Joe Burrow’s calf: How the Bengals got here and the upcoming offensive consequences

CINCINNATI — On Sunday evening, in the immediate aftermath of experiencing a “tweak” that reaggravated his calf injury, Joe Burrow said he would need “a couple nights, a couple sleeps” to assess the soreness he felt.

While Burrow gets his sleep, the rest of Cincinnati and those invested in the Bengals’ success will be up all night thinking about what comes next.

On Monday, head coach Zac Taylor couldn’t offer any future certainty regarding Monday Night Football against the Rams or beyond.

“Hard for me to say right now,” Taylor said. “He’s still sore today.”

Burrow was at the facility and walked briskly through the locker room without any significant impediment. Yet, in terms of judging any pain or comfort taking the field, everyone, including Burrow, lives with his holding pattern of treatment and rest.

With eight days between games, the next milepost to note will be the first practice of the week on Thursday.

“I think, first of all, we have to hear what the doctors have to say before we start to assume anything,” Taylor said. “Once we have that information, we are going to figure out what we are going to do.”

There’s the question. What are they going to do?

The Bengals are 0-2 with 20 points through two division games. The offense finally appeared to find itself just before halftime against the Ravens and looked more like the brutally efficient group that picked apart defenses during their 10-game win streak on the road to the AFC Championship Game last season. A wasted training camp after Burrow strained his calf on July 27 appeared to at last be left in the past as they drove into position for points on four of the final five drives.

Then, just prior to a second touchdown of the day for Tee Higgins, the tweak happened. Or, as Burrow said twice in his postgame press conference, a tweak happened “again.”

The staff felt great about the progress of Burrow up until that point. They’d limited the game plan to hedge against reinjury risk for two weeks. There were no snaps under center or designed rollouts. The majority of plays centered around quick, timing throws.

During the 10-game win streak last year, Burrow threw the ball in 2.5 seconds or less on 64 percent of attempts. In the first two games of the season, that rose to 73 percent. The 2.19 seconds average time to throw on Sunday was the second-fastest of any game since the start of the 2022 season.

Those adjustments plus two weeks of full practice without issue created a thought they were in the clear with the worst-case scenario of reinjury.

“We felt really good about it,” Taylor said. “Felt like he had a really good week of practice last week. Only he’s the one that can answer how he truly feels, but he had gotten the sense that it was really good.”

That’s what makes calf injuries tricky. Most aggravations occur when the athlete is close to 100 percent healed and pushes too far. That typically sends them back to square one and finding full health during the rigors of a season becomes increasingly challenging.

“At this point, it’s something he’ll have to manage the entire season,” said Dr. Jessica Flynn, sports injury analyst and sports medicine doctor for two decades at Lahey Hospital and Medical Center in Boston. “This is not going to go away. He will still be dealing with it most likely in December.”

Dr. Flynn outlined this exact, dreaded possibility in the immediate aftermath of the calf strain. She pointed to the NFL’s own research stating one in three players with lower extremity injuries experience a recurrence during the season and that’s why those have become a focus among league health and safety experts to institute a mitigation strategy.

“Muscle strains are the highest-burden injury to our players, year over year,” said Dr. Christina Mack, chief scientific officer, IQVIA and advisor to the NFL during a February presentation.

The Bengals will face the decision this week of whether it’s best to play through the issue, limit scrambling and continue to manage it, or shut it down for a few weeks in order to return to 100 percent.

“That is a finesse kind of a call,” Flynn said. “It really has to be, how bad are the symptoms? Is it all physical from the calf? Is it partly mental, partly physical? Only the training staff and the athlete can really tell you. At this point, in this particular situation where he took an entire training camp off and didn’t recover, I don’t think two weeks is going to get him 100 percent. Could two weeks get him 80 percent? Yeah, but there is still a risk of recurrence. We are early in the season. He doesn’t have the luxury to shut this down for another six weeks.”

Nor do the Bengals.

Cincinnati plays the Rams (1-1), at Titans (1-1), at Cardinals (0-2) and home against Seattle (1-1) before a Week 7 bye. Results from backup quarterback Jake Browning were not encouraging during the preseason and the idea they could survive an extended period of time without their $275 million quarterback after starting 0-2 feels like a longshot.

Of course, Ja’Marr Chase told everybody this. He made the comment before the season started Burrow should sit out as long as necessary – even as far forward as Week 5 – to rest assured his quarterback was healthy for the majority of the season.

On Monday, his opinion hadn’t changed.

“I wish we would have did that from the jump,” Chase said. “But, live and learn.”

Chase has been living and learning the hard way. He’s caught 10 passes for 70 yards and no touchdowns through two games. He’s only seen one target more than 20 yards down the field and no receptions of more than 10 air yards. His average depth of target Sunday was 4.5 yards down the field compared to 9.1 last season.

What exactly have we learned about the #Bengals at 0-2 and what do they need to realize about themselves?

From strength to weakness on D

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“We just got to be better.”https://t.co/bV5SjTE3s0

— Paul Dehner Jr. (@pauldehnerjr) September 18, 2023

Chase didn’t want to talk after Sunday’s game, a rarity, but promised to speak Monday. With 24 hours to think about it, he made clear he was happy to see Tee Higgins (eight receptions, 89 yards, two TDs) make big plays, the time has come for these conservative targets to change.

“If you look at the last two games, you don’t really see that many shots downfield,” Chase said. “We gotta take more shots downfield. That’s why we have deep-threat guys. Take a chance. The best I can do is ask to throw me a go ball. Ask for the ball. That’s all I can do.”

Partially, that connects back to reluctance toward calling plays that require holding the ball longer as well as Burrow not looking to work the pocket or extend plays as often. Those have been calling cards of his game in the past and often created opportunities downfield as teams specifically play defense to avoid Chase and Higgins beating them deep.

The Ravens and Browns both took that approach, but if Burrow continues to play through the injury, the idea of easily finding deep shots will remain difficult. As will a stationary quarterback against the likes of Aaron Donald and Jeffery Simmons.

As Burrow said Sunday, “not ideal.”

Maybe not, but it is the Bengals’ current reality.

They sleep. They monitor. They wait. They hope.

“These can respond,” Dr. Flynn said of the injury. “I wouldn’t say it’s all doom and gloom. They can get the right mix. He’s, I’m sure, getting treatment around the clock. There’s a lot that the training staff can do to try and promote healing. It’s just a matter of remaining hopeful this is something he can manage and find a way to be more effective.”

(Photo: Dylan Buell / Getty Images)

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