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After 3 injury-marred years, the Eagles’ medical staff changes have the team trending in the right direction

Whether it's Nick Sirianni's approach with less practice and more rest, a younger roster, medical staff turnover, or just luck, the Eagles have been healthier this season.

Eagles running back Miles Sanders gets helped off the field from team medical staff members while getting a tap from teammate cornerback Zech McPhearson against the Las Vegas Raiders on Sunday, October 24, 2021 in Las Vegas.
Eagles running back Miles Sanders gets helped off the field from team medical staff members while getting a tap from teammate cornerback Zech McPhearson against the Las Vegas Raiders on Sunday, October 24, 2021 in Las Vegas.Read moreYONG KIM / Staff Photographer

Last month, Nick Sirianni knocked on his news conference podium when the Eagles’ low number of soft-tissue injuries was brought to his attention.

“I’m not superstitious at all. I’m not,” he said. “But there you go.”

Luck, or a lack thereof, certainly factors into injuries, especially in a contact sport like football. Sirianni, despite his predilections, acknowledged as much with his gesture. His team, for the most part, has avoided casualties since.

But the Eagles coach also knows there are injuries that can be preventable or minimized with proper safeguards in training and treatment. Muscle strains or tears, particularly in the lower body, are some of the most common in the NFL, but they are also generally considered the most avoidable.

The 2018-20 Eagles couldn’t avoid them, or most injuries for that matter. But the soft-tissue kind plagued them and was one of the many reasons for their regression following the 2017 championship season.

The numbers, though, have turned. The Eagles, who had the third-most adjusted-games lost to injury in the three previous years, are on track to be one of the league’s healthiest teams this season.

Through 13 games, the Eagles had 18 players from the 53-man roster miss a total of 66 games to injury. Last year, they had 34 players out for 152 games over the same period of time.

The lower-body soft-tissue figures are just as good: The Eagles have had only six players miss 11 total games this season compared with the 17 who missed 43 games last season.

The practice and preseason restrictions the pandemic forced on NFL teams played a role in the large numbers a year ago. Injuries increased across the board. But this year has presented challenges, as well, and the primary reason for the Eagles’ overall improved health may actually be their reduced practice time.

It started in training camp with shorter and fewer workouts, and has continued in-season, most recently with Wednesday’s normal practice now just a walk-through.

“I do believe it’s a result of how we’re doing things and how we’re practicing,” Sirianni said last month, just before he scaled back on Wednesdays. “I think the system that we are in right now as far as how everything’s organized has been good throughout.

“The other teams in the NFL that have done it this way have done well.”

The Eagles have been trending in this direction for the last several years, too. Some former staff members thought there was a direct correlation between the lighter camps and the resting of starters in the preseason and the team’s early-season injury woes.

But it was speculative. The Eagles had undergone a medical and training staff upheaval following the 2017 title. The team’s top two doctors and head trainer weren’t brought back for various reasons. Their replacements were followed by more replacements.

Eagles general manager Howie Roseman acknowledged that the changes may have contributed to the malaise. He vowed after each of the last three seasons to correct the problems and then made changes at the top of the strength and sports science staffs.

But he seems to have settled on his leaders. Arsh Dhanota was hired before the 2019 season as chief medical officer and head team physician and is the point person for all the medical and training departments. And Tom Hunkele and Ted Rath were brought on as directors of sports science and performance, respectively, in February 2020.

They have helped implement a proactive approach to training, one based on tracking workloads by GPS, and modeled after some NBA and Premier League organizations. The NFL, though, plays fewer games and has a longer offseason than those leagues.

Some teams still believe that the best way to get players ready is by having no rest for the weary.

“Football is like boxing,” a medical source from another team said. “You got to be able to spar.”

But if there was a consensus on how best to handle player health, every team would follow it. Sirianni adopted the Eagles’ medical staff’s approach and took it even one step further, partly to prepare for the new 17-game season. Practices were streamlined, over-30 veterans got more time off, and starters hardly played in the preseason.

There was a brief spell early in camp when the Eagles had a dozen players sidelined by injury, most of the soft-tissue variety. But only one starter, safety Anthony Harris, has missed games because of a muscle strain. And it’s unclear if his groin or the other listed injury to his hands was more responsible for his absence.

Nevertheless, the Eagles have had far fewer players nursing soft-tissue injuries.

“I’ve added quite a bit into my just weekly regime, whether it’s massages or just doing different things [with] stretching, strengthening my muscles,” said tight end Dallas Goedert, who previously missed time with calf strains. “But then also I feel like we’re practicing less, we’re spending less time on the field. My body is going through a lot less wear and tear.

