The Training Room: Week 11 Injury Updates

The Training Room: Week 11 Injury Updates

By Russell Manalastas (Injury Expert), last update Nov 12, 2013

Russ Manalastas's picture

Russ is a Board Certified Sports Physical Therapist and Clinical Director at Lattimore Physical Therapy in Rochester, NY. He has a Doctorate in Physical Therapy from the University at Buffalo as well as his Bachelors Degree in Exercise Science. His board certification credentials in sports is what is required for PT's that work at the NFL level. Russ provides a unique perspective on NFL injuries as they relate to fantasy football.

Follow Russell Manalastas on Twitter: @RussPT.

Week 10 brings many injuries to the most premiere position in the NFL, quarterback. A lot of fantasy managers will argue which position, quarterback or running back, is more vital to winning on a weekly basis, but in reality, the quarterback reigns supreme for teams to find success on a yearly basis. Injuries this late in the season can really dismantle teams trying to sustain any momentum from the week before to position themselves for a playoff run. Let's take a look at a week that reminds us to always have a backup plan. For waiver pickups that you need to consider for your team, check out this week's waiver wire article by our Senior Editor, John Paulsen. 


Peyton Manning

High Ankle Sprain - The ligaments/connective tissue that lies in between the tibia and fibula (the bones of the lower leg), and just above the ankle, is what is affected in a high ankle sprain. Injury to this tissue is usually caused when the foot/ankle is rotated and the bones of the lower leg are fixed. 

Manning took a late, low hit to the ankles in the 4th quarter yesterday against the Chargers.  He was noticeably limping after the hit, but finished the game.  MRI revealed no further damage to his ankles compared to when he originally hurt it. 

Bottom Line - Manning's injury will continue to bother him all season long, and at this point becomes a matter of pain tolerance. High ankle sprains are very difficult to manage, but as a quarterback, especially a very immobile quarterback, Manning may not be as affected by it. The other thing that works to his advantage is that it's his right ankle, which he doesn't have to fully push off of the ankle to throw. The worry here is if he repeatedly takes hits to the lower parts of his legs, it could continue to get worse. There are always plenty of players at the feet of QB's as they are attempting to throw, so there is always that risk. Manning is still one of the top QB options moving forward unless he really suffers a setback, so continue to play him as you normally would.


Jay Cutler 

High Ankle Sprain - See Peyton Manning

Cutler was forced to leave the game before the Bears last possession due to an ankle injury.  X-rays initially were negative for any structural damage, but reports are stating that he is dealing with a high ankle sprain. 

Bottom Line - Managers that have Cutler rostered have to be prepared to be without him for multiple weeks as both the ankle and groin are going to need time to recover. It was surprising to see Cutler return from the groin injury as early as he did, but he clearly was not 100% and wasn't able to perform at a high level as the game continued. It's hard enough to rehab just a high ankle sprain, but throw in the fact that his groin on the same leg is giving him trouble will only complicate matters. There's a good chance Cutler misses 3-4 weeks which means you're going to need a QB to get you to the playoffs in the meantime. Backup Josh McCown is a nice QB2 or streaming option in Cutler's absense.


Jake Locker

Lisfranc Fracture - The foot is broken up into three regions: the rearfoot, midfoot, and forefoot. A lisfranc injury is a disruption of the stability in the bones/ligaments between the midfoot and forefoot. There can be a fracture, a tear in the ligaments, or both, which causes immediate swelling and pain. Walking becomes very difficult as the midfoot/forefoot region is the primary area of strain when you push off your foot.

Locker exited the game in the 2nd quarter against the Jaguars when he landed wrong on his foot when trying to make a handoff. Testing has revealed that Locker has sustained a Lisfranc injury and will miss the rest of the season.

Bottom Line - Lisfranc injuries do poorly when trying to manage it conservatively, as instability becomes an issue in the foot, so it may be that the Dolphins are waiting for the swelling to go down in Locker's foot to determine the extent of damage. If/when Locker undergoes surgery, he will be in a boot for 6 to 8 weeks and will be unable to put any weight through his foot. After that he will slowly be able to put pressure through the foot and start rehab. He should be ready in time for the start of next season. Matt Schaub suffered the same injury in November of 2011 and was ready for training camp next season, so I would expect the same with Locker with the potential for him to be ready earlier. 


Seneca Wallace 

Groin Strain - The adductors are the muscles on the inside of your thigh known as your groin muscles. In football, groin strains can happen when violent twisting, turning, or cutting motions of the hips/pelvis continue to occur. 

Wallace left the game in the 1st quarter when he scrambling outside the pocket to throw the ball away. He did not return and was diagnosed with a groin strain. 

Bottom Line - Wallace showed over the past two games that he didn't seem to be a great fit for the Packers offense. With the Packers committing to starting rookie Scott Tolzien this upcoming week, in addition to the signing Matt Flynn, there's a good chance Wallace won't regain the starting job even when he is healthy. He's safe to drop in any league that you might've taken a chance on him in. Tolzien appears to be a better fantasy play.


Terrelle Pryor 

Sprained MCL - The medial collateral ligament (MCL) is the main ligament on the inside part of the knee that helps with stabilizing the knee. Ligament sprains occur to this region when an external force is applied from the outside of the knee, which causes the knee to buckle in towards the other knee.

Pryor admitted after this past week's game against the Giants, that he has been dealing with a sprained MCL and that he has been feeling sore, which has limited his ability to play at his normal level on the field. 

Bottom Line - Pryor was in last week's injury report, but this week has revealed that the issue is more serious than it was led to believe. With the Raiders preparing to face a tough Texans defense against the pass, combined with Pryor's limited ability to run because of his knee, there are better options you can find this upcoming week to help your QB situation. 


Tony Gonzalez 

Sprained Toe - Repetitive, extreme ranges of motion when trying to sprint/run, can cause irritation to the ligaments around the toe, which can cause pain.  

Gonzalez didn't miss any time during the game against Seattle, but was seen limping significantly in the locker room after the game. Gonzalez was interviewed about his toe but did not go into detail as to which toe was bothering him.

Bottom Line - I'm going to assume here that Gonzalez is dealing with turf toe in his left big toe.  Turf toe has been known to be very difficult to manage because a lot of force is transmitted to the big toe when trying to push off to run, which only stresses the tissue that is irritated. I would expect Gonzalez to attempt to play through the injury, but with the Falcons clearly out of the playoff picture, check back for details from the Falcons as to what the specific issue is.


Vernon Davis

Concussion - Concussions are an insult to the brain from direct trauma. The brain suffers microtrauma and scarring with a variety of symptoms presenting, depending on where the trauma is located

Davis exited the game after fumbling the ball in the 2nd quarter.  He did not return and was later ruled out with a concussion.

Bottom Line - Davis was able to head back to the locker room under his own power and seemed to be ok after the game as well. He'll need to pass all the necessary concussion tests in order to gain clearance to play this upcoming week. Check back later this week to get an update on his status. 


Michael Floyd

AC Joint sprain - Direct trauma to the acromioclavicular (AC) joint cause disruption of the ligaments around the area that help support it. 

Floyd sustained the injury in 1st quarter of the game against the Texans and did not return.  Coach Arians thinks that Floyd should be able to play this week. 

Bottom Line - It sounds like Floyd is dealing with a minor sprain in the grade 1 range if they feel that he might be able to suit up this week. It'll be a matter of pain tolerance as anything he attempts to catch over his head or across his body might cause more discomfort in his shoulder. Make sure you check on his status at the end of the week to see if he's a viable option. Andre Roberts would see an uptick in targets if Floyd can't go this week. 


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