NFL Week 10 Injury Notebook

In the NFL, players run the risk of suffering a serious injury on every single play, whether it's during Week 10, conference championship week or the preseason.

Unfortunately, sometimes that serious injury comes before a player even sets foot on an NFL field.

Earlier this week, former San Francisco 49ers and University of South Carolina running back Marcus Lattimore announced his retirement. Lattimore suffered a dislocated knee in October 2012 as a member of the Gamecocks, and according to The Sacramento Bee's Matt Barrows, the 23-year-old could never quite rehab his knee back into shape:

"

The 49ers running back, a fourth-round pick last year, said the challenge of playing in the NFL became 'insurmountable.' He practiced for the first time this season last week. But after two days of practice, which included his first football contact since 2012, the soreness in his right knee returned and he began mulling his retirement.

"

In a classy move, the 49ers "will not seek repayment of (Lattimore's) $300,584 signing bonus," according to NFL.com's Chris Wesseling.

Lattimore's story highlights a major discussion point in today's sports world: compensation for college athletes. After all, it's certainly a shame that such a talented young back suffered what amounted to a career-ending injury while playing as an amateur.

The entire NFL community certainly sends Lattimore its well-wishes as he moves on to the next phase of his life, whatever that may be.

Let's get to this week's notebook.

Please note that the original form of this slideshow is current through Friday evening and will receive periodic updates throughout the weekend.

Sports Medicine Topic of the Week: X-Rays, CT Scans and MRIs, Oh My.

Wikimedia Commons

This lumbar spine MRI clearly shows three vertebrae and two intervertebral discs.

When an athlete goes down with an injury, a physical exam represents the first piece of the diagnostic puzzle. If necessary, various types of radiographic imaging come next.

X-rays are quick, simple and provide immediate results. All NFL stadiums have X-ray machines on site, allowing doctors to diagnose a fracture minutes after it occurs.

Additionally, by showing the relative position of a player's bones, X-rays can provide information about certain types of sprains and dislocations. Finally, in some emergent situations, they can show the presence of a collapsed or bruised lung, but by that point a player is usually on his way to a medical facility.

That said, not all fractures show up on X-rays. Subtle ones can hide from even the most experienced radiologists.

That's where CT scans come in.

A CT scan takes many X-rays from numerous different angles and uses a computer to put them together into a three-dimensional picture. The resulting images provide much more detail than a simple X-ray.

CTs often come into play when a team is worried about a spine fracture—as in the case of Dallas Cowboys quarterback Tony Romo—or a serious neck injury. A CT scan can also rule out an intracranial bleed after a hit to the head.

Yet neither X-rays nor CT scans show soft tissues very well.

MRIs, on the other hand, paint excellent pictures of ligaments, tendons and other such structures. For example, spine MRIs provide information about intervertebral discs, and knee MRIs can detect the presence of an injury to any of the four major knee ligaments.

Prior weeks' topics

Week 2: The spine board

Week 3: The air splint

Week 4: The hamstring strain

Week 5: High- versus low-ankle sprains

Week 6: What's meant by a "mechanism of injury"?

Week 8: The meniscus and meniscus tears

Week 9: The glenoid labrum

Fantasy Football Injury Advice of the Week: Identifying WR Decoys

Streeter Lecka/Getty Images

Unfortunately, most of the time, fantasy owners do not know if a wide receiver will play a decoy role until after a game concludes. After all, coaches want to keep opponents guessing as long as possible.

Nevertheless, certain types of wideout injuries may lend themselves toward the decoy role more than others.

For example, very new or recurring hamstring injuries always raise a red flag. A hamstring strain can limit a wide receiver's top-end speed, and too much work during a game can worsen the injury. A new groin strain, which can decrease lateral agility, may lead to a similar situation.

High-ankle sprains are another culprit. Last year, Atlanta Falcons wide receiver Roddy White's stats left something to be desired during the first half of the season as he pushed through a sprain. In 2014, Calvin Johnson has gone through his own difficult stretch.

