Despite coming off the franchise's first Super Bowl win, the Eagles turned over their medical staff leadership this offseason. Head athletic trainer Chris Peduzzi "stepped down" in February and head physician Peter DeLuca and internist Gary Dorshimer were let go in June.
For a professional sports team having just won a championship, it was virtually unprecedented.
Adding to the peculiarity was that the Eagles had so many players – most of the them expected to have substantial roles in 2018 – returning from surgery. While several have returned without delay, there have been abnormalities and further injury.
Wide receiver Mack Hollins had sports hernia surgery on the same February day as defensive end Derek Barnett, but he was sidelined with a groin injury during training camp and placed on injured reserve before the season opener. Safety Chris Maragos has missed more than a year with a torn ACL and a torn PCL in his knee and is seemingly nowhere near a return.
Quarterback Carson Wentz needed just over nine months to recover from a torn ACL and a torn LCL, but there was awkwardness early in camp when he was a full participant one day only to be dialed back and limited the next month without a medical setback.
There was further embarrassment when the medical staff failed to diagnose running back Jay Ajayi's torn ACL against the Vikings in October. It's unclear when and if the doctors looked at the injury, but at some point in the second half he was outfitted with a left knee brace.
The Eagles have also endured more than their share of soft-tissue injuries dating back to the start of camp. In just the first eight games of the season alone, the Eagles have had six players with soft-tissue leg injuries miss a total of 19 games.
The most significant has been Darren Sproles' hamstring strain. The running back/returner has missed seven games and will be sidelined Sunday against the Cowboys after he suffered another setback during practice Wednesday.
"People heal differently," coach Doug Pederson said Friday when asked why Sproles' recovery has taken so long. "Everybody is different. I'm not a doctor."
But eight weeks – nine if last week's bye is included – is unusual. Last year, for instance, the Eagles had eight players miss time because of hamstring strains, and two games was the longest absence related to the injury.
But Sproles hasn't been the only one to miss an extended period with a hamstring strain. Safety Corey Graham, who is slated to return Sunday against Dallas, has missed three games. And cornerback Sidney Jones will miss his third straight game. There was also the bye week during the period they were sidelined.
Pederson has acknowledged the Eagles' increased number of soft-tissue injuries. Defensive tackle Haloti Ngata missed three games with a calf strain, running back Corey Clement missed two with a quadriceps strain, and linebacker D.J. Alexander missed two, also because of a quad.
"There's not a ton of research out there on soft-tissue [injuries]," Pederson said. "So we're doing everything we can, whether it's through sports science or strength and conditioning, our doctors, our training staff. We're trying to gather all the information we can, our GPS tracking.
"I'd rather have soft tissue quite frankly than eight ACL injuries, and you lose players for the rest of the year. We're trying to put a finger on it."
Not every soft-tissue injury is the same. There are varying degrees of severity. The strains can be in different locations. And, as Pederson noted, not every player heals the same. Sproles is 35, he plays a position with a lot of movement, and he's coming off an ACL tear that ended his season in September 2017.
He finished the first game of the season without injury, but he strained his hamstring during the Wednesday practice before Game 2. He missed the next two games, but at the start of the following week he was on the field at the NovaCare Complex, at least stretching with the rest of the team.
That was the last time Sproles was seen at practice – until Wednesday. The Eagles forecast his return the day before when they released receiver/returner DeAndre Carter, and before practice Pederson said, the expectation was that Sproles would be ready for Dallas.
But he aggravated the strain Wednesday – Pederson declined to say how – raising more questions about how the Eagles have handled his recovery.
"I'm getting information from our medical staff, I'm getting it from our doctors and I'm getting it from the player," Pederson said. "And quite frankly, the bottom line is how the player feels, where is he at in his return to play, and we felt very, very comfortable moving forward to make that decision."
Two weeks ago, when asked if there was more to Sproles' hamstring injury than just a strain, Pederson said, "There's nothing really beyond that." On Friday, he did say that he was optimistic the running back would play sometime this season.
Sproles hasn't been available to interview, and he didn't respond to a text message Friday seeking comment.
Graham said that he never had a hamstring injury until he came to the Eagles last year. He missed two games last season with what he said was the same grade of injury as this year's – only worse.
"It was a Grade II," Graham said. "But it's a different spot. The place I had it last year ended up being way worse. And last year, I had two Grade II's."
Asked why this year's hamstring strain took longer to come back from, even though it wasn't as severe, Graham said that he wasn't 100 percent when he returned last season and played an additional month with the injury before he felt back to normal.
