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Fantasy Checkup: Week 5

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Welcome back to Fantasy Checkup, where our medical professionals provide us analysis of significant injuries that could affect your fantasy lineups. Come back each Friday to hear what Brion Gardner, the staff orthopedist at Camp Lejeune, and Mackie Shilstone Executive Director of The Fitness Principles have to say about each week's injury report.

Dr. Gardner's analysis:

There have been recurring themes in this injury season known as the NFL. The early front runners for the MVP of injuries were the MCL sprain and the broken rib. In the last couple of weeks, there have been strong showings from the PCL sprain, ankle ligament injury, and the neck injury. We will readdress the PCL and talk more about the ankle sprain.

Steve Breaston of the Arizona Cardinals has been nursing a knee injury since training camp. His productivity has been marginal thus far. I did some digging and discovered this "knee injury" is actually an injury to his PCL. I believe his recurrence on the injury report and poor showing this season reemphasizes the severity of this injury. I expect this will linger the entire season, if he is able to complete it at all. Keep an eye on all other players that have this diagnosis, I suspect they will have a similar fate.

This just in... Fred Taylor underwent surgery on his ankle to reconstruction torn ankle ligaments. He will be done for the season. Apparently, this is a chronic injury that was acutely worsened on his last carry of the game this past Sunday. The surgery involved reconstructing the ligaments on the lateral (outside) aspect of his ankle. When these ligaments are chronically stretched or torn (grade III injury), the ankle continuously rolls out. This condition is known as ankle instability and predisposes to recurrent ankle sprains. In severe cases or when the frequency of turning the ankle increases significantly, surgery to "tighten up" the ligament is performed to stabilize the ankle. At times, it is necessary to reinforce the native ankle ligaments with donated allograft tissue (tissue from a cadaver tissue donor). The recovery time for this surgery is generally 3 months before any running is allowed. Return to full activity is approximately 6 months.

In most cases of ankle sprains, after a period of rest and immobilization, the ligament can heal itself after a couple of weeks. But, with repeated sprains, surgery is a possibility. So, keep an eye out for Frank Gore and LaDainian Tomlinson. Frank Gore will be out again this week. The 49ers host the Atlanta Falcons, so he will be missed.

Jared Gaither is obviously out of action for the Baltimore Ravens after a scary, neck injury in the game against the Patriots. X-rays were negative for fracture or subluxation of his neck vertebrae. An MRI is pending, as he was too big to fit in a conventional machine. He sustained what is known as a "stinger". This occurs when the head is forcibly hit to one side with the shoulder going in the opposite direction. This stretches the nerves that come from the neck that go down into the arm, hand, and fingers. The condition usually resolves after a period of rest. Return to play is permitted after symptoms (tingling and temporary numbness in fingers) resolve. Expect a couple of weeks inactive for Gaither.

Derek Mason was limited in practice from a neck injury. From all reports, he will play and be the anchor of the Ravens receiving corps. (hint to Ravens management: acquire some secondary receivers!)

Jerricho Cotchery missed practice because of the proverbial hamstring injury. As we all know, this has killed the stats of many a wide receiver. He has been listed as questionable and, if he does make an appearance, will likely be limited in productivity. Hopefully, the newly acquired Braylon Edwards can fill in. (Although he has his own injury to deal with known as stone hands... he has led the league the last three years in on target dropped passes.)

Darren McFadden had surgery to treat a torn meniscus. He is out likely for a month. We will discuss the meniscus in a future post. Eli Manning is battling plantar fasciitis. He will likely play. Fortunately, he has an awesome offensive line and doesn't run much anyway. His receivers are playing phenomenally. Giants will continue to be strong.

And sadly, I must mention the Redskins. The Redskins have no key players on the injured list. Which begs the question, "What the F?" My only thought is that the Redskins are actually similar to the characters from the Wizard of Oz. They are in search of a "Heart", a "Brain", and some "Courage". They play in Carolina this weekend which is good for the Panthers and bad for the Redskins. They have barely scraped by at the "No place like home" FedEx Field. Mr. Wizard, please give our coach a brain, and our team some heart and courage.


