The NFL’s Week 4 was particularly brutal when it came to injuries, and Seahawks RB Chris Carson—who suffered a season-ending leg injury that week—walks through how it all unfolded.

This story appears in the December 18, 2017, issue of SPORTS ILLUSTRATED. To subscribe, click here.

The fourth week of this NFL season was so obviously painful, with so many spine-shaking hits to so many star players, that it made painfully obvious what images would come to define pro football this fall. That is, helmeted men crumpling to the turf, clutching damaged limbs as teammates pray and stadiums fall silent. Twenty-one players on SI’s preseason Top 100 fantasy list have been sidelined for significant time. You could fill a Pro Bowl roster with 2017’s injured stars. At quarterback: Aaron Rodgers; at receiver: Odell Beckham and Julian Edelman; at running back: David Johnson and Dalvin Cook. . . .

Week 4, as much as any other, embodied that theme: pain. For those who care about the players, who want them to live long and healthy lives, it was hard to watch. It was ambulances and blue medical tents and MRIs; concussions and torn ACLs and numb arms; a broken back, broken ribs and, in the case of Seahawks rookie running back Chris Carson, a broken left leg with a side of torn ankle ligaments. Over the course of 16 games, some three dozen players left with noteworthy injuries. But for anyone who finds that body count unusually high, who thinks that Week 4 is any different from the ones before it, here’s what those walking wounded want to make clear: It’s not. That’s football. The same carnage unfolds, to some degree, every single week, and its ripple effects are unrelentingly devastating.

A snapshot: It was 8:15 p.m., Seattle time, on Sunday, Oct. 1, when Carson, a promising seventh-round pick out of Oklahoma State, took a fourth-quarter handoff against the Colts, shot right and ran into a wall of defenders. Indianapolis linebacker Jon Bostic grabbed Carson by the waist, “but my foot was caught [under a body],” Carson says, “and my left ankle was trapped underneath him. Two other guys came in and pushed me—and I’m yelling, ‘Chill, chill, chill!’ My ankle was folding and I hear this pop.”

Lying on his back, Carson kept his eyes shut. He didn’t see quarterback Russell Wilson pushing defenders away or Pete Carroll standing over him or even the crowd standing and cheering as he was taken off on a cart. “I felt people touching my shoulder,” Carson says, “but I couldn’t look. All I was thinking was, Dang, my season’s over.”

Afterward teammates limped off the field at the end of another bloody, bruised and battered Sunday, half-celebrating a 46–18 win, while Carson sped away on a cart toward the X-ray room underneath CenturyLink Field, then back to the locker room, where he ran into offensive tackle Rees Odhiambo . . . who was being stretchered toward an awaiting ambulance with breathing problems. Odhiambo would spend the night a mile away at Harborview Medical Center . . . in the same hospital where another teammate, defensive end Cliff Avril, had been evaluated earlier that evening after losing feeling in his arms.

Week 4: so brutal. And yet not all that different from Week 3 or Week 14; the same as last year and the year before that. There may be more injured stars—almost a quarter of last year’s All-Pros have missed at least four games—but the extra attention their absences garner only underscores what has long been obvious: that gladiators who collide on every play rarely finish games and seasons and careers with all of their body parts intact.

A Timeline of the NFL’s Biggest Injuries This Season

One month after his injury, Carson sits in a coffee shop outside Seattle and considers all the carnage of Week 4. He hasn’t played since that Colts game. He still remembers what cornerback Richard Sherman told him back in training camp, that he should cherish every carry because he plays a sport with a 100% injury rate.

Later that night, after the coffee shop meeting, Sherman will rupture his right Achilles against the Cardinals, landing on injured reserve alongside Carson and Odhiambo and Avril. The running back laughed at Sherman’s warning back in August. He’s not laughing now.

Here’s how Week 4 unfolded.

