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Week 8 Fantasy Check Up

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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:

"The Fast and the Fragile" should be the name of a movie featuring the NFL's wide receivers. As we go deeper into the NFL season, the repeat offender list of injured players in highlighted by the pass catchers....

I will start with the most serious injury involving Brian Westbrook and talk about a couple of running backs. Then we will make the rounds of the receivers that may be gimping around this weekend's contests.

Brian Westbrook gave the entire nation a scare on Monday night. He sustained a concussion after being struck in the head by a defender's knee. He was unable to return to the game and unable to practice so far this week. Reports out of Philadelphia indicate that he is still having headaches. Concussions are transient neurologic injuries to the brain caused by direct trauma or sudden acceleration/deceleration to the brain. The symptoms can include loss of consciousness, memory loss, headache, dizziness, nausea/vomiting, vision changes, and mood swings. Recent studies suggest that concussions can lead to chronic depression and dementia. The symptoms usually resolve over time ranging from a couple of minutes to a couple of months. Concussions are graded as mild, moderate, and severe based upon symptoms and how long they last.

MILD: no loss of consciousness (LOC); amnesia < 30min; symptoms last <24 hours
MOD: LOC <1 min or amnesia>30 min but <24 hours; or symptoms >24 hours but < 7 days.
SEV: LOC > 1 min or amnesia > 24 hours or symptoms > 7 days

Return to activity following concussion has no standard algorithm. In general, return to exercise is recommend seven days after all symptoms resolve. Then the player is evaluated after exercise. If no symptoms develop, they can return to play. Recent studies also support cognitive testing (tests of memory, concentration, recall, and organization) in conjunction with the physical trial of exercise to determine return to play. If the cognitive tests return to normal (testing is done pretty soon after injury to compare later), then it is a stronger report for returning to play. The presence of LOC and how long a player is unconscious has little bearing in the recommendation for playing. The duration of symptoms is what is most important. Again, there is no universal acceptance of this rule, however, most team doctors would recommend terminating the season if there are three concussions sustained in the same season.

Westbrook will not play this week, by the way. (Not officially announced, but he hasn't been symptom free for even 24 hours, so I'm reading between the lines.)

Ahmad Bradshaw has been battling a foot and an ankle injury all season. The way he has been inflicting pain on opposing defenses, I can't tell. He has been diagnosed with a stress fracture in his fifth metatarsal. This is the bone in the foot that extends from the base of the pinky toe to just before the ankle. It is a very common injury in all athletes. It does not always require surgery and doesn't always keep a player from competition. Pain is the limiting factor. It will not heal, however, as long as the player keeps playing. There is a possibility of this stress fracture becoming a complete fracture and the bones becoming out of alignment -- that would require surgery.

He has also been dealing with ankle pain that is related to an injury sustained in college -- a small avulsion fracture of his ankle (severe ankle sprain in which a fleck of bone pulls off with the ligament as it tears). This sometimes leads to bony deposition in that ligament and can be painful. Bradshaw is wearing a walking boot during the week and sitting out most of practices. He has been doing this for several weeks. Based upon his stellar numbers splitting time with Brandon Jacobs, these injuries don't seem to restrict him one bit. He will continue to produce and delay surgery until the off season.

Donald Brown of the Indianapolis Colts has a sprained shoulder and has not practiced this week. It was originally described as a contusion but now is being referred to as a sprain. Again, with my reading between the lines tactic, he likely has a mild (Grade I) shoulder separation. He likely will not play this week and the carries will be more the adequately shared between Joseph Addai and Mike Hart. He shouldn't miss more than two weeks of action if his injury is consistent with what Indy is reporting.

And off to the races...

Keeping with the colts, their top two receivers are disabled this week. Anthony Gonzalez continues to rehabilitate his sprained PCL. He has not been practicing with the team and there isn't any indication that he will be in the next coming weeks. He has not been placed on IR, so at least the team is hoping for the best. The best I can see for him this season is marginal contribution.

Reggie Wayne is plagued by the next most common injury to a speedy receiver after hamstring... the groin strain. This is very similar to the hamstring in its ability to slow down a wideout. The muscles of the groin are very instrumental in the fast start, stop, and changing of directions that the receivers rely upon. Wayne did not practice Wednesday. He is still optimistic about playing on Sunday but may be a decision left for Saturday. Translation: he will be much slower against the 49ers.

Andre Johnson sustained a lung contusion in last Sunday's game. He was able to return to the game for a brief period, but was held out after he began spitting up blood. He was taken to the hospital and diagnosed with a lung contusion. This is potentially a serious injury, despite Johnson's aloof reaction and cavalier attitude at practice. A lung contusion is a deep bruise to the lung tissue with blood and fluid developing within the lung. It can compromise breathing and cause choking in the most severe form. Often times, patients require intubation (breathing tube down the throat). Johnson appears to not have any pain and to be eager to play. His team is being very cautious with him, even hiding his helmet from him. It seems as though he will be a weekend decision to play.

