Analyzing the Chiefs’ long injury list entering the weekend

The Kansas City Chiefs began preparation for the Chicago Bears on Wednesday, with five players missing practice for the team.

The players missing the first practice of the week for the Chiefs include wide receivers Richie James (MCL) and Kadarius Toney (toe), running back Isiah Pacheco (hamstring contusion) and linebackers Willie Gay (quadriceps contusion) and Nick Bolton (ankle sprain). Pacheco and Gay returned to practice in a limited capacity on Thursday.

Head coach Andy Reid implied that James’ MCL is the only one that could be considered a long-term injury, describing the others as “day-to-day.”

Richie James and his MCL injury

James first appeared on the injury report with a knee injury in preparation for the season opener against the Detroit Lions. It hasn’t been confirmed, but it is possible that this is the same knee injury that the Chiefs are now confirming as an MCL injury.

James was a limited participant in one practice during Lions week and a full participant (but listed on the injury report) for the entirety of the week in preparation for the Jacksonville Jaguars.

The MCL, or medial collateral ligament is one of the four major knee ligaments serving to stabilize the knee joint. It primarily serves as a stabilizer for the medial or inside portion of the knee, as well as serves to prevent lateral rotation of the tibia (shin bone).

MCL injuries are one of the most common knee injuries that occur in football, especially given the mechanism of injury. A direct trauma to the outside of the knee forcing a valgus (inward force or stress) to the inner knee can cause either a sprain or tear, as well as potential injury to other ligaments or soft tissue structures.

MCL injuries are graded on a three-point scale, with a grade III injury being considered a complete rupture or tear of the ligament. It is most likely that James has suffered a grade I or II sprain, meaning there is joint swelling, pain, tenderness to palpation, as well as potential instability or laxity of the knee. It’s important to note that even a grade I or II sprain means that some fibers of the ligament are torn, it just isn’t a complete tear.

The MCL does have a greater capacity to heal on its own without invasive intervention in comparison to the other ligaments of the knee due to its increased blood supply.

James has mainly been a special teams player for the team this season, serving as a kick and punt returner. It should be noted, however, that despite Reid noting the injury could be considered long-term, James was on the field for the offense in the Chiefs’ final drive against the Jaguars.

Photo by Sam Greenwood/Getty Images

Soft tissue contusions

Among the other injuries Reid informed the media of on Wednesday included Pacheco and Gay, with a hamstring and quadriceps contusion, respectively.

A soft tissue contusion (bruise) results from a direct blow to the muscle belly. These injuries can be very painful and frustrating, depending on severity. As with ligament sprains, there is also a grading scale for soft tissue contusions. A quadriceps contusion is more common than a hamstrings contusion.

Grade I and II contusions are minor injuries resulting in pain and swelling, with potential changes in gait depending on the severity of the injury or loss of range of motion. Grade III contusions are more severe resulting in bruising, severe swelling, reduced range of motion capacity, and cause an obvious limp.

Treatment of these injuries includes swelling management and gentle pain-free stretching of the muscle and surrounding muscles, with progression back to strengthening as tolerated. Both Pacheco and Gay finished the game for the Chiefs and were on the field for the final offensive and defensive series.

Impact on Week 3

According to Reid, it seems the Chiefs may be without James at least for this week or possibly longer. MCL sprains can take several weeks to heal depending on severity. As mentioned, this could be an injury that happened two weeks ago and potentially got re-aggravated, but that information has not been confirmed.

Pending any setbacks, it is anticipated that the four other players who did not practice should be able to suit up for Week 3. All five players were able to finish the game in Week 2 against the Jaguars. This includes Toney, whom Reid said postgame was available for “most” of the plays he was supposed to be in on. Bolton also walked off the field under his own power after suffering the ankle sprain, was evaluated by the athletic training staff and returned to lead the defense.

It is likely that the days off for these players were for rehab and treatment, as well as precaution. Their practice statuses to close the week will shed more light on their Week 3 availability against the Bears.