Stephania Bell: Fantasy Football
Here’s what we know as of Saturday afternoon:
Peyton Manning, Denver Broncos, ankle (P): Manning’s ankle issues are not behind him, but he’s proven he can play through the discomfort and still be effective. His biggest challenge is making sure he doesn't end up on the bottom of a pile where the vulnerable right ankle could get twisted. He certainly knows how to make adjustments, but Manning can’t be disappointed that the Chiefs will be without one of their key pass-rushers, Justin Houston, who has already been ruled out with an elbow injury.
Knowshon Moreno, Denver Broncos, ankle (P): This is the biggest (pleasant) surprise of the weekend injury report. Based on how Moreno looked last Sunday night both during the game (coming on and off the field in the final quarter, limping significantly) and afterward (in a walking boot, on crutches), his chances of playing this Sunday appeared slim. Moreno was reportedly dealing with a bone bruise in his ankle -- and a “significant” one at that -- suggesting his status for Week 13 was a legitimate concern. After all, bone bruises are not to be ignored. A severe bone bruise can take weeks to resolve and continued trauma to the joint, even in the simplest form of high-impact weight bearing, can lead to further problems.
That's why it was no surprise when Moreno was a non-participant in Wednesday’s practice, but it was a surprise when he not only turned up Thursday, but also looked to be moving pretty well on the practice field. By Friday, he increased his workload to “full” participation, and the team was confident enough in what they saw to list him as probable.
Now comes the tricky part. While Moreno is clearly on track to play Sunday, how much of a workload can be expected, given that he is coming off the recent ankle injury? It’s reasonable to think Montee Ball could see some extra touches in an effort to off-load Moreno. It’s also reasonable to think that how much Moreno plays will be fluid depending, at least in part, on how his ankle withstands the early work. In any case, the outlook for Moreno is far brighter than it was as recently as Wednesday. Despite the late kickoff Sunday, fantasy owners can feel confident that Moreno is expected to be on the field against the Chiefs.
Adrian Peterson, Minnesota Vikings, groin (P): It’s no surprise that Peterson got two days off from practice this week. After all, he has recently been nursing a sore groin -- not that anyone noticed with his 146 yards rushing and a score in Week 12 -- and the team plans to continue to rely on Peterson’s legs. Coach Leslie Frazier came right out and said as much, according to ESPN's Michael Wright. “We feel like we've got the best running back in the NFL on our team,” Frazier said. “So we’re going to try to play to our strength.” He will not get any arguments from fantasy owners.
Matt Forte, Chicago Bears, knee (P): Even with coach Marc Trestman’s confidence earlier in the week that Forte would be ready to go by Sunday, it’s still reassuring to see the probable designation next to his name at the end of the week. Forte hyperextended his knee in last Sunday’s game but, as noted here Tuesday, he returned to finish out the game, a positive sign. After sitting out Wednesday’s practice, Forte returned to a limited effort Thursday followed by a full practice Friday. He is expected to play as usual against the Vikings.
Zac Stacy, St. Louis Rams, concussion (P): The news for Stacy got better and better as the week went on and he increased his involvement in practice. By Friday, he was a full participant and as ESPN’s Nick Wagoner notes, Stacy was cleared to play against the 49ers. Barring any surprise return of his concussion symptoms, Stacy will be on the field Sunday.
DeAngelo Williams, thigh, Jonathan Stewart, ankle and Mike Tolbert, knee, Carolina Panthers (Q): It can’t be a good sign when the entire backfield comes into a game listed as questionable; the challenge then is figuring out who is more questionable than the others. Williams may be at the top of that list, with the Panthers expressing genuine concern about his availability. Williams did not practice the entire week because of a quad contusion sustained in last week’s game, and while he has not been ruled out, there is not a lot of optimism. Coach Ron Rivera made it plain and simple when talking to reporters after Friday’s practice, saying there are "a lot of concerns with DeAngelo."
The team seems far more hopeful when it comes to the availability of Stewart and Tolbert, who were limited in practice late in the week but are expected to play.
Andre Ellington, Arizona Cardinals, knee (Q): Fantasy owners do not like late-week downgrades, therefore they will not like seeing this change in Ellington’s status. According to ESPN’s Josh Weinfuss, Ellington injured his left knee late in Thursday’s practice. He did not practice Friday and will be a game-time decision, per head coach Bruce Arians. While Ellington sounded hopeful Friday that he would be able to play, there are the effects of a cross-country flight to consider, and the coach’s hint that he wants to be cautious with his explosive back. Even if Ellington is active, this setback won’t do anything to help his fantasy owners’ desire to see him get increased work, at least not this week.
Chris Ivory, New York Jets, ankle (P): Things didn't look so good for Ivory after he had to concede carries to teammate Bilal Powell in the Week 12 contest because of an ankle injury. He didn't miss any practice days, however, and after a limited effort Wednesday and Thursday, he returned to full practice Friday. The probable tag gives us confidence he will play. How well Ivory’s ankle holds up during the game may dictate just how much action he will see.
Ben Tate, ribs (P), Houston Texans: Perhaps the most notable thing about Tate here is that he is only listed on the injury report because of his ribs. His other injuries seem to have healed. Naturally, Tate is expected to play against the Patriots.
Ryan Mathews, San Diego Chargers, hamstring (P): As his teammate Antonio Gates noted, hamstring injuries are “tricky.” Despite coach Mike McCoy downplaying Mathews’ hamstring issue coming into Week 12, Mathews aggravated the injury in the third quarter of Sunday’s game and made an early exit. The setback didn't appear to be severe, since Mathews was back in practice on a limited basis Thursday, followed by a full workout Friday. He’s not out of the woods by any means, but he is expected to play against the Bengals.
Frank Gore, San Francisco 49ers, ankle (P): Gore is again listed as probable because of his ankle. He was held to limited practices this week (last week he was a full participant each day), indicating perhaps a little more soreness in that ankle, but he is in no danger of missing Sunday’s game.
Marshawn Lynch, Seattle Seahawks, knee (no designation yet): Lynch continues to be listed on the injury report because of his knee, but he has yet to miss a game. Expect him on the field for a big Monday night game against the New Orleans Saints.
Darren Sproles, New Orleans Saints, ankle (no designation yet): Sproles was inactive in Week 12 because of injuries to each leg, an ankle on one side and a knee on the other. Considering the Saints’ Week 12 game came just four days after their Week 11 contest, the move to hold Sproles out was wise. While the Saints did not offer much in the way of detail, Sproles’ return to full participation in practice Thursday suggests he is much improved after the week off. Sproles is expected to be back on the field Monday night when the Saints travel to Seattle.
Brandon Marshall, Chicago Bears, quadriceps (P): Marshall was limited Thursday because of the quad, but to the relief of his fantasy owners and Bears fans, he was back in full practice Friday. At probable, he is expected to play.
