Fantasy Football Week 4: Latest Injury Roundup and Analysis

Will Carroll@injuryexpertSports Injuries Lead WriterSeptember 24, 2013

Fantasy Football Week 4: Latest Injury Roundup and Analysis

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    Kevin Hoffman-USA TODAY Sports

    I spent hours as a kid with a deck of cards. I never got near the point of doing more than a quick trick trying to impress a girl in high school, but the time spent wasn't wasted. I learned how a lot of the tricks worked, even if I could never get them to work that way for me. (OK, cutting aces did come in handy a few times during the poker boom, but we won't go into that.)

    Misdirection and trickery are part of injuries as well. You show the shiny object over here, and the fans don't look over there. You say one thing while you sneak the ball out from under the cup. This column and all my injury writings are my homage to Penn & Teller's Cups and Balls

    If you know where to look, you might see how the trick is done. You might learn enough to hear the weasel words. You'll know when someone can deadpan through what they know is, politely, a lie. Just like a magic show, the Official Injury Report is built to fool you, but you can have some fun with it just the same.

    You may never end up able to master the trick, and you'll still be fooled sometimes, even after you know how the trick is done. What you learn then and learn to enjoy is just how good the magician is. With that and with nothing up my sleeves, let's take a look around the league:

Larry Fitzgerald

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    Matt Kartozian-USA TODAY Sports

    INJURY: strained hamstring

    OUTLOOK: expected to start Week 4

    I seldom trust athletes when it comes to their pronouncements about injuries. They live in a mindset we're not used to, denying pain, expressing optimism that flies in the face of fact. They're not trained to make medical judgements and are hardly disinterested observers at that.

    It's harder still for athletic trainers to trust an athlete. Even the best telling them "I can go" or "it will be fine" or that nod they give when told not to push it too much is going to end up on the medical staff if the player injures himself further. Balancing that with a coach pushing to have his star player back on the field is a nearly impossible task. 

    Larry Fitzgerald was given the leash, allowed to go out on the field and to say when his strained hamstring had had enough. He did well in Week 2, and in Week 3, it appears they all made the right decisions. Although Fitzgerald wasn't 100 percent, he was good enough to make it through the game. If he was holding back to keep his hamstring intact, that's long-term smart, and the loss is on everyone else not picking him up.

    Things look very positive. It's not often that a player tries to play through an injury like this and doesn't cost himself some extra time or worse, suffer any kind of setback. Give Fitzgerald and the Cardinals medical staff a lot of credit for this one. Expect Fitzgerald to get better from here. If you drafted Fitzgerald high, they may end up giving you enough points for an extra win.

Rob Gronkowski

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    Jared Wickerham/Getty Images

    INJURY: post-surgery lower back, post-surgery fractured forearm

    OUTLOOK: possible for Week 4

    This is the week that I've been targeting for Rob Gronkowski all along. Since he went to Dr. Robert Watkins back in the summer, the timeline for this kind of rehab has pointed here. The Pats and others have been optimistic, making many wonder if he could get back earlier, but while that was possible, this week's return is probable. There's a big difference.

    Of course, that doesn't mean Gronkowski will come back or that he'll be close to 100 percent. This was a significant injury and while Gronkowski has amped up his practice reps in the past 10 days, he still has yet to take contact. That's the last thing I'm looking for and as with Robert Griffin, there's a big difference between simulating it and experiencing it. 

    This weekend,'s Ian Rapaport said on NFL GameDay that Gronkowski was being held back by his forearm more than his back. I don't doubt Rapaport was told this, but it doesn't match up with what we've seen. In the drills that Gronkowski has done during practice, we've seen a lack of contact, but no lack of simple blocking or catching. Those kind of things would be more of a test on the forearm.

    That said, the forearm could be problematic. It re-fractured in a very odd fashion and adding in plates and a recurrent infection may have complicated whatever was going on. However, it's the back that remains untested. 

    Look for Gronkowski to take contact this week in practice. There's not a lot of full-contact tackling in NFL practices, but I think the Pats and Gronkowski will need to have some certainty and comfort before sending him out there. Once we see that, we'll know Gronkowski is back and no one will be happier than Tom Brady.

LeSean McCoy

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    Elsa/Getty Images

    INJURY: sprained ankle

    OUTLOOK: likely to play in Week 4

    One of the things I always look for is an athlete's reaction. Although I don't trust their words, I do look to see what they grab, how they move and what they do after the AT starts to work on them. LeSean McCoy's reaction to having his leg rolled up was pretty significant and it was scary, but it turns out it may have been as much about fear as pain.

    McCoy says he has a very minor ankle sprain, as detailed here by, and should have no problems by next week. (Early reports had the injury as a high ankle sprain, but that seems unlikely.) McCoy showed no real deficits after returning to the game, so at worst, he'll lose some touches to Bryce Brown, which isn't a bad thing for the Eagles.

    McCoy has shown great mobility this year, with a variety of quick hops, spins and who knows what else. Certainly, defenses would like it if he had a few less moves. The downside here is that we'll have almost no indication of what deficits he might have until he's in the game. It's doubtful anyone has the depth to make McCoy benchable, but monitor his practice this week to be sure. 

Ray Rice

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    Rob Carr/Getty Images

    INJURY: strained hip flexor

    OUTLOOK: likely to play Week 4

    So the Ravens say that Ray Rice is "close." That meshes with what we knew about Rice and his hip flexor going into their Week 3 game, but we want to know about Week 4 and beyond.

    Rice's hip flexor strain is one that can linger on and be very problematic for any sort of runner. The hip flexor is the one that helps raise the knee and anyone who remembers their middle school coach yelling at them about high knees will realize how key it is.

