Week 1 Thursday report: Beware of Palmer, Cassel

September, 10, 2009
9/10/09
3:36
PM ET
Hooray! The 2009 season kicks off tonight and the anticipation, the buildup, the projections ... they all come to a head amidst the excitement of the Week 1 matchups. And, of course, the real football is not bad either.

Naturally, fantasy owners know that injuries factor into each week's contests, and while they cannot be predicted or prevented, there are certainly strategies for working around them. The best offense is a good defense, as they say, so arming yourself with injury-related news can only help you make better decisions about which players to sit and start as each week rolls along.

It's true that more and more teams are going the secrecy route when it comes to revealing injury specifics. We already got a taste of that in the preseason when Denver Broncos quarterback Kyle Orton held up a bloody finger for all the viewing audience to see, and then the Broncos later referred to it as an "upper extremity injury." Really? Seriously? This is the type of firewall that more and more teams are prepared to stand behind when it comes to injuries, reporting only what is required weekly by the NFL for injury reports and leaving open plenty of room for speculation.

To that end, I have compiled a few "injury guidelines" to help fantasy owners navigate the maze of injury-related information that emerges each week. While injury information might emerge in bits and pieces, swathed in insinuation and innuendo, there are some rules fantasy owners can follow to help them stay on course when assessing injury impact on their fantasy teams.

1. No two injuries are identical: Injuries often are graded according to severity, and even then, there are often subtle differences that dictate different healing times. Also, players heal at different rates, so just because one guy recovers in two weeks from an ankle sprain doesn't mean another will recover at the same rate, even when the injury involves the same structures.

2. Player position must be considered when evaluating the impact of an injury: Each position places different demands on the body, and therefore some injuries affect certain positions more. A classic example is the MCL sprain, which can be more debilitating for a running back, who must cut frequently, than for a quarterback. It often translates to different amounts of time missed.

3. A player's injury history is worth considering, especially if it is a repeat injury: A player who has been healthy for years and has his first injury will often return faster than a player who has sustained multiple injuries in the past. This is especially the case when it comes to repetitive muscle strains in the same region. In other words, a guy who just suffered his fourth right-sided hamstring strain should not be expected to heal as quickly or as fully as the guy who just had his first injury in that region. There are, of course, exceptions to this (which should always be stated, really, as the first rule of medicine).

4. The severity of an injury cannot always be determined by how it looks on the field: Appearances can be deceiving. Just because a guy gets up and walks off the field doesn't mean he's not seriously injured. Sometimes the full nature of the injury is not appreciated until a day or two later. The reverse can also be true. An injury can appear devastating because it is initially very painful, but then turn out to be not so bad.

5. Beware of the following overused phrases:

&#8226 He's "100 percent healthy." No NFL player is 100 percent healthy once the season starts. Usually the phrase means that an athlete has been fully cleared and has returned to play, but it doesn't mean there are no underlying long-term changes (such as cartilage damage) that could crop up again.

&#8226 It was a "mild concussion." A concussion is a brain injury. Brain injuries are always serious. Period.

&#8226 That guy is "injury prone." There is bad luck and then there is bad tissue. While there is never likely to be consensus on what constitutes "injury prone," it seems as if a guy who misses time with more than one injury in his career gets the label. Football is a contact sport. Injuries happen and most often because of a series of random events. The average playing career lasts just a few years for that reason. The term is unfairly overused and in fantasy, valuable players might be avoided because they have that label.

Now that we've covered some of the ground rules for interpreting injury information this season, let's look at some of the players I'm tracking as we head into Week 1:

Tom Brady, QB, New England Patriots: This is the final reassurance for Brady owners everywhere. He's back. He's healthy. And he's ready to go on Monday night. In case anyone hasn't followed along, here's what has happened with Brady in the past year or so. Week 1, 2008: Brady goes down early in the opener with what would eventually be diagnosed as a season-ending knee injury (a torn ACL and MCL, to be precise). Not long after undergoing reconstructive surgery on his knee, Brady suffered a setback because of an infection. It was at that point that the alarms sounding the premature demise of the face of football began to sound.