Cecil Shorts, groin (P) and Mike Brown, shoulder (Q), Jacksonville Jaguars: By now, the practice pattern for Shorts is familiar enough that fantasy owners would perhaps be more surprised if he was not on the injury report. Listed as probable, Shorts is expected to play as usual. Unfortunately for him, he draws the Joe Haden coverage tag this week. Brown is a different story. He is contending with an AC sprain suffered two weeks ago and sat out last Sunday’s game. This week he will be a game-time decision, according to coach Gus Bradley. The team will work him out pregame to make a final determination as to his status. For fantasy owners who are considering Brown, be sure to check pregame inactive reports.
Steve Johnson, Buffalo Bills, groin (P): Johnson has hinted all week that he would be ready to take the field this Sunday after sitting out the Bills’ last game. That game was two weeks ago, as the Bills had a bye in Week 12, conveniently allowing Johnson some extra recovery time from this latest soft tissue injury, a right groin strain. He doesn't appear to be limping into this week’s contest, either, practicing fully each day and designated as probable. It should be nice and warm for Johnson, too, as the location for this week’s game is the Rogers Centre in Toronto, where presumably the roof will be closed.
Santonio Holmes, foot/hamstring and Jeremy Kerley, elbow, New York Jets (Q): Holmes returned from his hamstring injury following the team’s bye, but the injury is clearly not behind him. In fact, one wonders if he took a step backward. Holmes was limited in practice Wednesday but did not practice at all Thursday or Friday. The Jets are calling him a game-time decision and even if he does play, it’s questionable how much he’ll contribute. Meanwhile, Kerley is on the mend from an elbow injury and only shed his non-contact jersey this Wednesday in practice. He remained limited throughout the week and will likely come down to a game-time call.
T.Y. Hilton, Indianapolis Colts, shoulder (P): There was some understandable concern when Hilton did not practice Wednesday, but that was alleviated when he returned Thursday. Hilton put in full practice efforts both Thursday and Friday, and at probable, he is expected to play.
Hakeem Nicks, New York Giants, abdomen (P): Nicks says he could have played last week, but the Giants didn't agree. The abdominal strain that sidelined him still kept him limited in practice Wednesday and Thursday, but Nicks turned it up for a full practice Friday. At least fantasy owners can feel confident that Nicks will play this week, despite the late start. If only results on the field could be equally assured. It’s hard to believe, but Nicks has yet to find the end zone this season.
Eddie Royal, San Diego Chargers, toe/chest (D): Royal has been a fixture on the injury report, so the initial designation of questionable didn't raise a huge red flag. On Saturday, however, the Chargers downgraded Royal’s status to doubtful, according to Michael Gehlken of the San Diego Union-Tribune. The chest injury Royal suffered last week appears to be the culprit (the toe has been a long-standing ailment), and he appears very likely to sit this one out.
Percy Harvin, Seattle Seahawks, hip (D): (Note: This section has been updated to reflect Harvin's designation.) Harvin did not practice Saturday and the team has officially listed him as doubtful for Monday night’s game. After Harvin’s initial limited outing in Week 11, the Seahawks said that he experienced only minor soreness and hinted at removing restrictions from his playing time. Head coach Pete Carroll later seemed to retreat a bit emphasizing the team would be cautious with Harvin and would manage him going forward. Perhaps this limited practice is part of the management plan, which is entirely reasonable. But if Harvin is experiencing some lingering soreness or discomfort, it goes without saying the restrictions on his playing time will not be removed.
Tony Gonzalez, Atlanta Falcons, toe (Q): Gonzalez has come into the game listed as questionable the past two weeks because of his toe injury, but has played. While he is clearly not 100 percent, as is evident by his limited practices each day, Gonzalez is expected to play Sunday in Toronto against the Bills.
Antonio Gates, San Diego Chargers, hamstring (P): Gates hasn't been on the injury report much in the last two years, a welcome change for him and for fantasy owners after battling plantar fascia issues for more than two years. He resurfaces there this week, however, after suffering a hamstring injury in last week’s game. Gates had two days off to rest, and despite returning to practice Friday, he indicated if the game were to be played that day, he was not sure he could have taken the field. He described the injury as “tricky,” according to the San Diego Union-Tribune. “It's one of those injuries where you can't fully grasp whether or not you can do something because it's all running,” Gates said.
Friday’s practice gave the veteran tight end an opportunity to gauge his health, and it sounds as if the vibe was largely positive, given the probable tag assigned to him. Gates is expected to play but, as he noted, it’s a tricky injury. The hope is that he can get through the game without a setback.
Julius Thomas, Denver Broncos, knee (Q): Thomas sat out last week’s game when his hyperextended right knee had not recovered to the point of allowing him to participate. Although the injury, sustained in Week 11, was not considered particularly serious in that there was no significant structural damage, Thomas still had enough soreness and stiffness to limit his mobility throughout the week. The decision to hold him out appears to have been a wise one, and Thomas was held to limited practices throughout this entire week. But as ESPN’s Jeff Legwold notes, Thomas is on track this week to play against the Chiefs.
Rob Gronkowski, New England Patriots, back/forearm/hamstring (Q): It is not unusual to see Gronkowski on the injury report, but seeing him listed as questionable is a bit surprising. Since returning from offseason surgeries, Gronkowski has played each week, although the hamstring ailment is a new addition in recent weeks. The tag is likely a reflection of Gronkowski’s limited practice sessions. As of now, it appears he will take the field as usual Sunday.
Jordan Reed, Washington Redskins, concussion (Q): Reed sat out the Week 12 game because of a head injury and remains uncertain for this week. He has returned to daily limited practices and he said he expects to play, but Washington, assigning Reed a questionable tag, appears less ready to formally commit. According to ESPN’s John Keim, the Redskins are indicating Reed will play as long as there is no recurrence of symptoms. This is a Sunday night game, so fantasy owners should have an emergency backup plan in place.
Jay Cutler, QB, Chicago Bears, ankle: Cutler has graduated from a hard cast to a smaller brace on his left ankle, but he remains sidelined by his high-ankle sprain. The Bears still describe him as week-to-week.
Jason Campbell, QB, Cleveland Browns, concussion: Campbell was ruled out earlier in the week. Brandon Weeden gets the start for Cleveland.
After being admitted to the ICU and undergoing extensive testing, Finley made enough improvement by Monday evening to be transferred out of intensive care, although he remained in the hospital. Finley posted this note about his progress on Twitter: “I’m happy to report that I have been transferred out of the ICU and that I have full feeling in my arms and legs. As importantly, I was able 2 walk to & from the shower today, which was badly needed after yesterday’s victory!” On Tuesday afternoon, ESPN’s Ed Werder reported that Finley is expected to be released from the hospital within 24 hours.
So what does his future hold? It’s too early to say. In the immediate sense, the primary goal following an injury where there is bruising of the spinal cord is to ensure the patient is stable, both medically (e.g., cardiac) and from an anatomical standpoint: Are the cervical vertebrae and the ligaments that support them intact? Is there a fracture that is either displaced or that could displace with movement, which would threaten the spinal cord?