    Although Rice isn't a power back, he does push through tackles enough that losing that drive would limit him. Sure he could push, but he couldn't "reload" the legs for the next push, giving a defense more of a chance to bring him down. It will also affect his ability to make quick stops and the lateral hops often necessary in modern blocking schemes.

    Being close is nice, but I'll be looking for Rice to go through a full practice late in the week before I'm sure he'll be ready to go in what should be a favorable matchup against the Bills. The last thing people that drafted Rice in the first round want is another game off, no matter how close it was. 

Reggie Bush

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    Christian Petersen/Getty Images

    INJURY: inflamed knee

    OUTLOOK: unclear for Week 4

    As I noted in this video, the history and mileage on Reggie Bush is as big an issue as anything acute. Bush's knee swelling is a problem and does seem to come from some sort of trauma, but coming a few years after microfracture has to make us wonder whether the knee is grinding and if one wrong move created a bigger problem.

    If the problem is wearing in the articular cartilage, the thin layer over the ends of the bones of the leg that meet at the knee, this is very significant. While medical science is making advances, there's really not much we can do right now and especially short term to help the problem. Microfracture has poor long-term results in athletes and is a last chance for surgeons. Hyaline cartilage regrowth or replacement hasn't been done in high-level athletes, and no one wants to be first.

    This is going to end up a maintenance and pain-tolerance issue for Bush. The Lions' medical staff is going to have to find a way to keep him productive while holding the swelling down and keeping any internal damage to a minimum. The Lions are likely to have to keep Bush out until they do that or at least reduce his workload, which makes Joique Bell a good pickup, handcuff or not.

Steven Jackson

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    Scott Cunningham/Getty Images

    INJURY: quad strain

    OUTLOOK: unclear, unlikely for Week 4

    Steven Jackson's injury was originally talked down to a bruise, but the actual diagnosis, a quad strain came out last week here. I'm not sure I was the first to report it, but even then, my sources may have underestimated the issue.

    All indications to Sunday were that Jackson was looking at a low Grade II sprain, one that could have him back for next week. Now, there are reports and further indications that this is much more serious. It's unclear if it was downplayed or if Jackson had a setback during his rehab, but the Falcons don't expect to have Jackson back next week. With the bye in Week 6, the Falcons could elect to have Jackson wait until then.

    The Falcons did seem to miss Jackson, especially in short yardage situations. If that continues in Week 4, the coaching staff might push to have him back before the bye. Watch to see whether Jackson makes any progress over the next week, even limited action in practice. 

Jermichael Finley

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    Pat Lovell-USA TODAY Sports

    INJURY: Concussion

    OUTLOOK: unclear, could return for Week 5. 

    There are no clearer examples of concussion issues than the last two weeks for the Packers. Eddie Lacy was knocked out of the game and just plain knocked out by the kind of illegal helmet-to-helmet hit that the game needs to force out.

    This week, it was Jermichael Finley showing that rules won't take everything out. Finley was hit cleanly, but heavily in the head. He was twisted and the force was amplified by the players going in opposite directions. (Yes, I know that a head-on collision isn't purely additive, but this wasn't head on. It's the angular momentum acting on the brain that's as much an issue as the linear.)

    Finley tried to get up, wobbled a few steps in front of an official who had no reaction, and went to a knee. Trainers were out to him quickly and there was no hesitation in taking him off the field for treatment. Some might think skipping the concussion tests on the field is "against the protocol." It's not. A clear concussion doesn't need a test. There's room for some common sense here.

    Finley will be monitored and tested under the protocol, which means he could return at any time if he's able to pass the tests and get his brain back to normal function. As bad as the concussion looked, it's nearly impossible to put time frames on concussions based on what we see. Finley and the Packers get a little lucky with the bye coming in Week 4. They can take their time and hope that he's back for Week 5.

The Others

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    Doug Pensinger/Getty Images

    Terrelle Pryor: While details aren't firm after the late-night finish of the Monday game, Terrelle Pryor left with a concussion. He will go under the NFL's concussion protocol and may not be available for next week's game. As with any concussion, it is very difficult to put any timeline on the recovery. Matt Flynn would be the replacement.

    C.J. Spiller: Spiller left Sunday's game with a quad strain, but his absence has been called precautionary. Watch Spiller's practice reports, especially late this week. It looks like he won't miss any time, but the Bills might give Fred Jackson a few more carries to keep Spiller fresh.

    Le'Veon Bell: The Steelers had Le'Veon Bell in practice last week, and there are indications they believe he could be back for Week 4. As yet, he's done no hard cuts. The hardest thing would be an awkward cut to the outside of the affected foot or any sort of misplant. It's very hard to simulate that one, so the Steelers' medical staff is going to have to guess and trust Bell. His workload was so high his last season in college that I'm very worried. 

    Colin Kaepernick: Kaepernick's foot injury was thought to be no big deal, but he showed a marked reluctance to run against Indianapolis. Even the play-calling seemed to indicate that there was reluctance to free up Kaepernick, even against a defense that while physical, was hurting with missing starters. This is one to watch as the 49ers have to pull out of a tailspin quickly.

    Vernon Davis: The early indications were that Vernon Davis was going to be a GTD and that he was close. Now, it's sounding like he's no closer than he was at this time last week. The Niners certainly missed him. Look for any signs that he's doing more running by Thursday, but keep your Plan B tight end at the ready.

    Danny Amendola: Les Carpenter got the diagnosis right with Danny Amendola. I've said all along this was an adductor strain, but Carpenter's info narrows it further, and his article explains things very well. The timeline for his return is very optimistic in my opinion, but the Pats think he could be back as soon as Week 4. We'll have to watch this one for function, but I just can't see the quick return with the avulsion.