Davante Adams was carted off the field after absorbing a vicious hit from Danny Trevathan, but he returned to the field the following week. Jonathan Daniel/Getty Images Sport

SUNDAY, 10:30 A.M. PST

On the morning of the day that fate will hit pause on his career, Carson sleeps in, downs a breakfast of eggs and hash browns, and retreats to his hotel room to review the offensive script. Because we’re in Week 4, because Thomas Rawls (ankle) and C.J. Prosise (ankle) have already succumbed to injury, quickening Carson’s rise, he is getting his first start, so the 15 plays the Seahawks have planned for their initial possession matter more to him than ever.

As he studies, Carson is trying to forget a particularly brutal hit from three nights earlier, when Bears linebacker Danny Trevathan went helmet-to-helmet with Packers wideout Davante Adams. The receiver would later tell The MMQB’s Peter King that his first memory post-collision was of waking up in the hospital, his fiancée showing him the play on YouTube. “It made me sick to my stomach,” Adams says. (Nonetheless, he suits up 10 days later and scores two TDs against the Cowboys. “There’s no point in sitting out when you’re feeling great,” he tells reporters. “You’re not going to keep taking DayQuil if the cough is gone.”) The hit has dominated the NFL news cycle for days, leaving those who take the field on this Sunday to . . . do what, exactly? Write it off? Say, That’s football?

Legions of players across the league do just that, shrugging off ailments every week before enduring another Sunday of collisions: players like Giants defensive end Olivier Vernon, an All-Pro in 2016, who worries about his tender left ankle, injured a week earlier. The 6' 2", 262-pound lineman describes the pain—pain that would relegate any normal human being to bed rest—as merely “soreness.” Before Sunday’s game against the Buccaneers he asks himself: How will I feel when I’m trying to overpower some 300-plus-pounder?

The nine early games kick off, and by 1:25 p.m., six players have already sustained serious injuries.

SUNDAY, 10:40 A.M. PST

Panthers free safety Kurt Coleman hears a pop—this one comes after he takes a helmet to the back of his left knee in New England. “I’m just thankful it wasn’t worse,” he’ll say weeks later. Worse could mean tearing his MCL. A mere sprain, in this case, is good news, a simple workplace hazard that can more immediately be remedied.

Down the Eastern seaboard, in Atlanta, Bills linebacker Ramon Humber rushes to add to his team-leading tackles total, only to jam his right thumb into a lineman’s shoulder pads. He finishes the series, ignoring the pain, until he notices “something moving in there.” Later he’ll be asked how his wife felt when he went back into the game. “It wasn’t her decision,” he says. But was it the right decision? “Yeah. We won.” Humber’s thumb is broken and will require surgery. At the hospital he’ll run into his Bills teammate, Jordan Matthews, who’s also having a procedure to fix a broken thumb. “It’s better,” Humber later says of his digit. “It’s in place.”

Minutes after Humber’s injury, Falcons receiver Julio Jones exits with a right-hip flexor, never to return from the locker room. Fully-healthy Julio doesn’t resurface for weeks, and a three-game skid threatens Atlanta’s postseason hopes. Fantasy owners from coast to coast groan. It isn’t yet halftime in the early window.

SUNDAY, 11 A.M. PST

Titans quarterback Marcus Mariota scampers through the Texans’ defense for his second touchdown . . . only to strain his left hamstring on the play. He’ll miss one game (a loss to the Dolphins that could prove costly at the wire) and later be described by coach Mike Mularkey as a “quick healer,” an attribute, like “high pain tolerance,” that’s more important to a football player than it is to any other elite athlete. In his return, a win over the Colts, he’ll throw for 306 yards and teammates will laud him for his bravery—for playing hurt—more than for any of his passes. Availability trumps ability.

Back in Seattle, Carson reclines on the bed in his hotel room, readying himself for a late-morning nap. One of the last images he sees on TV before he drifts off is that of Vikings running back Dalvin Cook clutching his left leg. That sucks, Carson thinks to himself. Later he’ll learn that Cook tore his ACL while planting to cut, ending the promising season of an Offensive Rookie of the Year candidate.

SUNDAY, 1 P.M. PST

By the time Carson wakes up, at least a dozen players have left the field in some degree of agony. He watches their names scroll across the ticker but doesn’t worry. He’s certain it won’t happen to him.