The other immediate priority is to reduce any swelling around the cord. Swelling can cause compression, which impairs nerve function, something the patient perceives as loss of feeling and/or loss of strength in the extremities. The more pronounced the swelling and the longer it endures, the greater the risk of permanent damage. As the swelling resolves, the patient is observed carefully to see how the return of nerve function is progressing. In Finley’s case, based on his increased activity later in the day, he was progressing quite well.
But he is hardly out of the woods. There will be additional tests and consultations with various spine experts to evaluate what factors may have contributed to this episode. In some cases, the athlete is found to have underlying spinal stenosis, a narrowing of the spinal canal which houses the spinal cord. Decreased space around the spinal cord means there is less room for the spinal cord to move (which it normally does when the spine bends) without abutting up against another structure. Rapid extreme movements -- such as those resulting from a violent directional blow to the head and neck area -- that force the cord to collide with an adjacent structure can result in bruising (contusion) of the delicate tissue. A narrow canal increases the risk of such contact for the spinal cord, and therefore potentially increases the risk of serious injury. Stenosis can be something the athlete is born with (congenital), or it can be acquired as a result of changes in the tissue. A bulging disc, for instance, can occupy valuable space within the canal.
According to Werder, doctors told Finley that they believe his injury was caused by extreme torque and that it will not require surgery. Some athletes have returned to play following spinal cord contusions, including Baltimore Ravens linebacker Jameel McClain, but much depends on what unfolds over the course of testing following an injury. The athlete’s complete history -- including any prior episodes of neurological events -- will be evaluated in the context of determining the next steps. That process, along with the time allotted to ensure full recovery from this latest episode, is not quick, nor should it be. The Packers are not issuing any timetable for Finley, a perfectly reasonable approach given all the uncertainty around this injury.
In the meantime, the Packers are forced to evaluate their pass-catcher situation. With Finley out indefinitely, and Randall Cobb out until at least Week 15 with a fractured fibula, the status of James Jones becomes all the more important. Jones sat out Week 7 with a sprained PCL, not surprising based on the nature of the injury. The question now is if he will miss another week, or if he can return to help the team in Week 8.
Coach Mike McCarthy told reporters Monday that the team would have a better idea of Jones’ outlook Wednesday. McCarthy said the timeline provided to him regarding Jones’ injury was “probably two, possibly three weeks,” adding, “He’s genetically gifted, so we'll see what happens.”
The key for Jones is having enough quadriceps strength to control his knee with dynamic movement. Until he tests it on the practice field, there is no way to measure how close he is to a return.
Roddy White, WR, (hamstring/ankle): This appears to be shaping up as the week White is forced to miss the first game of his professional career. Some might argue that it should have come sooner; in retrospect, even White acknowledged the high ankle sprain has been more problematic than he expected. Nonetheless, he was determined to try to gut it out until the team’s bye week in an effort to contribute at some level.
After suffering a setback with the ankle in Week 4, then a hamstring injury in Week 5, it appears a single bye week isn’t enough time to get him back in playing shape. In fact, White was recently seen limping in the facility, as reported by ESPN.com’s Vaughn McClure. Not practicing at all this week certainly isn’t improving the chances that we'll see him on the field Sunday and at this point, it seems even White would acknowledge that he needs to get his body right in order to better help his team.
Steven Jackson, RB (hamstring): Jackson is another Falcons player who apparently has yet to get his body right. With no explanation coming from the Falcons through Thursday’s practice, his obvious absence was a bit puzzling. From the outset, Jackson’s hamstring injury was expected to cost him multiple weeks, but there were hints that he would be returning following the team’s Week 6 bye. That bye has now come and gone and Jackson has yet to practice with his teammates. According to McClure, Jackson is now expected to miss his fourth straight game.
Significant hamstring strains can take multiple weeks for recovery, and had there not been hints prior to the Week 5 game that Jackson was “close” to returning, this continued absence might not garner as much attention. Is the team simply being cautious, or is there something more serious to explain his situation? It sounds as if Jackson’s healing just hasn’t progressed in the latter phases, as the team had hoped.
Speaking to reporters after practice, coach Mike Smith offered this assessment: "It's a hamstring that's been tough to come back from at this point in time." Smith noted that once doctors have cleared Jackson to return to practice, he will be back out there with the team. With Jackson not even being cleared to practice yet, it becomes virtually impossible to make a game plan for a return.
He is a high risk for re-injury, not only because hamstring strains are known for recurrence but because of his age (30), his history (multiple soft tissue injuries) and his position (running back), all of which are associated risk factors. While it’s understandable that no one wants Jackson to return too soon and suffer a major setback, the increasing length of his absence is in and of itself worrisome, in that it reflects just how serious this injury actually was, an injury he suffered not even two full games into the season.
Jason Snelling, RB (concussion): On a positive note for the Falcons, Snelling returned to full practice this week after suffering a concussion in Week 5. As long as there are no setbacks, he should be available this weekend. That may turn out to be a big deal, as Jackson continues to be out of the picture.
Seattle SeahawksMarshawn Lynch, RB, hip (probable): Lynch popped up on last week's injury report with a hip issue. The worrisome part was that Lynch missed Friday's practice, then came into the Week 6 game listed as questionable. Coach Pete Carroll appeared to dismiss it, saying, “We did treat Marshawn for a little hip thing this week, but he's fine."
The last time a Seahawks player had “a little hip thing,” it was newly acquired wide receiver Percy Harvin in June OTAs, and we know how that ended up. Carroll’s report of Lynch being “fine” was on point, however, given that Lynch not only played last week but racked up as many receiving yards as rushing yards and netted two touchdowns, much to the delight of fantasy owners.
With this week’s game coming only four days later, it’s no surprise he saw some rest early in the week, including an off day Tuesday. He comes into this game as probable, however, not questionable like last week, leaving no doubt he will be taking the field in this divisional matchup.
Zach Miller, TE, hamstring, (probable): The Seahawks have been without their starting tight end the past two games as he has been nursing a hamstring injury. This week, Miller makes his return to the playing field after putting in back-to-back full practices Tuesday and Wednesday.
Although there are never any guarantees that an athlete is completely past a hamstring injury before he returns to competition, the fact that Miller was close to being cleared for last week’s game -- Carroll had called him a game-time decision in advance of Week 6 -- is encouraging. The bigger question might be whether Miller will see meaningful targets the way he did in Week 3, when he scored two touchdowns. At least fantasy owners can have confidence in the expectation that he will indeed be active for this game.
Arizona CardinalsLarry Fitzgerald, WR, hamstring, (probable): Fitzgerald is going to play, just as he has since originally injuring his left hamstring in Week 2. The question fantasy owners have is what to expect from him on the field, a question made a little more challenging considering the matchup with Seattle’s outstanding secondary.
