By Michael Hurley, CBS Boston
BOSTON (CBS) -- Everybody knew heading into the 2016 season that the Patriots' quarterback situation was going to be complicated for the first four weeks. But not quite like this.
When Jimmy Garoppolo suffered a sprain of the AC joint in his right shoulder on Sunday afternoon, it immediately threw a giant wrench into the Patriots' neat and tidy plans for life without Tom Brady. The fact that the Patriots' Week 3 game was scheduled to take place just four days after the injury did no favors for Bill Belichick and Co.
And so, even on a short week, media and fans alike have speculated about Garoppolo's ability to play, and the Patriots have certainly maintained a familiar cloak of mystery regarding the injury, unwilling to share details but very willing to throw up as many smokescreens as possible. In the NFL, that is more often than not the name of the game.
Yet with questions flying about Garoppolo's toughness, and with reports surfacing of the Patriots applying pressure on Garoppolo to play, it might be best to check in with an expert.
That's where Dr. Mark Adickes comes in. Adickes is a former NFL offensive lineman and collegiate All-American, and after his playing career ended he entered medical school -- Harvard Medical School, to be precise. He's now the chief of sports medicine and an associate professor of orthopedic surgery at the Baylor College of Medicine, and he's a member of the board at 3D4 Medical. One of his many jobs requires him to keep a close eye on injuries in the sports world.
As Adickes explained, the crux of whether or not Garoppolo can suit up or even play on Thursday night comes down to whether the injury was a Grade 1 or Grade 2 sprain. Based on his observations, there are reasons to believe it could be either.
"Now, based on the amount of pain he was in, based on the amount of force with which his shoulder was driven into the ground, to me it looked like it was the kind of force that could cause the more severe type," Adickes said Wednesday.
However the Patriots' actions -- or lack thereof in terms of not adding a quarterback to the roster -- indicate that it may indeed just be a Grade 1 sprain.
"I have to think that given the fact that they did not sign another quarterback and that he has been listed as doubtful and most likely would suit up, in my opinion probably in a backup role, it must be a less severe AC joint injury," Adickes said. "That's my opinion, given the fact that he looks by all accounts to be the backup quarterback going into Thursday's game."
The situation regarding Garoppolo and the Patriots is distinctly unique. If Garoppolo were on track to be the team's starting quarterback for all 16 games, then the decision to let him rest for a week or two and return to full health would be simple. But the fact that Brady will be returning in Week 5 lessens the need (from the team's perspective) for Garoppolo to reach full health quickly, and a hampered Garoppolo vs. Houston would likely look to be a better option than having a completely inexperienced Jacoby Brissett face a strong defense.
There's no easy solution, but Adickes explained the risk that Garoppolo could face if the injury is indeed a Grade 2 sprain.
"If he gets driven down on his shoulder, he's more likely to have an injury that could be a surgical problem than he would be if he allowed it to heal," Adickes said. "If you've sprained these ligaments that are keeping the AC joint stable, and then you fall on the same shoulder again, then you are more susceptible to injuring that joint more severely."
This video, created by Complete Anatomy and Lecture Builder by 3D4Medical, explains the AC joint sprain:
The risk, according to Adickes, lies only in getting hit. The motion of throwing a football doesn't put the AC joint at extra risk, other than for some increased inflammation. But dealing with the pain isn't necessarily easy.
"I've had a Grade 2 AC sprain, and I can tell you that it took me three weeks to be able to do a pushup," Adickes shared. "Now, throwing a football effectively in the NFL I would think would take a similar amount of force on the joint. But you could numb that joint up, and then maybe that would allow him to play. But I just think in four days, I don't know that he's going to feel comfortable enough to play on Thursday. But perhaps in an emergency situation, he would be able to come in and hand the ball off and maybe throw some shorter routes."
That may be the best expectation for Garoppolo on Thursday. Despite reports of Julian Edelman being prepared to serve as the backup quarterback, that cannot happen, really, unless the team severely limits his snaps on offense as a receiver. The injury risk otherwise would be too great. And at that point, when does taking Edelman off the field as a receiver just in case he has to play quarterback become a net loss for the team? Plus, he hasn't taken a snap and handed off a football in a game since November 2008, when he was quarterbacking the Kent State Golden Flashes against the Buffalo Bulls.
Likewise, the reports of tight end A.J. Derby (college quarterback) and receiver Chris Hogan prepping as scout team QBs seemed much too staged for the media to be a real possibility for the game vs. Houston. And having Garoppolo show up to Tuesday's practice after the media had left? It all seems like an effort by the Patriots to paint a picture of organizational scrambling when it might not be going on at all. Any minute that the Houston Texans spent preparing for Edelman or Derby or anyone else at quarterback could very likely prove to be a minute of preparation wasted. And considering Belichick knows Houston head coach Bill O'Brien very well, some old-fashioned gamesmanship should never be ruled out.
For Garoppolo, starting and playing every snap with the risk of further serious injury -- plus the discomfort and difficulty of playing through pain just four days after suffering the injury -- would likely be too tall a task for most any quarterback at any level. Yet if Brissett suffers some sort of injury and needs to miss a series or two, it wouldn't be unrealistic to expect Garoppolo to be capable of performing a simplified version of his job.
And that may be the only part of the Patriots' September quarterback situation that ends up being simple.
UPDATE: CSNNE's Tom E. Curran reported Thursday morning that Garoppolo suffered a Grade 2 sprain. That would presumably make him very unlikely to even suit up on Thursday night, but NFL Network's Courtney Fallon reported that Garoppolo will dress as the backup. ESPN's Mike Reiss then reported that Garoppolo will not be dressing for the game.
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