Understanding the potential severity of Joe Burrow’s injury

Shortly after Cincinnati Bengals coach Zac Taylor said Joe Burrow likely will miss “several weeks” after suffering a right calf strain the previous day, receiver Ja’Marr Chase told reporters it was good to see Burrow in the locker room Friday, even if the quarterback needed a crutch and a scooter to get around.

How soon Chase sees Burrow back on the field remains unclear.

The Bengals open with the Cleveland Browns on Sept. 10, and Taylor wouldn’t elaborate as to whether Burrow is in jeopardy of missing any regular-season games. Trevor Siemian and Jake Browning are in competition for the backup role.

Missing preseason games is nothing new for Burrow. The pandemic wiped out preseason games during his rookie year in 2020, and he took just three snaps in one game the following summer while recovering from ACL/MCL surgery. He was recovering from an appendectomy last preseason.

Exactly how long this injury will linger and what effects it will have on Burrow and the Bengals are among the topics ESPN NFL writer Stephen Holder and ESPN senior writer and injury analyst Stephania Bell break down.

What does it say about the severity of the injury that Taylor is estimating “several weeks”?

Bell: Although Taylor confirmed Burrow has a calf strain, the team has not specifically indicated the degree of injury. Soft tissue injuries can be classified as:

• Mild: Grade 1, little to no structural damage, minimal and localized pain/inflammation, minimal to no functional loss, typically days to a couple of weeks to recover.

• Moderate: Grade 2, structural damage present, increased pain/inflammation/functional limitation, typically multiple weeks to recover.

• Severe: Grade 3, complete tear, structure disrupted, often with a visible defect, significant pain/inflammation/functional loss, typically multiple weeks to months to recover.

Taylor said it will be several weeks before Burrow will return, which without further context, is suggestive of a moderate strain, but there should be caution in interpreting that statement.

Chase added a bit of context when he referenced Burrow being on “a scooter,” something often issued to athletes with a lower extremity injury to help them get around while not putting weight on the injured limb, or in the case of a calf strain, not pushing off the foot and engaging the injured muscle. It can also be a short-term solution to avoid aggravating an injury when trying to facilitate healing. Even if Burrow’s injury was diagnosed as a low-grade injury, the team could decide to bring him back to football activity slowly, given it’s early in the preseason.

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Is it the type of injury that could be prone to flare up during the season?

Bell: One of the most challenging things to evaluate with a calf injury in particular is the ability to tolerate functional loading — in other words, loading the muscle with sport-specific demands — and activity endurance. Athletes will often feel fine walking around, even jogging or running, while also demonstrating an ability to land and push off without discomfort.

And yet, when they attempt to return to peak loads — explosive movements, top acceleration or even sustained sports activity, for example — the symptoms could return. In fact, reinjury rates following calf strains in athletes are reported in the sports medicine literature as ranging from 19% to 31%. With the NFL preseason barely underway, and potentially six months of football yet to be played, the goal has to be not only return to play, but also to mitigate future injury risk.

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What was the mood in the locker room after practice Friday?

Holder: The Bengals are a headstrong group, both because of their veteran leadership and because of their recent success, including a trip to the Super Bowl two seasons ago. The loose mood Friday was evident from several indicators, including the blaring music and the levity with which they handled the news.

Veteran safety Michael Thomas joked with Browning as the latter passed by his locker, complimenting him on his strong performance Friday. Then he put the makeup of the team in perspective.

“We lost some guys to free agency, but at the end of the day, the core group that we have in here is strong,” Thomas said. “You can’t replace [Burrow], but you have to have a next-man-up mentality. And today, those other quarterbacks showed, ‘Hey, there’s a reason we’re here, too.'”

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How might the missed time affect Burrow and the offense?

Holder: Whether the Bengals’ slow start last season was related to Burrow’s missed time in the lineup is in the eye of the beholder. But the contrast between Cincinnati’s early season offensive performance versus its performance later on is undeniable.

The Bengals started 2-3 in 2022, in part because of spotty offensive performances that followed Burrow missing 19 days of camp because of his appendectomy. Consider their performance from the first five games: The Bengals ranked 18th in offensive efficiency, 19th in offensive expected points added and 19th in QBR. In their remaining games, the Bengals ranked third, fourth and sixth in those categories, respectively, winning 10 of 11 games to close the season.

Coincidence?

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What’s the plan if Burrow has to miss any regular-season action?

Holder: The Bengals planned on holding a competition for the backup quarterback job even prior to Burrow’s injury. Now that Burrow is out of the lineup, that competition between Siemian and Browning takes center stage.

Taylor said the pair will alternate days with the first-team offense. Next week, he said, they might progress to two consecutive days with the first team before swapping places. Siemian said he preferred that approach.

“I appreciate Zac for doing that,” Siemian said. “It’s easier to kind of feel the rhythm and the flow going with the same group. I’ll take the reps he gives me, certainly, but you’d like to be with the same group. The continuity helps.”

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Will this have any impact on Burrow’s contract situation?

Holder: Burrow’s on-field accomplishments — including leading the Bengals to a Super Bowl — easily trump whatever concerns there might be about his durability. Besides, here’s what matters: Burrow hasn’t missed a regular-season game because of injury in the past two seasons. Yes, a torn ACL cost him six games as a rookie in 2020, but he bounced back with a vengeance the next season, leading the Bengals on a playoff run that ended in the Super Bowl.

The Bengals have built their franchise around Burrow, and they’re all but certain to reward him with a contract that reinforces that.

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Is there a recent example of another quarterback dealing with a calf strain?

Bell: While no two injuries are identical, it is perhaps worth noting that Dallas Cowboys QB Dak Prescott, a right-handed thrower like Burrow, suffered a right calf strain in October 2021 during overtime of a game against the New England Patriots.

After the game, Prescott downplayed the injury, and the team headed into a bye week. Initially, it seemed he might return for the post-bye game. But the team opted to hold him out, and Prescott did not return until 21 days after the initial injury. He emerged following his return game unscathed and did not have a subsequent flare-up, playing in all remaining games that season, perhaps a credit to the decision to hold him out an additional week.