But once the infection cleared, Brady did what he always does. He went to work. He did the rehab, he did the conditioning drills, and he worked his way back in time to participate in June minicamps. He played in three preseason games and showed the world that his knee was healthy enough that he could run, throw and take hits. Of course he did give his team a mini-scare when he took a big hit to his throwing shoulder in Week 3, but it all turned out OK. We'll just have to wait and see how he's listed on the Patriots' injury report, but have no fear, fantasy owners, he will be ready to prove himself come Monday night.

Matt Cassel, QB, Kansas City Chiefs: We transition from Brady to his former understudy, Cassel, who went from not starting a game since high school to leading the Patriots through a pretty impressive season. Cassel parlayed his transformative season into a permanent starting gig a little farther west. But will Cassel, in fact, be starting for his new team this Sunday?

Cassel suffered a sprained left MCL when tackled during the Week 3 preseason game. Despite the fact that Cassel returned to practice this week, it has been on a limited basis, suggesting that he is not fully recovered from the injury. Nor should he be. Sunday will mark just one day over two weeks since the injury, enough time for some scar tissue to form, but not enough time for the ligament to fully heal and adapt to the stress of playing on it. Cassel, if he plays, will be in a brace, which does afford some protection in terms of lateral stability should he take a hit. However, it cannot remove the feeling of instability and discomfort that Cassel likely is still experiencing.

Although his position does not require the agility and quickness of a running back, Cassel does need to be able to move effectively inside and out of the pocket to escape the rush, and he needs to plant firmly on his left leg to deliver the ball downfield. Both of these acts are likely to be compromised so early in the recovery process. Oh, and by the way, he's facing the Ravens, so he will definitely need to be able to get out of danger. Ideally, Cassel will sit this one out and allow his knee some additional healing. But if he does end up playing, and coach Todd Haley has said that Cassel would need to put in a full practice by Friday in order to start, he will not be at his best.

Carson Palmer
Chris Graythen/Getty ImagesCarson Palmer is back at practice, but we still don't know how his ankle will react in a game situation.
Carson Palmer, QB, Cincinnati Bengals: In the Week 3 contest against the Giants in 2008, Palmer suffered an ulnar collateral (Tommy John) ligament injury, the reconstruction of which has become almost commonplace amongst elite throwers in baseball. It is a far less frequent injury in football, partially due to the fact that the throwing mechanics in football are less stressful on the elbow than in baseball. A direct insult to the arm, however, which is what happened to Palmer during a hit while releasing the ball, could result in an injury to the ligament and nearby tissues that could then be further impacted by throwing.

After considering his options, Palmer opted for the nonsurgical rehab route to heal his elbow, and in training camp, it certainly appeared to have been effective. Palmer was throwing the ball well, gradually building up the endurance of his arm, and everything was coming along beautifully ... until Palmer suffered a high ankle sprain on his left leg (plant leg) in Week 1 of the preseason games. He has just recently returned to practice. A major concern for Palmer was that if he were to return too soon and his ankle did not allow him to plant effectively, he could then end up putting excessive stress on his throwing elbow.

The good news is that Palmer has been able to return to full practice this week and has declared himself fully healthy and ready to go. It is worth noting, however, that Palmer has not been tested for a full game since Week 2 of last year. It is also worth noting that in his shortened season, Palmer took a number of hits, leading to a bloody nose and, ultimately, the elbow injury that would sideline him for the remainder of the season. No matter how good Palmer's ankle feels going into this game, the tissue is still repairing itself. If he is not well-protected Sunday, a setback to the ankle, or something else, is not out of the question.

Kyle Orton, QB, Denver Broncos: Orton's bloody finger injury, sustained during a Week 3 preseason game, told the tale of an open dislocation. The injury is called a dislocation because the joint at the tip of the finger was displaced, open because the skin was broken. Once the joint was reduced (put back in place), some of Orton's pain was alleviated immediately. The issue potentially threatening his start in Week 1 has more to do with the "open" aspect of the injury.

