Ertz likely a game-time decision in Week 1
Dave Pratt, DPT, checks in on Zach Ertz, Arian Foster, Victor Cruz and the fantasy-relevant injury news for Week 1 of the NFL regular season.
Ertz likely a game-time decision in Week 1
After suffering through a preseason littered with injuries, the NFL regular season is finally upon us. It’s now time to take a look at all of the current fantasy-significant injuries heading into Week 1. This article will be updated later in the week as more information becomes available.
Geno Smith suffered a broken mandible (jaw) this preseason, and underwent surgical repair. His surgery was not as extensive as initially reported, so his timetable to return will be sooner than initially expected. During Monday’s practice, he participated in individual drills. He will not play in Week 1, but could be back prior to the Jets’ bye in Week 5.
Robert Griffin III was demoted to second-string quarterback, behind Kirk Cousins, last week. He is recovering from a concussion, and is scheduled to visit an independent neurologist on Friday. He will need to be cleared by the neurologist prior to returning to play. Griffin’s fantasy relevance is close-to-none.
Johnny Manziel has missed the latter half of the preseason due to having elbow pain with throwing. He has reportedly been diagnosed with an elbow tendinitis – likely lateral epicondylitis, also known as “tennis elbow.” He has undergone conservative treatment thus far, and is expected to begin throwing a football again this week. If he can throw the football effectively without exacerbating his elbow pain, he could be ready to backup Josh McCown in Week 1.
Arian Foster underwent a groin surgery on Aug. 7. Initial reports indicated Foster suffered a grade III groin strain, where the muscle and tendon detach from the bone. Then, reports came out that Foster actually underwent a “sports hernia” repair. To most, these reports seemed to contradict each other.
Well, they actually don’t. A “sports hernia” is a clinical diagnosis of exclusion. Once other diagnoses are ruled out, and the athlete’s clinical presentation and history is consistent with mechanical groin pain, he is diagnosed with a “sports hernia.” This umbrella diagnosis is misleading because there’s no actual hernia involved. In Foster’s case, his diagnosis of “sports hernia” most likely entailed his hip adductors (groin) being fully or partially detached from the pelvic bone, and the surgeon would have reattached whatever was detached.
With that settled, it’s time to look at Foster’s outlook for the rest of the season. The type of surgery he likely underwent has a very high success rate (95%+). If the tendon had fully detached – which was the initial report – it would take him almost six months to return to play. However, if the tendon were partially detached, it would take closer to 2-3 months to return to play. On Sept. 7, ESPN’s Adam Schefter reported the Texans believe Foster “could” return in four weeks – which would indicate the latter of the two surgeries mentioned.
At this time, it’s difficult to trust anything being said about Foster’s rehab. Hearing Texans’ personnel say he is “doing well” is not a real objective measure. Foster may return as early as Week 5, but that’s nowhere near a sure thing. Whenever he does return to play, he will likely only be near 80 percent of his full health.
Foster’s season-long outlook is bleak. His extensive history of lower extremity soft tissue injuries – which have very high recurrence rates – is alarming. Regardless of when he returns to play, his durability is difficult to trust. Consider his fantasy owners warned – yet again.
C.J. Spiller underwent an arthroscopic knee surgery three weeks ago. The Saints have provided very few details about the nature of this knee surgery. Spiller likely had loose fragments of his meniscus removed. Such a surgery would not significantly increase his risk of reinjury when he returns to play. He will be inactive in Week 1, and will likely suit up for Week 2.
David Cobb suffered a calf strain this preseason, was immediately placed in a walking boot, and then was placed on injured reserve-designated for return. He will first be eligible to play in Week 10. If he does not fully rehab the calf, he will have a significant reinjury risk when he returns to play. However, 10 weeks should be sufficient for him to fully rehab and heal – unless there is something else going on that the team hasn’t mentioned.
Duke Johnson continues to progress through the NFL concussion protocol. He will need to be cleared by an independent neurologist prior to returning to contact. His practice participation throughout the week will best indicate his availability for Week 1. This is the first reported concussion of his college or pro career, so his concussion history does not warrant any extra concern. Update (9/9/15): Johnson has been cleared to practice.
Jay Ajayi fractured multiple ribs during the Dolphins’ fourth preseason game. He was then placed on injured reserve-designated for return. He is now ineligible to play in the first eight weeks. Once he returns to play, he will not have a significant chance of suffering a reinjury.
Joique Bell is returning from reportedly “minor” offseason Achilles tendon and knee surgeries. He was activated from the active/PUP list in late August. The Lions never released details regarding the nature of Bell’s knee surgery. His rehab timetable is most consistent with a microfracture surgery.
