The Dynasty Doctor: Week Two Injury Report
Editor’s Note: Injuries are a huge part of winning and losing each year in fantasy leagues. Staying abreast of the injury situations is key as knowing what to expect from your players health-wise in the short term can help you make educated decisions in managing your team. Lucky for us, we have a Doctor in the house. Dr. Scott Peak is an ABPN board certified neurologist and neuro-oncologist. He is also a dynasty football addict and huge friend of Dynasty League Football. He’s excited to lend his expertise in medicine with hopes he may help the DLF Team and its followers better understand medical conditions and injuries that may impact NFL players and dynasty football owners. If you have a question for The Dynasty Doctor, just click here. Please remember The Dynasty Doctor is geared towards questions regarding medical science, injuries to players and their collective impact in fantasy football. Stay tuned each week as we’ll post his thoughts each and every Tuesday.
This was a brutal week for injuries in the NFL. Eddie Lacy and Steven Jackson were the first fantasy football stalwarts of the day to sustain game-ending injuries. The early exits of Lacy and Jackson undoubtedly gave many fantasy football owners ulcers. Break out the Tums, as unfortunately that was a sign of things to come. Hopefully week three will be kinder to NFL players and fantasy football enthusiasts.
Larry Fitzgerald, WR ARI
Fitzgerald was listed as questionable, but did play in the game against the Detroit Lions. His hamstring was described as a ‘tweak,’ and it happened in practice last week. He was able to return to practice on a limited basis. Fitzgerald did suit up and play against the Lions, but with limited results (two receptions for 33 yards). After the game, he was quoted as saying he would play next week. Hamstring injuries can be very tricky and carry a high recurrence rate if not properly managed (15 to 30%). 80% of hamstring strains are grade 1 or 2. Grade 1 hamstring strains can take 3 weeks to recover, and grade 2 strains can be 4 to 6 week injuries. Miles Austin missed six games in 2011 from a hamstring injury. Fitzgerald is at risk for worsening the injury unless he gives it enough time to heal. He reportedly did not aggravate the injury in the Lions game, so that is good news. He is a tough player and if anyone can get through this injury, it is Fitzgerald. I am not worried about his dynasty value from this injury, but if he aggravates it by playing too soon, he could end up missing more games in 2013. If you own Fitzgerald, close monitoring is warranted. For more information, check out this article on hamstring injuries:
Ray Rice, RB BAL
When Rice got hurt while playing the Cleveland Browns, the entire fantasy football universe stood still. The injury did not involve contact, and there was no visible mechanism of injury. Rice received the handoff from Joe Flacco, took a couple steps, then fell to the ground in pain. The injury is a hip flexor strain. Reports out of Baltimore are that Rice may be able to play this weekend, but could be a game-time decision. That sounds more like a grade 1 hip flexor strain, which is the least severe. Grade 2 hip flexor strains can take 1-2 weeks to recover, and grade 3 strains are 6 weeks or longer. So long as Rice does not have a grade 3 strain, and that appears to be unlikely based on currently available reports, the range for return to play could be this weekend or 1-2 weeks. Either way, it does not appear to be a long-term injury, so his dynasty and re-draft value in 2013 are not significantly impacted. If you can buy Rice low from panicked owners, do so with confidence. Bernard Pierce gets a nice bump if Rice misses any games.
Vernon Davis, TE SF
Add Davis to the list of prominent fantasy football talents with hamstring injuries. At one point in the game, Davis had a step on Seattle Seahawks cornerback Richard Sherman, but the pass intended for him was a bit underthrown. Davis reached back, but could only watch Sherman intercept it. Davis grabbed his left leg, just behind his knee. This is a common mechanism of injury with hamstring strains. Either the hamstring stretches too far while the lower leg extends forcefully (running hard on a pass route), or the hamstring is strained while resisting leg extension (stopping suddenly to catch a pass). Both injury mechanisms are the result of hamstrings trying to oppose leg extension by quadriceps. As noted in the Fitzgerald comments above, return to play depends on the severity of the strain. No word yet from the 49ers on the severity of his hamstring injury. He was not able to return to play, and will be re-evaluated this week. Davis has not missed a game in five years and hopefully this trend will continue.
Steven Jackson, RB ATL
Jackson sustained a thigh injury on his touchdown reception in the first quarter of the Atlanta Falcons game against the St. Louis Rams. It is a bit strange as the tackle did not look that bad. Jackson did land hard on the ground as he dove to reach the pylon to score the touchdown as Alec Ogletree wrapped him up at his thighs. Maybe Ogletree hit Jackson hard in the thigh, and that might explain why Jackson did not seem too happy about it after the play was over. He got up, walked off the field, and did not seem to be in any pain. He was taken to the locker room and never returned to the game. Jackson does have a history of thigh injuries, but hopefully this is more of a bruise or contusion. Based on the mechanism of injury, I doubt he will miss much time, but further updates from the Falcons are pending as I wrote this article. As a comparison, Jamaal Charles sustained a quadriceps contusion a week ago, and managed to play quite well this week.
Eddie Lacy, RB GB
Lacy took a helmet-to-helmet shot from Brandon Meriweather in the game against the Washington Redskins. Lacy had a nice ten yard run on his first carry, but unfortunately he was knocked from the game on that play as Meriweather’s helmet hit Lacy on the side of his head. Lacy was able to get up under his own power and walk to the sidelines. He did not return to the game, suggesting he had persistent symptoms. The American Academy of Neurology has published guidelines on concussion grades, and these are ranked 1 to 3. Grade 1 and 2 concussions do not feature a loss of consciousness, unlike the most severe grade 3 variety. Return to play depends on resolution of symptoms related to the concussion, such as headaches, confusion, dizziness and memory loss. Players with grade 1 or 2 concussions typically return to play in 1 or 2 weeks, so Lacy may not be out long. Still, players with a history of concussions are 4 to 6 times more likely to get a second concussion, and given the NFL has taken considerable interest in this important issue, Lacy owners in dynasty should take note. I think Lacy will likely be back in 1 to 2 weeks, if not sooner. For a more detailed article on concussions, click here.
