s often difficulty with power, push-off, cutting, and jumping. When cleared for return, these should all be assessed and be near symmetrical side to side, which would minimize any potential drop in form.

Sam Darnold, QB (SEA)

Injury: Glute Tendon

Projected Return: Week 5-7

Sam Darnold avoided a season-ending injury on Wednesday night. It is said to be a glute tendon injury, with some sources saying he will be missing up to 4-6 weeks. It sounds like he had a gluteus medius or minimus tendon strain or partial tear after he underwent a compressive force on his knee on Wednesday night. The Seahawks appear to be getting second opinions on a timetable for return, so this one might change over the next week.

De’Zhaun Stribling, WR (SF)

Injury: Medial Ankle Sprain

Projected Return: Week 5-6

De'Zhaun Stribling was confirmed to have a rare medial ankle sprain, or deltoid ligament sprain. Reports say he is expected to miss at least a month, with surgery not off the table. The fact that surgery is being considered tells me that it is likely an unstable grade two (partial tear), likely not a full tear. While this is typically not a surgical treatment in the general population, the threshold for requiring surgery in a high-level athlete is much lower, with greater ankle stability required.

It seems like the plan with Stribling is to monitor for significant instability throughout early rehab with both repeated imaging and functional testing, and to pivot to the surgical treatment option if deficits persist. There is data that shows a 2-3 month return on the faster end of protocols for isolated deltoid repair, though the average seems to be around five months in research.

Kyler Murray, QB (MIN)

Injury: Concussion

Projected Return: Week 3-4

A nasty hit ruled Kyler Murray out of the game Sunday afternoon with a concussion, and he will now have to clear a concussion protocol before returning. The return timeline can vary based on the individual, but the average return for NFL athletes is about 15 days. The concussion protocol typically starts with light aerobic exercise, progressing to sport-specific exercise, then non-contact training drills, and eventually full-contact practice and return to play. Stages are not progressed until a patient’s symptoms have fully resolved.

Zay Flowers, WR (BAL)

Injury: Hamstring

Projected Return: TBD

Zay Flowers appeared to have re-injured his hamstring injury that he was dealing with in August, though it’s unconfirmed if it’s the same leg. I’ve talked before about the significant re-injury risk when returning from muscle strains. There is often elevated risk in the first game back, a 20-fold increased risk if there is a strain in the past eight weeks, and elevated risk for 15 weeks when returning to competitive play. If this is an additional strain, expect him to miss at least some time, depending on the grade severity. It is possible the Ravens are playing it safe with Flowers based on his trouble with the hamstring in August. As of now, he’s questionable for week two.

When returning, there’s often difficulty with power, push-off, cutting, and jumping. When cleared for return, these should all be assessed and be near symmetrical side to side, which would minimize any potential drop in form.

Ladd McConkey, WR (LAC)

Injury: Chest

Projected Return: TBD

Ladd McConkey exited Week 1 after he took a big hit. It’s said that he suffered a chest injury. Could be a rib contusion that would sideline Ladd for days to a couple of weeks, or a rib fracture, which could put him out for 3-6 weeks. I’ll wait to speculate further until his injury is confirmed.

Omar Cooper Jr., WR (NYJ)

Injury: High Ankle Sprain

Projected Return: Week 5-6

Omar Cooper Jr. suffered a high ankle sprain, with an MRI scheduled on Monday. If there is no further ligament damage, research points to at least a four-week absence. He will have to work to get back his push-off, power, and symmetrical strength before returning to make sure he can return without a drop in performance.

Chig Okonkwo, TE (TEN)

Injury: Hamstring

Projected Return: TBD

Chig Okonkwo left Sunday’s game with a hamstring injury. A muscle strain will have to be carefully managed when returning, with an elevated risk when returning. Depending on the severity of his hamstring injury, he may miss some time over the next few weeks.

Dylan Sampson, RB (CLE)

Injury: Knee

Projected Return: TBD

Dylan Sampson was seen on crutches and with a brace on his left knee after the game Sunday. He was able to jog on the sideline before ultimately exiting the game. We’ll wait to hear the severity of the knee when he undergoes further testing, though it’s a good sign he was able to do some light jogging.

Ja’Kobi Lane, WR (BAL)

Injury: Wrist

Projected Return: Week 7-11

Ja'Kobi Lane fell on his outstretched hand when attempting to make a catch on Sunday, injuring his wrist. Differential diagnosis for this mechanism of injury includes a distal radius or ulnar fracture, carpal fracture, or TFCC tear. We’ll have to wait to hear about testing and wait to see if it’s a serious injury.

UPDATE: It's confirmed that Lane fractured his wrist and will miss several weeks. It depends on the exact bone of the wrist that is fractured, but especially because the wide receiver position requires so much wrist demand, it's possible he can miss anywhere from 6-10 weeks.