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Peyton Manning, Jake Locker land on the Week 10 injury report

Another week of NFL games, another round of injured quarterbacks. SB Nation's medical expert Dr. Ali Mohamadi walks through the latest news and what it means for the players and teams.

Sunday's NFL contests were particularly unkind to quarterbacks, with several starters failing to finish their games due to injury. Here's a rundown of yesterday's notable injuries, and their impact.


Jay Cutler, Chicago Bears (ankle)

Cutler suffered an ankle injury late in the first half of yesterday's loss to Detroit but stayed on the field until just over two minutes remained in the fourth quarter. While the exact diagnosis (high vs. mid-ankle injury) is unclear at this time, that he was able to remain in the game despite the injury is a positive prognostic sign. Backup Josh McCown again acquitted himself nicely in relief, coming a failed two-point conversion short of tying the game in the waning moments, and he would get the start in Week 11 against the Ravens if Cutler can't take the field.

Jake Locker, Tennessee Titans (foot)

The Tennessee QB suffered a right foot injury while running the ball in the second quarter of the Titans' 29-27 loss to Jacksonville, and early indications are that he may have suffered a Lisfranc injury that would require surgery and end Locker's season. Lisfranc injuries occur as a result of trauma to the midfoot. In the case of a football player, they most commonly occur when the forefoot is planted on the ground with the heel in the air. A downward or twisting force on the heel causes stress on and potential damage to the foot.

There are three types of Lisfranc injuries, which sometimes occur together:

Sprains: The Lisfranc ligament, as well as other ligaments on the bottom of the midfoot, are stronger than the ligaments on the top of the midfoot. Therefore, when they are weakened through a sprain (a stretching of the ligament), patients experience instability of the joint in the middle of the foot.

Fractures: A break in a bone in the Lisfranc joint can be either an avulsion fracture (a small piece of bone is pulled off) or a break through the bone or bones of the midfoot.

Dislocations: The bones of the Lisfranc joint may be forced from their normal positions.

The treatment of a Lisfranc injury depends upon whether it considered "stable" (bones still in proper orientation) or "unstable" (bones out of normal alignment). A stable injury often requires 2-3 months of healing and rehab, whereas an unstable injury would require surgery. Following surgery, the patient must be non-weightbearing on the operative foot for about 6-8 weeks. Subsequently, the amount of weight bearing allowed is gradually increased over the next few weeks, followed by physical therapy. At some point, once the torn ligaments have been given sufficient time to heal, the screws used to fix the Lisfranc injury are removed to allow normal motion and function to take place in the midfoot region. Although the actual timing is somewhat controversial, this usually occurs somewhere between 3 and 6 months after the initial surgery takes place.

Either way, if it is indeed a Lisfranc injury, Locker would be out for a significant amount of time. Backup QB Ryan Fitzpatrick took over yesterday in Locker's absence and would get the call this Thursday night when the Titans face the Colts.

Peyton Manning, Denver Broncos (leg/ankle)

Although it appears unlikely he'll miss next week's showdown with the undefeated Chiefs, Manning will undergo an MRI after taking several shots to the lower legs in yesterday's 28-20 win over the Chargers and feeling "pretty sore" afterwards. Manning has been dealing with soreness of both ankles in recent weeks, and the hits he took from Chargers' defenders, most notably a low hit from DT Corey Liuget in the fourth quarter, had the Denver QB hobbling as he tried to close out the game. In the case that Manning cannot play next week against Kansas City, backup Brock Osweiler would take over at quarterback for the Broncos.


Seneca Wallace, Green Bay Packers (groin)

The hits just keep on coming for the reeling Packers, who lost Wallace after one series yesterday when the quarterback -- himself filling in for Aaron Rodgers -- suffered a groin strain. Groin injuries are notoriously slow to heal and prone to reinjury if a player returns to the field at less than 100 percent, and so Green Bay has already announced that third stringer Scott Tolzien, who was on the team's practice squad until this past week, will start Week 11 against the New York Giants.

Tight Ends

Vernon Davis, San Francisco 49ers (concussion)

Davis left in the second quarter of San Francisco's 10-9 loss yesterday to Carolina after being driven headfirst into the turf on a pass thrown his way. Davis left the field woozy and was diagnosed with a concussion shortly thereafter. The 49ers struggled to mount any sort of passing attack in his absence, and Davis will need to pass neurological testing this week in order to suit up against the Saints next Sunday.

Tony Gonzalez, Atlanta Falcons (toe)

The future Hall of Famer, who has missed only two games in his 17-year career, suffered a left toe injury in the Falcons' loss to Seattle yesterday. Although he finished the game, he will undergo further testing today to determine the extent of the injury. One possibility is turf toe, which is technically a joint sprain that can result in significant pain and limited range of motion, keeping an athlete out for weeks. Gonzalez's availability for the Falcons' Week 11 matchup with Tampa Bay will become clearer following today's tests.


Sean Lee, Dallas Cowboys (hamstring)

Lee suffered a hamstring injury early in last night's loss to New Orleans and was ruled out shortly after being helped off the field. It appeared that Lee twisted his leg underneath himself while attempting to make a tackle, and he was having noticeable difficulty bearing weight on the affected leg as he walked to the locker room. Dallas has a bye next week, but if Lee is forced to miss any time, it would be a huge blow to a defense that has struggled this season, especially defending the pass.

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