The Lions have recently stated that Bell is still their No. 1 running back. He is currently going through the conditioning phase of his rehab. As long as he progresses nicely through that phase, and his knee symptoms are not exacerbated, he will return to full participation in practices, and start receiving managed workloads in games. However, expectations should be tempered: Week 1 is likely too soon to see him on the field.
Lorenzo Taliaferro is sidelined with an MCL sprain. Reading between the lines, it sounds like he has a Grade II sprain. Grade II MCL sprains typically take players 2-4 weeks to return to play. That would make Taliaferro’s likely return to be in Week 2 or 3.
LeSean McCoy suffered a hamstring strain on Aug. 18. Later that day, Coach Rex Ryan stated that McCoy’s hamstring was still “intact.” In other words, the tendon did not detach from the ischial tuberosity. Ryan’s comment suggests McCoy suffered a high-grade II proximal hamstring strain.
Such an injury typically takes a player 4-6 weeks to return to play. Once able to run pain-free, he must then gradually recondition himself. On Monday, McCoy was participating in individual drills, which is a positive. However, even if he does play in Week 1, he would not have had enough time to be fully reconditioned. Therefore, at best, McCoy will have a partial workload in Week 1.
It’s also worth noting that this particular type of hamstring injury, a high-grade II proximal strain, has a high recurrence rate. Injuries involving tendons do not heal as well as strains that occur in the muscle belly. They tend to scar more than the latter. Because there is a correlation between the amount of scar tissue found in hamstrings and the occurrence of future strains, McCoy owners should be sure to have adequate running back depth during the early part of this season. Update (9/9/15): McCoy was a full participant in Wednesday’s practice. He is expected to start in Week 1.
Todd Gurley is in the final stage of rehab for his ACL repair. He is no longer wearing the yellow no-contact jersey at practice. He has already been ruled out for Week 1, and will likely not suit up for the first three weeks. In early October, he will likely make his NFL debut with a light workload. He’ll not have a full workload until at least midseason.
Tre Mason suffered a hamstring strain on Aug. 29. As of Tuesday, he has yet to return to practice. Coach Jeff Fisher stated he will likely be a game-time decision. If that’s the case, he will be too risky to start in Week 1. His owners should closely monitor his practice participation for the rest of the week. Update (9/9/15): Mason was absent from Wednesday’s practice.
Alshon Jeffery suffered a high-grade II calf strain over three weeks ago. This injury is tricky as symptoms can be exacerbated easily once the athlete returns to running. Because Jeffery has been out of commission for the past month, he will need to ramp up his reconditioning program very soon. As of Tuesday, NFL.com’s Ian Rapoport reports Jeffery is “progressing well,” and he could be available for Week 1.
If Jeffery is able to practice on consecutive days without any setbacks, there is a good chance he will be available for Week 1. But, if he doesn’t, his availability can’t be trusted. That is why his owners need to monitor his practice participation throughout the rest of the week.
On a side note, due to the high recurrence rate of this injury, Jeffery could easily suffer a reinjury during his first few weeks back playing. His fantasy owners should be aware of this, and build wide receiver depth on their rosters. Update (9/9/15): Jeffery practiced on Wednesday, and appeared to be running at almost full speed without displaying any signs of discomfort. If he practices full on Thursday without any setbacks, he will almost certainly start on Sunday.
Brandon Lafell was placed on the reserve/PUP list due to a foot injury. In typical Patriots fashion, very few details have been given regarding the nature of his injury. All we are sure of at this point is he’ll be ineligible to play until Week 8.
Breshad Perriman suffered a sprained PCL during the first practice of training camp. Coach John Harbaugh said there is no timetable for his return except that it will not be “tremendously far down the road.” Considering he said Perriman’s MRI was unremarkable, it’s difficult to trust anything Harbaugh says on the matter.
The severity of Perriman’s sprain is unknown, but considering he was seen running during the pregame warm up of the last preseason game, his return will likely be before October. His owners are advised to keep an eye on his practice participation. Only when he participates in consecutive practices should his owners plan for his return.
DeSean Jackson suffered a separated shoulder (i.e. AC joint sprain) in early August. He will be active in Week 1, and the injury should not affect his production in any meaningful way.
Devante Parker underwent a surgical revision of the bone screw in his foot during the summer. He played a limited number of snaps in the Dolphins’ preseason finale, and is expected to be active in Week 1. However, due to all of the time he has missed, he has been listed with the second-team offense on the depth chart. He will need to be gradually reconditioned before he can compete for a spot on the first-team offense.
