Week 4 NFL injury report full of MCL sprains to Dez, Brandon Marshall and Russell Wilson

BY foxsports • September 27, 2016

Dez Bryant (UPDATE: hairline fracture in knee), Brandon Marshall and Russell Wilson

Every season there seems to be one type of injury that comes in waves. This year's MCL sprains appear to be the injury du jour, with multiple players suffering the ailment in recent weeks.

The medial collateral ligament (MCL) is one of the four major ligaments of the knee and sits on the inside aspect of the knee. It helps stabilize the knee during lateral motion but is particularly prone to injury in football. Most would-be tacklers attack the offensive player laterally, hitting the outside portion of the legs. The force is transmitted across the knee joint, stressing the MCL with what is known as a valgus force. If the amount of stress pushes the MCL past its yield point, a sprain occurs.

If the sustained damage is minimal and limited to micro tearing of the MCL, the sprain is considered mild or a Grade 1 sprain. If the MCL partially tears, it's assigned a Grade 2 designation. A complete tear is considered severe and is referred to as a Grade 3 sprain.

In addition to the damage accrued by the MCL, special attention is given to any associated damage to the medial meniscus. Specific fibers of the MCL adhere to the shock-absorbing disc, making the meniscus vulnerable to injury when the ligament is overloaded. While MCL sprains usually are treated without surgical intervention, meniscus damage often requires a trip to the operating room.

Fortunately, low-grade MCL sprains don't generally require players to miss time, especially since taping and braces can help support the area. This happened in Week 3 when Dez Bryant went down on the second play of the game. Members of the Dallas medical team evaluated Bryant's knee and taped the area, allowing him to return to the game. Bryant was on the field for a majority of Dallas' snaps on offense and hauled in a 17-yard touchdown reception on a critical fourth-quarter drive. Bryant was scheduled for a Tuesday MRI but given how the situation has played out so far, a mild MCL sprain appears to be the most likely scenario.

Bryant's situation was similar to that of New York's Brandon Marshall. The former Pro Bowl receiver briefly left the team's Week 2 win over Buffalo with a MCL sprain but returned after being checked out. He finished the game with six receptions for 101 yards. After being limited in practice throughout the week, Marshall did play in Week 3, though his final stat line of three catches for 27 yard left much to be desired.

In Seattle, Russell Wilson is also dealing with a mild MCL sprain sustained in the third quarter of the team's win over San Francisco. Unlike the two aforementioned wide receivers, Wilson did not return, though the team is preparing for him to practice on Wednesday and play on Sunday against Marshall's Jets.

In all three cases the associated damage appears mild and any meniscus problems have been avoided. Bryant, Marshall and Wilson should be available for Week 4 though expectations should be properly adjusted. This is particularly true for Wilson who relies on his mobility a bit more than the two receivers.

Thomas Rawls

The Seahawks running back will miss several weeks while recovering from a lower leg fracture. Rawls suffered a hairline fracture to his left fibula in Week 2 and did not play against the 49ers.

The fibula is one of the two bones of the lower leg. It's situated on the outside or lateral aspect of the leg and helps support the tibia (shin bone). Fortunately for Rawls, the fibula isn't considered a primary weight-bearing bone and recovery simply requires time, especially since no ligament or nerve damage is being reported. However, Rawls' previous injury could prolong the recovery window.

The distal end of the fibula is known as the lateral malleolus and helps form the ankle mortise. If you recall, Rawls entered training camp recovering from surgery to repair a broken ankle sustained on the same leg. While Rawls had completed his rehab and returned to the field, his latest injury may need additional time to insure the overall stability and integrity of the ankle.

While bone tissue is capable of healing in four to six weeks, Rawls' previous injury will likely push this to the latter end of that timeline. With one week of healing already logged, look for Rawls to be back around midseason. Christine Michael will remain the feature back in Seattle and has proven he's a fantasy friendly option, averaging 5.2 rushing yards per attempt.

Turf Burns

Rashad Jennings and Shane Vereen: The Giants running back corps took a major hit over the weekend. Jennings didn't dress in the team's loss to Washington due to a thumb sprain sustained in Week 2. He was limited all week in practice and was a late scratch on Sunday. Vereen assumed the starting role but sustained a ruptured triceps in the process. The injury will require surgery and will likely end his season. Jennings is optimistic about his chances of a Week 4 return, but keep an eye on his level of participation throughout the week. Furthermore, a thumb injury can often result in diminished grip strength, making Jennings vulnerable to fumbles. Orleans Darkwa and rookie Paul Perkins will see an increase in usage and could be decent fill-in options now that bye weeks have arrived. However, the Giants don't play until Monday night, making this a tricky situation to manage.

Jeremy Langford: Langford suffered a right ankle injury in Sunday night's loss to the Cowboys. The injury appears to be more complex than a simple lateral ankle sprain, with some reports suggesting it is a high ankle or syndesmotic sprain. The four-to-six week window currently being conveyed further strengthens this belief. As a result, Jordan Howard becomes a must-add in all formats.

Ryan Mathews: The often-injured running back is battling a lingering ankle problem that has been an issue since training camp. He reported stiffness on Sunday and was limited to just two carries in the win over the Steelers. The team insists Mathews is the feature back when healthy, but that's always been a problem for the 29-year-old running back. As a result, look for Philadelphia to rely heavily on a committee of running backs that includes veteran Darren Sproles, Wendell Smallwood and Kenjon Barner.

Jeff Stotts works as a Certified Athletic Trainer (MAT, ATC, PES, CES). He won the 2011 Best Fantasy Football Article in Print from the Fantasy Sports Trade Association.

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