On the other side of the coin, some injuries might not affect a wideout much at all. Minor acromioclavicular (AC) joint sprains do not affect speed or agility. If treatment provides adequate pain control, minimal to no limitations will follow—assuming the player avoids another big hit to his shoulder.

Of course, from the far outside looking in, a player's health always remains a bit of a mystery despite the best speculation. Yet what is fantasy football other than educated guessing, anyway?

Prior weeks' advice

Week 4: Beware WRs with hamstring strains

Week 5: Analyzing practice status trends

Week 6: Injuries and player attributes

Week 8: Your player's concussed. Now what? 

Week 9: Be careful with RB ankle sprains

Bye Week Recap

Tony Gutierrez/Associated Press

Make sure players from the following teams are out of your fantasy football lineups:

1. Houston Texans: Star running back Arian Foster will appreciate the bye week. He is recovering from a groin strain that he suffered in Week 9.
2. Indianapolis Colts: Veteran wide receiver Reggie Wayne put up good numbers last week after missing one game with an elbow injury. The bye week should only help him continue that trend.
3. Minnesota Vikings: Tight end Kyle Rudolph hopes to return after the bye. He underwent sports hernia surgery earlier this year.
4. New England Patriots: Defensive lineman Chandler Jones remains out with a hip injury. However, the current Patriots roster is otherwise one of the healthier squads out there.
5. San Diego Chargers: According to U-T San Diego's Michael Gehlken, running back Ryan Mathews may make his long-awaited return from an MCL sprain after the bye.
6. Washington Redskins: Quarterback Robert Griffin III will look to complete back-to-back regular-season games for the first time this season when his team returns to action in Week 11.

Aaron Rodgers, QB, Green Bay Packers (Yellow)

Bill Haber/Associated Press

Player: Aaron Rodgers, QB, Green Bay Packers

Injury: Hamstring strain

Latest News: Rodgers suffered his injury during a Week 9 matchup against the New Orleans Saints but stayed in the game. According to Fox Sports' Paul Imig, Rodgers said "it's feeling better now" but "that it 'took most of the (bye) week' for his hamstring to start feeling better."

Alert Level: Yellow

Relevant Medicine and Anatomy: The hamstring muscle group, three muscles in total, connects the pelvis to the lower leg. It controls knee flexion—bending of the knee—and hip extension.

A hamstring strain causes pain in the back of the thigh. Mild injuries can amount to as little as day-to-day re-evaluation, while complete tendon ruptures often require season-ending surgery.

Possible On-Field Limitations and Considerations: Hamstring injuries can lead to pain and weakness, especially with full leg extension. A strain that is still producing symptoms may manifest as a shorter stride length on the affected side—and thus lower top-end speed.

Fantasy Advice: Fortunately, Rodgers plays at the quarterback position and primarily relies on his arm. Unfortunately, the running game factors into his play more than most signal-callers.

That said, do not think twice here. Rodgers takes on a lackluster Chicago Bears secondary this week. While hamstring strains always carry a risk of re-injury in the early recovery period, there is not nearly enough out there to warrant benching the 2011 MVP.

Follow-Up: In addition to the aggravation risk, one hamstring strain is a proven risk factor for future strains. The Packers will certainly keep that in mind moving forward.

Tony Romo, QB, Dallas Cowboys (Orange)

Ronald Martinez/Getty Images

Player: Tony Romo, QB, Dallas Cowboys

Injury: Two transverse process fractures

Latest News: According to ESPN.com's Todd Archer, Romo earned a "probable" tag this week:

"

Dallas Cowboys quarterback Tony Romo went through a full practice Friday and is listed as probable for Sunday's game against the Jacksonville Jaguars, making it a virtual certainty he will start.

Romo, who has two transverse process fractures in his back, went through a limited practice Thursday. He said he felt better as the practice went on, but there was some soreness.

"

Alert Level: Orange

Relevant Medicine and Anatomy: A transverse process is a bony extension of a vertebral body. Each lumbar vertebrae carries two—one on the right and one on the left—jutting out sideways from the main portion of the bone.

Transverse processes serve as muscle attachment points.

Possible On-Field Limitations and Considerations: Romo's status and effectiveness depend on three factors: pain control, protection and avoiding further hits.