Jordy Nelson suffered a torn ACL during the preseason. He’ll miss the rest of the season.
Julian Edelman missed most of the preseason with an ankle injury. He was able to participate in some positional drills at the tail end of training camp. Due to the time he has missed, he will need to work on his general conditioning for the time being.
With the limited information available, it’s difficult to determine when he will return to play. One thing Edelman has working in his favor is he is very familiar with the Patriots’ offensive scheme. Once he is physically ready to play, the coaching staff will likely get him on the field with a managed workload. At this time, his fantasy owners are advised to closely monitor his practice participation throughout the week. More likely than not, Edelman will be active in Week 1. Update (9/9/15): Edelman is not on the Patriots’ Week 1 injury report.
Kelvin Benjamin suffered a torn ACL during the preseason. He’ll miss the rest of the season.
Kenny Bell was placed on IR with a torn hamstring. He’ll miss the rest of the season.
Michael Floyd dislocated three fingers in early August. Wide receivers typically return from this injury in a month. Floyd is scheduled to practice on Wednesday. If he does, his fantasy owners can expect him to be active in Week 1. He should be back in playing form quickly considering he could condition throughout the preseason.
Mike Evans suffered a hamstring strain in the Buccaneers’ second preseason game. Prior to that, he suffered one in June – demonstrating the recurrent nature of the injury. Hopefully for him and his fantasy owners, this does not plague him for the rest of the season.
As of Monday, Evans hasn’t returned to practice. Until he is able to participate in consecutive practices without any exacerbation of symptoms, he should not be trusted to start in any fantasy lineups. His risk would be too high.
Roddy White underwent elbow surgery in late August to have bone chips removed. This will not affect his availability for Week 1.
Randall Cobb suffered a separated shoulder (i.e. AC joint sprain) during the Packers’ third preseason game. Typically, athletes with this injury are able to return to play within two weeks after onset. Cobb will be exactly two weeks out in Week 1. Therefore, he is expected to play.
It’s worth mentioning that this injury can be easily exacerbated with a forceful blow to the shoulder. But, considering the upside Cobb has in Week 1 against the Bears, if he plays, he should be started in fantasy lineups regardless of that risk.
T.Y. Hilton suffered a concussion on Aug. 29. An independent neurologist has yet to officially clear him to return to play. Nevertheless, he is expected to play in Week 1.
Victor Cruz suffered a calf strain on Aug. 19. He had been rehabbing from a patellar tendon repair throughout the offseason and preseason. His calf strain occurred shortly after he was cleared to participate in team drills. It’s not uncommon for athletes returning from this major surgery to have biomechanical abnormalities. Typically, such abnormalities cause tissue(s) to be overstressed somewhere along the kinetic chain. More likely than not, that was the cause of Cruz’s almost-immediate injury upon returning to play.
As of Monday, Cruz has yet to return to practice. He will likely be inactive for Week 1. For the rest of the season – and possibly his career – Cruz’s durability is too shaky to trust. His owners are advised to put his roster spot to better use.
Julius Thomas underwent a surgical repair of a tendon in his finger on Sept. 2. He has been ruled out for Week 1-3. His earliest return would be in Week 4.
Zach Ertz underwent a sports hernia operation one month ago. The conditioning phase of his rehab has already begun as he was seen running comfortably last week. Reports have indicated he has been cleared to practice. If he continues to progress without having any setbacks, he is expected to be active on Monday night. However, his fantasy owners should expect him to have a limited snap count. Update (9/9/15): Ertz is expected to be a game-time decision on Monday. His owners need to find a fill-in for Week 1.
Dontari Poe is still recovering from an offseason back surgery. Coach Any Reid believes he has a chance of playing in Week 1. His practice participation throughout the week will be the best indicator of his availability.
Vontaze Burfict has been placed on the reserve/PUP list with a knee injury. He will be ineligible to play prior to Week 8.
Charles Tillman has completed the NFL concussion protocol. He has been cleared to play in Week 1.
Orlando Scandrick has torn his ACL and MCL. He will miss the entire season.
Dave Pratt, DPT, is a licensed physical therapist and a former collegiate football player. He has years of experience analyzing game footage and injuries. Throughout the NFL season, he will breakdown and discuss all fantasy-significant injuries in this weekly column, commonly known as the “Fantasy Injury Ward.” The first edition of the column will be made available on Monday afternoons, and updates will be made throughout the week. Follow him on Twitter @PFF_DavePratt