NFL Week 14 Injury Notebook

Week 14 kicked off Thursday night, and it saw the NFL's third internal organ injury in less than a week.

In other words, it's not always bones, joints and tendons.

According to ESPN's Adam Schefter, Chicago Bears wide receiver Brandon Marshall suffered two broken ribs and a collapsed lung—known as a "pneumothorax"—after he took a defender's knee to his back's midsection. The injury ended his season.

The Bears medical staff did an excellent job of recognizing the injury and promptly arranging treatment, as some types of pneumothoraces can turn into medical emergencies in a matter of minutes. Indeed, those watching Thursday Night Football saw Marshall leave in an ambulance while connected to heart monitoring.

Most likely, Marshall's broken ribs pushed inward and cut the lining and outer layer of his right lung. This cut lets air travel through the airways, into the lungs and out of the lungs via the laceration to collect between the lung and the lining that encases it. In extreme cases, the air can continue to collect in the chest but outside of the lung, compressing the organ and preventing normal oxygenation and heart function.

Thankfully, Schefter mentions doctors successfully treated the issue. Treatment likely involved inserting a small tube between the lung and its lining and vacuuming out the air from where it didn't belong. The tube remains in place for some time, and the damaged tissue will begin to heal, sealing the gap caused by the broken ribs.

Assuming Marshall avoided serious complications of the injury, he should heal well with time.

Thankfully, pneumothoraces do not occur all that often in football, and their frequency comes nowhere close to the injuries—quite a few of which are ankle injuries—that populate this week's injury notebook.

Let's take a look around the league.

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

Zach Mettenberger, QB, Tennessee Titans (Yellow)

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Player: Zach Mettenberger, QB, Tennessee Titans

Injury: Grade-1 acromioclavicular (AC) joint sprain

Latest News: NFL Network's Ian Rapoport provided the official diagnosis earlier this week. The Tennessean's Jim Wyatt called the quarterback "a go" after he practiced on Friday.

Alert Level: Yellow

Relevant Medicine and Anatomy: The AC joint marks the location where the clavicle—the collarbone—meets the shoulder blade. It is one of four joints within the shoulder, all of which need to function reasonably well in order to complete the throwing motion.

A Grade-1 injury implies mild overstretching of the ligaments that span the joint. However, the bones remain in their proper anatomical position, and the injured tissue should eventually scar down on its own.

Possible On-Field Limitations and Considerations: Rapoport mentions Mettenberger's injury involves his right shoulder. As such, it could affect his throws.

The rookie will likely obtain anti-inflammatory treatment prior to the game, and ongoing pain and soreness could manifest as inaccurate or weaker throws. However, if he avoids another hit to the shoulder, he can play through the sprain.

Fantasy Advice: Mettenberger is probably a decent QB2 this week. However, if you are in a one-quarterback league and are caught with the former LSU Tiger as your only option, you might consider looking to the waiver wire.

Follow-Up: Owing to the contact nature of football, this injury will probably linger on and off for a few weeks. However, if Mettenberger can avoid another big hit to the area, it shouldn't bother him beyond 2014.

C.J. Anderson, RB, Denver Broncos (Green-Yellow)

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Player: C.J. Anderson, RB, Denver Broncos

Injury: Ankle injury

Latest News: The Broncos list Anderson as "probable" after he practiced in full all week despite the injury.

Alert Level: Green-yellow

Relevant Medicine and Anatomy: The exact circumstances of Anderson's injury aren't clear. It could be a minor sprain. It might be a bruise. Either way, the fact that he practiced in full all week is reassuring. Consistent practice implies one day of work didn't cause enough swelling or pain to limit the next.

Possible On-Field Limitations and Considerations: Anderson may receive some supportive taping or anti-inflammatories prior to the game, but all signs point toward the mildest of mild ankle injuries.