The cut required stitches, and healing soft tissue at the tip of the index finger can interfere with a quarterback's ability to throw the ball. In fact, many doctors will opt to leave the stitches in initially to help ensure that the skin does not reopen when the athlete begins throwing again. Orton was able to return to practice this week and was nicely outfitted with some thin gauze over the wound, as well as a glove. Orton clearly appears motivated to play. The key will be whether he can make all his throws (long balls will be the toughest), and if not, whether the Broncos will be amenable to altering the game plan to accommodate a short-pass and ground game. As coach Josh McDaniels said earlier in the week, "If he's able to be the most effective guy we've got, then certainly he'll play."

This might come down to a game-time decision, but chances are that Friday practice will give some clues. If Orton is unable to go, then backup Chris Simms, who himself just returned from a high ankle sprain, would get the nod.

Maurice Jones-Drew, RB, Jacksonville Jaguars: Jones-Drew suffered a shin contusion in the final preseason game, and there was some concern that the injury would affect his status for Week 1. Fear not, fantasy owners, as Jones-Drew returned to full practice Wednesday, and although he no doubt still has soreness in the leg, it does not appear that it will threaten his status or his production Sunday. Imaging tests, which could have shown additional soft tissue damage or a bone bruise, were negative. The Jaguars will face the Colts, who are expected to be without staunch run defender Bob Sanders, so fantasy owners should be looking forward to seeing what Jones-Drew can do.

Pierre Thomas, RB, New Orleans Saints: Thomas was another victim of a preseason MCL sprain, which he suffered during a Week 2 exhibition game, and as a running back he's more challenged in his position than the aforementioned Cassel. The medial collateral ligament reinforces the inner aspect of the knee joint and is subject to stress with lateral movements, particularly cutting toward the inside. Even a ligament that is healing can take a step backward in that process if aggravated early on. Just ask Pittsburgh Steelers running back Willie Parker, who suffered the same fate last year.

Thomas has not been able to return to practice as expected, another sign that he might be forced to sit out the season opener. According to the New Orleans Times-Picayune, Thomas was still limping Monday, and although he hasn't been ruled out for Week 1, the fact that he has not been able to do much beyond individual work is of concern. Naturally, the Saints (and his fantasy owners) would love to have him Sunday. At this point, though, that doesn't appear likely, and even if he does play, he is bound to see significantly less action. Fantasy owners should be making other plans at this point.

Jonathan Stewart
AP Photo/Chuck BurtonJonathan Stewart has returned to the practice field, but when will he return to form?
Jonathan Stewart, RB, Carolina Panthers: A nagging Achilles injury has kept Jonathan Stewart out of practice and out of games for virtually the entire preseason. If there's any good news here, it's that Stewart was able to return to full practice Wednesday. This news is encouraging heading into Week 1, but that's only half of the battle. We'll still need to see if he experiences any soreness following his return that limits him later this week.

The frustration with this kind of condition is that it is not the type of thing that disappears magically. It is typically associated with overuse, which means the more Stewart uses the tendon, and he will every time he pushes off with that foot, the more risk he has of aggravating it. The healthier the tissue is going into the season, however, the less chance of it flaring up. Knowing the talent of the medical staff in Carolina, this has no doubt factored into why Stewart has been so limited in preseason action and why he has been relegated to non-weight-bearing activities such as the bike and the pool. For fantasy owners, this might signal that Stewart will be used more sparingly at first to help ensure that he does not overdo it early on. So while he might look great when he's on the field, his time on the field might be limited, just to protect him.

Thursday and Friday practices will give us a better hint as to what the final status of these players will be heading into Week 1.

Out: Normally this space is intended for a list of key fantasy players, not including those who have been moved to Injured Reserve status, who are officially listed as "Out" for the upcoming game. As of now, there are no key fantasy options listed as Out, as of the most recent NFL injury report.

Note: Catch Stephania's injury chats Tuesdays and Fridays from 11 a.m. to noon ET, as well as Sundays from 10 a.m. to 10:30 a.m. ET. Also, she'll have another injury update Saturday.

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