Calvin Johnson practiced on Thursday in a limited fashion and should play this weekend. The Lions have been very hush-hush on the nature and severity of this "not significant" knee injury that kept him out of the last game and practices up until Thursday. The only thing I can deduce is that he is getting better and will catch anything thrown his way.

DeSean Jackson has a foot sprain that limited him in the second half of the Monday night scrimmage against the Redskins. Again, no details about exactly WHAT is sprained but he did practice Thursday. I am confident that he will be in the lineup this weekend against the Giants and will be dangerous in the return game and offense.

Musin Muhammad is combating a knee injury as well. He has missed practice and the Panthers are planning on starting Dale Jarrett. Keeping with the common theme, no report as to the nature and severity of his injury. The only thing I know is that Musin didn't practice and Jarrett is working with first team. Therefore, I'd diagnosis his severity as at least moderate -- more to come in the coming weeks. The panthers unfortunately, are going to struggle with or without him.

Bernard Berrian has the usual hamstring injury. He will be slowed, as he relies on speed. This is the opposite hammy from the one that was hampering him in the beginning of the season. Fortunately for the Vikings, Berrian has been invisible and Sidney Rice has been shining. The passing game shouldn't miss a beat. Hopefully, Berrian recovers and is able to contribute later in the season.

Anquan Boldin was noticeably limping in last week's game. His ankle sprain is still problematic. He has practiced and appears to be in the lineup for this weekend. He will do what he does, which is catch the tough balls over the middle and on possession downs. He will not be strong on the outside and down the field.

Jeremy Shockey ended up on the injured list with a shoulder sprain. He didn't miss practice and the New Orleans newspapers barely mentioned it. So, I can only surmise he will continue to catch touchdowns.

Redskins Injury report: (feel free to stop reading). The redskins have a bye week so we should all be able to recover from the pain they have caused us.......


Mackie Shilstone's analysis:

Week 8's N.F.L. injury report is marked by more than just our revolving door in sick bay.

Wednesday N.F.L. Commissioner Roger Goodell appeared before the House Judiciary Committee, where as one headline said, "N.F.L (was) scolded over injuries to its players." The initial evidence seems to point out "that there is a link between playing professional football and cognitive impairment in later life."

Speaking of cognitive impairment, Eagles running back Brian Westbrook left with a concussion in the first quarter of last Monday's nights 27- 17 win over the Redskins. Head coach Andy Reid said "he won't risk Westbrook's health at the expense of a game." If you recall in the first weeks of the season, Eagles quarterback Donovan McNabb was held out with a rib injury. The Eagles seem to be having trouble maintaining a first team backfield. I think they should learn to fly like the logo on their helmets when they host the Giants this week.

Speaking of the Giants, New York listed back up running back Ahmad Bradshaw as "did not practice " on the Wednesday and Thursday, according to the N.F.L injury reports. Bradshaw said he would continue to play despite having a cracked fifth metatarsal bone which runs along the outside of his right foot between the ankle and the toes. If he keeps pushing, it he has a potential to break the bone. What are you doing Ahmad? You do not have to take one for the team. Did the team doctor not explain the risk potential?

The Redskins' six time Pro Bowl left tackle Chris Samuel was injured when he butted heads with a defensive player while blocking early in the first quarter of Washington's loss two weeks ago to Carolina. He commented recently that "I will continue to seek medical advice. I hope to see where I am physically over the next couple of months." If Chris watched Congress dole out "heated criticism" on Commissioner Goodell for "neglect in handling of active and retired players with brain injuries," then he might need to think a long time before returning too quickly, if at all.

Miami cornerback Will Allen got banged up in the Dolphins' loss to the Saints last week. It appears that it is a season ending ACL injury (rehab about 6 months). Miami will put two rookie cornerbacks out on the flanks against the Jets this week. The big question is whether Jets' QB Mark Sanchez will be able to take advantage of them with his rookie inexperience, as a veteran QB might be able to do.

Colt's president Bill Polian commented this week on the status of wide receiver Reggie Wayne's groin; he anticipates Wayne playing this week, against the 49ers. How does your groin feel Reggie ? Are you ready to play? When you run your routes and you feel the groin spasm, I think you will have your answer. Listen your team trainer and physician, not president. Better yet, listen to your body.

Arizona wide receiver Anquan Boldin continues to be bothered by his sore ankle. He will have trouble making cuts and if the defense covers him one on one, he is in for a lot of soreness. If he continues to play, it will only get worse as the season progresses. Watch out for his knee which tends to be at risk with an ankle injury.

Last on my list is my home town team -- the Saints, who face the Falcon's on Monday night. Tight End Jeremy Shockey, who must have enjoyed the Saints' recent victory of the his former Giants team, is nursing a shoulder problem that limited him in practice on Thursday. I am not too concerned about him. He has a point to prove this year, so watch out.

Until next week, let's hope the performance of the N.F.L. play gets better than the minor league football we've been watching.

By Emil Steiner  |  October 30, 2009; 10:01 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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