Looking at injuries in the NFL

http://www.sacbee.com/2013/07/30/5608685/extra-points-examining-the-cause.html

By John McMullen

PHILADELPHIA - Sometimes life on the NFL beat feels a bit macabre. You show up at training camp, grab a roster and start checking off names to see who is and who isn't practicing that day.

Injuries are always the headline of any camp and too often the job becomes a
waiting game, almost a biding of time until the next hamstring or calf is
tweaked.

Those are the good days. The bad ones involve torn ACLs or ruptured Achilles
tendons and reporters around the league haven't been kept waiting long in
2013.

The first big casualty this year came in Oxnard, Calif. on July 21 when
Cowboys second-year defensive end Tyrone Crawford succumbed to a season-ending
Achilles injury.

"Crushing," Dallas VP and director of player personnel Stephen Jones said
after seeing Crawford go down. "Absolutely crushing."

Crawford would hardly be the last impactful injury during the first 10 days
of camp around the league, however.

Fate turned on Eagles coach Chip Kelly just two days into his first training
camp as an NFL mentor when arguably his best receiver, fifth-year veteran
Jeremy Maclin, went down with a torn ACL in his right knee on Saturday.

Maclin was carted off after suffering a non-contact injury during 7-on-7
drills. The University of Missouri product laid on the ground in pain for
several minutes as concerned teammates made their way over to check on him.

Kelly and another assistant helped Maclin to his feet but it was clear that
the receiver was favoring his right leg quite a bit. As the cart drove Maclin
off the field, the fans assembled cheered but Maclin seemed terribly dejected
and draped a towel over his face.

"I saw it out of the corner of my eye," quarterback Michael Vick said
following the practice. "I saw him fall. And usually when a guy falls
like that, it's something to be worried about. But hopefully everything will
work out."

It didn't -- the Eagles confirmed Maclin tore the ACL in his right knee hours
later and Maclin himself addressed the issue on his Twitter account.

"Appreciate all the love and support twitter fam....sad day but I have
setbacks my entire life. Minor setback for a MAJOR comeback!" Maclin Tweeted.

That same day about 110 miles south in Owings Mills, MD, Ravens tight end
Dennis Pitta suffered a season-ending dislocated hip injury after colliding
with safety James Ihedigbo during a jump ball situation.

"Asking for prayers for a speedy recovery and heal time as I go through this
ordeal," Pitta wrote on Facebook.

The next day it was the Denver Broncos turn to handle adversity as veteran
center Dan Koppen was carted off with a torn anterior cruciate ligament of his
own.

"I always cringe," Broncos coach John Fox said when asked about seeing players
get hurt. "You never like to see players get injured, particularly severely
injured. But you understand when you do this long enough, whether you're a
player or a coach, that this happens."

On Monday the Chicago Bears watched defensive lineman Turk McBride succumb to
a ruptured Achilles hours before the Eagles were slammed yet again when
linebacker Jason Phillips, a special teams stalwart, suffered the same injury
as Maclin two days earlier, a torn ACL in his right knee.

Overcoming misfortune is essential for any NFL team and the league-wide motto
might as well be "next man up," the most popular refrain when league
executives talk about injury.

"It's sadness," Kelly said when asked about injuries. "When you get back, the
reality of it is you got to get ready with the guys that are able to play and
healthy to play.  It's kind of like someone dropped their shield in battle and
the other guy has to pick it up, pick up the slack for him."

The mind-numbing series of early season-enders brings to the forefront the new
practice rules since the implementation of the new Collective Bargaining
Agreement before the 2011 regular season.

There is much less contact in today's NFL practice landscape and teams are
under stringent offseason restrictions regarding seemingly simple things like
press coverage.

Kelly, for one, allows no tackling to the ground at any of his practices.

"No, we have four preseason games for that." the former University of Oregon
coach said Monday when a reporter asked if the Eagles would be tackling at all
during practice sessions. "They're hitting pretty good when they get an
opportunity. The big thing with tackling, you want to be on your feet anyway.
We don't want people diving. We want to be good form tackle so they get an
opportunity. In the first team period we do every day, we're going to be doing
that."

The thought process behind Kelly's no tackling-manta is limiting injuries,
something which obviously takes a hit considering he has already lost two
players to ACL tears without any violent collisions.

"When you get guys on the ground, it is not really the two guys that get
tackled, it's what's chasing it," Kelly explained.  "We're trying to keep
everybody in every situation up. You have a lot of big bodies moving. There's
a fine line what we have to get done from a work standpoint. We also know we
have to get our guys to the game, too."

"I know Chip Kelly is probably going to get killed but I'm not sure the same
thing doesn't happen if Andy Reid was still the coach (in Philadelphia)," Dr.
David Geier, one of the top orthopedic surgeons in sports who once assisted in
the care of the St. Louis Rams, said. "Most of these (injuries around the
league) have been non-contact so there is not much you can do."

That said, more than one coach has privately questioned whether things like
the lack of contact or the scaled-down offseason programs are having an affect
on things.

Players arrive at camp these days after a six- or seven-week respite for two
mandatory practices with no pads before finally being asked to ramp things up.
Some think that could be like jumping into an ice cold shower, a shock to the
system in what remains a terribly physical game built upon violent contact.

"Time away can play a role," Geier explained. "It's a possibility it could be
a cause but I think for different reasons than a coach might think. It's not
like these guys are sitting around on couches for weeks but the one thing you
can't replicate is the repetition during team activities. The ability to run,
cut and plant your foot with a defender there."

"All those repetitions are functional movements and they are hard to replicate
without the spontaneity of movement," he continued. "It's a muscle memory
thing and that's why you usually see a spike of these types of injuries in the
first seven to 10 days (of camp)."

Others argue certain players work out far too much and their tendons, joints
and muscles are ticking time bombs when they finally hit the field.

"We think there is something to that," Geier said when asked about overdoing
it, "but it's hard to say there is a direct cause and effect. Jerry Rice was
famous for his work ethic and he stayed healthy for the vast majority of his
career."

So is there a way to prevent these kinds of injuries or at the very least
scale them back?

"Yes and no," Geier said. "It's hard to say any rule change is going to make a
difference but the  U.S. Women's Soccer team implemented a program which
teaches landing mechanics when turning and pivoting in the air. That type of
thing could be very helpful."