Mackie Shilstone's Analysis:

Week 5 in the NFL Sick Bay seems to be a revolving door not unlike the training room on Monday morning. Going out the door this week is Seahawks' QB Matt Hasselbeck ,who practiced with the hope of playing Sunday against Jacksonville. It appears a decision will not be made until Friday. In Philadelphia, it appears that Donovan McNabb is back at practice and is expected to play Sunday against Tampa Bay.

Also out of the training room with a "full go" status is Jerious Norwood, the Falcon's back up running back/kick return specialist, who sustained his second concussion against Carolina on September 20. The first concussion occurred in the preseason against San Diego.

In Dallas, safety, Gerald Sensabaugh will undergo surgery to repair a broken plate in his right thumb and could be out for one month. Wide receiver Roy Wilson missed practice with a rib injury, although he might play this week at Kansas City. Center Andre Gurode and running back Felix Jones were both out with knee injuries.

In Washington, Redskins' punter Hunter Smith pulled a groin muscle on his first punt last Sunday against Tampa Bay. He may need a fill in, since this type of injury can be a nagging problem and punting might prolong his effective recovery.

And, the Steelers may miss running back Willie Parker this week against Detroit, as he went down last week in San Diego, with an injury to his left big toe.

Into the training room, last Sunday, went Giants' QB Eli Manning with a heel/ankle injury, which forced him to leave the game against Kansas City. Manning's non-contact injury was diagnosed as an "inflamed tissue in his right foot (Plantar Fasciitis)," late Monday. Giants' team physician, Dr. Russell Warren, told Manning "he could play this weekend against Oakland, if he could tolerate the pain."

So what is Plantar Fasciitis and how will it affect Eli's performance, if he does continue to practice and play in the upcoming games? "Plantar Fasciitis is an inflammation of the plantar fascia, the thick fibrous tissue that runs the length of the long arch on the sole of the foot. The longer the inflammation lasts, the greater the possibility a bone spur will develop at the point where the plantar fascia attaches to the heel bone."

If you look at the reports after the game, Manning is quoted as saying "anytime you feel a pull or strain, especially down there, you don't know what it is." He also stated that he felt a "twinge" before throwing a pass. The typical onset of symptoms of plantar fasciitis is usually gradual, where the athlete can still run and jump for weeks or months. Eli might have also noted that he had pain for the first few steps upon getting out of bed in the morning. As the discomfort becomes more severe, the individual may avoid walking on the involved heel and shift the weight to the forefoot.

As stated in the media reports by various experts, treatment may include among other modalities, taping the foot, stretching, cushioning the areas, using ibuprofen or other anti-inflammatory medicine. And, a cortisone injection could also help.

I have two thoughts that Eli might want to run by his team doctors. I have found that if you kick the covers back at the end of the bed before retiring and sleeping with no covers on the feet, you prevent the plantar fascia tissue from shortening during the night from the weight of the covers and the typical tossing and turning during normal sleep.

Also, I have found rolling the involved foot over a rolling pin, with soft padding around it, can actually stretch out the sole of the foot along the fascia line. I have seen tennis players use a tennis ball and roll it up and down the sole of the foot and baseball players using a baseball for the same purpose.

In the short run, Eli may see his movement mechanics altered in order to work around the discomfort, such as dropping back to pass. Quoting from The Sports Medicine Bible, "chronic plantar fasciitis may take several months to a year to resolve." I am confident, however, that Eli will be able to stay in good form with the Giants' medical team supporting him all the way.

Here is another observation worth keeping an eye on. I was at the game, last Sunday, to see my hometown New Orleans Saints give Jets' QB Mark Sanchez a rookie welcome to the NFL. During the game, I watched Saints' running back, Pierre Thomas, get tackled by a Jet linebacker, such that he was spun around while standing with a fixed right foot and then slammed to the ground. Pierre got up and went to the huddle and put his hand on his right (lateral aspect) hamstring. From what I could see, he seemed fine the rest of the game. The Saints have an off week this week, so let's see if anything turns up on future Saints' injury reports, if Pierre is involved.

Until next week, the sick bay is always open for business in the NFL.

By Emil Steiner  |  October 10, 2009; 9:08 AM ET  | Category:  Fantasy Check Up Save & Share:  Send E-mail   Facebook   Twitter   Digg   Yahoo Buzz   Del.icio.us   StumbleUpon   Technorati  
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Comments

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I see that Roy Williams has decided to start using an alias.
Good move.

Posted by: Matt | October 9, 2009 11:58 AM

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