NFL Injury Report: Could 49ers QB Trey Lance return this season?

Written By Will Carroll on September 23, 2022 - Last Updated on December 4, 2022
trey lance

Quarterback injuries are the biggest NFL injury report stories going into this weekend. Two could play Sunday – Saints QB Jameis Winston (back) and Chargers QB Justin Herbert (ribs) – but how much are their injuries baked into NFL Week 3 odds? Another was thought to be lost for the season, but new information means 49ers QB Trey Lance could be back in 2022.

Each week, we’ll provide the latest expert NFL injury report analysis and reporting from inside sources to help you make smarter bets.

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Week 3 NFL Injury Report Analysis: Quarterbacks

Will Carroll has covered injuries in sports for more than 20 years and has written four books, including the newly published “The Science of Football”. He also consults with several pro teams. Will is currently the Director of Bioanalytics for Northstarr, a sports science startup company.

Editor’s Note

JAMEIS WINSTON, QB SAINTS (fractured back)

“Broken back.” 

It sounds bad, and is, but for NFL injuries, the kind of fractures Jameis Winston has in his spinal column are manageable. He’s in no danger, just some pain. The fractures are in a small area called the transverse process, and they’re thought to exist to protect the spinal column. Winston’s is in the lower back (lumbar) and covers multiple levels, meaning multiple fractures, all which heal on their own timelines.

Winston played Sunday and seemed to have no issue. He was wearing a larger than normal flak jacket to protect the area, but watching the game back, I don’t see any instances where he showed signs of pain or was slow getting up. Winston appeared to have full range and didn’t resist twisting, as some might. In essence, it had no effect on his game. So absent another big hit, Winston should be a normal play in an offense that’s still finding itself and has potential to get better.

With Winston essentially normal and signs that Michael Thomas is healthy and back, the Saints offense could open up. Chris Olave should get better in the middle of the season and a healthy Alvin Kamara (bruised ribs) could help.

JUSTIN HERBERT, QB CHARGERS (rib cartilage fracture)

Justin Herbert has a fracture to his rib cartilage, a painful injury that he is expected to play through. However, a lawsuit was just filed against the Chargers team doctor by Tyrod Taylor, who alleges his lung was punctured during a painkilling injection, a malpractice. Guess what procedure Herbert is going to need to play?

Risk and pain tolerance are the issues here. Functionally, Herbert should be able to do everything for the Chargers, but contact and some motions are going to be painful. There’s no way to simulate the kind of in-game hits he’s going to take. While any hits aren’t good, the biggest concern is for weight on him when he’s down. The ribs won’t be able to move and the cartilage is what gives. As always, keeping Herbert off the ground is key, but even more so over the next couple of weeks.

It’s impossible to gauge how Herbert will respond, but adjustments to scheme might help. Shorter throws lead to less rush hits and can rack up volume yardage and play totals. We could see more running or play-action help. Austin Ekeler yardage totals could be a nice play. The deep ball should be available, but comes at more risk. Monitor Herbert yardage unders to see if adjustments have been made by the books. 

TREY LANCE, QB 49ERS (fractured/sprained ankle)

Most assumed Trey Lance was lost for the season after being carted off in an air cast, and the 49ers releasing a statement that he should make a recovery by the start of the 2023 season. However, it’s not out of the realm of possibility he returns in 2022.

A trusted source tells me that the ligaments involved were not in the ankle, but in the “high ankle” or syndesmosis. That is usually repaired using a technique called “tightrope”.

The comp here is Tua Tagavailoa, who had this procedure in both ankles and has lost no mobility despite those surgeries, even after a significant hip injury as well in his last year at Alabama. 

It makes me wonder if the 49ers made a call to Dr. Lyle Cain, Alabama’s team doc and a partner of Dr. James Andrews in Birmingham. Regardless, there’s a high degree of success for both operations, and Lance has every chance to return. 