Fitzgerald seemed to have made improvements in his recovery until last week, when he suffered a second injury. Up until game time, there was much rumbling not only about whether Fitzgerald, listed as questionable, would be able to play, but also whether he would serve as much more than a decoy. The assumption was that he would not be able to stride fully, which would make it difficult to gain separation. Fitzgerald ended up starting that game, and, when it was over, he had proved he was more than a decoy. On one play in particular, a 75-yard touchdown reception, Fitzgerald looked to be running just fine.
But that’s not the entire story. Fitzgerald is dealing with a right hamstring injury to go along with his previously injured left side. After Sunday’s game, he was in enough discomfort that he was having trouble bending down in the locker room, according to The Arizona Republic. Still, Fitzgerald was listed as a limited practice participant Monday and Tuesday, followed by an upgrade to full participation Wednesday.
It’s worth noting that these practices are significantly scaled back on a short week, with walk-throughs and light drills largely constituting the bulk of the activity. Light work is perhaps the best thing for Fitzgerald, as rest might be his best friend while he tries to manage these bilateral hamstring issues. It’s hard to know what to expect as far as productivity from Fitzgerald on Thursday night, given that he is not truly 100 percent healthy and faces a tough matchup. But everyone knows what to expect from him as far as effort, and he has made it clear he plans to play.
Here are updates on more of the fantasy-relevant injury situations that I've been following ahead of Week 5 of the NFL season.
New England Patriots
Rob Gronkowski, TE (back/forearm): It feels like a broken record when discussing the injury status of Gronkowski and Danny Amendola; both are practicing on a limited basis, and both will likely be listed as questionable heading into Sunday's game in Cincinnati. Another week of practice means another week of confidence for Gronkowski, which seems to be one of the primary issues for him in stepping back onto the playing field. From a practice perspective, he may still be limited on reps, but Gronkowski is participating in all forms of drills. Other than facing a true opponent -- which is a legitimately different experience from practicing with teammates -- there is little left for Gronkowski to test. But after nearly a full year of recovery from various surgeries, and the setbacks associated with some of those surgeries, who can blame him for wanting to feel extra confident that he is prepared to take the field again?
After sitting out last week’s game in Atlanta, it seems unlikely Gronkowski will opt to test his readiness in Cincinnati just one week later. But a Week 6 home game in New England against the New Orleans Saints just seems more likely. It has the makings of an exciting matchup, taking place in Foxborough, where Gronkowski will be surrounded by friends and family and undoubtedly welcomed with thunderous applause. More important, he will have just passed the 16-week mark since undergoing back surgery (the operation was June 18). Three months post-surgery is typically the soonest return for an athlete after this type of procedure; this is Gronkowski's second such operation (albeit at a different spinal level). Tacking on another month's worth of additional training and conditioning can have a profound impact on confidence level.
The extra time also allows the forearm more time to adapt to the workout stresses being placed on it, which in turn helps prepare it for the in-game loads it will encounter. Of course, no one can offer a foolproof guarantee that there is zero rate of reinjury, and the last time Gronkowski set foot on a playing field, he reinjured himself. Whatever hesitancy he may be experiencing is certainly justified. Look at it this way, fantasy owners: While he's out, readying himself for his NFL return, at least Gronkowski isn't adding any new injuries to the list.
Danny Amendola, WR (groin): Meanwhile, Gronkowski's teammate Amendola continues to make progress, but is no sure bet to return in Week 5 either. He remains on a limited practice schedule as he increases the level of demand on what is certainly a still-healing adductor tear. The hardest part about gauging Amendola's return is trying to determine when the risk-reward changes so the reward of him playing outweighs the risk of reinjury. If Amendola is still lacking power or mobility (particularly with hard breaks on routes or any sharp directional changes), he runs the risk of further injury. These things are always hard to measure in practice, but even more so if the athlete is not consistently working at full speed. By Amendola's account, the progress has been substantial, but the Patriots tend to be conservative with these soft tissue injuries and Amendola's history has to make them a bit more cautious than usual. If Amendola does manage to play in Week 5, it's hard to envision him playing at full speed for a full game.
Stevan Ridley (knee) and Brandon Bolden (knee), RBs: Also among the Patriots' MASH unit is running back Stevan Ridley. Ridley bruised the area above his knee in last week's game, and has not practiced. If he has been dealing with significant swelling, the rest will move him further toward the goal of being available Sunday than trying to practice. That said, Ridley should be on the field Friday to improve his chances of playing this week. Meanwhile, Brandon Bolden has been a regular on the injury report because of his knee and so far this week, he has been kept to limited practices. The fact that he has been a participant to some degree bodes well for his chances of suiting up this weekend, barring a setback.
Ahmad Bradshaw, RB (neck): The news for Bradshaw is not good. He was held out of Sunday's game after suffering a neck injury in the Week 3 contest against the San Francisco 49ers, and the word from the Colts was that he was still being evaluated. The evaluative process continued into this week, as Bradshaw traveled to California for a consultation with noted spine surgeon Dr. Robert Watkins (who operated on both Peyton Manning and Rob Gronkowski). According to ESPN.com reports, Bradshaw is still undecided about surgery, but in the meantime, he has yet to practice since the injury. Last year, Bradshaw suffered a neck injury in Week 2 which caused tingling in his hands. He underwent a battery of tests and later revealed the injury to be a bulging disc.
"It's pretty much like an inflamed disc, and it's just sitting right on the spinal cord, I guess," Bradshaw told the Newark Star-Ledger at the time. After the symptoms subsided, Bradshaw was cleared to return to play but he knew then the symptoms could return at some point. The Colts have not indicated whether this current injury is related to the problem Bradshaw had last year, but it would certainly make sense, particularly given the chronic nature of disc injuries. These injuries can go through quiet phases, not provoking any symptoms, until there is an event which triggers a worsening of the injury and an inflammatory reaction. While Bradshaw considers his options, fantasy owners should consider whom they would choose to replace him for this week and, quite possibly, for the remainder of the season.
Darren McFadden (hamstring) and Marcel Reece (knee), RBs: McFadden left Sunday's game in the first half with a right hamstring injury, and only returned to the sideline as an observer for the second half. Although the Raiders did not specify the severity of the injury, McFadden's absence from practice is telling. He is no stranger to lower extremity injuries and has missed numerous games throughout his career as a result. Although McFadden entered the season healthy, it seemed only a matter of time before another soft tissue injury cropped up. One month into the season, McFadden is contending with a hamstring ailment and looks to be in danger of missing at least Week 5, if not longer. The Raiders will play in an unusually late Sunday night game (the result of sharing a stadium with the Oakland Athletics, who will host a playoff game hours before), so fantasy owners should make alternate plans in advance.
Reece also left Sunday's game early with a non-specific knee injury (sprain) that warranted an MRI, but he returned to practice on a limited basis Wednesday, then followed it up with another limited practice Thursday. Apparently the injury is not as serious as it first appeared, and with McFadden likely out, Reece's availability as a complement to Rashad Jennings becomes more important.