Later, on the bus to CenturyLink Field, he listens to the same song over and over at max volume—“Steady Hustlin” by Ice Billion Berg. It’s a fitting anthem for a guy who, after tweaking his hamstring on the first day of rookie mini camp, figured he might have to win a roster spot with his special teams play. And here he is. He’s not leaving anything to chance for his first start: At the facility he hops into the hot tub, gets a hamstring massage and deploys a foam roller on his legs. He’s loose, pliable, ready.

Giants running back Paul Perkins feels it too—“like a million bucks,” he’ll later say—as New York kicks off in Tampa. He has banished some rib soreness from his mind . . . until he’s hit so hard on the first offensive series of the second quarter that he can’t breathe. He heads to the locker room for X-rays, feeling what he’ll later describe as “a stabbing pain.”

In Arizona, 49ers receiver Marquise Goodwin leaves his game in the first quarter with what is initially described as a “head and eye” injury but is later revealed to be his fourth concussion in 14 months.

Perkins’s mom calls, worrying. He tells her he can’t do anything but ice his ribs and watch. The toll has already reached almost two dozen.

Odell Beckham Jr. injured his finger in Week 4, but was knocked out for the remainder of the season the following week when he suffered a broken ankle. Roy K. Miller/Icon Sportswire via Getty Images

SUNDAY, 2:10 P.M. PST

Odell Beckham Jr.’s season takes a painful turn when he dislocates his right index finger trying to haul in an Eli Manning laser against the Bucs. After pogoing around the sideline in pain he’ll tell reporters that the finger “just popped out” and describe it as “not a comfortable feeling,” though his Instagram post of his index finger bent at a 90-degree angle suggests much worse. Beckham goes back in, but seven days later he will land awkwardly and fracture his left ankle, ending his season the same week that fellow wideouts Brandon Marshall and Dwayne Harris land on IR. That’s football: Manning loses three pass catchers in one week and the seeds of his eventual benching are sown.

Later in that Week 4 Giants game Vernon realizes he can’t push off on his tender ankle anymore. “It felt like the upper part was about to break,” he says afterward with the nonchalance of an office worker gently complaining that the supply closet has been emptied of paper clips.

Injuries Strike Dalvin Cook, Marcus Mariota, Julio Jones, Derek Carr in NFL Week 4

SUNDAY, 3 P.M. PST

Colts center Deyshawn Bond warms up before his Sunday Night Football appearance at Century-Link. He’s not thinking about how he got here—undrafted out of Cincinnati, signed as a free agent by his hometown team, already a starter.

He’s also not aware about what’s happening halfway across the country, in Denver. While the Raiders and Broncos keep playing, Oakland quarterback Derek Carr is getting X-rays for what will eventually be revealed as vertebrae chipped in several places when an opponent’s knee is driven into his nameplate. Reporters ask Carr what he felt as he crumpled to the turf, and he answers simply, “Pain.” Yet he remains optimistic that he’ll return in a matter of weeks. He does—only after EJ Manuel takes a costly loss to the Ravens. Carr’s explanation for his quick turnaround is just another way of saying That’s football. “It’s one of the worst things,” he says of the injury. “You can’t walk.” And yet, he continues, “within a couple days I was able to do absolutely everything.”

Across the field from Bond in Seattle, Avril jogs out of the tunnel. After racking up a career-best 11 1/2 sacks and earning his first Pro Bowl nod in 2016, he’s off to a slow start in Year 10—but he believes that will change against Indy. He heads back into the locker room for an IV drip before kickoff. “Best I’ve felt all season,” he says.

In Tampa, Vernon cannot say the same. He finishes on the sideline and knows this injury will cost him time; he’s just not sure how much. He won’t return until Week 10, missing an NFL game for the first—and then second, third and fourth—time in his career. Not being there for his team hurts, but also, says Vernon, “It’s more of a pride thing—priding yourself on playing football. You’re never going to be 100% healthy.

“A lot of guys have been through worse.”

SUNDAY, 5 P.M. PST

Carson stands in the home team’s tunnel at the Clink while his teammates charge into the stadium. Finally his name booms over the loudspeakers and he shoots onto the field, pushing both hands downward, reminding himself to remain calm.

