Week 3 Injury Update

Unlike Weeks 1 and 2 when almost nobody of significance (apart from Reggie Bush) was listed on the 49ers injury report, Week 3 has a few major names on the list thanks to some damage done during the Pittsburgh game. Let's go through them one by one.

Carlos Hyde

There were a couple of injury concerns with Hyde during and after the Steelers game. In the first quarter, Hyde noticeably limped to the sideline after a low hit. At first it looked like he got his ankle twisted, but other reports are that it looked like he took a hit to the knee. Officially, the 49ers called it a "leg contusion", which is a technical term for a bruise. Now, calling it "just a bruise" is likely minimizing what the injury actually is. The mechanism behind a bruise is the rupturing of tiny blood vessels in the skin that cause the area to swell up with blood and fluid. The location of a contusion is the most important part in determining how debilitating the injury is. A leg contusion is the most common type encountered in football because ballcarriers can get hit low (between the knee and ankle) where they have no padding. However, since the swelling occurs in a location of the leg where there is no joint and therefore no movement, it does not usually hamper a player's ability to accelerate or change directions. All in all, Hyde came back in the game and seemed to have no ill effects from the initial hit so it seems like this particular injury shouldn't have any lasting effects.

The second, and perhaps more important, injury concern coming out of the game for Hyde was the fact that he was evaluated for a concussion in the 2nd half and did not return to the game. The good news is that the 49ers report Hyde was evaluated, but not diagnosed with, a concussion and Tomsula said it was his decision to keep him out of the game after he was cleared. There are a few things fans should know about concussions and in-game concussion testing. Firstly, concussions are a black and white diagnosis--that is, either someone has one or they don't. Secondly, in game concussion testing is done by an independent neurologist. If that neurologist diagnoses the player with a concussion, they are ineligible to return for the rest of the game. So therefore we know that since Hyde was cleared to return, he did not have a concussion. It is a situation worth monitoring, however, because if Hyde experiences concussion symptoms during the week it is likely that he did have a concussion on Sunday and the testing simply did not pick it up because the symptoms were not evident at the time. This may seem like a flaw in the testing system, but concussion symptoms can be delayed and can be exacerbated by activity, making the immediate diagnosis complicated.

Reggie Bush

Bush was diagnosed with a calf strain during the Vikings game. All muscle strains are tears, but when teams use the term strain they usually mean that the muscle is torn, but not completely. The severity of the strain is unknown, but Bush tweeted that he was ready to get back on the field this week.

It remains to be seen if he's healed enough to play this weekend. The practice reports that come out Wednesday through Friday should go a long way in determining how the healing process is going. If Bush is even a limited participant in practice later on in the week, it seems like he's a good bet to be active on Sunday.

Torrey Smith

Smith also left the game with a leg contusion and he did not return. As noted in the paragraph about Hyde, if the contusion does not involve the knee or ankle joint, it is unlikely that Smith will miss time. The most likely scenario here is to assume that he is limited in practice early in the week and goes to being a full participant by Friday.

Bruce Ellington

Ellington had been dealing with an irritating hamstring injury during the offseason and preseason, but was active in week 1 and had a punt return TD that was called back by penalty. Tomsula reported in the preseason that he had a conversation with Ellington about his conditioning, which, by how Tomsula described it, seemed to be more of a stern lecture (hyperlink: http://espn.go.com/blog/san-francisco-49ers/post/_/id/14763/a-sit-down-talk-with-jim-tomsula-helped-bruce-ellington-mature) about conditioning an maturity. So it has to be a bit painful for the 49ers to see Ellington pop up on the injury list with an ankle problem late in the week. The exact injury has not be disclosed yet, but Ellington is another player who will be an interesting name to follow on the practice reports this week. For a player who has yet to make a sizeable impact in his 1+ seasons with the team, it doesn't seem like Ellington can afford to be in and out injury flux for a long period of time.

Vance McDonald

McDonald left the Steelers game in the first half with a knee injury. Tomsula reported the injury was below the knee and that initial x-rays were negative, which mean that they did not detect any obvious swelling or fracture of a bone in the joint. It's hard to speculate about what exact this injury could be, but the possibilities include a contusion (this time it would be more likely to involve a joint and therefore be more debilitating than Hyde's leg contusion, for example) or a ligament sprain (sprains are partial tears of ligaments, which are fibrous tissues that connect bones to other bones). All in all, it seems like McDonald is more likely to miss time due to this injury than anyone else on this list.