Green Bay Packers
Eddie Lacy, (concussion) and Johnathan Franklin (foot), RBs: Lacy suffered a concussion on his first carry of Week 2, and was held out of the following game. The Packers had a bye in Week 4, giving Lacy some additional down time. Coach Mike McCarthy indicated prior to the Week 3 game that Lacy had made good progress, so it came as no surprise that he was back practicing with his teammates this week. In fact, Lacy has been a full participant and barring a setback, he'll play this Sunday.
With James Starks already ruled out, Franklin would figure to be next in line behind Lacy, but he is dealing with an injury of his own, a foot ailment suffered late in the Week 3 game where he replaced the injured Starks. Franklin was able to practice fully both Wednesday and Thursday and should be available for Sunday's contest against the Lions.
Jermichael Finley, TE (concussion): Finley suffered a concussion in Week 3, then provided some insight into just how sobering an experience that can be when he posted a video describing the event on his personal website. As ESPN.com's Rob Demovsky pointed out, Finley's video was the first time that the media had heard from him following the injury. In his video, Finley talks about the play where the injury occurred, and the initial symptoms he experienced after regaining consciousness, which included visual disturbances and balance issues. Finley has made great improvements since the injury, as evidenced by his clearance to return to football activity after passing numerous tests. As Demovsky reports, Finley called the testing process a "long haul," but seems to appreciate the steps that are in place, perhaps as a result of his personal encounter with a head injury. "You have to do several things to get back, and you have to respect the league for doing it," Finley said. "It's much respect from me."
Kansas City Chiefs
Jamaal Charles, RB (toes): Charles popped up on the injury report with the body part listed as "toes," presumably because of the "extensive blisters" coach Andy Reid described after the Week 4 game. ESPN.com's Adam Teicher reports that Charles participated in the team walk-through Wednesday despite not formally practicing, a good sign for his likelihood of playing Sunday against the Titans. Charles was upgraded to limited practice Thursday, and appears to be on track for Week 5.
The play ended with Lacy's concussion on a helmet-to-helmet collision with Redskins safety Brandon Meriweather. (Meriweather would exit the game early in the second quarter with a concussion of his own.) As is generally the case with concussions, there is no predicting a recovery timetable because each injury is different.
As any lingering at-rest concussion-related symptoms clear, Lacy will gradually be introduced to increasing physical and cognitive activity, a rehab program of sorts for the brain’s response to stimulation following a concussion.
Each team has its own program, but generally the plan involves introducing light cardiovascular work and cognitive tasks (such as quiet reading), followed by more aggressive football-related drills and advanced cognitive demands (such as watching film, participating in meetings).
In order to return to play, however, Lacy will have to meet the NFL league guidelines. He will have to be free of symptoms both at rest and with exertion; his neurocognitive (ImPACT) tests will need to return to baseline; and he will need to be cleared by both team physicians and an independent neurological consultant.
Depending on the severity of his symptoms, it’s possible a decision on his status could remain undetermined until late in the week.
Chiefs running back Jamaal Charles bruised his quad Sunday, but by Tuesday the team was expressing hope Charles would be ready to go for Sunday’s game against the Cowboys. By Wednesday, the team – and Charles – sounded more confident. According to Adam Teicher of ESPN.com, Reid said of Charles, “I think he’ll be OK for the game.” And Charles made it clear he plans on playing.
In an effort to get him well enough to run full speed by Sunday, the Chiefs held Charles out of practice Wednesday. By Thursday he was back on a limited basis. The next step is seeing how Charles feels on Friday and if he is able to continue increasing his work. The key is in balancing the activity with the risk of increasing injury to the muscle. If there are no setbacks before Sunday, it appears Charles has a good chance to play.
He started, but only after much drama and the revelation that there was more to his injury than initially reported.
Now that we know it’s a high ankle sprain, what should we expect for Week 2? White tweeted on Monday, “As far as fantasy if I don't participate in practice than don't start me it's a red flag.”
If you’re planning on following his advice, consider that White did not participate in practice Wednesday or Thursday. Although it seems likely that he will again suit up and function in a role similar to last week, even that is not guaranteed yet.
Until we actually see White making sharp cuts and breaks, which he acknowledged last week he could not do, it is hard to expect a top-flight performance. It will be worth noting whether he does get back into any practice before the week is out, but White may have given fantasy owners all of the advice they need.
As always, injury concerns regarding players heading into the Sunday and Monday games can be critical. Each week, this blog entry will be dedicated to those who appear on the official Friday NFL injury report and how their status might affect fantasy teams.
For those who might be first-time fantasy football players: Injury reports provide clues to a player's status for eager fantasy owners. The NFL requires teams to submit their injury reports several times a week, identifying the body part that is involved in the injury. Early in the week, these reports will indicate whether a player is not practicing, is limited in practice or is a full participant in practice. On Fridays, all players on the injury report are assigned one of the following designations by their teams: probable, questionable, doubtful or out. Teams playing Monday night do not have to issue their designations until Saturday. The explanation for each designation is as follows.
Out: This is the easy one; the guy definitely won't be playing Sunday. As painful as it might be to see this designation next to a player on your fantasy roster, at least you know in advance of the game that he's sitting out and can plan accordingly.
Probable (P): This designation indicates that a player has a greater than 50 percent chance of playing. Most players listed here are expected to play, barring a setback between the final injury report and kickoff.
Questionable (Q): This is the fantasy owner's most dreaded player designation, yet it manages to be the one used most frequently by teams (often to keep everyone guessing). It means a player's status is on the fence; there is a 50-50 chance he'll be on the field come game time, although, as many fantasy owners have come to learn, many teams use the questionable designation for any player with a hint of injury. Whether a player ends up active or inactive often comes down to a game-time decision based on how he performs in warm-ups. It is important for fantasy owners to check status reports leading up to the game.
Doubtful (D): The "doubtful" designation theoretically means a player has less than a 25 percent chance of playing that week. Rarely does a player labeled as doubtful end up playing, unless he experiences a major turnaround before game time. Fantasy owners who need to make roster adjustments beforehand can feel fairly confident about sitting a player listed as doubtful.
Each week in the Saturday blog, we run down a list of key fantasy players, by position, who appear in the Friday injury report, along with the injured body part as listed on the report, player status, and any relevant developments or insights. The primary fantasy positions are covered (quarterback, running back, wide receiver and tight end). At the end, key fantasy players listed Friday as "out" for that week's games will appear as a group.
Good luck in Week 1, everyone! May your players stay healthy and win for you.
EJ Manuel, Buffalo Bills, knee, (P): Manuel was named the starter earlier in the week based on his recovery from arthroscopic knee surgery. After again participating fully in practice Friday, Manuel showed he is healthy enough to make his first NFL start.
