NFL Week 4 Injury Report: Fantasy Advice Heading into the Weekend

Will Carroll@injuryexpertSports Injuries Lead WriterSeptember 26, 2013

NFL Week 4 Injury Report: Fantasy Advice Heading into the Weekend

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    Usually, I open my columns with a thought about trends or the story of the day, but today, I've made so many calls and gotten last-minute information on so many things, including Rob Gronkowski and Ray Rice, that to sit here and punch out thoughts would delay things.

    I won't do that, because the one thing that needs to be talked about is the evolution of concussion management. The NFL has taken justifiable heat for how it managed concussions for decades, but over the last few years, it deserves credit for implementing and iterating the policy. It is better, but the last couple weeks have shown it has to get better. The observer system, in particular, has clearly failed its intent.

    I'll get back to that next week, but for now, let's look around the league at all the impactful injuries.

Rob Gronkowski

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    Mark L. Baer-USA TODAY Sports

    INJURY: post-microdiscectomy

    OUTLOOK: expected to play Week 4

    I don't like being wrong. Ever. Ask anyone who knows me; I can be downright pedantic. I've had mentors who stressed attention to detail and focus on precision in a life-or-death manner. Boy, did I pick the wrong job.

    Here's the thing about "wrong": How most people use it is not how it actually is. Sure, I'm going to miss some things; I'm going to mistranslate or misunderstand. But what usually happens is that something changes. If two teams are talking about a trade and I hear from both sides that it's close, and then something better happens to drop the first deal, I wasn't wrong, but it looks that way. (This actually happened with the Trent Richardson deal.)

    So I like being right. With Rob Gronkowski, it wasn't hard. This was a six- to 10-week recovery, noted by Dr. Robert Watkins. When one of the best doctors in the world tells me something, I take his word for it. I'll add some context and some knowledge about the player and situation, and then I'll make my analysis. 

    Gronkowski was always going to be on the long end of the recovery because of the time line and because of his previous forearm problems. It's less the forearm than the worry of infection, but here we are, very likely to see Gronkowski make his debut on Sunday, giving Tom Brady a real target.

    Don't mistake "playing" for 100 percent. Gronkowski is going to have to adjust, and the medical staff will have to monitor him closely. I'd guess he'll see about half his normal snaps, but the Pats will do all they can to maximize those snaps.

    I'll be watching Gronkowski on Sunday morning to make sure he's ready to go and deserves to be in your lineup. On most rosters, he's going to be a must-play when they make him active.

Ray Rice

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    Rob Carr/Getty Images

    INJURY: strained hip flexor

    OUTLOOK: game-time decision for Week 4

    Ray Rice has been on the practice field both days this week, trending positive for a game-time decision in Week 4, per The Baltimore Sun. The Ravens tend to be conservative, and with the play they got last week from Bernard Pierce, they might be more inclined to let Rice rest if necessary.

    It's that "if necessary" that's the key. Rice is looking good and trending positive. Hip flexors don't tend to recur, and once they return to function, there's not much to be gained from a few extra days. The muscle is very easy to feel and deal with on a treatment and function level, so the medical staff has an advantage they wouldn't have over the knots of muscle that make up the quad or hamstring.

    Rice won't be overworked. Pierce might even get more touches, but this is Ray Rice, and he is getting paid a lot of money. Rice isn't wearing down, as some have suggested, or at least it's going to take a lot more evidence for me to buy into that. He has a muscle strain because he's human, not because his odometer clicked over.

Reggie Bush

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    Jeff Gross/Getty Images

    INJURY: inflamed knee

    OUTLOOK: likely to play Week 4

    Reggie Bush started off the Week 4 practices without limits. The Lions won't go full contact, but Bush is on the field and doing all the drills. Absent a setback, he's going to play this week, though I imagine he's a game-time decision in the sense that the medical and coaching staffs will want that one last look at him.

    Stories that Bush is practicing without a brace are something of a red herring. The problem is internal inflammation, not stability. A brace—at least one that would allow him to function—would do little to help the problem that he has. (The brace that Carlos Beltran of the Cardinals uses for a similar but more serious issue just wouldn't work in football.) 

    Expect Bush to be at a near-normal level of touches, though Joique Bell has proven he can handle a bit more. It wouldn't surprise me at all if there were a functional split, giving each more chances based on role and situation rather than any sort of mathematical division.