Reggie Bush, RB DET
Bush added a knee injury to his growing list of ailments to start the 2013 NFL season. Last week, he injured his knee, hip and dislocated a thumb. Fortunately, those injuries were minor and he was able to play this week. While playing against the Falcons, he took a shot to his knee, was able to return to play, but was pulled from the game given concerns about the injury adversely impacting his explosiveness. After the game, Bush thought he would be fine, but head coach Jim Schwartz seemed less convinced. An MRI of the knee was reportedly negative on Monday, and that is certainly a relief. Bush may get the questionable designation this week, but disaster has been averted. Fantasy football owners with Bush on their teams would be wise to acquire the services of Joique Bell, who might be the most important handcuff in fantasy football right now.
Maurice Jones-Drew, RB JAX
Jones-Drew sustained an injury against the Oakland Raiders for the second consecutive year. The injury is being called an ankle tendon sprain. He was downgraded from probable to questionable to return, and that implies the injury was more significant than the initial evaluation suggested. Head coach Gus Bradley felt Jones-Drew’s ankle was “a little loose.” That does not sound good to me. Tendons in proximity to the ankle include the posterior tibial tendon, the peroneal tendon and a few others. Posterior tibial tendon injuries can be a significant problem, especially if the tendon dislocates or is torn. The posterior tibial tendon helps the foot push up on the toes, and thus is important for explosive movements typical of a running back. Peroneal tendon injuries result when excessive dorsiflexion occurs (foot is moved up at the ankle, toes off the ground), such as when a skier digs their skis into the ground and is thrown forward, their feet bent upward as they fall downward. The peroneal tendons lift the forefoot off the ground, and can be injured or dislocated if excessive force occurs. These injuries may be misdiagnosed as an ankle sprain. Peroneal tendon injuries can also result in ankle joint laxity, and this is concerning given Bradley’s comments that Jones-Drew’s ankle was “a little loose.” Conservative treatment might include immobilization for four weeks, but if surgery is needed, it could stretch out much longer (2 to 4 months). Right now, the Jaguars are not saying much. It is certainly possible that Jones-Drew may be back sooner than I expect, and I am basing this information on the diagnosis of an ankle tendon sprain. Pay close attention to this injury, as it could get worse before it gets better, but I hope I am wrong about it. I would advise against trading for Jones-Drew as a buy-low until this issue is clarified by the Jaguars.
Hakeem Nicks, WR NYG
Nicks dislocated his middle finger playing against the Denver Broncos. He was able to return to the game, and was described as “fine” after the game was over. Nicks had a nice game (four receptions, 83 yards on 7 targets), and the injury did not seem to impact his production. Fantasy football owners can breathe a sigh of relief. Looks like Nicks will be just fine.
Malcom Floyd, WR SD
Floyd sustained a nasty hit in a game against the Philadelphia Eagles. He made a catch over the middle and his head bent downward as he was being tackled from behind. DeMeco Ryans came in front of Floyd and hit him straight on the head, jamming the force of his momentum into Floyd’s neck. The injury looked scary. Fortunately, Floyd was able to move his arms and legs after the hit, and ultimately head coach Mike McCoy described him as “okay” after the game. On Monday, McCoy felt it was “unlikely” that he would play week three. A return to play is likely once his symptoms have resolved and tests are confirmed negative for instability in the spine. Until that time comes, bump up Eddie Royal and Keenan Allen.
Andre Johnson, WR HOU
Johnson was evaluated for a concussion sustained in the fourth quarter against the Tennessee Titans. Johnson was hit in the side of the head by Bernard Pollard, who led with his right shoulder into Johnson’s helmet. Much like Meriweather’s hit on Lacy, this is an example of poor tackling technique that gets players concussed, on both sides of the ball. Amazingly, both hits did not get flagged, and that is surprising given the attention head injuries receive in the NFL today. Johnson was down awhile, but was able to walk off the field on his own. Owen Daniels described Johnson as “alright,” and that he wanted to go back into the game, but was not allowed. That is most consistent with a grade 1 or 2 concussion. I am cautiously optimistic Johnson will not be out long, but this will depend on how long his concussion symptoms last. Much like Lacy, he could return as soon as this week, but it is possible he could miss 1 or 2 games. Hopefully he feels better in the coming days and will not miss any games. On Monday, reports out of Houston were optimistic that Johnson could play this week.
Danny Amendola, WR NE
Amendola has an ailment described as a groin injury from torn adductors to a sports hernia. Groin pain can result from a variety of sources, such as a sports hernia, adductor strains or even a labral tear in the hip. If it is a sports hernia, those injuries can be difficult to diagnose. Sports hernias most commonly respond best to surgery, and if this is Amendola’s injury, he is looking at a 6 to 8 week recovery. Adductor strains are reported in athletes and are associated with groin pain. It occurs when athletes change direction quickly with forceful twisting motion at the hip. Return to play depends on the severity of this strain, and can be 2 to 3 weeks for mild injuries, or 8 to 12 weeks for more severe adductor strains. Best case scenario is a mild adductor strain. Notably, Amendola did practice on Monday, so that is encouraging. However, he was described as moving gingerly in his routes. I would not count on getting a clear idea about his injury from Head Coach Bill Belichick. Hopefully Amendola owners have secured Julian Edelman, as Amendola is at risk for missing multiple games.
See you next week!
Ken is on Twitter at DLF_KenK
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