Fantasy Advice: I cannot in good faith mark a running back who is dealing with an ankle injury as "green"—hence the "green-yellow" alert level. After all, the ankle anchors a running back's agility. However, there isn't anything out there to dissuade you from starting him this week.

Follow-Up: As long as Anderson avoids an aggravation, he might not show up on his team's injury report at all next week.

Andre Ellington, RB, Arizona Cardinals (Red)

Rick Scuteri/Associated Press

Player: Andre Ellington, RB, Arizona Cardinals

Injury: Hip pointer

Latest News: Fox Sports' Alex Marvez relayed head coach Bruce Arians' report of his running back's "severe" hip pointer earlier this week. According to the team's injury report, Ellington did not practice all week and is out this Sunday.

Alert Level: Red

Relevant Medicine and Anatomy: A "hip pointer" describes a deep bruise of and around the iliac crest—the bony part of the pelvis that can be felt above the hip. The bruise usually heals with rest and time, but it can cause extreme pain and limit agility and range of motion.

Possible On-Field Limitations and Considerations: A hip pointer can drastically affect a running back's agility, speed and lateral movement. It's no surprise the Cardinals ruled him out this week.

Fantasy Advice: Be ready for a multiweek injury. Once Ellington strings together a couple of practices, he will become a viable start once more, but if next week sees him make minimal progress—such as practicing on a limited basis on only one day—be very careful.

Follow-Up: Ellington's injury should heal fine with time. The question is: How much time?

Rashad Jennings, RB, New York Giants (Orange)

Bill Kostroun/Associated Press

Player: Rashad Jennings, RB, New York Giants

Injury: Ankle sprain

Latest News: NJ.com's Jordan Raanan reported on Jennings' status on Friday:

"

Giants running back Rashad Jennings is officially listed as questionable for Sunday's game in Tennessee with an ankle injury. That gives him a 50-50 chance of playing against the league's worst run defense.

Jennings practiced for the first time this week on Friday. He was a limited participant and looked somewhat hobbled by the sprained right ankle. 

"

Alert Level: Orange

Relevant Medicine and Anatomy: Jennings' ankle anatomy is the same as C.J. Anderson's, but Raanan's report suggests Jennings is dealing with a more significant injury than his counterpart in Denver.

Possible On-Field Limitations and Considerations: Whereas Anderson's practice status is reassuring, Jennings' is anything but. According to the team's injury report, his only practice this week was a limited session on Friday.

Not only does a single limited practice suggest the running back's injury is more serious, but it leaves fantasy owners wondering what his ankle will do on Saturday after being worked on Friday.

Fantasy Advice: I'm not high on Jennings this week. Even if he does play—far from a guarantee—he hasn't done enough this week to convince me that he'll see double-digit carries, and the risk of an aggravation is likely fairly high.

Follow-Up: Most mild ankle injuries will scar down with enough setback-free time.

Jerick McKinnon, RB, Minnesota Vikings (Red)

Tom Szczerbowski/Getty Images

Player: Jerick McKinnon, RB, Minnesota Vikings

Injury: Lower back injury

Latest News: The Vikings ruled McKinnon out for this week. It's the second week in a row he will miss due to the injury.

UPDATE: Saturday, Dec. 6, 3:15 pm ET

According to ESPN's Adam Caplan, the Vikings placed McKinnon on injured reserve.

--End of update--

Alert Level: Red

Relevant Medicine and Anatomy: The lower back is a complicated beast, and low back pain is one of the most common chief complaints at doctors' offices across the country. It can stem from a sprain (ligament injury), strain (muscle injury), stress fracture or herniated disc, to name a few causes.

Possible On-Field Limitations and Considerations: Hopefully, McKinnon's injury is nothing more than a minor sprain or strain with ongoing muscle spasms. A disc or nerve issue, on the other hand, could prevent him from seeing the field again in 2014.

Fantasy Advice: If McKinnon perks up quickly next week, he's likely dealing with spasms due to a mild soft tissue injury. Such a scenario would mean fantasy owners could possibly start him as soon as Week 15. However, slow or minimal progress by the end of next week could signify a much more serious issue.