Blaine Gabbert, Jacksonville Jaguars, thumb, (Q): The main question has been whether Gabbert’s thumb would prevent him from being able to grip and throw normally. A few days ago, coach Gus Bradley hinted at a possible game-time decision, something he continued to lean toward after Friday’s practice despite Gabbert taking the majority of the first-team reps. He has made steady progress, but the Jaguars apparently will wait and see what an additional couple of days will do before making the call.
Kirk Cousins, Washington Redskins, foot, (P): ): Cousins’ participation in full practice Thursday and Friday would hint at his being available, should that be necessary. No one wants to think about what “should that be necessary” would mean for the Redskins, knowing it will be RG III’s first competitive action since ACL revision surgery.
Arian Foster, Houston Texans, calf, (P): After much drama in the offseason between Foster’s calf injury during organized team activities and his back issues in training camp, the Texans fully expect him to play Monday. The only question seems to be how much work he will get in his first game action of the season. As noted Thursday, there is little doubt Foster can still be productive even if he touches the ball fewer than 30 times.
Ahmad Bradshaw, Indianapolis Colts, foot, (P): As expected, the Colts have Bradshaw ready to go for Week 1. Full participation in practice every day this week is a strong sign that he is capable of returning to action. Given that this will be his first game since his latest foot surgery, it’s unclear just how much work the team has planned for him in this initial outing. And the Colts aren't sharing. Fantasy owners should temper expectations in Week 1, but, if Bradshaw has a good first outing, his workload should continue to increase.
Rashard Mendenhall, Arizona Cardinals, knee, (P): As predicted Thursday, Mendenhall’s status did become clearer after Friday’s practice. He did move up from limited practice Wednesday and Thursday to a full practice Friday. His "probable" status indicates the team expects him to play. The knee will be something to keep an eye on this season, though; no guarantee this is behind him.
Mike Tolbert, Carolina Panthers, hamstring, (P): With Jonathan Stewart on the PUP list and Kenjon Barner out with a foot injury, someone needs to be available to spell DeAngelo Williams on Sunday. Tolbert practiced fully Thursday and Friday and is expected for the season opener.
Roddy White, Atlanta Falcons, ankle, (Q): It’s hard to believe White’s status is truly questionable, especially after his comments earlier in the week. He put in limited practices every day this week and hasn’t missed a game in his NFL career. Although it’s always possible that a tweak of the ankle in-game could cause him to get pulled early, it would seem the odds are in favor of his playing. At least it’s an early game, so the mystery will be solved before lineups must be set.
Marques Colston, New Orleans Saints, foot, (P): Colston also started last season on the injury report with a foot ailment. Although it has been kept fairly quiet, Colston is dealing with a plantar fasciitis issue, an injury that rarely resolves quickly and tends to get worse with activity. On the plus side, Colston has looked good in practice when available (he also played briefly in the team’s final preseason game) and the Saints plan on having him Sunday. The concern is that, given that the foot issue is a carryover from last year, this might not be the last he has seen of this problem.
Danny Amendola, New England Patriots, groin, (P): At least there’s very little guesswork involved in the decision-making about Amendola; the "probable" tag tells us the Patriots plan to have him on the field Sunday, as expected. Amendola moved from limited practice Wednesday and Thursday to a full practice Friday, definitely a good sign. Still, injury concerns will surround Amendola throughout the season, based on his history. For starters, there’s no guarantee this groin issue is completely behind him; the only presumption is that it has improved to the point that he can play. Amendola getting through a complete game would be a nice start to the season.
Victor Cruz, New York Giants, heel, (P): Cruz told reporters this week that his heel was much improved, and the sight of him in consecutive practices each day, albeit on a limited basis, would support that. The "probable" designation indicates the Giants expect to have him for the big Sunday night opener against the Cowboys; the hope is that he will not aggravate the heel during the game.
Sidney Rice, Seattle Seahawks, knee, (P): Rice went overseas in training camp to undergo a procedure on his knee. The team has offered few details but always maintained that Rice would be ready by Week 1. With newly acquired Percy Harvin on the PUP list, Rice’s presence takes on added significance. After practicing fully each day, it indeed appears Rice will start Sunday against the Panthers.
DeAndre Hopkins (concussion) and DeVier Posey (Achilles), Houston Texans, (P): Both receivers practiced fully throughout the week. Hopkins suffered a concussion in the team’s second preseason game but has progressed back to full, consecutive practices. There seems to be a good chance the rookie will make his regular-season debut Monday night, although it’s not clear just how much he’ll play. Posey is working his way back from an Achilles tendon repair but did manage to see some preseason action. He should also be available for the Texans; however, coach Gary Kubiak has indicated he will be available only for limited service.
Malcom Floyd, WR, San Diego Chargers, knee, (P): Shortly after the Chargers lost Danario Alexander for the season to an ACL injury, Floyd went down with a right knee injury, and the team feared the worst. Fortunately, it ended up being a mild sprain and Floyd has recovered nicely. This week, he was able to practice fully with the team, and he is expected to play Monday night against the Texans.
Andre Roberts, Arizona Cardinals, quadriceps, (P): Roberts cropped up on the team’s Thursday injury report with a quadriceps strain. The fact he was able to participate Friday, even on a limited basis, is a good sign, and the "probable" designation tells us the team plans to play him Sunday.
Santonio Holmes, New York Jets, foot, (Q): Holmes has been recovering from Lisfranc surgery since last fall, and the progress has been slow. A slow recovery after such an extensive injury is not a surprise, but the dissonance between Holmes and the Jets when it comes to his status is a concern. The Jets have sounded optimistic about his availability, but Holmes has been extremely guarded when it comes to projecting a return. Whom to trust? Probably the player in this situation, as in, he doesn’t sound like someone who is ready to play football. Even if he does suit up Sunday, can anyone else really have confidence when Holmes has so little?
Rob Gronkowski, New England Patriots, back, forearm, (D): Gronkowski’s injuries have been discussed at length ever since he suffered his first forearm fracture in November. Although his presence on the active roster will permit him to return whenever the medical staff deems him ready for full-blown games, the "doubtful" tag indicates he is not going to be playing this week.
Heath Miller, Pittsburgh Steelers, knee, (D): Miller is still working his way back from multi-ligament knee reconstruction. Although the sight of him taking part in limited practice every day this week is encouraging, he is not yet ready for game participation. There is no definitive return date, but it might take a couple of weeks more before we see him in action.
Matt Bryant, Atlanta Falcons, back, (P): Bryant has been on the injury report since experiencing some tightness in his back in the preseason, but it never seemed to truly threaten his Week 1 availability. Bryant practiced fully every day this week and is expected to be on the field Sunday.
Sebastian Janikowski, Oakland Raiders, right calf, (P): The Raiders need Janikowski, and it looks as if he will be available. After taking Wednesday off, Janikowski participated on a limited basis Thursday and Friday.
This space is intended for a list of key players, not including those who have been moved to injured reserve status, who are officially listed as "out" for the upcoming game.
