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Aaron Rodgers, Tony Romo show tricky nature of injuries

In Dallas this week, the hope was that a doctor's shot injected into Tony Romo's back would relieve the pain caused by his herniated disk. In Green Bay, they gazed at scans, trying to determine if incremental healing of Aaron Rodgers' collarbone had finally passed a nebulous threshold that would allow the Packers to clear him to play.

The take-two-aspirin-and-keep-your-fingers-crossed status of two of the NFL's most critical players just days from the final regular-season Sunday of the year underscored the unpredictable nature of the playoff race in the NFC. While in the AFC, every division and one wild-card berth has been secured -- there are four contenders for that last spot, all of whom, mind-bogglingly, need help to get in -- the NFC carries a special air of drama and pressure -- for players and coaches certainly, but in this case, even for team doctors.

On Friday, the Cowboys announced that Romo will be placed on injured reserve after undergoing back surgery, leaving starting duties for their most important game of the year thus far to journeyman backup Kyle Orton. Just one day earlier, Rodgers was finally cleared to play after missing seven games with a broken collarbone. The decision came at least one week after Packers coach Mike McCarthy said Rodgers looked like he was ready to get back on the field after watching him in practice and, according to McCarthy, at least three weeks after Rodgers felt it was worth the risk for him to return.

"We've gone through all the evaluations," McCarthy said. "We feel that it is time for Aaron to play."

With one week left, there are still 18 teams in contention to go to the Super Bowl, the most since 2008. But the last time an entire conference went into the final day of games without any division wrapped up, as the NFC is about to do, was 2000. Thirteen of 16 games might have playoff implications. Still, there are just two win-or-go-home matchups -- and both might turn on the fraught decisions made about the injuries to Romo and Rodgers at the highest level of the players' teams. That, too, seems fitting for a season in which 13 squads used backup quarterbacks extensively. With Orton set to start, that number will rise to 14, including all four teams in the games that will decide the NFC East and NFC North.

That, of course, raises questions about what goes into delicate deliberations over when injured players can return. Rodgers' readiness was so closely followed for so many weeks that Patrick McKenzie, the team's doctor since the early 1990s, has become a household name nearly as familiar as general manager Ted Thompson's. McKenzie maintains a medical practice in Green Bay too, so he surely did not miss the angst surrounding Rodgers' health. Still, while team doctors undoubtedly feel internal pressure, McKenzie said back in 2011 -- in an article that appeared on after McKenzie was named the league's top team doctor -- that he appreciated that McCarthy and Thompson never tried to get him to make a call that might put a player's long-term health at risk.

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Decisions about when players return to action are usually not made by doctors alone. They are often group decisions -- with the player, coach, general manager and doctor all having to sign off before the player can return. If any of those principals says "no," the player will not play. Athletic trainers and doctors frequently describe the decisions as weighing the risk of further injury versus the reward of getting the player back to action -- and players have been known to press doctors to clear them or pursue aggressive treatment even when nobody else in the organization is.

In 2011, McKenzie described what his interactions with McCarthy and Thompson were like in 2010, when the Packers placed 15 players on season-ending injured reserve and had many others hurt.

"When I have to tell Mike and Ted (a player's season is over), it's difficult, because they're disappointed and frustrated and it screws up everything they've got planned," McKenzie told "But it's not difficult, because they're such class guys. They accept it and move on and deal with it, which is not that way everywhere. Our medical staff is very fortunate that we've always had guys like that here."

However effective Rodgers and Orton prove to be Sunday, the two play-in games -- one between the Packers and Chicago Bears, the other between the Cowboys and Philadelphia Eagles -- will serve as a case study in the myriad ways backup quarterbacks can shape, and sometimes save, a season.

Nick Foles, who lost out on the starting job during the Eagles' training camp, seized it for good after Michael Vick was injured early in the year. As for the Bears, Jay Cutler has returned to his starting role after mid-season injuries, even though Josh McCown played well in his absence -- so well, in fact, that Marc Trestman's decision to go back to Cutler will surely be questioned if Chicago is eliminated this weekend. Against the Packers in his career, Cutler is 1-7 with 16 interceptions, his most against any NFL team -- he's thrown multiple picks in five of those eight matchups.

Still, the Eagles and Bears at least knew who their starting quarterbacks would be during practices earlier this week. The Cowboys clearly hoped Romo would be able to play. An epidural was administered on Monday, and on Thursday, Jason Garrett said it was not a requirement for Romo to practice for him to play on Sunday. Then, of course, came Friday's announcement ending Romo's season.

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Romo's reputation for big-game failures has been well-documented; he's 0-3 in regular-season elimination games and 1-3 in playoff games, which makes him 1-6 in his career in all-or-nothing contests. Orton, on the other hand, has not started since 2011 and has never played in a win-or-go-home contest.

Though Matt Flynn kept the Packers afloat while Rodgers was out, there was little question that, even with less practice time, Rodgers, who is 9-2 against the Bears in his career, would give the Packers a considerable advantage. Since Rodgers became the starter in 2008, the Packers are 57-27 with him and 2-7-1 in games during which he was injured or absent.