At the same time, Bond allows himself a moment. The spectacle of it all, “it kind of brought me back to reality,” he says. “Like, Wow, I’m really here.”

And then he isn’t. His night lasts two plays. “I felt something in my [left] knee, and someone under my foot,” Bond recalls. “I’m falling backward, but I’m being pushed the other way.” He tries to rise and fails, signaling for Indy’s trainers, who ask him to flex his left quadriceps. He can’t even feel it. Right away he knows he has suffered his first significant football injury. His torn quad is a rite of passage. “I was crushed,” he says.

SUNDAY, 6 P.M. PST

Avril can feel his extra film studies paying off. “Early on, passing down, I’m running game with Mike [Bennett],” he says, referring to his bookend on the D-line. “We’re chasing [QB Jacoby Brissett] down and—freak accident—I’m trying to make a tackle and somehow I get a heel to the face.”

He doesn’t see Brissett’s foot approaching his chin until the moment his head snaps backward. He thinks maybe it’s a stinger, because he can’t feel his arms for more than 10 seconds. But that’s football, he reasons as he heads into a blue medical tent on the sideline. (Ever wonder what’s in one of those tents? Nothing, Avril says. Just a table and a doctor who tells Avril that a stinger wouldn’t cause both arms to go numb. “This,” the doctor explains, “is pretty serious.”)

“You’re gonna get banged up,” Avril will say weeks later, plainly. “The game is really about how tough you are. A normal person would probably panic [in that situation], but my pain tolerance is higher. I’m not scared.”

Avril feels . . . fine. At least by football standards. He couldn’t feel his arms; now he can. But when he tries to return to the game, Seattle’s team doctor gives him a medical stiff-arm. As the lineman heads to the locker room, where an ambulance waits by the back door, teammates yell, “What’s up?”

“I’m going to the hospital,” he tells them casually, like he’s off to the supermarket on a grocery run. He changes clothes and rides with his wife to Harborview. The game goes on.

Back on the field, Carson glances at his left tackle, Odhiambo, and notices blood coming out of his mouth.

At halftime, Bennett reaches out to Avril over FaceTime. Avril tells his best friend that he’s about to slide into an MRI tube, where he’ll have to sit still for 45 minutes—especially difficult given his spiking adrenaline. As he slides into the machine, the Seahawks trail by five points.

When he emerges, they’re up 14. “What happened?” he asks the nurse.

SUNDAY, 9 P.M. PST

Odhiambo leans forward at his locker after the Seahawks’ victory. He’s in obvious pain, clutching his chest and grimacing. He moves to the ground and trainers scamper over. Carroll hovers nearby and teammates form a wall trying to shield reporters from what’s happening.

Security officers stand guard. Wilson stops and prays. Carroll walks away, rubbing his temples. What else could possibly happen today? Eventually trainers place Odhiambo on a stretcher; they leave the locker room . . . and run into Carson, who’s coming back from X-rays. Back in the locker room wideout Doug Baldwin explains that Odhiambo took a shot to the sternum and had trouble breathing. He doesn’t seem particularly worried. No one does. The celebration resumes. At Harborview, Avril is getting ready to leave when someone tells him another Seahawk is coming in.

Carson, hobbling out on crutches, gets a ride home from Rawls, who recounts how he came back from a similar injury—broken ankle, torn ligaments—a year earlier. He promises to help. Later, Carson’s mother reminds him of the torn ACL he overcame in high school. Eventually he shuts his phone down and climbs into bed.

Avril orders takeout on the way home while he tries to make sense of his murky test results. “I felt normal, honestly,” he says. “But the MRI showed something different.” He stays up with his wife, weighing the future. He wants to be able to play basketball with his children.

Up at cruising altitude on the Colts’ flight home, Bond is wearing an immobilizer on his injured leg. He can’t bend the knee at all, which means he can’t sleep. Week 4 is not even over yet.

