NFL Injury Analysis: Coleman May Sit Out Mile High Game

NFL Injury Analysis: Coleman May Sit Out Mile High Game

This article is part of our Injury Analysis series.

Tevin Coleman

The Falcons did most of their damage through the air against the Panthers, but it's their ground game that is driving their offensive attack. The potent duo of Devonta Freeman and Coleman has steamrolled its way to 451 total rushing yards. Much to the chagrin of those who invested heavily in Freeman, Coleman has shown a nose for the end zone and has scored four touchdowns through the first four games. However, a genetic disorder could put Coleman's availability at risk when the team travels to Denver in Week 5.

Sickle cell disease (SCD) is a collection of genetic conditions that affect the red blood cells' ability to carry oxygen. While most people are familiar with sickle cell anemia, a less severe type of SCD is known as sickle cell trait (SCT). Instead of two sickle cell genes, an SCT carrier carries a lone sickle cell gene, inherited from just one parent. While SCT isn't quite as serious as sickle cell anemia, individuals with SCT, like Coleman, can be susceptible to health issues in areas of low oxygen or high elevation. As a result some SCT athletes will opt not to play in the thin air of Denver. Former NFL safety Ryan Clark had SCT and was not able to play when his team traveled to Denver for the majority of his career. The decision came after a scary incident in 2007 when Clark was forced to have both his spleen and gall bladder removed after becoming extremely

Tevin Coleman

The Falcons did most of their damage through the air against the Panthers, but it's their ground game that is driving their offensive attack. The potent duo of Devonta Freeman and Coleman has steamrolled its way to 451 total rushing yards. Much to the chagrin of those who invested heavily in Freeman, Coleman has shown a nose for the end zone and has scored four touchdowns through the first four games. However, a genetic disorder could put Coleman's availability at risk when the team travels to Denver in Week 5.

Sickle cell disease (SCD) is a collection of genetic conditions that affect the red blood cells' ability to carry oxygen. While most people are familiar with sickle cell anemia, a less severe type of SCD is known as sickle cell trait (SCT). Instead of two sickle cell genes, an SCT carrier carries a lone sickle cell gene, inherited from just one parent. While SCT isn't quite as serious as sickle cell anemia, individuals with SCT, like Coleman, can be susceptible to health issues in areas of low oxygen or high elevation. As a result some SCT athletes will opt not to play in the thin air of Denver. Former NFL safety Ryan Clark had SCT and was not able to play when his team traveled to Denver for the majority of his career. The decision came after a scary incident in 2007 when Clark was forced to have both his spleen and gall bladder removed after becoming extremely ill following a game in Denver.

Coleman and the Falcons medical staff are well ware of the perils of playing and are weighing their options. Coleman is admittedly uneasy about the situation and said he understands sitting out might be the safest thing. The teams square off in the afternoon game Sunday, though it's unknown when a decision will be made. Sitting Coleman would be a prudent move by all involved parties and his fantasy owners should show some empathy if he sits.

Carson Palmer and Cam Newton

Both quarterbacks from last year's NFC championship game were placed in the NFL's return-to-play protocol after suffering concussions in Week 4. Palmer left in the fourth quarter of his team's loss to the Rams after slamming his head into the turf. Newton suffered his concussion following a helmet-to-helmet collision during a two-point conversion run in Sunday's loss to the Falcons.

Because both quarterbacks are in the league-mandated concussion protocol, they could be hard-pressed to be ready for Week 5. The protocol actually begins before the hit ever occurred. Prior to the season, players take a neurocognitive test known as ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing). The test is carried out on a computer and analyzes the individual's mental status through a variety of neuropsychological tests that include simple to more complex matching, memory recall and color and shape recognition. Due to a high variability in symptoms in concussed athletes, the ImPACT test provides a baseline set of information for each individual tested.

Following a concussion, the athlete retakes the test once their symptoms have dissipated. Their secondary scores must return to their initial baseline numbers before an injured individual can progress in the protocol.

