The Training Room: Week 3 Injury Updates

The Training Room: Week 3 Injury Updates

By Russell Manalastas (Injury Expert), last update Sep 16, 2014

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 2 is a perfect example of why no one is safe when it comes to injuries. The injury bug hit hard and continued to pile up victimes as the games progressed, with fantasy owners left trying to pick up the pieces. Let's get right into it and discuss all the injuries that you need to know about so you can attack the waiver wire informed and with confidence.

Below you'll find a severity chart of ligament sprains and muscle strains to refer to when reading this week's column. Ligament sprains/muscle strains follow the same grading so hopefully it'll give you a better understanding of what the player is dealing with.

Grade 1 (Minor): Overstretching in the tissue causes small microtears and irritation. Pain is mild with swelling being variable depending on the location.

Grade 2 (Moderate): Swelling is present in the surrounding area with more microtears in the tissue due to overstretching, but does not completely disrupt function. Pain is more significant.

Grade 3 (Severe): Microtears are very severe, with some cases causing complete ruptures of the tissue. Movement becomes very difficult with swelling and bruising being very prevalent.


Jamaal Charles

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. Charles exited the game in the 1st quarter against the Broncos and did not return.

Bottom Line: It's a tough blow for fantasy owners, myself included, that Charles suffered a high ankle sprain as opposed to the more common lateral ankle sprain. Recovery timetables for a high ankle sprain can range from 2-4 weeks depending on the severity. Coach Reid is calling Charles' sprain mild, which would put his injury in the grade 1 range. CJ Spiller comes to mind when it comes to a running back dealing with a high ankle sprain, with Spiller never really returning to the form due to re-aggravating the injury during the season. Be prepared to be without Charles' for at least one game and potentially more depending on how his recovery goes.


Mercedes Lewis

High Ankle Sprain: See Jamaal Charles. Lewis left the game against the Redskins in the 3rd quarter and did not return.

Bottom Line: The Jaguars offense has been abysmal over the last few quarters and this won't help their cause. It sounds like Lewis' high ankle sprain is of the grade 2 variety which would force him to miss at least 6-8 weeks. If you have Lewis, move on and start looking elsewhere for a TE. Our Streaming TEs article coming out later today is a good place to start.


A.J. Green

Turf Toe: Repetitive, extreme ranges of motion when trying to sprint/run, can cause irritation to the ligaments around the big toe, which can cause pain. Green left the game in the 1st quarter and did not return.

Bottom Line: There are some reports that Green is dealing with a ligament sprain in the foot as opposed to turf toe. Regardless, either is a tough condition to deal with. The Bengals have a Week 4 bye, so it's not out of question for the Bengals to hold Green out until then, in hopes he'll have no issues moving forward. There's a chance he plays in Week 3, but prepare as if he's going to be unavailable. There shouldn't be too many lingering issues moving forward if they caught the issue early, but there's always risk for re-injury.


Robert Griffin III

Dislocated Ankle: A dislocated ankle usually involves the bones of the ankle and the bones of the lower leg (tibia, fibula) shifting out of place, causing complete disruption of the ligaments that help stabilize the area. RGIII was carted off the field in the 1st quarter after landing awkwardly on his left ankle. He was immediately ruled out for the rest of the game.

Bottom Line: His MRI revealed no fracture associated with the dislocation, so that is a good sign for his long term outlook. I would still expect RGIII to miss at least 6-8 weeks, with an 8-10 week timetable possible. Recovery of the muscles, tendons, and more importantly the ligaments surrounding the ankle that were compromised, will determine his availability this season. Kirk Cousins should step in and be productive immediately with it being fair to wonder if they hold RGIII out longer if Cousins continues to win.


Knowshon Moreno

Dislocated Elbow: The elbow is made up of your humerus (long bone of upper arm) and the two bones in your forearm, the radius and ulna. A dislocation occurs when either the humerus or the ulna/radius come out of normal alignment and stay out of alignment due to a traumatic force. Eifert sustained the injury in the first half against the Ravens and did not return. Moreno was hurt on his 1st carry of the game and did not return.

