Week 4 fantasy football injury report LeSean McCoy, Davante Adams

Ben Roethlisberger

For the third consecutive week, a high-profile player went done with a significant injury. While the Cowboys felt the pain in Weeks 1 and 2 with Dez Bryant and Tony Romo, respectively, the Steelers and Roethlisberger’s knee injury grabbed the spotlight in Week 3 when he went down in the third quarter of the team’s win over St. Louis.

Roethlisberger absorbed contact from Rams safety Mark Barron just below the left knee. The hit placed a type of force on the knee that is medically known as a valgus force. In this type of stress, the hit is taken on the outside but the force is diverted across the knee and places strain on the ligaments on the medial (inside) portion of the joint. A MRI taken late Sunday confirmed a medial collateral ligament (MCL) sprain with no damage to the ACL or PCL.

Let’s start with the good news. The MCL is able to heal without surgical intervention even when it is partially torn, like in the case of Big Ben. Additionally, he appears to have avoided any damage to his medial meniscus, a big concern since the MCL is intertwined with the fibrocartilage disc. As a result, Roethlisberger will avoid the operating room, and time and progressive treatment will be the best course of action.

However, Roethlisberger is expected to miss multiple weeks and an additional injury sustained on the play could prolong his recovery. The evaluation also revealed a bone bruise of the area, an injury that shouldn’t be taken lightly despite the suggestive name. A bone bruise can occur in varying degrees that all involve damage accrued to various layers of bone tissue. In the lower extremities, the most common type of bone bruise is periosteal bruising or a sub-periosteal hematoma. This occurs when the connective tissue that covers the surface of the bone is damaged and blood collects under the outer covering of the bone. Interosseous bruising occurs when the damage is deeper and includes the bone marrow. While the extent of Roethlisberger’s bruising has not been revealed, the body repairs both in a similar way laying down new bone tissue to repair the damage just as it would a true fracture. Even worse, the biomechanical properties of the knee are often counterproductive to the healing process and delay a return to play. As a result, it’s likely that Roethlisberger’s return is on the latter end of the four-to-six-week window.

Michael Vick will take over at quarterback, though his performance on Sunday wasn’t overly inspiring. Vick will have plenty of offensive weapons to utilize, but the matchups the next four weeks are a mixed bag. Pittsburgh is slated to next face Baltimore, San Diego, Arizona and Kansas City. Of these, the Chargers and Cardinals rank in the top 10 for pass defense while the Ravens and Chiefs sit in the bottom 10. Thus, Vick looks more like a fantasy quarterback best used as a bye-week or injury replacement while the overall productivity for Le’Veon Bell and Antonio Brown will take minor hits.

LeSean McCoy

The Bills are leaning toward holding out McCoy for the team’s Week 4 game against the Giants. The three-time Pro Bowl running back has been limited by a hamstring strain since early August. The injury has sapped his breakaway speed and hindered his elusiveness. Hamstring injuries remain one of the most frustrating injuries for players as they tend to heal slowly and are easily aggravated.

McCoy has historically been slow to recover from injuries, and this episode is remarkably similar to the start of his 2014 campaign when he struggled with turf toe. Buffalo would be wise to treat the situation proactively and give McCoy a week or two off so that he can be full healthy on the field instead of playing on "one-and-half legs," as he described it Sunday. Furthermore, the impressive performance of rookie Karlos Williams should buy McCoy some additional time to heal. Fantasy owners invested in McCoy should make an all-out push to add Williams.

Davante Adams

Adams limped off the field Monday night after aggravating a sprained ankle. After the game it was revealed Adams had been dealing with a high-ankle sprain, a specific type of sprain considered more serious than the low-grade lateral ankle sprain it was assumed he was managing.

In a "normal" ankle sprain, the ligaments on the outside of the foot are stressed when the joint is forced into inversion. However, a high-ankle sprain, or syndesmotic sprain, occurs when the ligaments located at the distal end of the two lower leg bones are disrupted or overstretched. These ligaments fortify the anterior aspect of a location known as the ankle mortise. When sprained the integrity of the ankle joint is compromised, resulting in swelling, pain and a loss of function. They tend to take longer to heal, though treatment for the injury is the same.

Initial reports out of Green Bay have the wide receiver missing "some time," suggesting this will be a multi-week injury. Given the severity of the injury and an overall lack of success thus far, Adams is droppable in most formats. Veteran James Jones continues to impress and has become a must-start while rookie Ty Montgomery is worth picking up, if available.

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Turf Burns

Drew Brees: The Saints quarterback will test his ailing shoulder Tuesday in hopes of playing Sunday night against the Cowboys. However, I’m worried that Brees’ arm will still be an issue even if he can play and his ability to throw the deep ball will be negatively impacted. The rotator cuff injury remains a concern, especially when Brees’ previous shoulder problems are considered. Luke McCown will get another start if Brees is out.

DeMarco Murray: The Eagles gave Murray the weekend off after he tweaked a hamstring during practice. The decision wasn’t overly surprising as Philadelphia’s medical team is one of the more proactive staffs in the NFL. Unfortunately for Murray owners, the injury created an opportunity for teammate Ryan Mathews, who took advantage of the extra reps. Mathews rushed for 108 yard on 25 carries and added a receiving touchdown, potentially creating a running back controversy. Murray will be evaluated this week, but given Mathews’ success I suspect they split carries even if Murray is cleared.

Marshawn Lynch, Alshon Jeffery: Both are dealing with hamstring strains suffered while recovering from calf strains. This combination of injuries is fairly common as the origin of the calf sits in close proximity to the insertion site of the hamstrings. Furthermore, both muscle groups work synergistically to bend the knee, meaning they rely on each other for fluid and strong movement. As a result, an injury or imbalance in one of the muscle groups can easily affect and weaken the other. Both Lynch and Jeffery are considered day-to-day, though the situation is a bit more significant than their teams are willing to admit. Monitor their practices this week but begin preparing suitable backup plans for both, especially Jeffery. Sammy Watkins is in a similar boat and is listed as day-to-day with his low-grade calf strain.

Stotts works as a Certified Athletic Trainer (MAT, ATC, PES, CES) and is a former winner of the Best Fantasy Football Article from the Fantasy Sports Trade Association.

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