Once at baseline scores, the recovering athlete is gradually returned to exercise. If the concussion-related symptoms return during this process, the protocol stalls until the individual is able to complete that phase. To further strengthen the validity of the protocol, the player must be cleared by an independent neurological consultant in addition the team's physician and neuropsychology consultant. Only then can a player return to the field.

Given the complexity of the process, it's often difficult for a player to make a quick return. Palmer is under a significant time crunch with the Cardinals traveling to San Francisco for the Thursday night game. Keep a close eye on how both Palmer and Newton progress throughout the week, but don't count on them playing. Drew Stanton will start for Arizona, while Derek Anderson would replace Newton should he not play.

Dez Bryant

The Cowboys' receiver missed Sunday's win over the 49ers with an injured right leg. Originally thought to be a MCL sprain, Bryant was ultimately diagnosed with a hairline fracture of his tibia, specifically the lateral plateau. However, there's a growing belief that Bryant's injury isn't a true fracture but instead a bone contusion or bruise.

A bone contusion can occur in varying degrees depended on the amount of damage to the layers of the involved bone tissue. In the lower extremities, the most common type of bone bruise is a subperiosteal hematoma or periosteal bruising. This happens when the outer surface of the bone is damaged and blood collects underneath. Interosseous bruising occurs when the damage is deeper and involves the marrow of the damaged bone. If the damage includes every layer of bone, the injury is then referred to as a fracture.

Regardless of whether the injury is a complete fracture or a bone contusion, the body's healing response is same as new bone tissue is laid down to repair the damage. As always, providing the area with ample time is key to a full recovery. Given the uncertainty surrounding the specifics on Dez's injury, that could be anywhere from two to six weeks. If he prematurely returns, he runs the risk of aggravating the injury and potentially displacing the currently stable injury site.

With a Week 7 bye looming, don't be surprised if Dallas opts to hold out Bryant the next two weeks. The fiery wideout might have other plans and could press the team to allow him to return against Cincinnati. Hopefully, the situation will become more transparent throughout this week's practices.

Turf Burns

Eric Decker: The Jets' receiver is dealing with a partially torn rotator cuff that is threatening his season. He did not play in Week 4 and is a major question this week against the Steelers. While the injury is limiting in nature, the primary concern is Decker aggravating the area and increasing the severity of the tear. The fact that the Jets consider the issue a "week-to-week" problem and have kicked around the idea of placing him on the injured reserve is a good indication the injury will linger the rest of the season. Decker owners should stash him until a final decision about his long-term availability is made and actively search for a replacement.

Trevor Siemian: The Broncos' quarterback suffered a left shoulder injury against the Buccaneers on Sunday and is questionable this week. It appears Siemian injured the AC joint, the spot where the collarbone meets the shoulder blade. Multiple players have endured the injury this season, including Patriots quarterback Jimmy Garoppolo. Garoppolo's AC sprain occurred to his throwing shoulder and has kept him sidelined since. Fortunately, Sieman sprained his non-throwing shoulder, and the team is optimistic about his chances of playing. Paxton Lynch would start if Siemian is unable to play.

Dwayne Washington: With starter Ameer Abdullah already on the IR with a sprained foot, the Lions' running back corps continues to get thinner. Washington suffered a sprained foot and ankle in Week 4, and the team is unsure if he'll be ready for Sunday. While the rookie running back has been Detroit's most consistent running threat since Abdullah went down, the injury solidifies Theo Riddick's spot atop the depth chart. Zach Zenner is the only other running back on the roster.

Sammy Watkins: Watkins was placed on the IR and could be headed for a second surgery on his previously fractured fifth metatarsal. This a common theme among wide receivers who suffer similar injuries, as Dez Bryant and Julian Edelman required multiple trips to the operating room for their fractured feet. Look for a decision soon, with all signs pointing toward Watkins' season being over.

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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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