Bottom Line: Moreno's elbow bent in a position that the elbow shouldn't have gone. His timeline will follow closely that of Tyler Eifert's last week, missing anywhere between 4-6 weeks or longer depending on progression through rehab.


Ryan Mathews

MCL sprain: 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. Mathews was carted off the field and did not return.

Bottom Line: Mathews injury looked pretty ugly, and he's fortunate to not have sustained any more significant injury. His timetable of 4-6 weeks would put his MCL sprain at a grade 2, with reducing pain and improving stability in the knee the main concern. Mathews should be fine when he does return, but his injury risk is just too great to rely on him moving forward.


Tavon Austin

MCL Sprain: See Ryan Mathews

Bottom Line: Reports are that Austin is expected to miss about 2 weeks, which would be a grade 1 MCL sprain. Barring any setbacks, he should be fine moving forward once he returns, but he's pretty far off the fantasy radar.


Eric Decker

Hamstring Strain: The hamstring muscle is the primary muscle in the back of the thigh responsible for bending the knee and extending the hip. When it relates to sports, it's a very important muscle in aiding to accelerate/decelerate the lower body to allow proper running and cutting. Decker left the game in the 2nd half and did not return.

Bottom Line: Soft tissue injuries such as hamstring strains are tough to manage. Re-aggravation of a previous hamstring issue becomes even more problematic, as now it seems Decker will have to play through some discomfort or risk missing some time. Consider him day to day, but keep an eye on his practice participationt his week.


Vernon Davis

Ankle Sprain: An inversion sprain is often referred to as "rolling" your ankle. The ligaments/tendons/muscles on the outside of the ankle get overstretched and cause pain/swelling.

Bottom Line: It's never a good sign when you have your starting TE leaving the stadium on crutches. It could just be precautionary to reduce the strain on the ankle, but it also could mean that the injury could be more complicated. Consider him day to day until we get the results of his MRI.


Lamar Miller

Ankle Sprain: See Vernon Davis; Miller injured his ankled in the 4th quarter against theBills and did not return.

Bottom Line: Just when you thought Miller would have a clear path to carries after Moreno went down, he gets hurt as well. Consider him day to day for now, but make sure he is practicing in some form before considering him for your lineup. Damien Williams and freshly re-signed Daniel Thomas would be the next men up.


Allen Hurns

Ankle Sprain: See Vernon Davis; Hurns hurt his ankle when he was tackled late in the 4th quarter. He was seen on crutches after the game.

Bottom Line: With Cecil Shorts on the mend, it's going to be tough for Hurns to get meaningful snaps moving forward, especially if he misses time to recover from his ankle injury. Consider him day to day for now, but if you have better options available on the waiver wire, I wouldn't hesitate to drop him.


DeSean Jackson

Sprained AC Joint: Direct trauma to the acromioclavicular (AC) joint cause disruption of the ligaments around the area that help support it. Normally an AC joint sprain is caused when falling directly on the shoulder. Jackson left the game in the 1st quarter after landing on his shoulder. He did not return.

Bottom Line: It sounds like Jackson may have avoided any serious issues with the shoulder. Whenever you land on the shoulder, it irritates the AC joint which makes it very painful to move the shoulder (Jordan Cameron is the example of this). Consider him day to day for now, but DeSean shouldn't have any lingering issues as long as the shoulder heals properly.


Mark Ingram

Broken Hand: Direct trauma to a bone that exceeds the force the bone is able to withstand causes a fracture. There was no indication when the fracture occurred until after the game.

Bottom Line: Ingram's fracture in his hand will not require surgery. He'll be in a cast for about 4-6 weeks, and once the cast is removed, he'll start rehab to strengthen his hand. Grip strength might be a concern at first, but I don't think he'll have any issues when he does come back.

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