Le’Veon Bell, RB, Pittsburgh Steelers, foot: Bell might not play this week, but he said he was hopeful of playing in Week 2. The optimism is nice, but let’s see whether he’s able to practice next week first, something he did not do this week. In the meantime, Isaac Redman gets the start Sunday.
Kenjon Barner, RB, Carolina Panthers, foot: Barner has not practiced all week, and his absence does not come as a surprise.
Mark Sanchez, QB, New York Jets, right shoulder: It’s been clear for a while that Sanchez would not play this week, but what isn’t clear is the exact nature of his “shoulder bruise.” He has not yet practiced and looks to be out beyond this week.
Off the injury report!
Here’s a fun new section for fantasy owners. When teams remove a player who has recently been dealing with an injury from the injury report, it sends a signal that the player is now considered healthy. Any time there is one less status concern, it makes setting those lineups so much easier. With that in mind, here are a few players who had injury worries before the start of the season but do not appear on this week’s injury report.
Robert Griffin III, QB, Washington Redskins: Unless you were living under a rock for the past year, you’re well aware of Griffin’s injury (torn ACL/LCL, underwent reconstructive surgery in January) and every detail of his progress since. Officially declared the Monday night starter this week, Griffin -- who did not play in any preseason games -- is not on the team’s injury report.
Jordy Nelson and Randall Cobb, WR, Green Bay Packers: Nelson and Cobb dealt with training camp injuries, but both now appear to be in the clear. Cobb had a right biceps strain, and Nelson underwent arthroscopic surgery on his knee. Both returned to practice in late August. According to the Milwaukee Journal-Sentinel, Nelson has been running full speed for more than two weeks and more recently added cutting without any issues. Neither receiver played in any preseason games, so Sunday will be their first game action since last year.
Maurice Jones-Drew, RB, Jacksonville Jaguars: Jones-Drew spent the offseason recovering from surgery to repair a Lisfranc injury, but everything has gone smoothly throughout the process. Jones-Drew appeared in two preseason games and indicated that his foot felt great. Clearly everyone is satisfied with the health of his foot, as he does not appear on the opening week’s injury report.
Trent Richardson, RB, Cleveland Browns: Richardson was challenged by a right shin injury intermittently in the offseason and into training camp. He did play portions of two preseason games, however, and is not on the team’s injury report.
Be sure to check out "Fantasy Football Now," Sundays on ESPN2 at 11 a.m. ET, for last-minute inactives, rankings, injury impact and more.
Here’s who we’re keeping an eye on heading into Week 1.
EJ Manuel, Buffalo Bills , (knee): After putting in a full practice Wednesday and apparently doing enough to convince coach Doug Marrone his knee would not be an issue, Manuel was named the Bills’ starter for Sunday’s season opener. Manuel had already shown signs that he was moving well and could step forward onto that left leg to throw without a hitch. Manuel then returned to a full practice Thursday and barring an unusual setback will see his first NFL regular game action on Sunday.
Blaine Gabbert, Jacksonville Jaguars, (right thumb): Gabbert suffered a small fracture to the thumb of his throwing hand in the team’s second preseason game. He has progressed to light throwing but still has some discomfort in the thumb leading coach Gus Bradley to hint the decision could come down to gametime. Obviously the thumb is critical to a quarterback’s grip and accuracy and apparently there were some concerns in that regard after Wednesday’s practice. During a conference call with Kansas City media, Bradley said of Gabbert, “at times he looked good and at times he looked like he had an injury.” The Jaguars face the Kansas City Chiefs Sunday and if Gabbert is not able to go, Chad Henne would get the start.
Mark Sanchez, New York Jets, (right shoulder): A “bruised shoulder” is all the Jets have offered as far as a diagnosis for Sanchez, a vague description which could imply a range of severity from relatively benign to more serious. It would appear this is on the more serious side given that there is talk of Sanchez not being available for multiple weeks.
Ahmad Bradshaw, Indianapolis Colts, (foot): Despite not seeing any preseason action as he worked his way back from another foot surgery, Bradshaw has been a full participant in practice all week, giving the appearance he will be ready to play. The question then is how much. According to the Indianapolis Star, Bradshaw’s workload has yet to be determined. The best takeaway from this week of practice thus far is that Bradshaw put in complete work on consecutive days. It’s possible given his extended downtime that his playing time is controlled in Week 1; hopefully the Colts will add a little more clarity before Sunday.
Jeremy Brevard/US PresswireAll signs points to Arian Foster playing Monday.
Arian Foster, Houston Texans, (calf): The most interesting thing about Foster's presence on the injury report is that he is listed with only the calf ailment; there is no mention of his back. Foster has been a full participant this week, and there is every expectation that he will play Monday night in San Diego. Coach Gary Kubiak said that Foster will not be a "30-carry guy" Monday night, according to the Houston Chronicle, given his limitations during the preseason.
Flash back to last season: Foster was a game-time decision for the season opener because of knee soreness, and the team hinted at increased work for Ben Tate as a result. Well, Foster ended that game with 26 carries for 79 yards and two touchdowns. Even if he sees fewer carries in Week 1, Foster has shown he can be efficient and productive in shorter bursts.
Rashard Mendenhall, Arizona Cardinals, (knee): Mendenhall is with a new team this season, but the injury bug hasn't left him. He sprained his right knee during the preseason – that's the same knee in which he tore his ACL in 2011 -- and described it as "looseness," according to head coach Bruce Arians. Last year, after a delayed start to the season coming off ACL surgery, Mendenhall dealt with Achilles and hip issues. There has to be some concern about whether he can re-establish his health and put together a complete season. On the positive side, he did participate in practice on a limited basis both Wednesday and Thursday. His status for Week 1 should become clearer after practice Friday.
Kenjon Barner, Carolina Panthers, (foot): Barner may not be a starter on many fantasy teams, but his appearance on this report does have relevance, primarily for those who own DeAngelo Williams. Jonathan Stewart is on the PUP list for the Panthers, and Barner currently holds the No. 2 position on the RB depth chart behind Williams. But Barner has not practiced this week due to a foot injury, and it looks like there's a decent chance the rookie will be sidelined for Week 1. Fullback Mike Tolbert could contribute, but it's worth noting that he has been dealing with a hamstring injury recently. Tolbert was able to move from limited practice Wednesday to full practice Thursday and does appear in line to play Sunday, however.
Victor Cruz, New York Giants, (heel): Cruz has been practicing on a limited basis this week as he tries to get past a heel bruise sustained in a mid-August preseason game. He has said he is feeling better each day and told ESPN New York’s Ohm Youngmisuk that he is still awaiting medical clearance but fully expects to take the field Sunday night against the Cowboys. As the Newark Star-Ledger reported, Cruz tested the heel with hard-breaking routes earlier in the week and experienced no discomfort. The signs appear to be pointing towards Cruz playing Sunday night; the bigger worry with this type of injury is the possible in-game flare-up.
