By Jaboner Jackson 8 am | Updated at 230 pm | We reviewed the injuries of Peyton Manning and Arian Foster previously with our team medical expert, Hassan A. Riaz, MD, MBA. When we spoke to Dr. Riaz about Manning a month ago, he had expressed concern about Manning’s second neck surgery. He had also worried about Foster’s first hamstring injury. Manning has finally been taken off of the Physically Unable to Perform (PUP) list but Foster has suffered another pulled hamstring. I caught up with Dr. Riaz early this morning to get his thoughts on these two players. As always, Dr. Riaz is not treating the aforementioned players and is relying on publically available information to form his opinions.
Peyton Manning has finally been cleared by his doctors to begin practicing for the Colts. Will he be ready for the start of the regular season?
It’s safe to assume that if Manning were still having resting neurological symptoms and signs such as tingling, pain, or loss of upper limb strength, he would not be cleared to practice. So when Manning is stationary, he’s doing well.
But the question is whether neurological manifestations will return with activity. For example, the doctors will have to find out if the physical demands of quarterbacking exacerbate his symptoms. I suspect he will have at least some residual symptoms with the resumption of vigorous exercise. Since the nerves from the cervical spine provide sensation and strength to the arms, I would anticipate him missing at least a couple of games to start the season.
Didn’t you draft Manning in the fourth round of the FOOTBALLPHDS fantasy football draft last weekend?
Yes. I couldn’t pass up that kind of value. But I recognized that he would likely not be ready for the start of the NFL reason and so drafted Matthew Stafford in the seventh in preparation for Manning not playing right way. Nonetheless, I hope Manning is well enough to start despite my opinion. Life is more than just fantasy football, you know. These are real people and I always wish them speedy recoveries.
Well said, Doc. Foster tweaked his hamstring again. You always say that hamstring injuries are “harbingers of doom.” What do you mean by that?
A strained muscle means that muscle fibers were partially torn. Torn hamstrings occur because of overuse or inadequate conditioning. In the case of Foster, I suspect inadequate conditioning. Foster tore his hamstring in his first training camp practice. It’s important to remember that Foster had offseason knee surgery to repair cartilage damage, which may have contributed to his deconditioning.
After resting for a couple of weeks, Foster returned to the field. He re-injured his hamstring this weekend. Again, this is a sign of deconditioning.
How can Foster best heal from his hamstring?
The only way to heal a torn hamstring is by resting it. Once the hamstring tear is healed, the player must begin the gradual resumption of activity. A player must work his way up to explosive moments. He cannot go all out just because he is now pain free. Rather, a player should work to 100% maximum explosion over at least two or three weeks to prevent re-aggravations. Flexibility, which is a part of fitness, is also key.
Are you concerned about Foster?
I was concerned a month ago and I am concerned even more now. For a running back, his explosion is his lifeline. Hamstring injuries can linger. And even when they don’t, players often are psychologically affected by hamstring injuries. Players are often hesitant to go all out for fear of pulling up lame once again.
Didn’t Foster go first overall in our FOOTBALLPHDS draft?
Yes, he did. But I would’ve taken Adrian Peterson.
UPDATED AT 2:30 PM. Arian Foster tweeted a picture of his hamstring MRI this afternoon, about which I texted Dr. Riaz. His reply: "Doesn't change anything I've said. Just supports it. Likely out first couple weeks of regular season."
Dr. Riaz is President of Mercy Medical Center outside of Long Beach, CA, where he is a practicing physician. He went to medical school at Keck School of Medicine of the University of Southern California and did his postgraduate training at Harbor-UCLA Medical Center. You may contact him through the webmaster at firstname.lastname@example.org.
Photo: Off The Record