Follow-Up: Details remain scarce. Next week's practice statuses could shed more light on McKinnon's injury.

Larry Fitzgerald, WR, Arizona Cardinals (Orange)

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Player: Larry Fitzgerald, WR, Arizona Cardinals

Injury: Grade-2 MCL sprain

Latest News: Cardinals reporter Darren Urban tweeted Friday that Fitzgerald remains a "game-day decision."

Alert Level: Orange

Relevant Medicine and Anatomy: Despite the optimism week in and week out surrounding Fitzgerald's injury, a Grade-2 MCL sprain—a partial ligament tear—does not heal over the course of a week or two.

This Sunday will mark the three-week anniversary of Fitzgerald's injury. Three weeks represents a much more conceivable time frame, but there is no guarantee here. Recoveries of more than a month following a Grade-2 injury are not uncommon.

Possible On-Field Limitations and Considerations: Fitzgerald's ligament continues to tighten up on its own—MCL injuries do not require surgery—but a pregame exam may determine his fate. Any lingering looseness within his knee could send him to the sidelines once again.

Fantasy Advice: If Fitzgerald returns this week, the chance that he plays a decoy role is, unfortunately, real. Even if not, with Drew Stanton under center and a matchup against the Kansas City Chiefs, it's worth looking elsewhere.

Follow-Up: Fitzgerald should fully recover with time. If not this week, next week is a strong possibility.

Demaryius Thomas, WR, Denver Broncos (Yellow)

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Player: Demaryius Thomas, WR, Denver Broncos

Injury: Ankle "cleat"

Latest News: The Broncos list Thomas as "probable." He practiced on a limited basis on Wednesday and Friday, sitting out Thursday. According to Broncos columnist Andrew Mason, head coach John Fox said his wideout "will be fine."

The Denver Post's Troy E. Renck gave a more precise diagnosis:

"

Demaryius Thomas, who suffered a bruised right ankle when cleated and stepped on during a team drill on Wednesday, talked more optimistically.

"I did enough running. It felt good. It's getting better," the Pro Bowl receiver said Friday. "That's the goal (to play).

"

Alert Level: Yellow

Relevant Medicine and Anatomy: Like running backs, wide receivers rely on their ankles to help stabilize their foundation while pushing off the ground to cut away from defenders.

Possible On-Field Limitations and Considerations: Thomas' practice tally this week is less than reassuring. However, the "probable" tag suggests he will see, at minimum, some snaps this week. Athletic trainers can help support his ankle with tape, as well.

Fantasy Advice: Thomas remains a touchdown threat regardless of his injury. He's not a lock for a 10-reception, 100-yard receiving game, but owners need to keep the weekly fantasy stud in their lineups and hope Fox was being at least mostly truthful.

Follow-Up: Most mild ankle bruises will heal well with time.

Roddy White, WR, Atlanta Falcons (Orange)

Mike Ehrmann/Getty Images

Player: Roddy White, WR, Atlanta Falcons

Injury: Ankle sprain

Latest News: As of Friday night, White has not yet seen significant work on the practice field this week. According to the team's injury report, he sat out Thursday and Friday.

Alert Level: Orange

Relevant Medicine and Anatomy: White sat out last week. The fact that his status remains up in the air this week suggests his injury lies closer to the moderate range of the severity spectrum.

Possible On-Field Limitations and Considerations: White's practice status on Saturday will help clarify his health a bit, but even a limited practice—it seems unlikely he'd jump right back up to full practice—wouldn't be all that reassuring.

Fantasy Advice: White is a tough call this week, and the fact that the Falcons take on the Green Bay Packers on Monday complicates matters even further. Even if he practices on Saturday, you need a backup plan if you decide to bank on him.

Follow-Up: White is doing better now compared to this time last week. As long as he avoids a setback, the veteran wideout should continue his upward trend.

