I was becoming very pleased with the relative lull of major injuries in the NFL over the past few weeks. There were some nasty concussions and a few knees here and there, but nothing like, well, Week 8, for example.
Then Sunday happened.
Your regular injury expert Will Carroll is out this week, and he entrusted me to take over his regular fantasy column. Unfortunately, after Sunday's carnage, it wasn't easy.
A number of key players went down Sunday with significant injuries. Some are or may very well prove to be season-ending, while others can be fought through.
While sifting through those that are concerning for the remainder for the fantasy football season—as well as those that aren't—it helps to examine not only the injury reports themselves, but also the underlying anatomy, a player's mechanism of injury and his practice status.
With that in mind—and if I may do my best impression of Mr. Carroll here—let's take a look around the league.
INJURY: Fractured left collarbone
OUTLOOK: Awaiting medical clearance
Aaron Rodgers is now five weeks out from the most famous collarbone fracture in sports, and at this point, his injury is well into the healing process.
Athletes begin to approach clinical stability following a non-displaced clavicle fracture at about the six- to eight-week mark.
As such, rumors and hearsay will surely swirl this week once again.
According to the official Green Bay Packers Twitter account, Rodgers will work out Tuesday and undergo further evaluation this week.
Unfortunately, pain, range of motion and strength are not the issues here—and, quite possibly, have not been for some time.
Rather, it comes down to a risk assessment. For more on this, see my article from last week.
Briefly, after five weeks, a healing bone callus sports quite a bit of moxie and strength, but it cannot yet compare to healthy bone.
In other words, if Rodgers takes a hit similar to the one that caused the injury in the first place, a re-fracture becomes very likely—and perhaps almost definite.
Furthermore, as a healing callus cannot withstand the same amount of force as a healthy clavicle, the fracture may displace. Displaced fractures require surgery and a few to several months of rehab. They can also threaten the underlying structures of the shoulder and, in very rare circumstances, the neck.
Nevertheless, if doctors deem it safe for Rodgers to start Week 15—probably extremely unlikely, but possible—fantasy owners should feel safe inserting him back into their lineups.
After all, this is an all-or-nothing thing. If active, the Packers signal-caller will likely play at or close to his normal level—barring a crushing hit to his left side, of course. As mentioned, such a disaster would probably send him to the sidelines—and likely surgery.
So goes the continuous evaluation of risk versus reward.
INJURY: Midfoot (?) sprain
OUTLOOK: Unclear, but wants to play Week 15
Whatever combination of genes, fitness and healing ability Adrian Peterson carries, sign me up.
One year after returning from reconstructive knee surgery only to fall a medium-length golf putt short of the all-time single-season rushing record—while playing through a sports hernia, I might add—Peterson continues to be a dominant force on the field.
Let's also not forget that teams likely primarily focus their defenses on stopping the elusive back, yet he still produces.
Then, on Sunday, the entire northern Midwest held its breath when AP went down in agony with an apparent foot or ankle injury.
NFL.com's Ian Rapoport reported a midfoot sprain shortly after the injury occurred.
On Monday, the Star Tribune's Master Tesfatsion wrote that according to Peterson, an MRI "came back great." He will visit a foot specialist and obtain CT scans and X-rays—the best imaging method to examine the integrity of bones.
Nevertheless, head coach Leslie Frazier mentioned that he will take the Vikings' 3-9-1 record into account when deciding when to bring his superstar back to the field, per Tesfatsion.
The fact that details remain a bit murky further complicates matters for fantasy owners.
A midfoot sprain frequently implies some degree of a Lisfranc injury, but according to Tesfatsion, Peterson himself ruled out the possibility.
As Lisfranc injuries come in many shapes, sizes and degrees of severity, it's possible AP sports a very minor version of the injury, and a simple media disconnect is to blame. It's also possible that fractures do exist, and the visit with a foot specialist represents a second opinion.
Either way, if fractures become apparent on repeat imaging, Peterson may very well not play again in 2013.
On the other hand, a very minor strain or sprain may lead to no missed time whatsoever. Fantasy owners will have to pay very close attention to reports in the coming days.
INJURY: Ankle sprain
OUTLOOK: Pending practice status
That said, as noted by Fox Sports Wisconsin's Paul Imig, Lacy later returned to the game.