"Really, it's about the training staff, whether or not they allow you to come back," Graham said. "We have a hamstring protocol here where you have to go through different phases."
Is last year's protocol different from this year's?
"We don't make those decisions," Graham said. "We just do what we're told."
Injuries are as much a part of playing football as the goalposts. Chance plays as much a role as anything in the number. The Eagles, under the previous regime, had dubious injuries, diagnoses, or lack thereof.
Wide receiver Jordan Matthews said just six months ago that the DeLuca-Peduzzi medical staff misdiagnosed two of his injuries in his first stint with the Eagles. The team's doctors failed to detect an aortic aneurysm that could have killed former Eagles long-snapper Jon Dorenbos had he not been traded and his new team, the Saints, not discovered his condition before last season.
DeLuca and Dorshimer have long had great reputations. They each worked with the Eagles for more than 20 years and remain with the Flyers, where they've also been for nearly the same span. But they were jettisoned in June. A source told the Inquirer and Daily News then that the Eagles wanted to go in "a new direction."
Dorshimer declined to comment via email and DeLuca didn't respond to a voice message.
In August, the Eagles announced the hiring of Stephen Stache as head physician and the promotion of Christopher Dodson as head orthopedic surgeon. They also created a new position and named Shireen Mansoori director of rehabilitation.
The Eagles declined interview requests for anyone from the medical staff or for executive Howie Roseman, who oversees the department and made the hires. Roseman has been available to the media only twice since June – on Sept. 1, after roster cuts, and on Oct. 29, after he traded for receiver Golden Tate – long after the medical changes were made.
Peduzzi said in February, two weeks after the Super Bowl, in a statement released by the Eagles, that he was stepping down to "take some time off." But sources close to the situation said that the trainer, who had worked for the team in some capacity for 19 years, was forced out.
Peduzzi, who currently works for the Rothman Orthopaedic Institute, recently declined to comment. The Eagles didn't hire his replacement, Jerome Reid, until June.
Dodson had previously been the Eagles' assistant team physician. He is also the head physician for the 76ers. Stache is on the Philles' medical staff and is also a consultant for the 76ers. Both are part of the Rothman Institute, like DeLuca and Dorshimer. Players are free to seek treatment from other physicians, and some still see Dorshimer, per team sources.
The Eagles were snake-bitten by injuries last season. They lost five key players to season-ending injuries – tackle Jason Peters, linebacker Jordan Hicks, Wentz, Sproles, and Maragos.
Peters, who tore his ACL, hasn't missed a game this season, but he has played through a quadriceps strain and biceps tear. Hicks, who ruptured his Achilles tendon, hasn't missed a game. Wentz was held out of the first two games, but he's been healthy since his return.
Maragos, who's on the physically-unable-to-perform list, declined to comment when he was asked Thursday if the medical staff turnover had anything to do with his lengthy rehab.
Receiver Alshon Jeffery (shoulder), defensive end Brandon Graham (ankle), Hollins, and Barnett had surgery for their injuries after the season. Jeffery sat out the first three games but has been healthy since his return.
Graham, who played through the postseason with a high-ankle sprain, didn't have surgery on his ankle until May. Asked why there was three-month gap before he went in for a cleanup, he declined to comment.
Hollins practiced as early as the spring, but he struggled in camp and was soon sidelined. He missed all the preseason, but days before the opener against the Falcons, he said that he would be ready. He was placed on IR, however, just hours before kickoff. Pederson has said that Hollins' groin injury is unrelated to his sports hernia.
Barnett appeared to have no problems following his sports hernia surgery, but he tore his rotator cuff in Week 4, and after playing two games he was shut down for the season and placed on IR.
The Eagles have seven players on IR – safety Rodney McLeod (knee), receiver Mike Wallace (fibula), tight end Richard Rodgers (knee), cornerback Elie Bouka, Ajayi, Barnett, and Hollins — and can bring two off on short-term designation. Defensive tackle Tim Jernigan, who returned to practice this past week but remains on the non-football injury list, had back surgery in May after he suffered an injury away from the Eagles' practice facility.
The Eagles have an assortment of other injuries — tackle Lane Johnson's knee and center Jason Kelce's knee, for instance — that players have simply opted to play through.
Many of the over-30 players the Eagles decided to retain or sign this offseason have been injured — Sproles, Ngata, Corey Graham, Peters, Wallace – and it would be fair to question the decision to have so many. But there have been just as many or more under 30 who have been sidelined.