NFL injury mailbag: Re-injury risk for Mark Andrews, Aaron Jones’ hamstring history and more

In this week’s injury mailbag, Greg Scholz looks at the re-injury risk for Mark Andrews if he returns this week, looks at the history of hamstring injuries for key Packers and weighs in on the debate between grass vs. turf.

First, here’s a quick glossary of terms commonly used by Inside Injuries:

• IRC = Injury Risk Category (three designations: “Low,” “Elevated,” “High”) — the overall likelihood a player will get injured
• HPF = Health Performance Factor (Peak, Above Average, Below Average, Poor) — our metric to predict player performance
• ORT = Optimal Recovery Time — the amount of time a player needs to fully recover from an injury (not the same as how much time they will actually miss.

Q: How much could Mark Andrews’ play be affected by the quad injury if he returns Week 2, and could it be a season-long risk? – Dawson D.

Currently, Andrews’ HPF is considered Above Average, so if he does play this week, his production levels should be on par with what you’d expect. The bigger concern here is his risk of re-injury. Despite not having any true specifics on what the injury is, the verbiage that’s been used by him and the team has led us to believe it’s a Grade 2 quad strain.

The quadriceps are four muscles that make up the front of the thigh. Their main function is to straighten the leg — think running, jumping, and kicking, how you essentially pull your leg forward and straight to achieve results. When strained, it means the muscle fibers are compromised (tearing present) to some extent. Grade 1 strains, which generally heal in around 1-3 weeks, have minimal tearing in only a few muscle fibers. Grade 2 strains feature more damaged fibers, but the muscle itself is not fully ruptured. These strains tend to require 3-7 weeks to heal completely.

Back to Andrews, he should be reaching ORT in the next week provided there are no setbacks and he is able to log a full practice on Friday. As for his Injury Risk for the rest of the season, we’ll consider it High for the first few weeks, but it’ll decrease into Elevated range before mid-season if everything goes well.

Q: Should I be concerned about Aaron Jones? – Ryan R.

Short answer: yes. Longer answer: Jones has a history with lower body injuries dating back to 2017. More specifically, he’s battled hamstring issues in the past, which always makes things worse.

Hamstring injuries tend to linger and reoccur because they rarely are given adequate time to heal. On top of that, a lot of players assume once the pain is gone that the injury must be as well, which is rarely the case.

Another reader mentioned how much I’ve written about hamstrings, so I’ll try to keep it concise here. The hamstrings do a lot for lower body movement, primarily helping bend the knee and extend the hip. If an athlete can’t do either or both without pain, they’ll be highly limited. Beyond that, the hamstrings have a relatively limited blood supply, which slows down the healing process after they become injured.

After suffering the injury last Sunday, Jones was seen grabbing at the top of his hamstring on the sideline. There is some speculation here, but generally when we see a player reach for this area, it indicates an injury to the long head of the biceps femoris (one of the muscles that make up the hamstring). If this is the case, it’s technically good news as this is the most commonly injured hamstring muscle, so treatment should be fairly straightforward.

Jones’ Injury Risk will be High for the foreseeable future, but we believe this to be a Grade 1 strain — with that comes an ORT of 11 days from the time of writing.

Q: Any update on Austin Ekeler’s ankle? — Unknown

Not much has come up regarding Ekeler’s ankle since head coach Brandon Staley acknowledged it on Monday. Ekeler was a non-participant on Wednesday and Thursday, but it’s worth mentioning that he is reportedly dealing with a personal matter as well. It’s unclear which one is contributing more to his absence, or if it is a combination of the two.

Going back to Sunday’s game, there isn’t a clear indication of when the injury occurred. Ekeler did appear to come up a little limp after his 35-yard catch in the third quarter, but there was nothing about that play that points to a specific ankle injury, especially because he continued to play after it.

Our algorithm is tentatively categorizing this as a Grade 1 sprain, which gives him a High IRC and a Below Average HPF heading into this weekend. Additionally, his ORT is 11 days away. That being said, if the absence from practice is more so because of the personal matter, then those metrics are being graded a little higher than they should be because the algorithm doesn’t account for these potentially mitigating factors.

All things considered, Friday should give us a much clearer picture of where Ekeler is at. Until then, we expect Ekeler will play in Week 2 due to the low injury grade and relatively short ORT.

Q: You’ve written a lot about hamstring injuries, so I know it’s a bad sign that Christian Watson missed this past week with one. What is his timeline for recovery looking like, and how do his past injuries factor in? — Mason B.

Watson is definitely in a worse spot than his teammate, Aaron Jones. He’s been out since late August with a hamstring injury and we don’t expect him to return for Week 2. His metrics aren’t great (High IRC, Below Average HPF) and he’s still four weeks away from Optimal Recovery. He may return before that, but we wouldn’t recommend it.

Watson’s past injuries are a major concern here. Let’s quickly circle back to Aaron Jones. We last cataloged a hamstring injury for him in 2021. That’s less than ideal, but it wasn’t something that bothered him in 2022. Watson is a different story. He missed three games at the start of 2022 due to a hamstring strain, and here we are not even a year later. In short, a troubling trend is starting to develop.

I’ve brought him up in past articles about hamstring injuries, but Julio Jones is a great recent example to point to. Jones’ hamstring issues started in 2011 (maybe even earlier) and continued to bother him well into 2021. Now, in that decade he managed to put together a Hall of Fame career and is widely considered to be a Top 15 WR all-time. Unfortunately, his career has taken a steep decline in recent years and hamstring issues are partly to blame.

Jones might have been able to overcome his issues early on, but not everyone can be him, and I’m not saying that to disparage Watson. By that, I mean these injuries really can derail a career from the start. Do we predict that for Watson? No, not at all, but it’s important to remember what can happen anytime these hamstring strains start to show up with frequency.

Q: Any updates on Kyler Murray? — Mahdav C.

Murray began this season on the PUP list, meaning he won’t be eligible to practice or play until Week 5 versus Cincinnati. Aside from that, all signs point to a successful rehab that will put him in line to return around that Week 5 mark. We’re anticipating a return closer to Week 7, though.

Right now, Murray’s Injury Risk and Health Performance Factor are not in a good enough spot to return in Week 5. His IRC remains High (42%) and his HPF is Poor (31%). There is some variability to those values, but around Week 5 his Injury Risk will likely be in the range of 28-35%, but his HPF will improve faster and should be closer to 60-65%.

If he returns around Week 7, the IRC should be in the 21-27% range, and his HPF should jump up to 65-75%. At that point, his IRC would still be High (will stay there for a few weeks after he’s back), but his HPF would be Above Average and trending towards Peak territory.

Q: The NFL keeps saying injuries happen at the “same rate” on turf as on grass. But injury rate doesn’t say anything about the severity of those injuries. Is this just weasel-ish wording from the NFL to equate tweaked hamstrings on grass with ligament tears on turf? — Brendon R.

I don’t have an answer to your question, but I wanted to highlight it because I think it is a good discussion piece.

Personally, I — and this is my own opinion — think playing on grass is the best option available for professional sports. That opinion tends to be shared across most, if not all, sports communities that have the option to play on grass fields.

Moving away from opinion, the argument for grass fields causing fewer serious injuries hinges on the natural cushioning aspect of grass, allowing for more “give.” On the opposite side of things, turf sometimes has the effect of excessive traction, which sort of pins the lower limbs in place, which can be dangerous. Furthermore, grass and dirt naturally absorb force better than the leveling layer that sits beneath turf fields. This leads to reduced wear and impact on players’ bodies.

Circling back to your point about the NFL not specifying injury severity along with injury rate, I think it’s a great observation — the two should not be conflated. Like I mentioned up top, though, I can’t say for certain that’s what the league is doing, but it wouldn’t hurt their argument for turf fields if they made their points clearer or, better yet, their research publicly available.

(Getty images: Todd Rosenberg/NFL)