Injury Analysis: Rams Suffer Double Trouble

Injury Analysis: Rams Suffer Double Trouble

This article is part of our Injury Analysis series.

Brandin Cooks, Cooper Kupp

The Rams pulled out a victory over the Seahawks in Week 5 despite playing the entire second half without their top two receivers. Both wideouts made early exits following head injuries, later diagnosed as concussions.

Cooks was injured following a helmet-to-helmet collision with Seattle safety Tedric Thompson. Cooks immediately went limp, fumbling the ball. If you watch the replay you will also notice his arms go rigid and extend outward. This is likely a display of the fencing response, a neurological motor reflex resulting from a head injury. This type of abnormal posturing is used as an indicator of head trauma and a clear sign that the affected athlete should be removed from competition.

Kupp's injury reportedly occurred near the end of the first half when his head struck the turf. He finished out the series but later self-reported symptoms to the Los Angeles training staff.

Just a day later, coach Sean McVay expressed optimism about his receivers' availability for their game this week against the Broncos. He said both appeared symptom-free and would continue to progress in the league's mandated protocol. While this is encouraging, both receivers have a long way to go before they can play, especially Cooks.

When a concussion occurs, the injured individual is placed in the return-to-play protocol. The first step is completed when the player exhibits no symptoms while at rest. The athlete will then be allowed to sit for a neurocognitive test known as ImPACT (Immediate Post-Concussion

Brandin Cooks, Cooper Kupp

The Rams pulled out a victory over the Seahawks in Week 5 despite playing the entire second half without their top two receivers. Both wideouts made early exits following head injuries, later diagnosed as concussions.

Cooks was injured following a helmet-to-helmet collision with Seattle safety Tedric Thompson. Cooks immediately went limp, fumbling the ball. If you watch the replay you will also notice his arms go rigid and extend outward. This is likely a display of the fencing response, a neurological motor reflex resulting from a head injury. This type of abnormal posturing is used as an indicator of head trauma and a clear sign that the affected athlete should be removed from competition.

Kupp's injury reportedly occurred near the end of the first half when his head struck the turf. He finished out the series but later self-reported symptoms to the Los Angeles training staff.

Just a day later, coach Sean McVay expressed optimism about his receivers' availability for their game this week against the Broncos. He said both appeared symptom-free and would continue to progress in the league's mandated protocol. While this is encouraging, both receivers have a long way to go before they can play, especially Cooks.

When a concussion occurs, the injured individual is placed in the return-to-play protocol. The first step is completed when the player exhibits no symptoms while at rest. The athlete will then be allowed to sit for a neurocognitive test known as ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing). The ImPACT test is a computerized exam that analyzes the individual's current mental status by guiding them through multiple neuropsychological tests, including memory recall, immediate shape and color recognition and matching. The results are than compared to a set of baseline scores collected prior to the start of the season. Before an athlete can proceed to the next step of the protocol, his most recent ImPACT score must return to or be better than his original baseline score.

Once the ImPACT test has been successfully completed, the recovering player can increase his amount of exertion. This is done so in a gradual manner under strict guidance of the team's medical staff. The last step involves receiving clearance from an assigned independent neurologist. If the physician approves the collected data and information, the player is cleared to return to full football related activities.

Cooks may have a harder time completing the program than his teammate due to his injury history. Cooks has sustained at least two concussions in the NFL, including a concussion that knocked him out of last season's Super Bowl. The problem with multiple concussions occurs because the effects are cumulative, meaning symptoms are often amplified and tend to linger with each subsequent injury. As a result, it wouldn't be surprising to see Cooks miss at least one week.

Closely monitor how Cooks and Kupp progress throughout the week to get a better idea of their playing status. Look for Josh Reynolds and KhaDarel Hodge to see plenty of reps this week with a chance at moving up the depth chart.

Turf Burns

Jay Ajayi: The Super Bowl champs will be without Ajayi for the rest of the season after he tore his anterior cruciate ligament (ACL) on Sunday. He is slated for surgery later in the week. Wendell Smallwood is the best investment in the Philly backfield due to his clean bill of health and effectiveness the last two weeks. Corey Clement remains a decent addition in deeper leagues but is still recovering from a quadriceps injury.

Saquon Barkley:
The Giants' rookie running back gave his owners a scare when he came up limping after a late scoring run. Barkley appeared to jam his leg into the turf after leaping over a would-be defender. However, the team reported his ankle and knee were fine and that his back absorbed most of the force. Fortunately he avoided injury there too and has been deemed "fine, healthy, and ready to go" by coach Pat Shurmur.

Matt Breida:
Add ankle sprain to Breida's growing list of injuries that also includes a sprained shoulder and hyperextended right knee. While the sprain is reportedly mild, the culmination of injuries appears to have finally caught up the 49ers running back. He is doubtful for Week 6 and could miss additional time with San Francisco facing a compressed schedule the next three weeks. Alfred Morris will become the top option on the depth chart with Raheem Mostert and fullback Kyle Juszczyk also in line for expanded roles.

Evan Engram:
Engram plans to practice fully this week, setting him up for a Thursday night return. The Giants tight end has missed the team's last two games after spraining the medial collateral ligament (MCL) of his right knee. Despite being targeted 12 times in the first two weeks, Engram has had a slow start to the season. As a result, it may be worth keeping him on the bench until he can prove he's healthy and able to contribute.

T.Y. Hilton:
The Colts receiver remains limited by a hamstring injury despite sitting out the team's loss to the Patriots. He was not on the practice field Monday, clouding his status for Week 6. This is setting up to be a game-time decision for Sunday's matchup against the Jets.

Leonard Fournette, Dalvin Cook:
Like Hilton, Fournette and Cook remain sidelined thanks to problematic hamstrings. Fournette has twice injured the muscle group and his been a spectator for three of Jacksonville's five games. It appears as that number will be pushed to four as he is not expected to play against the Cowboys. Considering his most recent setback, I wouldn't be shocked to see the Jaguars hold him out through their Week 9 bye. T.J. Yeldon remains a must own, especially with Corey Grant suffering a season-ending Lisfranc injury in his foot.

Cook's status also remains in limbo but he will reportedly look to build on last week's progress. If he is unable to return to a meaningful practice by mid-week, consider looking elsewhere for Week 6. Latavius Murray would remain the top option out of the backfield if Cook is ruled out.

Adrian Peterson:
The former MVP is slated to undergo a MRI after dislocating his shoulder in the team's loss to the Saints. The joint was reduced and returned to its normal alignment but limited him to just two snaps in the second half. Coach Jay Gruden did report Peterson had strained his shoulder, suggested the force that shifted the joint injured the surrounding musculature. A MRI will help provide a better idea of the involved tissue and would go a long way to determining Peterson's status for Week 6.

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ABOUT THE AUTHOR
Jeff Stotts
Jeff Stotts works as a Certified Athletic Trainer (MAT, ATC, PES, CES). He won the 2011 Best Fantasy Football Article in Print from the Fantasy Sports Trade Association.
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