There’s been some speculation that Lance could return in-season, and while it’s plausible, it’s not likely. Reggie Bush famously returned from a fibula fracture in five weeks and most are in the six-to-eight week range. The current return-to-play protocols for Tightrope are at 12 weeks. That would mean everything would have to go well, and he’d need to be able to get up to speed quickly, just to get back by Week 13 or 14. 

However, if the 49ers are in playoff contention then, I can’t see them making the switch. If they fall out of contention, perhaps they’d get Lance some more reps in 2022.

UPDATE: Despite the 49ers losing Jimmy Garoppolo for the season to a broken foot in Week 13, Kyle Shanahan ruled out Trey Lance from returning to the active roster after the win over the Miami Dolphins.

Week 3 NFL Injury Report Analysis: Running Backs

D’ANDRE SWIFT, RB LIONS (sprained ankle)

D’Andre Swift was said to be on a play count heading into Sunday’s matchup. Ending with five carries and five targets, Swift’s production was largely on one big run and one big catch. Two plays disguised that Swift essentially becomes a big play lottery, though he is admittedly good at breaking big plays. 

The ankle didn’t appear to be an issue, but it was heavily taped. Swift made some hard cuts and jump stops, but the number of touches he got doesn’t give us any idea if he was having further trouble. Another week of time and treatment should help, though we’ll see in practice this week if he’s more normal and will be more normally used.

Swift should be a normal play in what is looking like a much more explosive Lions offense. Lions QB Jarred Goff and WR Amon-Ra St Brown figured something out late last season and it’s special. Looking at yardage and points lines tell me that the books are behind on figuring out that the Lions offense is better than expected all around.

ALVIN KAMARA, RB SAINTS (bruised ribs)

Alvin Kamara couldn’t go on Sunday due to bruised ribs, or what is believed to be bruised ribs. There’s been no official clarification, but Dennis Allen said on record that he didn’t believe the injury would affect Kamara for multiple weeks. Let’s go with bruised and assume that it should clear up, especially with the time off and no hits this week. 

That’s the simple expectation, but it’s unclear if this is a simple injury. As with Herbert and others, rib injuries can involve soft tissue as while as bone. Intracostal or chostocondral issues can also be in play and can be very painful, even just sitting around. Adding NFL impacts? No, thank you.

We should get early indication from practice reports if Kamara is limited. My expectation is we’ll see him all four days, but with limited contact. Kamara is a speed guy, so his legs will be fresh and it would be easy to scheme him away from between-the-tackles work. That means more Mark Ingram, but a pretty normal Saints offense.

Week 3 NFL Injury Report Analysis: Wide Receivers

JERRY JEUDY, WR BRONCOS (bruised ribs)

The shoulder is one of the most exposed parts on a modern player. Shoulder pads help with impact, but don’t give any support to the joint itself. We’ve seen more quarterbacks take injuries to the AC joint, the collarbone, and the shoulder labrum, often from falls or being spun to the turf, but it happens to receivers too, especially on plays with their arm extended and a defender coming over the top and landing on them. 

That’s exactly what happened to Jerry Jeudy … except the Broncos clarified after the game that it was Jeudy’s ribs that were injured. The initial word was shoulder, so I’m not sure what happened here. The mechanism is similar for both, being landed on with force, and functionally, the ribs is better for Jeudy. Arm strength and length is tougher to deal with that the pain of a rib injury, which can at least be dulled.

The Denver offense hasn’t found itself but remains talented. Expectations on the whole offense have to be dulled, but they’re home underdogs in Sunday Night Football odds. Check in with me on TheLines Injury Podcast (live on Twitter at 3:05 p.m. ET Fridays) to see if Jeudy’s progressing as expected.

Related: When will Cardinals WR DeAndre Hopkins Return?

Week 3 NFL Injury Report Analysis: Tight Ends


The posterior cruciate ligament is perhaps the least damaged of the four main ligaments of the knee in sports settings. It crosses behind the ACL, hence the name, and takes less stress when the leg is normally extended and running forward. For Dalton Schultz, it’s the “normal extension” that was the issue, when he was hit on the quad while planted. His leg went into mild hyperextension as he went down, but word from the team is that it’s mild. 

Schultz is likely to miss a week, maybe two with this, but he was more involved in blocking than catching with Cowboys back-up QB Cooper Rush, who appears to follow a pattern of second stringers being more comfortable with guys they likely worked with in practice. Losing Schultz isn’t going to create many more opportunities for CeeDee Lamb or even Noah Brown, but it is going to make it very tough for the offense to use 12 personnel packages, as they dealt with last year.

Those struggles without depth at TE might not be as telling, with different quarterbacks in play, but Kellen Moore is going to have to cross off a part of his offensive scheme now. That isn’t good, but it does leave deeper passes and shorter crosses. That could force more running and play action, but I expect similar struggles in coming weeks.

GEORGE KITTLE, TE 49ERS (strained groin)

Missing two weeks with a groin strain has cost a lot of headaches for the Niners, with some even questioning if George Kittle’s absence as a safety valve and primary receiver led to the playcalling of more runs and RPOs, leading to Trey Lance’s injury. That’s a lot of butterfly wings flapping to get there, but Kittle’s absence isn’t precautionary and it might not be done.

Kittle’s groin strain is more than just an annoyance. I’m told that it’s a significant strain. Remember, a strain is a tearing of muscle fibers. Doctors use grades to describe how many fibers are torn. Here, read this primer for more on that. Kittle’s strain is Grade II and is in the belly of the muscle, the thickest, strongest portion. More fibers torn means the strain takes longer to heal and that healing, done with scar tissue, is never as strong. Recurrence is more likely in the early stages, which is why Kittle’s recovery and on-field return can’t be rushed.

The adductor muscle is key to quick starts and strong pushes. Those are two skills that help make Kittle one of the better tight ends in the game and a drop in skill means a drop in production. I’m worried about Kittle in the short and medium term, especially in terms of being able to separate. I think this means more looks for Deebo Samuel, who can effectively take on some of Kittle’s blocking in his role as hybrid.

Quick Hits

Allen Lazard was still affected by his ankle injury, rounding cuts off the affected side and avoiding hard cuts altogether. Stepped on or not, that’s a more severe and lingering sprain than expected … Devin Durvernay couldn’t match his week 1 breakout because of a concussion. Concussion timelines are impossible to predict, but he could be practicing by Thursday if all goes well. Watch for that as a positive signal … Same for Hunter Renfrow, who also suffered a concussion … Gabe Davis didn’t play Monday, not that the Bills seemed to suffer without him. The ankle sprain should heal over the next week … Michael Pittman’s quad injury was played down, until Saturday when the Colts ruled him out. Going from questionable to out without a practice intervening is unusual and calls into question those “very physical practices” for the Colts in Week 2. Frank Reich said on Monday he expects Pittman to play this week … Taylor Lewan was carted off Monday night with a suspected knee injury. Any absence hurts the Titans offense, especially the passing game … Patrick Surtain will test his sprained shoulder in practice this week. He’s likely to play normally, but also likely to match up with Deebo Samuel, which is a huge test regardless of a bad shoulder … Jadaveon Clowney has already been ruled out for Week 3 after a severe ankle injury. No details yet, but the walking boot isn’t a good indication … Steven Means ruptured his Achilles and is done for the year. We’re seeing very good recoveries from this over the last few years due to better surgical techniques and better rehab … Injury numbers in Week 2 look similar to Week 1. That means, I think, that last year’s pattern of increased injuries to Week 6 is in play. Cinch up, boys, could be a rough ride.

Best of luck navigating the Week 3 NFL injury report.

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Will Carroll Avatar
Written by
Will Carroll

Will Carroll has covered injuries in sports for more than 20 years, working at places like ESPN, Baseball Prospectus, Football Outsiders, and FanDuel. He’s written four books, including the upcoming “The Science of Football” and consults with several pro teams. He is currently the Director of Bioanalytics for Northstarr, a sports science startup company.

View all posts by Will Carroll