The Training Room: Week 4 Injury Updates

The Training Room: Week 4 Injury Updates

By Russell Manalastas (Injury Expert), last update Sep 29, 2015

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.

On The Mend

Drew Brees (Bruised/Strained Rotator Cuff): Brees continues to rehab with the most recognized sports medicine staff in the U.S., so it's not for a lack of effort his arm isn't progressing as fast as fantasy players would like. Like we discussed last week, how his shoulder feels and his velocity when he throws will ultimately decide if he's back this week. Pain in or around the rotator cuff causes the muscles to not work as well as they should, so asking them to help with a dynamic motion such as throwing can be a tall task. Projection: Brees starts Week 4. Drew Brees at less than 100% is better than no Brees at all, especially with the Saints desperate for a win.

DeMarco Murray (Hamstring strain): Early reports on Murray's hamstring are he's feeling slightly better, but his practice participation should be a good indicator of where he is in his progression. Projection: Murray will be active for Week 4, but might be on a snap count. The Eagles offense looked better with Ryan Mathews getting the start, especially against a stingy Jets defense. The Eagles will likely make sure Murray doesn't experience any setbacks to keep the long-term goal in mind.

Andre Ellington (PCL sprain): Ellington continues to get in limited practices since he's dealing with his PCL sprain. Hopefully he'll test the knee more and can get in full practices to see how it reacts. Projection: Ellington will be active for Week 4 against the Rams. The Cardinals will form a pretty impressive RBBC with Ellington, Chris Johnson and David Johnson, with Ellington likely to be on a snap count.

Reggie Bush (Strained Calf): Bush continues to make his way back from his calf strain, but due to his lack of practice time, it seems like he could be held out one more week. Projection: Bush misses Week 4 and plays Week 5. Seems like my two-week absence projection when he first got hurt was a little too optimistic for Bush.

Devante Adams (Ankle sprain): Adams re-injured his ankle on MNF and did not return. Risk of re-aggravations to ankle sprains can be high if the ankle is not given enough time to fully heal. Projection: Adams misses two weeks and returns for Week 6. Per usual, Aaron Rodgers continues to show us how effective he can be regardless of who his receivers are. Adams could be a nice buy-low target if someone has soured on his lack of production.

Victor Cruz (Calf strain): Cruz has stated he will make his long-awaited return to the field this week against the Bills. Projection: Cruz starts Week 4 against the Bills. There is still some risk of a setback during the week, but he seems to be as close to full health as he's been in a long time. It will be interesting to see the explosiveness and burst in Cruz's legs after the patellar tendon rupture and now this calf strain. The hope is he's able to stay healthy once he does finally return.

Alshon Jeffery (Hamstring strain): Jeffery continues to make his way back from injuries to both his hamstring and calf. It seems he has put the calf issue behind him, but there's always the thought in the back of your mind that it could rear its ugly head again. Unfortunately, a lot of his production hinges on having Jay Cutler back under center as well, as Jimmy Claussen was miserable last week. Projection: Jeffery starts Week 4. You can't take anything Coach Fox says nowadays when it comes to injuries, but it seems like Jeffery is trending in the right direction to play.

Eric Decker (PCL sprain): Decker seemed like he was close to returning last week, but opted to give his knee one more week to recover. Decker has been adamant he won't come back until he's fully healthy, so keep an eye on if he's practicing fully or if he's still limited to figure out if he's close to returning. Projection: Decker starts Week 4. He seems to be dealing with a low-grade sprain and the fact he was able to practice in some manner bodes last week well for his availability this week.

Tevin Coleman (Broken Ribs): Coleman will continue to be week-to-week, with pain being the primary limiting factor. There is a good chance he might try and practice with some padding around the ribs to see how the pain is. Projection: Coleman misses one more week and returns Week 5. The technology of padding to help distribute force away from the affected area has improved dramatically, so I think Coleman is closer to returning if he can withstand his current pain level.

Jay Cutler (Hamstring strain): Cutler continues to be week-to-week, but his practice time this week will be telling in terms of how close he is to returning. Projection: Cutler misses one more week and returns for Week 5. Could Bears fans actually be missing Jay Cutler? Another week of watching Jimmy Claussen and I'd say there's no question!

Arian Foster (Sports Hernia): Foster continues to practice and work on his conditioning. Coach O'Brien says Foster is close, but what that actually means is anyone's guess. Projection: Foster misses one more week and returns for Week 5.

Ladarius Green (concussion): Suffering multiple concussions in a span of 10 days is a very serious issue. There is a good chance the Chargers hold Green out longer to make sure he is asymptomatic during and after practices to ensure full recovery. Projection: Green misses one more game and is eligible to return for Week 5. Antonio Gates should get his starting job back, so if he's available, now is the time to stash.

Training Room

Ben Roethlisberger

MCL Sprain and Bone Bruise

Bottom Line: An MRI revealed no structural damage to his ACL, which the injury was originally feared to be. Although he escaped with "just" an MCL sprain, the bone bruise he also suffered will be the more concerning and time-consuming injury in that will frustrate owners. He'll be week-to-week, and although Ben is as tough as they come, this could be an injury he could have a tough time beating his projected time missed.

Projection: Roethlisberger misses six games. The thing I'm worried about most is that due to the injury being on his plant leg, the bone bruise will continue to cause pain when trying to push off his throwing leg, possibly even when he decides to return. Big Ben's elusiveness could suffer as well if he tries to return too soon. He could wear a brace to help offload the knee to manage the pain, but at this point it's too early to tell.

Sammy Watkins

Calf Strain

Bottom Line: Initial tests revealed Watkins suffered a mild calf strain. Although the term "mild" can mean a number of things, it seems Watkins came out with a Grade 1 strain. He'll be day-to-day and will more than likely sit out most of practice this week to allow his calf to recover.

Projection: Watkins misses one game. Percy HarvinRobert Woods and Charles Clay will see more work with Sammy missing time. I like Clay against the Giants this week as he seems to have developed good chemistry with Tyrod Taylor.

Marshawn Lynch

Hamstring Strain

Bottom Line: Lynch will be day-to-day for now. He's now nursing calf and hamstring strains and soft tissue injuries can linger, so the Seahawks will be a keeping close eye on his recovery.

Projection: Lynch misses one game. Lynch is in unchartered waters as he's been able to play through most of his back issues and other injuries he's had. I feel like the Seahawks will try and give him an opportunity to recover longer in the hopes he's healthier the rest of the season.

Jacob Tamme


Bottom Line: He'll be day-to-day as he works through the league's concussion protocol.

Projection: It's too early to say. The addition of an independent neurologist to clear NFL players before returning to the field seems to have slowed the recovery process for players returning, which is a good thing. But that just further complicates being able to project when a player returns from a concussion.

Lesean McCoy

Hamstring Strain

Bottom Line: There is a very good chance the medical staff shuts downs McCoy for the majority of practice this week to give his leg an opportunity to try and recover. He could try and test things out later in the week, but the Bills will manage his reps as much as they can.

Projection: McCoy misses one week and returns Week for 5. McCoy's style of running, the constant start/stop, and hard cutting can overload the hamstring, especially if not fully recovered. This is about being smart with a player who has been trying to gut it out, and reducing risk of having a strain become worse.

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