Given the fact that he played through it, Lacy's injury seems to be on the minor end of the spectrum. However, this week will further clarify his exact status.
After all, when it comes to ankle sprains, practice participation reigns above all else.
If Lacy makes it through two consecutive full practices this week without an aggravation, fantasy owners can feel more confident in his Week 15 availability and effectiveness. Consecutive days of practice participation imply his ankle did not flare up overnight after a full workload the day prior.
Conversely, a week of limited repetitions—or a week of mixed rest and practice—should raise red flags in owners' minds.
Pay close attention to media reports before this week's games, but also give a nod to the details and pattern on the official injury reports of Wednesday, Thursday and Friday.
INJURY: MCL sprain
OUTLOOK: Hopes to return by Week 17
According to Joe Person of The Charlotte Observer, a team spokesman announced Jonathan Stewart suffered a torn MCL on Sunday. The Observer's Jonathan Jones notes the running back will not play this week and hopes to come back by Week 17.
Reading between the lines a bit, Stewart's injury likely constitutes a grade-two MCL sprain, or a partial ligament tear. Grade-two sprains usually require between three and four weeks of rehab and recovery.
As one of the four main ligaments of the knee, the MCL prevents the knee from buckling inward. It must fully heal before a running back can entertain returning to the field, as playing on a seriously injured MCL risks more injury to the other structures within the knee.
From a fantasy standpoint, there is little reason to keep Stewart on a roster—if he was even on it in the first place. He has not been a viable starter this season.
On the other hand, DeAngelo Williams may see even more carries from here on out as a result of Stewart's injury. As such, Williams may warrant some starter or flex consideration in deeper leagues.
INJURY: Hamstring strain
OUTLOOK: Questionable for Week 15
Maurice Jones-Drew pulled up with an obvious hamstring injury during Week 14's installment of Thursday Night Football. He underwent an MRI the next day, per Ryan O'Halloran of the Florida Times-Union (via Pro Football Talk's Mike Florio).
Also via Florio, MJD stated very confidently that he will play Week 15 during an interview on SiriusXM Fantasy Sports Radio:
Definitely. Definitely. That’s always been the plan. Right now, I mean, I just want to make sure everything is on track. And then we’ll see how it goes next week, but I expect to be out there playing with my teammates.
Precise medical details are not available to the public, but MJD's confidence may suggest his injury is of a grade-one variety.
In other words, his hamstring MRI showed signs of inflammation and injury but no obvious muscle or tendon tear.
Grade-one hamstring injuries can heal over the course of a week or two, and the long layover between games for the Jaguars may prove crucial for their running back's availability.
Nevertheless, fantasy owners must keep an eye on his practice status this week. Hays Carlyon of the Florida Times-Union calls MJD's availability "very questionable" at this point, and the star merely hopes to practice by Friday.
Hamstring strains can linger and flare up at any point—especially for a running back, a position that utilizes quick starts and cuts as much as any other on the field. Any aggravation or setback throughout the week may sideline MJD on Sunday.
INJURY: Calf strain
OUTLOOK: Day-to-day, questionable for Week 15
Despite last week's optimism, Reggie Bush's calf strain concerned me enough to warn owners to check on his status prior to kickoff Week 14.
Unfortunately, an aggravation did, indeed, occur during pregame warm-ups, and Bush dropped a goose egg in the fantasy box score.
Regrettably, it's the nature of the beast when it comes to calf strains.
As a muscle primarily responsible for pointing the toes—and therefore pushing them into the ground to run, cut and leap—strong calves play a vital role in a running back's productivity.
They also come into play with every single step.
Currently, Bush's calf injury lands him in the "day-to-day" category, according to Lions insider Tim Twentyman.
In other words, he will practice as much as pain and swelling allow.
Once again—and at the risk of sounding like a broken record—fantasy owners need to play close attention to the running back's practice status throughout the week. The fact that the Lions play on Monday in Week 15 only serves to complicate things further.
As a rule of thumb, two consecutive days of at least limited repetitions offers at least a small amount of reassurance; anything less raises concern for a repeat of Week 14.
Even then, nothing is a given, as this past Sunday morning showed.
INJURY: Torn ACL, MCL
OUTLOOK: Out for 2013, start of 2014 in doubt
Rob Gronkowski fell victim to a classic knee mechanism of injury: a hard hit to the outside of the knee that, according to ESPN's Adam Schefter, tore the ACL and MCL. For more details, see my article here.
