Update/ Mattison lightly practiced on Saturday. This was more than likely rehab related and not a true practice. Expect Mike Boone to start and Mattison to sit.

First things first: follow me on Twitter here and on Facebook here for frequent injury updates and a platform for questions. Now, I’ll preemptively apologize for typos and errors as I’m furiously typing as fast as I can so it gets out before waivers. Life as really sped up for me during this, my last holiday break, as I’m studying intensely for board exams that are around the corner. It’s my break and things have gotten busier, how sick is that? Okay, no fluff on this one let’s get to the Vikings backfield injuries and help you make a decision before waivers run.

Dalvin Cook– What happened?

On Sunday it seems that Cook dislocated his shoulder. This is the fourth time he’s suffered this kind of shoulder injury dating back to his high school days. My tweet below will give a better description of what happened. The bottom line is that when this happens damage occurs to the labrum, which helps to hold the shoulder joint in place. Cook has damaged his labrum twice before so this is not a new injury, which counter intuitively is actually an advantage. When a person has this kind of recurring instability issue, most of the damage is done after the first dislocation.

Can't really spot the mechanism but around :23 it appears that Cook throws his arm up to potentially reduce ("put back in place") his shoulder. Not 100% confident in that but Cook has dislocated/torn his labrum twice before in '14. Not looking good at all.https://t.co/BeKTcN6zAH — Dr. Edwin Porras (@FBInjuryDoc) December 15, 2019

What does it mean?

In fact, a study in 2018 found that a whopping 92% of NFL players who had a shoulder instability injury (subluxation or dislocation) were able to return that same season. Players who who had a subluxation (i.e. shoulder dislocated partially but went back on its own) returned to play at a median at zero weeks. This means they didn’t miss any time. The players who had a complete dislocation (required some pushing and pulling to put back) were able to play at a median of three weeks. This means half of them came back before three weeks and half of them came back after three weeks. The downside? Almost half of these players (47%) re-injured the shoulder once they returned. At that point, Cook’s season would almost certainly be over.

What are the chances he plays?

Even though I hate giving out percentages as there’s very little objective way to determine this, I would say Cook has about a 40%-45% chance of playing as of now. Remember that this is before practice reports, so check back with me.

At the very least, Cook has a chance to play on Monday as Mike Zimmer informed the media that Cook’s shoulder already felt better on Monday morning. This isn’t just coach speak because as I mentioned earlier, a glenohumeral dislocation is not necessarily detrimental for a player who has dealt with these kind of issues his whole life. The damage has been done. The question is this: will the Vikings put Cook out there knowing he’s at a major risk for a recurrence that will almost certainly land him on the IR? I’m not sure I can answer that question rationally as the Vikings control their own destiny and can clinch a playoff berth with a win against the Packers in Week 16. They can either risk-it-for-the-biscuit for a shot at clinching a playoff spot or allow Cook to heal up for a few weeks before the playoffs begin. A classic case of what “should” a team do versus what *will* a team do?

Don’t you love just love the timing of the Vikings’ backfield injuries?

🚨Another Cook update:

Even if he *can* play it doesn't mean he *will* play.

When you couple this report with the fact that the average return to play time for dislocations is 2-3 weeks, it would make sense to wait until the playoffs to bring him back.



1+1=2. Add Mike Boone. pic.twitter.com/ZhIEFq0cMo — Dr. Edwin Porras (@FBInjuryDoc) December 17, 2019

Alexander Mattison- What happened?

Mattison’s last carry in Week 14 happened with 2:08 left in the 4th quarter. He took a handoff to the right and was tackled with both his ankles in an awkward position. Although this is admittedly speculation, my hypotheses are this:

Eversion ankle sprain to his right ankle and lateral “low” ankle sprain to the left. High ankle sprain to the right and lateral “low” ankle sprain to the left. Isolated lateral ankle sprain to the left.

See my tweet below for a visual of Mattison’s last snap in Week 14.

Mattison's last carry in Week 14 w/ 2:08 left in the 4th. He got up slowly & didn't finish the game. Hypotheses:

1⃣Eversion sprain to R

1⃣.A. High sprain to R

2⃣Lateral sprain

It's late, but favorite this as I'm writing currently writing what all of that means. Article tonight. pic.twitter.com/RubU5VtFna — Dr. Edwin Porras (@FBInjuryDoc) December 18, 2019

What does it mean?

Any way you slice it, Mattison has missed one week already and is at risk for missing another because even a grade I high ankle sprain will take at least three weeks to fully resolve. In fact, according to this study the quickest time he could return based on averages is about four weeks. I’m not so sure this is a high ankle sprain for Mattison, but it is within the realm of possibilities.

Going with my first hypothesis of an eversion ankle sprain doesn’t necessarily help his cause too much although severe injuries of this type are not very common, so he’s got that going for him. If he has an eversion sprain, he would need to gain full range of motion and strength then practice fully without a setback to play on Monday night. I’m still not optimistic about this type of injury because it damages the strongest ligament in the foot/ankle and requires a minimum of two to three full weeks to truly heal. The upside would be that he’s likely to recover more quickly from a mild eversion sprain as compared to a mild high ankle sprain.

What are the chances he plays?

If all Mattison did was pick up a low ankle sprain to his left ankle, he could return to play this week with minimal concerns (relative to the other two types of injuries) so long as he gets in at least one full practice by Saturday. The bottom line is that even if Mattison is active without Cook, I’m not confident he’ll dominate the snaps and be healthy enough to produce with Mike Boone chomping at the bit. At this point before practice reports come out I would say Mattison has a 50%-55% chance of playing.

So, what do I do?

Even with Cook active and Mattison inactive, the Vikings have shown us they have no issue reducing Cook’s snaps coming off injury (see Week 14) and Mike Boone has proven he can share the load. Conversely, if Mattison is active and Cook is not, there’s no guarantee Mattison will be be 100% based on recovery times for the plausible injuries he sustained. To make matters worse, the Boone Factor (sounds like a rec league dodge ball team) is still in play with this scenario. If Cook and Mattison are both active?

Whoof.

It sounds insane, but from an injury perspective, I’m seriously considering not even using the Vikings backfield if I have the option, especially if both backs are active alongside the Boone Factor. The only obvious situation in which I would feel 100% confident in a Vikings running back is if Cook and Mattison are both inactive. For that reason blow all of the remaining FAB you have on Mike Boone to insulate yourself and check back with me for updates.

To Summarize

Cook has a small chance at playing, but if he does there’s a 50% chance he re-injures the shoulder based on the medical research. Mattison has a better-ish chance at playing compared to Cook, but he needs to show it in practice first and there’s a very good chance he and Boone will end up splitting touches. If Mattison and Cook are both inactive (a more likely scenario) Mike Boone is a smash start.

The Vikings’ backfield injuries have caused a fantasy football mess. Ultimately, this is your fantasy championship so you make the call. I hope I was able to provide a bit more context and evidenced based assessment before you put waivers in tonight. Lastly, as a future healthcare provider, I hope all of these players get healthy and stay that way starting tomorrow. Good luck!