Furthermore, a transverse process fracture is an entirely different injury than what the veteran dealt with last year.

Entirely.

Last year's injury, a herniated disc, can cause back pain, thigh pain, leg pain, foot pain, numbness and weakness. This year's injury mostly comes down to back pain and flexibility.

Romo will likely receive pain-relieving treatment in the form of anti-inflammatories and antispasmodics prior to the game. He will almost certainly wear additional protection around his lower back, as well.

Despite those precautions, another hit to Romo's back could easily send him to the sidelines and end his day. Pain in his core—and also the aforementioned extra protection—could also limit his mobility and range of motion.

Fantasy Advice: If and when Romo starts, he becomes one of this week's toughest fantasy decisions. He captains a dynamic offense, but the risk speaks for itself. If you are fortunate enough to own an equivalent or slightly inferior quarterback option, the safer move is to keep Romo on the bench for now.

Follow-Up: The pain and spasms Romo is surely experiencing will only decrease with setback-free time. Hopefully, the Cowboys offensive line can oblige.

Fred Jackson, RB, Buffalo Bills (Orange)

Gary Wiepert/Associated Press

Player: Fred Jackson, RB, Buffalo Bills

Injury: Groin strain

Latest News: According to the Bills' injury report, Jackson practiced on a limited basis all week, earning a "questionable" tag. Jackson is rehabbing a groin injury that originally carried a recovery time of up to a month.

Alert Level: Orange

Relevant Medicine and Anatomy: Groin strains usually involve one or more of the hip adductors—muscles that bring the thigh back toward the body's midline. They play a large role in a running back's lateral agility.

Possible On-Field Limitations and Considerations: Significant groin injuries—it seems Jackson's is more than a minor pull—are tough injuries for running backs. Specifically, they affect a back's cutback ability, as planting to quickly change directions requires the hip adductors to forcefully tug on the femur—the thigh bone—and pull it back toward the pelvis.

Fantasy Advice: Even if Jackson returns from this significant injury, he faces a tough Kansas City Chiefs run defense this week. There are probably better options out there.

Follow-Up: Groin strains fall into the "potentially lingering injury" category. Once Jackson returns, the possibility of significantly limited work in his first game back is quite real.

Marshawn Lynch, RB, Seattle Seahawks (Green-Yellow)

Otto Greule Jr/Getty Images

Player: Marshawn Lynch, RB, Seattle Seahawks

Injury: Calf strain

Latest News: The Seahawks' injury report lists Lynch as "probable." He did not practice on Wednesday or Thursday but returned in full on Friday.

Alert Level: Green-Yellow

Relevant Medicine and Anatomy: The calf muscles attach to the back of the heel via the Achilles tendon. When they contract, they pull on the tendon, which in turn pulls upward on the heel. Plantarflexion—pointing of the toes—is the end result.

A player uses strong calf muscles to push his toes into the ground in order to drive forward or leap into the air.

Possible On-Field Limitations and Considerations: Lynch famously makes his living by going into "Beast Mode" and refusing to go down. A painful or weak calf could lower his ability to keep driving his legs forward into opponents.

Fantasy Advice: Lynch's return to full practice on Friday is reassuring. However, follow reports on the running back closely up until kickoff. Calf injuries can lead to setbacks at a moment's notice.

Follow-Up: A few aggravation-free weeks will usually heal most minor calf injuries.

Lamar Miller, RB, Miami Dolphins (Yellow)

Wilfredo Lee/Associated Press

Player: Lamar Miller, RB, Miami Dolphins

Injury: Acromioclavicular (AC) joint sprain

Latest News: The Sun Sentinel's Omar Kelly tweeted Friday that the Dolphins gave Miller a "questionable" tag this week. However, the Miami Herald's Adam Beasley expects the back to play on Sunday.

Alert Level: Yellow

Relevant Medicine and Anatomy: The AC joint marks the location where the clavicle—the collarbone—meets the shoulder blade. An AC sprain implies stretching or tearing of the ligaments that stabilize the joint.

Possible On-Field Limitations and Considerations: Will Carroll, Bleacher Report's lead writer for sports medicine, makes a good point here about Miller: If he plays, how willing will he be to lower his shoulder into defenders? After all, the running back position absorbs far more regular shoulder contact than most other skill positions.

Fantasy Advice: Miller's matchup this week, the Detroit Lions, is less than favorable. Furthermore, a significant hit to his shoulder could take him out of the game.

While neither of the above considerations represent an absolute contraindication to starting the 23-year-old in fantasy lineups, they merit consideration.

Follow-Up: Like other AC joint injuries from this year, the longer Miller can go without suffering another blow to his shoulder, the better.

On the other hand, he plays a position that demands upper body contact numerous times per game. Don't expect this issue to go away any time soon.

Percy Harvin, WR, New York Jets (Green)

Kathy Willens/Associated Press

Player: Percy Harvin, WR, New York Jets

Injury: Heel laceration

Latest News: According to New York Daily News' Justin Tasch, another player stepped on Harvin's heel and caused a laceration "down to the white meat." The team's injury report lists the wideout as probable after he practiced in full on Thursday and Friday.

Alert Level: Green

Relevant Medicine and Anatomy: The injury occurred on Wednesday. By Sunday, the laceration will be closing up.

Possible On-Field Limitations and Considerations: Harvin might wear some extra padding in his shoe, but nothing suggests he will experience any limitations this week.

Fantasy Advice: Start him as you normally would.

Follow-Up: The laceration should heal well.

Calvin Johnson, WR, Detroit Lions (Green-Yellow)

Joe Sargent/Getty Images

Player: Calvin Johnson, WR, Detroit Lions

Injury: High-ankle sprain

Latest News: According to the Lions' injury report, Johnson practiced in full three days in a row this week, earning a "probable" tag.

Alert Level: Green-Yellow

Relevant Medicine and Anatomy: High-ankle sprains heal more slowly than the more common "low" injuries. They often occur when a hit or tackle forcefully turns a player's toes outward relative to his leg and thigh.

High-ankle injuries can produce significant pain when planting and turning the lower leg.

Possible On-Field Limitations and Considerations: Ordinarily, I would caution against starting a wide receiver coming back from a high-ankle sprain without him first proving his health. However, Johnson's extended layoff and full week of practice are quite reassuring.

Fantasy Advice: Start him as you normally would.

Follow-Up: At this point, his injury is probably closing in on being completely healed. As long as he can avoid a tackle where his body falls over his knee and ankle, he should be fine.

Wes Welker, WR, Denver Broncos (Green)

John Froschauer/Associated Press

Player: Wes Welker, WR, Denver Broncos

Injury: Back injury

Latest News: The Broncos' injury report lists Welker as "probable" after he practiced in full all week.

Alert Level: Green

Relevant Medicine and Anatomy: Those watching Welker's injury saw the wideout take a massive hit to his back. However, his full week of practice suggests he suffered nothing more than a contusion or minor sprain.

Possible On-Field Limitations and Considerations: Welker apparently put his spine back together as well as could be expected following that jaw-dropping hit. He might wear some additional protection this week, but he can play well despite the injury.

Fantasy Advice: If you are in a position where you need to start Welker, his back injury shouldn't dissuade you.

Follow-Up: I was actually more concerned about a concussion following the hit that caused Welker's injury. A concussion can occur in the absence of direct contact to the head if a body blow causes the head to whip back and forth with enough force.

Martellus Bennett, TE, Chicago Bears (Yellow)

Jeff Gross/Getty Images

Player: Martellus Bennett, TE, Chicago Bears

Injury: Rib injury

Latest News: Adam L. Jahns of the Chicago Sun-Times provided head coach Marc Trestman's description of the injury on Friday: "It was just kind of awkward on the practice field. That’s kind of all there was. He twisted a little bit and we’ll see where he is."

The Bears' injury report lists Bennett as "questionable." He did not practice Friday after a limited session on Thursday.

Alert Level: Yellow

Relevant Medicine and Anatomy: Trestman's description of the injury suggests Bennett is dealing with a rib sprain or intercostal muscle strain. The intercostal muscles connect a rib to the ribs immediately above and below it.

Possible On-Field Limitations and Considerations: Players play through rib injuries relatively frequently. Most of the time, it comes down to a player's ability to remain effective in spite of pain.

If active, Bennett will likely wear additional rib protection.

Fantasy Advice: Bennett's injury is new, which creates more uncertainty compared to an older, lingering issue. The Bears' late start complicates matters even further.

If you decide to roll with the big tight end, check in on his status Sunday evening and have a backup plan.

Follow-Up: Time heals most rib injuries well.

Patrick Willis, LB, San Francisco 49ers (Red)

Billy Hurst/Associated Press

Player: Patrick Willis, LB, San Francisco 49ers

Injury: Big toe injury

Latest News: The Sacramento Bee's Matt Barrows tweeted an ominous update on Willis on Friday afternoon. Willis' "questionable" tag this week may be a generous one.

At one point, Barrows tweeted the injury is a strain—a muscle injury. Elsewhere, Pro Football Talk's Twitter account called the injury a sprain.

Big toe sprains often imply a metatarsophalangeal (MTP) joint injury, or turf toe. However, head coach Jim Harbaugh previously stated the injury did not constitute such a diagnosis.

Alert Level: Red

Relevant Medicine and Anatomy: Rumors continue to swirl about Willis' toe, and reports remain inconsistent. However, the linebacker's longer-than-expected recovery strongly hints at a lingering injury of his MTP complex.

The MTP joint marks the location where the base of the big toe meets the foot. It houses ligaments, bones, tendons and cartilage, and several types of injuries to the area heal very slowly.

Possible On-Field Limitations and Considerations: A healthy MTP complex allows a player to forcefully push his big toe into the ground, helping him with quick starts, acceleration, plants and cuts. An ailing joint hampers those abilities.

Fantasy Advice: The 49ers visit the New Orleans Saints this week. Few defenses do well there.

Follow-Up: Willis' injury is becoming more concerning by the week. Despite its size and relative obscurity, the MTP joint can take down even the toughest athletes.

Fantasy Football Quick Hits

Jack Dempsey/Associated Press

Quarterbacks

• Remember Arizona Cardinals quarterback Carson Palmer's nerve issue? According to CBS NFL Insider Jason La Canfora, the team inked the veteran to a new, three-year contract on Friday, effectively putting to rest any lingering concerns about his health.

Running backs

• Even if Denver Broncos running back Montee Ball returns this week, he is coming back from a severe groin strain—a tough injury for any back. Furthermore, Ronnie Hillman put up good numbers in Ball's absence and probably earned a more consistent role in the Broncos backfield. Wait and see when it comes to the former Wisconsin Badger, even if he takes the field this week.
• According to the team's injury report, Detroit Lions running back Reggie Bush practiced in full all week. It looks like he will play on Sunday.
• According to The Times-Picayune's Evan Woodbery, New Orleans Saints running back Mark Ingram is confident he will play through a shoulder injury this week. Ingram rushed for an impressive 272 total yards his past two contests.
• Don't look to New York Giants running back Rashad Jennings just yet. The team's injury report lists him as "doubtful" as he continues to recover from a knee injury.

Wide receivers

• The Tampa Bay Buccaneers' injury report lists wide receiver Vincent Jackson as "questionable" with a knee injury. However, his practice status trended up all week, offering some reassurance.
• Buffalo Bills rookie wide receiver Sammy Watkins is battling a groin injury that caused him to sit out of practice on Thursday and Friday, according to the team's injury report. If you own him in fantasy, have a backup plan ready. The possibility of him playing as a decoy is also real.

Tight ends

• New Orleans Saints star tight end Jimmy Graham remains on the team's injury report with a shoulder injury. However, he practiced in full all week, and he remains a rare "start whenever active" fantasy football option.

Dr. Dave Siebert is a second-year resident physician at the University of Washington and a member of the Professional Football Writers of America. He plans to pursue fellowship training in Primary Care (nonoperative) Sports Medicine.

Stats were obtained from NFL.com official statistics.

Questions about players on this list? Not on this list? Send 'em to Dave on Twitter.

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