Seahawks RB Chris Carson falls victim to a leg fracture and a high ankle sprain in his first start of the season for the Seahawks. Otto Greule Jr/Getty Images

MONDAY MORNING

Carson barely sleeps, such is the throbbing pain in his ankle. He ignores a stream of texts and phone calls. Everyone means well, he knows—they just don’t know the heart of it. Sure, playing football hurts. But not playing football hurts way more.

Bond gets an MRI, which confirms he’s out for the season. Coleman notices little swelling in his injured leg, which he sees as a “good indicator” that he won’t miss much time. (He doesn’t play again until Week 8.) Perkins’s X-rays come back negative, but his rib pain feels like a “constant stabbing”; a shift in any direction makes it hard to breathe. Vernon tries to remain positive—if he doesn’t, he’ll never make it back. “Whatever injury you’re going through,” he says, “you’ve got to come back and play.”

Or not. Avril bumps into Odhiambo in Seattle’s locker room on Monday and they swap tales from the hospital. Avril had security; Odhiambo did not, and strangers knocked on his door asking for autographs. They share a laugh, a momentary distraction from the scary reality that Avril must now confront. Doctors are telling him he cannot work out. He needs more tests. His absence is explained to media as a neck injury, but it affects his spine. And “that changes everything,” he says. “My life and my kids are more important than football.”

Minutes later he says he wants to play again. He cannot be more clear. He wants to play again this season—a hope that is squashed when he undergoes neck surgery in late November.

“I’ve never heard of this many high-caliber guys, Pro Bowlers, going down in one week,” he says. “That’s crazy.

“At the same time, that’s the NFL.”

MONDAY, 5:30 P.M. PST

There’s still another game to play: Redskins-Chiefs. Washington’s Pro Bowl left tackle, Trent Williams, spent Sunday watching games, noting the injuries on the ticker—and then he gets rolled up from behind and goes down clutching his right knee cap on his team’s first play of the second quarter. (MRI: nothing devastating; he’s back for the next game.) Right before halftime, cornerback Josh Norman takes a foot to the midsection. He argues with team doctors to remain in the game, even as a decoy. “I [wanted] to go, regardless,” he tells reporters afterward, launching into a soliloquy about “mortal” bodies and how moments like this remind him he’s “still here on Earth.” With a broken rib and punctured lung, he’ll be sidelined for two games, including an inter-divisional game in which the Eagles’ Carson Wentz carves up the Skins’ depleted secondary.

Chiefs guard Laurent Duvernay-Tardif, too, limps off the field, with pain in his right knee. Duvernay-Tardif attends medical school at McGill in between seasons, learning how to heal others when he’s not causing destruction on the field. Knowing how these collisions destroy bodies still does not diminish his love for the game. Never will, he says.

Two summers ago, during his residency, an obstetrician asked Duvernay-Tardif: What do you even like about football? The lineman explained that he understands the risks and believes that the positives—the camaraderie, the social interaction, even the physicality—outweigh them. Not to mention his five-year $42.5 million contract.

On Tuesday morning he gets an MRI and fights the urge to jump across the exam table to read the images himself. It’s his MCL—just as he predicted—not an ACL tear. He won’t play for a month, but he’ll play again this season.

At the coffee shop, Carson sits back and weighs all of this Week 4 wreckage. Even if the NFL’s injury rate remains painfully constant, the fact that he’s even talking about the piles of bodies demonstrates how much football has changed in recent years, how awareness of the consequences has evolved. Rules have been changed, protocols introduced; promising young players have retired early rather than face 16 (or more) versions of Week 4. There’s talk of no-contact practices, of a CTE test for active players . . . .

Those who stick around, like Carson, recognize that they’ve made a choice. They’re playing a violent game because they want to, because the rewards outweigh the risks. A broken ankle is the cost of competing in the game they love. All Carson wants, anyway, is to return.

He started to jog on an Anti-Gravity treadmill a week ago and threw his walking boot away this morning. “Look,” he says. “It’s not like a serious, serious injury, where you can’t come back or won’t come back the same.

“I’ll be fine,” he says. “It’s the NFL,” he says.

The Seahawks play tonight. He’s not sure he’ll watch. Too painful.

Additional reporting by Jacob Feldman and Jonathan Jones.