Whatever happens with the Packers and Cowboys at quarterback this weekend could either hasten the arrival of the offseason or send their teams into the playoffs.

With the hope of the postseason for so many teams and the dread of Black Monday looming side by side, there are at least 10 more things to watch, too:

1) Can Russell Wilson stay upright long enough to give the Seahawks the NFC West title and home-field advantage throughout the playoffs? The two games in which Wilson has been sacked the most in his career were both against the Rams, who got Wilson seven times in Week 8 and six times in Week 17 last season. Wilson's completion percentage has dipped by more than nine points in the past three weeks, a stretch during which the Seahawks have gone 1-2. Getting the passing game going against St. Louis on Sunday might bolster Seattle's title chances. The Seahawks' passing game ranks 26th in the league -- only one team (the 1982 Dolphins) with a passing offense ranked that low or lower has ever made the Super Bowl. The champions with the lowest ranked passing offense were the 2005 Steelers, who were 24th.

2) Want a peek at what the New England offense may look like in the playoffs? With Rob Gronkowski lost for the season with a knee injury, Danny Amendola and Julian Edelman have been targeted a combined 47 times in the Patriots' past two games (58.02 percent) while everyone else has been targeted just 34 times (41.98 percent).

3) How much will the Broncos' defense miss Von Miller? Of course, Oakland's Terrelle Pryor and the Raiders' 24th-ranked passing offense might not be the best measuring stick. Still, while Miller had just five sacks in nine games since returning from a six-game suspension for violating the league's drug policy, he led all 4-3 linebackers in quarterback hurries, collecting 27 before going down for the season with a torn ACL. The Broncos allowed 131.8 fewer passing yards with Miller than they did without.

4) Can Carolina beat Atlanta to win the NFC South and get a first-round bye? The Panthers held the Falcons to just 10 points in their first meeting this season, which was one of 12 games in which a Carolina opponent scored 20 or fewer points. The Panthers are 11-1 in those games. The Falcons have averaged just 22.2 points per contest this season, four fewer points than they averaged last year.

5) Do the Lions stop their freefall against the Vikings and save Jim Schwartz's job? The Lions and Vikings have both been eliminated from the playoff race, and both teams could have new coaches next season. Schwartz has two years remaining on his contract, but he might lose his job because the Lions are stagnating. They have finished above .500 just once since Schwartz took over in 2009. While his offense has ranked in the NFL's top five the past two seasons -- it's ranked third this season -- the scoring defense, which is currently ranked 17th, has never finished better than 19th. Since 2009, the Lions have the second-most accepted penalties against them in the league, and they've recorded the fourth-most giveaways.

6) Will a return home to face the Buccaneers cure what's been ailing the Saints' offense? New Orleans has scored 23 or fewer points in six of its past eight games after doing so just twice in the first seven games of the season. Drew Brees has been sacked a career-high 36 times. Either a win or a loss by Arizona would put the Saints in the playoffs, but they really need to win and hope the Panthers lose to Atlanta, which would give the Saints the NFC South title -- and at least one home playoff game. They average 15 more points at home than on the road this season, and allow seven more points on the road than at home.

7) Which Dolphins team shows up against the Jets -- and is it the one that's good enough to go to the playoffs? The Dolphins, like the other contenders for the final AFC playoff spot, need help, but first they have to help themselves. They were shut out by Buffalo last week after scoring at least 23 points in their three games before that -- including a Week 13 victory over the Jets in which they rushed for 125 yards. Against the Bills, however, Miami ran for just 14. The Jets' defense is currently ranked 11th. If it stays there, it would mark the unit's first time finishing outside of the top 10 under Rex Ryan.

8) Which team will get steadier quarterback play and more help for the playoffs: the Ravens or Bengals? Baltimore and Joe Flacco need assistance just to get in, while Cincinnati and Andy Dalton, who have already made it, are trying to improve their seeding. Flacco, who is hobbled by a knee injury, has his lowest passer rating in the division against the Bengals (75.7), and the offense is ranked 29th overall. Dalton has been erratic, enduring a four-game slump a month ago in which his completion percentage was 53.9 and he threw six touchdown passes and nine interceptions. In three games since then, Dalton has completed 65 percent of his passes while throwing nine touchdown passes and no interceptions. He struggles against the Ravens, though, with a 53.1 completion percentage in five games.

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9) Will the Texans finish with two victories and the first overall draft pick in 2014? St. Louis, which owns the Washington Redskins' first-round pick in 2014, would currently have the second overall selection. If the Texans beat the Titans and the Redskins lose to the Giants, Houston and Washington would be tied with 3-13 records. The tiebreaker is strength of schedule -- Houston's is currently .569 and the Redskins' is .520.

10) Is there any scoring record the NFL will not break this season? Teams have combined to score 11,322 points in 2013, topping last year's total through Week 16, which was then the most ever, by 408 points. Teams have scored 1,265 touchdowns, also the most ever through Week 16, and they have combined for 757 passing touchdowns -- again, tops all-time through Week 16. Finally, teams have combined for 62 pick-six interception returns for touchdowns. That's the second most in a season since the 1970 merger. The record is 71, set last year.

Follow Judy Battista on Twitter @judybattista.

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