Greg Olsen, TE, Carolina Panthers (Yellow-Orange)

MIKE MCCARN/Associated Press

Player: Greg Olsen, TE, Carolina Panthers

Injury: Knee injury

Latest News: The Panthers list Olsen as "questionable" after he completed two limited practices on Thursday and Friday. He did not practice on Wednesday. ESPN's David Newton tweeted earlier this week that the tight end said he was "fine."

Alert Level: Yellow-orange

Relevant Medicine and Anatomy: Details are a bit scarce, but The Charlotte Observer's Jonathan Jones gave a midweek update from head coach Ron Rivera:

"

Olsen had swelling in his knee following the game and did not practice with the team.

"We’re resting it and we’re trying to keep him off of it so the swelling goes down," Rivera said. "No concern for him at all.

"

Many different types of knee injuries—some serious, some not—can cause swelling.

Possible On-Field Limitations and Considerations: Rivera sounds quite confident, but the fact that Olsen's knee is swelling enough to limit his practice work this week raises at least some concern.

If and when he plays this week, his knee pain and swelling could return in the later stages of the game. The Panthers medical staff may employ anti-inflammatory medications to deter the threat as long as possible. 

Fantasy Advice: Do not take Olsen's status for granted. Follow media reports closely this weekend and make sure the Panthers deem him active before you finalize your lineup.

Follow-Up: Nothing yet suggests Olsen will follow such a path, but persistent knee pain and swelling commonly ends in arthroscopic knee surgery to diagnose and treat the underlying cause.

Julius Thomas, TE, Denver Broncos (Orange)

Joe Mahoney/Associated Press

Player: Julius Thomas, TE, Denver Broncos

Injury: Ankle sprain

Latest News: According to the team's injury report, Thomas practiced on a limited basis all week, earning a "questionable" tag.

Alert Level: Orange

Relevant Medicine and Anatomy: Thomas is potentially facing his third straight game on the sidelines, which suggests his sprain involved some ligament tearing. Higher-grade sprains generally lead to more pain, swelling and, sometimes, instability.

Possible On-Field Limitations and Considerations: If Thomas plays, do not expect to see his normal level of agility. However, he remains a red-zone threat.

Fantasy Advice: If the Broncos declare Thomas active, he would become a somewhat tough call this week. His fantasy value will likely rely on touchdown receptions, though with Peyton Manning under center—not to mention Thomas' track record in the red zone—there's always a good chance for the tight end to find paydirt. However, Thomas owners will need to have a backup plan. Denver plays in an afternoon game this Sunday.

Follow-Up: The Broncos likely won't risk their star tight end if any significant doubt exists. He is too valuable for their looming playoff run, and his sprain should heal with enough time.

Fantasy Football Quick Hits

Mark Zaleski/Associated Press

Quarterbacks

• The San Diego Chargers list quarterback Philip Rivers as "probable" after he practiced in full on Thursday and Friday despite a chest injury. If you need to, you can start him.

Running backs

• According to the Baltimore Ravens' injury report, running back Justin Forsett is "questionable" this week. He is dealing with a knee injury.
• It looks like the Oakland Raiders will welcome back running back Latavius Murray this week. The team lists him as "probable" as he continues his return from a concussion.

Wide receivers

• After a scare last week, the NFL.com injury report lists Miami Dolphins wide receiver Brian Hartline as "probable." He is dealing with a knee injury.
• ESPN.com's John Keim called Washington Redskins wide receiver DeSean Jackson a "game-time decision." He suffered a knee injury last week. Those watching saw him take a shot to the outside of his knee, which caused a bruised fibula.

Tight ends

• According to Scott Petrak of the Elyria Chronicle-Telegram, Cleveland Browns tight end Jordan Cameron continues to struggle with a concussion that he suffered in late October. He will meet with an independent neurologist in hopes of receiving medical clearance.

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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