Hoge: Don't Rule Out Early Return For Cutler
By Adam Hoge-
HALAS HALL (CBS) — One week down. Less than three to go?
It's only been a week since the Bears announced Jay Cutler would be out "at least" four weeks with a torn groin, but the quarterback was out on the practice field Monday helping with quarterback drills — catching passes from backup Josh McCown and even gingerly jogging from spot to spot every once in a while.
"I am encouraged by his sense for how he is improving," Bears head coach Marc Trestman said Monday. "That is a positive sign. I think we have to stay within the framework that the doctors gave us. I think that is prudent right now. And we'll see where he is next week."
But Trestman isn't exactly denying that Cutler is trying to get back sooner than the original timetable — which ends right around the Nov. 17 game against the Baltimore Ravens.
"I think he is trying to get better as quickly as he can," Trestman said. "I don't know that he is trying to push it. He wants to get back as soon as he can. That is all that I can really say. I think we've got to stay in line with what the doctors have said and if it's better than that, we would certainly be happy about that."
The Bears may indeed end up being happier than they originally thought.
Cutler's injury could have been worse. According to Dr. Neil Ghodadra, a sports orthopedic surgeon who has appeared on the NFL Network, it looks like Cutler tore his left adductor muscle (located on the inside of the thigh that allows you to bring your legs inward) and because it was a full tear, it didn't require surgery, which would have prolonged the recovery time.
"From the MRI and what it seems like happened, he actually had a full-on tear, which may sound terrible, but is not as bad," Ghodadra told 670 The Score. "Sometimes when athletes have bad groin tears that have been going on for a long time we actually end up cutting that tendon anyway, just to help them get rid of that pain. So it's as if he's gone through that surgery already and already tore that tendon. So it takes 3-4 weeks for the pain to go away and given his position and the way he plays, he might be back sooner than we think."
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Ghodadra said the adductor muscle isn't really used for walking, which explains why Cutler was walking without a limp at practice Monday and was even able to jog a little bit. The adductor muscle is used more for cutting, which is why the diagnosis for the injury is usually 6-8 weeks. But because Cutler is a quarterback, he doesn't use the muscle as much for cutting, so four weeks is more reasonable.
"That's more for players like Cutler, or quarterbacks who don't move as much. The adductor muscle will bother him when he makes his throws, the difference being though, he doesn't have to make those sharp cutting moves, so he can actually get back sooner," Ghodadra said. "So what will actually help him get back sooner will be just getting pain relief and getting his motion back and that obviously depends on each individual person, but that usually takes at least 3-4 weeks."
Cutler has already shown an ability to play through pain in his career, which may explain why Bears wide receiver Brandon Marshall predicted on MSNBC last week that his quarterback would be back in two weeks.
The question is, how much will the pain restrict Cutler's ability to function within the offense?
"When he plants back and then throws forward, he's going to really rely on those adductor muscles as he's lunging forward on his left leg," Ghodadra said. "So big, heavy throws — 50-yard, 40-yard throws — is where he's really going to feel it. So when you see him make those throws again, then we can say to ourselves, 'You know what, he feels great.' In the early stages, I bet you, he's only going to make those quick throws, 5-yard or 10-yard throws that he can make kind of off his back foot. And sometimes with Cutler, he throws off his back foot anyway, so it might not be as big of an issue."
Of course, given Trestman's dedication to working with Cutler on his mechanics, that could still be an issue. Ghodadra admitted that if Cutler comes back before the original four-week timetable, "he won't be as effective as before." Fortunately, Trestman's offense calls for shorter, quicker passes that don't rely on the adductor muscle as much, but the quarterback will still need to prove that his mechanics are in tune.
And then there's always the possibility of re-injuring the muscle. According to Ghodadra, coming back too soon can cause pain, even without re-tearing the muscle. That's similar to what Patriots wide receiver Danny Amendola experienced when he suffered a similar injury Week 1 and came back after missing only three games.
"Don't be surprised to see (Cutler) on the practice field in a couple weeks running with the team and moving and throwing," Ghodadra said. "He may not be game-ready though, because he needs to be able to through a full four quarters like that."
Briggs Needs To Be Careful
As big of a loss as Jay Cutler is, losing weak side linebacker Lance Briggs may end hurting the Bears even more. The official word on Briggs was that he would be out "around" six weeks with a fracture in his shoulder and Ghodadra said the linebacker needs to be careful about trying to come back too soon.
"Six weeks is kind of the minimum timeframe we always give athletes because that's how long it takes the bone to heal," the doctor said. "I don't care how great of an athlete you are, how great of shape you're in, you can only go through nature that fast."
Ghodadra said a fracture in the shoulder usually occurs either at the end of the clavicle or within a shoulder joint. Either way, it takes six weeks for that bone to heal and the biggest restriction occurs with how the injured player can move his arm. Fortunately for Briggs, even though he uses his arms to tackle, he doesn't necessarily lift them high above his head very often.
"He may come back a week sooner than that," Ghodadra said with some caution. "You have to be careful with fractures. Look at Rob Gronkowski. He came back in four weeks. I know he had surgery, but you still wait for the bone to heal, even after surgery. He came back in four weeks and he re-fractured it after a fall. You have to be very careful with these types of athletes and patients. So I would say six weeks is a good timeframe. He'll come back fine. Once the shoulder heals, obviously he didn't need surgery, so once it heals it's just a matter of getting motion, pain relief and he'll be right back on the field. And once it's healed, it's as good as new."
Figuring Out Tillman
Cornerback Charles Tillman is the other Bears player dealing with a significant injury as he continues to deal with inflammation in his knee. Tillman left last week's game against the Redskins after aggravating the knee and even after a bye week to rest, he did not practice Monday.
While it's just speculation, Ghodadra has some ideas about what Tillman has been dealing with since the injury popped up Week 1.
"It means there's something else going on that we're not really being told about," the doctor said. "So for a guy like him who's having a lot of trouble, I'm not saying this is what he has, but usually it can be kind of an early arthritis type thing. Kind of a cartilage lesion, causing swelling and repeated inflammation, kind of what Dwyane Wade has."
Treatment can include therapy, cortisone injections and getting fluid drained. And if that diagnosis is correct, it won't exactly be going away.
"For the position he plays and how much he's been running on that knee over the years, I wouldn't be surprised if he just has a little early cartilage degeneration, causing recurring swelling," Ghodadra said.
Other possibilities include an MCL sprain or even a meniscus tear that Tillman is playing on.
"When the meniscus tears, it's like a hangnail. You know, sometimes you can put bandaids on it, and that's like therapy, treatment, injections, but as you know, bandaids fall off. All it takes is sharp movement and a tear like that can kind of flip up like a hangnail and really cause severe pain. So I wouldn't be surprised to see him have something like that too," Ghodadra said.
A torn meniscus would require surgery at the end of the season and at this point, that appears to be the earliest the Bears will reveal what's really wrong with the cornerback.
Adam Hoge covers the Bears for CBSChicago.com and is a frequent contributor to 670 The Score. Follow him on Twitter at @AdamHoge.