“The things that I was asked to do the last three years compared to this year is a little bit different.”

The Eagles suffered several season-ending or significant injuries early in the season. Starters Brandon Graham (Achilles tendon rupture), Brandon Brooks (torn pectoral muscle), and Isaac Seumalo (Lisfranc foot fracture) went down in Weeks 2-3.

But those were likely unpreventable, unless age in the case of the 33-year-old Graham or the 32-year-old Brooks was a factor. Roseman likely lessened the Eagles’ odds for injury this offseason by simply parting with veterans, like Jason Peters, DeSean Jackson, and Alshon Jeffery, who were often in the training room.

The roster got younger, but that doesn’t always equate to a healthier squad. Sometimes it just takes time to implement change, and with stability in the sports medicine department, perhaps that is why the Eagles’ novel approach has apparently come to fruition.

“It’s tough because I don’t want to take credit from anyone or put blame on anybody. Injuries are really finicky,” Eagles center Jason Kelce said Wednesday. “A lot of the time the strength department takes the blame, or the training room, or the doctors. Sometimes it is what it is and there’s luck and there’s [injuries] that are preventable and you have to really have an honest assessment of which ones are preventable and which ones are things we could be doing organizationally to do a better job of staying healthy.

“And the Eagles certainly the last three years have done their best to limit injuries. But a lot of guys who were on the staff during the Super Bowl run, the strength coach we had before — Josh Hingst — they were all in place with [former coach] Chip Kelly when we had like the lowest injury rate in the history of the NFL that first year he was there, and everybody was talking it up: ‘This is why the injury rate was that.’”

From 2013 to 2015, when Kelly was in charge, the Eagles finished first, fifth, and sixth in Football Outsiders’ rankings for adjusted-games lost to injury. But they’d always been one of the NFL’s healthier teams under the stewardship of team physicians Peter DeLuca and Gary Dorsheimer and trainer Rick Burkholder.

Chris Peduzzi replaced Burkholder when he left with Andy Reid in 2013, and even after Doug Pederson took over for Kelly, the Eagles didn’t miss a beat and finished seventh in 2016 and 11th in 2017. But they ranked 32nd, 21st, and 30th from 2018 to 2020, and only the 49ers and Jets had more games lost over that span.

But it wasn’t just the numbers that spoke to Eagles’ medical unease. There were multiple examples of dubious recovery and questionable practice in the treatment of players.

The only notable mystery this season, if it qualifies, is why the Eagles haven’t yet opened the practice window for Brooks when Sirianni said in September that his injury wasn’t season-ending. The coach said he would have an update on Brooks’ timeline after last week’s bye, but that didn’t prove to be the case.

Quarterback Jalen Hurts suffered an ankle sprain two weeks ago against the New York Giants, and while he said he would be ready the following week against the Jets, it was merely over-optimism on his part.

It has since been reported that Hurts has a high-ankle sprain, which typically takes three to four weeks to recover from, and his status for Tuesday against Washington is questionable. But the Eagles should enter the game not as shorthanded as their opponent, who had as many as 21 players in COVID-19 protocols as of Thursday.

Despite the spike around the nation and in the NFL, the Eagles have only wide receiver Quez Watkins and practice squad running back Jason Huntley on COVID-19 reserve. They are only the fourth and fifth players on the team to be placed on the list since the start of the regular season. Only four other NFL teams have had fewer.

The Eagles have increased their efforts to combat the spread of the virus. They’ve spaced meetings out, increased the mask-wearing, and amped up the messaging on social distancing away from the NovaCare Complex.

“We’re very aware obviously of everything that’s going on and we’re taking precaution of what we’re doing,” Sirianni said Wednesday. “I’m not going to get into everything that we’ve done that’s different, but we’re taking precaution to make sure that we have a competitive advantage over other teams.”

Of course, their cases could jump, and the same could be said of injuries. All it takes is an unfortunate bounce or two. Kelce knows as well as anyone.

He said he should be ready to play in his 119th straight game on Tuesday against Washington, despite not being able to finish against the New York Jets two weeks ago. The 34-year old aggravated an ankle injury that had bothered him earlier in the season. The week before, he tweaked his knee and left for a stretch.

Kelce’s toughness and devotion to his teammates and his craft can’t be underestimated in his durability. But having missed most of his sophomore season, and four games two years later, he knows his longevity and the Eagles’ recent injury good luck can be snatched away in a moment.

“I’ve been really, really fortunate,” Kelce said. “I don’t want to take anything away from that. I’ve missed games before, but my mindset wasn’t any different. I just got hurt. But I’ve been lucky the last few years to play a lot of games.”

Knock on wood.