Le'Veon Bell

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    Geoff Burke-USA TODAY Sports

    INJURY: Lisfranc fracture

    OUTLOOK: expected to play Week 4

    Le'Veon Bell's return has everyone in Pittsburgh excited, except for Ben Roethlisberger. The QB apparently doesn't like that Bell came back from a Lisfranc injury that normally takes much longer. I'm sure the medical staff was happy about Ben's offhand remark as well. 

    Happy or not, Roethlisberger has a new running back behind him, but there are questions. Not so much about Bell's work ethic, but how much work he can handle. The foot is at the extreme low end of the normal recovery range for a Lisfranc injury, and there's a huge recurrence risk at this point. Note that the foot might be completely healed; what I'm talking about is averages.

    Bell is expected to take some of the load, but not a feature back's load in Week 4. In the past, he's shown he can take a heavy load, perhaps too heavy. I am worried about just how much wear and tear he took in his near-400-carry season in college.

    There are enough questions between the current injury and the past workload that I wouldn't rely on Bell this week. If you can afford to wait and watch for a week, you'll have a much better idea what he can and can't do and how Mike Tomlin will or won't use him. Remember, too, that the Pittsburgh offensive line has been very bad.

Nate Burleson

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    Jennifer Hilderbrand-USA TODAY S

    INJURY: fractured arm (non-football injury)

    OUTLOOK: expected return in Week 10

    A pizza, Nate? You can afford another pizza. Instead, Nate Burleson tried to catch the sliding pizza and ended up in an auto accident. The result is a broken arm, surgery to fixate the fracture and a loss of at least a month. Burleson lost much of last year to a broken leg, so maybe he should ramp up the milk drinking a bit.

    The Lions seem to think that Burleson's injury will take him only a month, but I have a hard time thinking that a wide receiver, one who relies on his arms for all sorts of activities and has a fracture that necessitated a plate, can come back so quickly. Even six weeks is a bit of a reach, but it's possible.

    Burleson will be able to keep up his conditioning and even practice to some extent, but he won't be game-ready until the fracture has healed. Unlike defensive players, he won't be able to wear a cast or really do much to protect it, though I'd sure be calling Evoshield for some kind of padding if I were him.

    Look for Ryan Broyles to step into Burleson's role, which could make him a good value in most formats, especially PPR. Opposite Calvin Johnson, Burleson has shown that single coverage makes for many opportunities. 

Roddy White

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    Stacy Revere/Getty Images

    INJURY: high ankle sprain

    OUTLOOK: will play in Week 4, but limited

    Roddy White is in the same situation in Week 4 as he was the first three. The worry here is that by playing through the injury, he's slowing the healing. (For more on that in video form, click here.) It's clear that White can play, but it's also clear that he can't play well.

    There is no less valuable record in sports than consecutive games. It's nice; it indicates a bit of luck, a bit of pain tolerance and a lot of power. But a game off here or there, when the best thing to do is rest, isn't weakness. In fact, forcing yourself into the lineup for a meaningless stat is selfish.

    White figures to be about like he has been the last couple weeks. There's been little if any discernible improvement. If the Patriots are able to shut down Julio Jones because of the matchup and White's inability to get clear of single coverage, Mike Smith is going to have to rethink his indulgences.

The Others

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    Terrelle Pryor: The NFLPA requested the league look into how Terrelle Pryor's concussion was handled on Sunday. The entire "concussion observer" program isn't working, and I'll have more on that this week. Pryor is about halfway through the protocol for a return to play, so it looks like Matt Flynn will get the start this week.

    Christian Ponder: Ponder's bruised ribs have many pondering (sorry) whether it's enough of an excuse to bench him. Matt Cassel is at the ready, and it wouldn't surprise me to see Ponder benched if the team falls behind or even if the box gets stacked against Adrian Peterson as it has been. If Ponder is your bye-week backup, you should check the waiver wire now. (UPDATE: Ponder has been ruled out for Week 4.)

    Larry Fitzgerald: Trusting an athlete to play through an injury and not make it worse is tough. The Cardinals' medical staff trusted Larry Fitzgerald, and he's shown that he can handle it. He made it through a full game in Week 3 after coming out in Week 2. Assuming there was no setback, with a week of healing and treatment, Fitzgerald should be closer to 100 percent and improving. He's a must-start.

    Andre Johnson: Johnson is back from his concussion, but a shin injury has limited him so far this week. Things are trending positive, but Johnson will be a game-time decision. It's looking more and more like DeAndre "Nook" Hopkins is going to be the WR1 rather than Johnson's complement sooner rather than later. Act now to trade for him before his value soars.