Roddy White, Atlanta Falcons, (ankle): White injured his ankle in the team’s second preseason game, suffering what was called at the time a mild lateral ankle sprain. He has never missed a start in his NFL career, a virtually unheard of stat for a wide receiver, so it’s unlikely that would change now. White participated in practice on a limited basis both Wednesday and Thursday and told the Atlanta Journal-Constitution, “Come Sunday, I’ll be ready to go.” That’s music to fantasy owners’ ears.
Jordy Nelson (knee) and Randall Cobb (biceps), Green Bay Packers: Neither of them appears on the Packers’ injury report this week, thereby eliminating the anxiety for fantasy owners over whether they will play on Sunday. Cobb has not been as much of a question mark; the biggest concern with him is whether this biceps issue will resurface during the season. For Nelson, coming off arthroscopic knee surgery so close to the start of the season, the question was whether he would have enough time to not only recover from surgery but truly get into game shape. As reports trickled out of Green Bay in recent weeks, it appeared the Packers were more confident about his recovery than Nelson himself. Nelson initially would not commit to being ready by Week One but his recent practice activity and removal from the injury report seem to speak on his behalf. Hopefully he has regained adequate strength and conditioning to avoid compensating and risking some type of soft tissue injury; recall last year Nelson dealt with a hamstring issue which sidelined him for several weeks.
Danny Amendola, New England Patriots, (groin): Aha! For a while there, the Patriots were not disclosing the nature of Amendola's ailment (shocking!). This week, however, the injury reports are out, and Amendola's groin has been identified as the problem. Although he was absent from practice for much of the past two weeks, Amendola did return on a limited basis Wednesday and repeated the effort Thursday. It appears he will suit up Sunday, but given that this is yet another soft-tissue injury for Amendola, the bigger question is whether he can get through a game without it turning into something bigger.
Pittsburgh Steelers rookie running back Le'Veon Bell has been unable to stay on the field consistently this preseason. First, it was soreness in his left knee, which caused him to miss the Steelers' preseason opener. Days later, he aggravated the knee in practice. He returned quickly enough to make an appearance in the Steelers' second preseason game, but that outing was cut short due to injury. This time, it was not his knee; Bell sprained his right foot after playing in just one series.
The big question is how long this latest injury, called a midfoot sprain by coach Mike Tomlin (and originally referred to as a Lisfranc sprain in ESPN reports), will keep Bell on the sideline. At this point, there is no timetable being offered by the Steelers, but on the positive side, Bell's injury will not require surgery.
So what is a realistic expectation for fantasy owners? And why does panic ensue when we hear the term "Lisfranc" associated with a foot injury?
AP Photo/Keith SrakocicLe'Veon Bell has fallen to 40th among running backs in the ESPN fantasy's RB rankings.
As for what fantasy owners can expect, the only sure thing is that this will be a multiweek injury. Bell has already been ruled out of Pittsburgh's third preseason game, and while the Steelers are not saying when they expect him back -- in their defense, it's too early to make that projection with any degree of certainty -- early reports suggest a recovery time of 6-8 weeks. That time frame is fairly typical for nonsurgical Lisfranc sprains, but it should be noted that, depending on the actual degree of injury, the athlete's ability to heal and whether any setbacks occur along the way, the estimate could fluctuate in either direction.
Ray Fittipaldo of the Pittsburgh Post-Gazette reported Thursday that Bell said he was walking without discomfort and feeling positive about his progress. While that's great news, the big tests will come when he has to push off with running and pivot, twist and cut on that foot. Although the details of the injury aren't available, if it's indeed a Lisfranc sprain, it's difficult to imagine Bell returning to football before late September. It's critical to the long-term foot health of any player who suffers this type of injury that complete healing occurs prior to a return to play, hence the slow progression, even when the player says he feels fine.
This standard slow progression is part of the reason the word "Lisfranc" engenders panic. The standard absence for players who suffer this injury ranges from six weeks for the mildest form to season-ending for the more severe variety. Last season, Jets wide receiver Santonio Holmes, Green Bay Packers running back Cedric Benson and Jacksonville Jaguars running back Maurice Jones-Drew all saw their seasons end due to Lisfranc injuries.
Perhaps more noteworthy is that these injuries were all unique and Holmes was the only player whose season was declared over shortly after the injury. Benson was initially placed on the IR/designated for return list after suffering the injury in Week 5 but did not progress as hoped and ultimately underwent season-ending surgery in late November. Jones-Drew was also hoping to avoid surgery after his Week 7 injury, but his problem persisted and he too underwent surgery in December.
It should be noted that last season Cowboys running back DeMarco Murray suffered a midfoot sprain that cost him six weeks, but he recovered fully and returned during the season.
Maybe now it's a bit clearer as to why the term "Lisfranc" inspires dread. But what is this Lisfranc injury? Lisfranc refers to an area of the foot where the long bones of the forefoot (metatarsals) articulate with the small (tarsal) bones in the middle of the foot. This joint is called the tarsometatarsal joint, or the Lisfranc joint. This joint is in the midfoot region, hence the confusion about the terms, which are often used interchangeably.
Why Lisfranc? Frenchman Jacques Lisfranc, a field surgeon in Napoleon's army, described an amputation technique through this region to address forefoot gangrene following frostbite. There is also a story that soldiers wounded in battle would fall from their horses, but a foot would often remain caught in the stirrup, right at that tarsometatarsal joint. Such an injury often resulted in amputation of part of the foot, from the injured joint forward. Thankfully, with modern medicine, these injuries don't typically require amputation, and surgery can preserve the joint.
Since NFL players aren't riding horses, how does this injury happen? Well, in sports, especially football, one scenario is that the player is running forward with his weight on the ball of his foot and he gets hit or stepped on from behind against his heel. The resultant force through the portion of the foot in between the ball and the heel (midfoot) causes it to buckle, and the midfoot is injured. But it can also result from shearing forces at the foot, the result of a twisting injury when the forefoot remains planted and locked into the ground as the player moves another direction.
Not all Lisfranc injuries are identical. When the midfoot buckles, the ligaments that connect the various bones can become damaged. Ligament injury without any bony impact would be the mildest version of a Lisfranc injury. The more mild sprains can be treated conservatively with rest and rehabilitation. If the damage to the ligaments is more extensive, it can affect the relative position of the bones in the area, and they can shift or dislocate, which is often accompanied by a fracture, resulting in a more serious injury. In the worst-case scenario, an artery passing over that area can also be damaged, affecting blood supply to the foot.
Shifting of the bony alignment typically requires surgery to realign the joint and provide stability, but it's not always easy to detect. Failure to properly correct the injury, however, can result in chronic instability and pain, eventually leading to major arthritis in the area. Even with surgery, it appears that those who have suffered a significant Lisfranc injury may be at increased risk for arthritis down the road, simply because of the trauma to the joint.
The bottom line is that players who suffer these injuries must have their treatment managed carefully, not only with surgery when indicated but in the rehabilitation process as well.