NFL Injury Analysis: Quarterback Injuries Take a Toll

Anatomical and medical terminology is often very straightforward to help minimize confusion and create a shared language among medical professionals. Words utilized to describe the various structures of the body are often based on positioning and direction, resulting in precise designations. For example, the anterior cruciate ligament (ACL) gets its name because it crosses (think crucifix) in front of its counterpart, the PCL. However, occasionally shared terminology can cause some confusion, as structures located in different joints can possess the same name. This exact scenario happened in Week 2 with two Pro Bowl quarterbacks.

Drew Brees and Ben Roethlisberger

Both Brees and Roethlisberger suffered significant damage to an ulnar collateral ligament (UCL) in their upper extremities. However, their expected recovery times widely vary, as each quarterback tore a UCL in a different joint.

The name UCL is applied to a ligament when it sits on the lateral (outside) of the upper extremity on the same side as the ulna bone of the lower arm. The UCL runs parallel with the opposite collateral ligament, providing support to the side of its respective joint. Ligaments that carry the UCL tag are located in the elbow, wrist, thumb and fingers.

In New Orleans, Brees tore the UCL in his right thumb. The UCL in this location helps stabilize the base of the thumb at a joint known as the metacarpophalangeal (MCP) joint. The UCL of the thumb is the primary stabilizer and sits on the inside of the thumb, near the webbing of the thumb and pointer finger. Here it's able to help prevent excessive motion at the joint, particularly while gripping or pinching. 

UCL tears are common occurrences in sports with multiple prominent athletes enduring the injury, including MLB's Bryce Harper and Mike Trout, and NBA All-Stars Chris Paul and Shaquille O'Neal. Fortunately, studies in all major sports have noted a high return to play rate following surgical intervention, and the long-term ramifications are minimal. Studies in the MLB have noted players miss an average of eight weeks recovering, while NBA players are often back in action roughly seven weeks after the injury.

Brees was slated to visit with Dr. Steven Shinn, the director of hand surgery at the Kerlan Jobe Orthopedic Clinic in Los Angeles. Dr. Shinn has pioneered a specific type of thumb surgery that resulted in an abbreviated rehab window and a quicker return to play. Dr. Shinn's approach includes a ligament repair and the inclusion of an internal brace. The synthetic tape reinforces the injury site and often allows the injured athlete to begin functional movement earlier. Dr. Shinn has performed the surgeries on Paul, Trout and numerous other professional athletes. It sounds like Brees will add his name to the list in the coming days and is expected to miss at least six weeks. An IR designation could be in play, sidelining Brees for eight weeks. Regardless, Teddy Bridgewater will take over as New Orleans' quarterback for the short-term and is worth a speculative add given the offensive weapons still available.

Roethlisberger wasn't quite as lucky, as his injury is believed to involve the UCL in his elbow. Here, the UCL is also a chief stabilizer and helps divert and absorb various stresses placed on and through the elbow joint. UCL injuries of the elbow are synonymous with baseball pitchers and Tommy John surgery, the procedure utilized to reconstruct the ligament. The associated recovery for Tommy John is a long one for pitchers due to the high degree of stress placed on the elbow during the overhead throwing motion. However, the mechanics for throwing a football and baseball vary enough that quarterbacks are often able to come back quicker than baseball players. Still, the recovery is a lengthy one, and Big Ben's season is over. He intends to return next season, and the timing of the injury should make that a realistic possibility. Mason Rudolph will become the starting quarterback for the Steelers and probably should be a priority add over Bridgewater.

Turf Burns

The Eagles WRs

Alshon Jeffery and DeSean Jackson likely will be limited in the week ahead due to soft tissue injuries sustained in Week 2. Jeffery suffered a calf strain, while Jackson strained his groin. Both injuries can be particularly limiting for receivers as they restrict the individuals' ability to make hard cuts and explosive movements. To complicate the issue, the Eagles play on Thursday in Week 4 setting up a scenario in which the team will play three games over a 12-day span. As a result, it wouldn't be surprising to see Philadelphia take a conservative approach with their receivers' care and hold them out of regular practice and potentially a game. Both likely will.be game-time decisions with Nelson Agholor, Mack Hollins and J.J. Arcega-Whiteside rounding out the depth chart.

Sam Darnold: The Jets quarterback will be sidelined indefinitely as he recovers from mononucleosis (mono). Mono is a viral infection that can results in fatigue, weight loss and headaches. Mono can also result in an enlarged spleen (splenomegaly), making it vulnerable to injury in contact sports. As a result, athletes infected with mono are often sidelined for a considerable amount of time and cannot return to play until the spleen has returned to its normal size. Recovery can widely vary, but look for Darnold to miss multiple games. Third-string quarterback Luke Falk is currently the starter, after Trevor Siemian suffered a gruesome ankle injury during Monday night's loss to the Browns.

Michael Gallup: The second-year wide out is expected to miss at least two weeks after suffering a knee injury in Week 2. Gallup suffered a minor meniscus injury and will have surgery Tuesday to address the issue. The estimated timeline suggests Gallup will undergo a meniscectomy to remove the damaged tissue. Seattle receiver DK Metcalf faced a similar recovery window for his knee debridement and was back in less than three weeks. Randall Cobb should see an increase in usage with Gallup sidelined, with Devin Smith worth consideration in deep formats. Smith finished with three receptions for 74 yards, including a 51-yard touchdown, in Dallas' win over Washington. 

Cam Newton: The Panthers quarterback has struggled to start the year, failing to throw a touchdown in the first two games and rushing for a grand total of -2 yards on five attempts. It appears the midfoot sprain he sustained in the preseason may have been a contributing factor to his limited mobility. To make things worse, he reportedly aggravated the injury in Week 2 and may not be available against the Cardinals in Week 3. Even if he is able to suit up on Sunday, fantasy owners may want to consider benching Newton until he has proven the injury is a nonfactor. Twenty-three-year-old Kyle Allen would start for Carolina should Newton be unable to play.

David Njoku: The Browns tight end suffered a concussion on Monday night and could be hard-pressed to complete the league's mandated return-to-play protocol in time. Cleveland faces a truncated week due to the Monday night appearance, limiting Njoku's recovery time. Make sure you have a backup tight end readily available.

Tyrell Williams: The Raiders receiver expects to play against the Vikings in Week 3 despite a hip pointer. A hip pointer is a contusion to the iliac crest and surrounding musculature of the hip. The area serves as an attachment site for several muscles but is poorly protected. Hip pointers are often very painful and extremely limiting ,as hip flexion (raising the leg) and trunk rotation become difficult. Look for Williams to remain limited throughout the week but active come Sunday. 

Damien Williams and LeSean McCoy : Both Kanas City running backs are nursing minor injuries though neither is expected to miss time. Williams is dealing with a knee contusion, while McCoy suffered a mild ankle sprain. Keep an eye on their availability throughout the week but look for the two to continue to split carries in Week 3. Darwin Thompson may be leaned on a bit more to save his two teammates from additional wear and tear.