Briefly, inward-directed motion of the knee causes the tibia—or shin bone—to overrotate with respect to the femur. The ACL, on the other hand, attempts to prevent such motion. However, if the outside force is of great enough magnitude, the ACL cannot keep up and tears.
Inward motion can also damage the MCL—a ligament that ordinarily tries to deter the inward collapse of the knee—as it did in this case.
Gronkowski may also have some meniscal damage within his knee. Meniscus injury often accompanies concurrent ACL and MCL tears in the so-called classic "unhappy triad" knee injury combination.
Nevertheless, surgeons will not truly know the full extent of the damage until the tight end is on the operating table.
Furthermore, knee reconstructions can require anywhere from six to seven months of rehabilitation on up, and recent repairs in the NFL require an average of about nine to 10.
With that in mind, Gronk's status for the start of 2014 falls very much on the uncertain side.
OUTLOOK: Not expected to play Week 15
I've suffered at least three concussions myself, and needless to say, I do not envy Welker right now. I hope he recovers well and without difficulty—not just for a return to football, but for his overall health and well-being.
While all concussions are unique in characteristics and timeline to recovery, the proximity of Welker's injuries certainly does not help. Current theory holds that subsequent concussions may lead to more severe and longer-lasting symptoms.
That said, once his symptoms subside, the Broncos wideout will begin the concussion return-to-play protocol—a process that involves both physical and cognitive testing.
In short, Welker must prove that his cognitive capabilities have returned to his baseline via a computerized examination designed to test items such as verbal memory, spatial reasoning and other mental tasks.
Additionally, he needs to show doctors he can proceed through a standardized sequence of exercises without his symptoms returning. The steps include light cardio activity, heavier activity, non-contact practice and full-contact practice.
A neurological consultant must also provide his or her blessing before the player can return to the field.
At this point, it is impossible to say how long the entire process will take. However, a bet that Welker will not take any snaps this Thursday is a safe one.
Jay Cutler, QB, Chicago Bears
Jay Cutler's high-ankle sprain continues to mend, and all the while, backup quarterback Josh McCown continues to explode past expectations in his absence.
High-ankle sprains involve injury to one or more ligaments that connect the tibia to the fibula, and as such, rehab is much trickier than the low-ankle counterpart.
That said, head coach Marc Trestman said Cutler will take the reins of the offense once medically cleared, according to ESPNChicago.com's Jeff Dickerson.
Lamar Miller, RB, Miami Dolphins
According to ESPN.com's James Walker, Lamer Miller suffered a concussion Week 14.
As with all concussions, Miller must pass the concussion protocol. A return to full practice by Friday would bode well for Week 15; anything less suggests the running back will sit out on Sunday.
Percy Harvin, WR, Seattle Seahawks
Percy Harvin had a cortisone injection in his surgically repaired hip last week. Cortisone is a steroid that reduces inflammation—and therefore pain.
Despite a brief-but-strong return earlier this season, details on Harvin's status remain scarce. Practice injury reports should help clarify things a bit, but rumors that the Seahawks may shut him down until the playoffs are gaining steam.
Peyton Manning, QB, Denver Broncos
The health of Peyton Manning's ankles comes up just about every week, but he just doesn't seem to care.
As the saying goes, that one's gonna hurt in the morning. Er, offseason.
Randall Cobb, WR, Green Bay Packers
At this point, with the Packers on the outside of the playoff picture looking in, fans may not see Randall Cobb on the field again in 2013.
That said, Ty Dunne of the Milwaukee Journal Sentinel reported last week that according to head coach Mike McCarthy, Tuesday is a "big day" in terms of Cobb's future availability.
Tyrann Mathieu, DB, Arizona Cardinals
According to Fox Sports 910's Mike Jurecki, Tyrann Mathieu suffered a torn ACL and LCL. Like Gronkowski, he will need reconstructive knee surgery, and his availability for Week 1 of the 2014 season may be in jeopardy.
Dr. Dave Siebert is a resident physician at the University of Washington and a member of the Pro Football Writers of America. He plans to pursue fellowship training in Primary Care (non-operative) Sports Medicine.
For questions about players not on this list, follow Dave on Twitter: