DeSean Jackson’s surgery raises more questions about Eagles’ handling of injuries

If DeSean Jackson had surgery after he suffered a core muscle injury on Sept. 15, the Eagles wide receiver would have likely been back in time for Sunday’s showdown with the Patriots. It’s possible he would have returned sooner.

Spoiler alert: Jackson, instead, decided not to go under the knife for the first time, rehabilitated for the next six-plus weeks, returned for the Bears game on Nov. 3, and played only four snaps before aggravating his injury and then having surgery, ending his regular season.

While there was some uncertainty about the decision-making process at the time of the initial injury, coach Doug Pederson confirmed Wednesday that Jackson had the final say.

“Ultimately, it’s up to the player,” Pederson said in his first news conference since the Eagles placed the receiver on injured reserve last week. “I can recommend, but the player has to make that decision ultimately.”

It’s not as if the Eagles could have held down Jackson on the operating table against his will. But, could they have made a stronger recommendation? Could they have made a case for surgery, considering the usual timetable for recovery? And, aren’t they ultimately obligated to do what’s best for the team?

Pederson has been evasive about Jackson’s injury, but the one piece of information he was willing to divulge cleared the Eagles of any culpability in the decision to not have surgery two months ago.

“It’s elective by the player,” Pederson said. “We support this decision. We support DeSean. He wants to be out there with his teammates. It’s unfortunate that this happened, but it did. Injuries are a part of this game. [Reccurrence] of injuries are a part of this game.”

The Eagles have been down this path before, many times.

All NFL teams must weigh player safety vs. team interests. In New York, for instance, the Jets were engaged in a public dispute with guard Kelechi Osemele over whether he should have had shoulder surgery. He wanted it, they said he didn’t need it, and he was released after he refused to practice and had unauthorized surgery. Osemele has filed a grievance against the Jets.

The Eagles have found themselves on the flip side of that coin more than they likely have wanted over the last three seasons. Injuries have plagued them, and in situations when surgery was an option rather than a requirement, they have typically given players the freedom to choose their path.

Sometimes, it pays off. Sometimes it doesn’t.

In 2017, wide receiver Alshon Jeffery played with a torn rotator cuff, defensive end Derek Barnett and receiver Mack Hollins played with groin strains, and defensive end Brandon Graham played with a high ankle sprain.

Each of those players had offseason surgeries that carried over, in some way, into the 2018 season. Hollins needed a second surgery to correct a core muscle injury, and it’s fair to wonder whether he’s still hindered by the ordeal. Barnett played with a torn rotator cuff for two games the next season before finally undergoing season-ending surgery.

But there wasn’t much ambiguity about the severity or potential timetable for return because, in those cases, the injuries were unknown. Last season, however, there were multiple cases when players missed time under dubious circumstances.

There are far too many to render here, but the one that resonates the most in relation to Jackson was Jalen Mills’ foot injury that October. Initially, it didn’t seem serious, as Pederson called it “day to day.” But Mills was spotted wearing a boot several weeks later, and he eventually was placed on IR.

Pederson has a lot to consider when he’s at the podium answering questions about injuries. He doesn’t want to give opponents a competitive advantage, and he also has the players’ perspective to consider. In Mills’ case, he was giving the cornerback leeway to recover on his own, just as he did with Jackson.

“It’s on the athlete,” Mills said Wednesday. “We were still in the depth of the season at the time, and I still wanted to see how it would play out. [The Eagles’ medical staff] is good at giving you a timetable, how long it might take to come back from surgery, how long it might take if you rehab.”

Mills said he had no regrets. He didn’t have surgery until after the season and missed the first seven games of this season. But it’s fair to wonder how some of this year’s earlier losses, when opposing quarterbacks picked on the Eagles’ cornerbacks, might have played out had Mills had the procedure on his foot at the time of the injury.

Carson Wentz didn’t need surgery on the stress fracture in his back in December, but the Eagles clearly influenced the decision to shut him down. Wentz said that he wanted to keep playing, even after a scan revealed the break. But he also said that everyone involved agreed that there would be far too much risk.

The Eagles were 6-7 at the time, and the playoffs were seemingly out of reach. But they also had their franchise quarterback’s long-term future to cogitate.

Jackson received a three-year extension after the Eagles traded for him in March. But his acquisition was primarily about this season. He was to be the deep-ball missing piece on offense, one that could conceivably return the Eagles to the Super Bowl.

And it appeared as if that might be the case after Jackson caught nine passes for 154 yards and two 50-plus-yard touchdowns in the opening-day win over the Redskins. But he injured his abdomen in the first quarter of the Week 2 game at the Falcons – the Eagles originally listed it as a “groin” injury – and the next two months became a downward spiral into a lost season.

Pederson’s updates didn’t help the perception that no one knew exactly what was going on with Jackson. Originally, the coach listed the 32-year-old receiver as “day to day,” whether he was referring to his timetable for return or the Eagles’ handling of Jackson. As the days passed, and then weeks, though, it became increasingly clear that Jackson probably should have had the surgery.

On Oct. 7, Pederson was asked specifically whether Jackson needed surgery.

“No, nothing like that,” he said. “Just rehab. Just his normal rehab.”

But the rehab was more like abnormal. There was nary an appearance at practice, and when Jackson was spotted in mid-October, he was off to the side gingerly going through conditioning drills.

Jackson even called in his longtime trainer, Gary Cablayan, from Los Angeles to help with training. When the receiver finally returned to practice the week before the Bears game, he was a limited participant.

Pederson said two days before the game that he was “optimistic” Jackson would play, but when the receiver met with reporters for the first time since the injury, he was more subdued. He declined to answer any questions that sought to provide details on how the injury occurred, whether surgery was initially recommended, and why the recovery seemingly took so long.

“It’s been a while,” Jackson said. “So, you know, I don’t want to overshoot the gun, get myself too over-amped up.”

His restraint would prove to be prescient. Jackson lasted all of four plays. Pederson said that Jackson felt discomfort and was removed for precautionary reasons, and even went so far as to say the next day that he fully expected Jackson “to be good in a couple weeks” for the Patriots.

But it would be just another sleight of hand. Jackson was placed on IR later that day and had surgery by William Meyers the next day.

Jackson could return if the Eagles make the playoffs, but he wouldn’t be eligible to play until the second round, on the weekend of Jan. 11-12.

That would be about nine weeks after the surgery, or the approximate time between the surgery he could have had in September and Sunday’s meeting with New England.