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Week 11 Fantasy Checkup

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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 running backs have been hit the hardest with this week of those injured. There are some big names on the list this week, and the news, at least for this week, is not good.
 
Ronnie Brown did not play last night and is out for the season. He is to have surgery to repair an injury to the LisFranc ligament in his foot. (who the Hell is LisFranc????). Dr. LisFranc was one of Napolean's doctors and is most famous (at least in the orthopaedic world) for describing this injury to the foot. (he was also a gynecologist....???? ...but I digress). 

A LisFranc injury is a tear of the ligament between the big toe and second toe in the middle aspect of the foot. It is very common when landing on a planted flat foot and then being hit from behind. It almost always requires surgery to heal and takes six months to recover. It involves placing screws across the joint at that level.
 
In that same game, DeAngelo Williams was reported to have a knee injury, but he ran all over the Dolphins, so I think he looks just fine for next week. (side note, Jake Delhomme obviously is not the same after his elbow surgery.  If it weren't for him, I think the Panthers would only have one or two losses. His elbow is weak from my very distant medical observational standpoint).
 
Kyle Orton was knocked out of the game last week against the Redskins and obviously is an integral part of the success of the Broncos. He has been limping around the mile high city and is questionable for this week. Chris Simms has been taking all the snaps, and the San Diego Chargers have been "charging up" their engines. It will be a rough week again for the Broncos. Shawne Merriman is reported to have an ankle sprain, but he has been telling San Diego papers he won't miss the game and the opportunity to put Simms on his back.
 
Brian Westbrook sustained his second concussion in three weeks. He is out for the next three games. We have discussed the progression of concussive injuries. It is bad to have this "second hit" concussion so early.  I would recommend an early end to his season for his future health. We will see what the team does.
 
Cedric Benson has a strained hip abductor muscle. This is the big muscle directly on the side of the hip that allows the leg to be swung out directly to the side. It can be very painful when strained and limits the ability to change side to side direction quickly.  He has hasn't practiced and is questionable (read: not going to play) for this Sunday. Larry Johnson has been signed, but there is no indication he will get any substantial carries.  Benson may be down for a couple weeks.
 
Michael Turner was knocked out of the loss to the Carolina Panthers last week with an ankle injury. There has been some doubletalk in Atlanta, but it appears he has a "high" ankle sprain. This is a layman's term to describe an ankle injury that is more severe than your run of the mill ankle sprain. 

In a "high" ankle sprain, the ligament that runs between the two bones of the lower leg near the ankle (the tibia -- bigger bone -- and the fibula -- smaller bone) is injured. The extent of the injury to that ligament can go from the ankle and progress halfway up the leg. It is more sever because this area takes longer to heal than the standard ankle sprain, which is a ligament on the outer aspect of the ankle. 

Turner has stated he is not ruling himself out, but expect him to be out three to four weeks, if not longer. Jerrius Norwood is still nursing a hip flexor (muscle that allows you to bend hip up) injury, but he is still limited in practice. Without Turner's strong ground game, the Falcons offense will struggle, especially because Roddy White is still limited by his knee sprain. Giants defense will be teeing off.
 
A couple of quick notes . . .

Reggie Bush is nursing a knee injury. He is reported to still have swelling in his knee. He really hasn't had a huge impact on the team, but he still is a high profile name. Lance Moore is out with an ankle injury. But the Saints are loaded with weapons and won't miss a beat.
 
Joshua Cribbs has a neck injury and was limited this week. But he states the team will have to hide his pads for him not to play.
 
Troy Polamalu is out this week with an injury to his previously injured knee. He received an MRI this week. He has a strain to the PCL!!!! Remember back earlier in the season when I talked about the PCL???

Think of all the players who have been rehabbing a PCL injury and which ones are putting up stellar numbers. I'll give you a hint: NONE!!!! So, this is bad news for the Steelers.  I think he will be sidelined for several weeks.  His return this season is uncertain at this point.
 
Now, on the heels of a very solid victory for the Redskins. I will finally comment on the team's injuries. The biggest news is Clinton Portis is still out this week. He is being seen by a specialist at the University of Pittsburgh for recommendations. (this is the same place Westbrook went to prior to his second concussion). 

Again, my medical recommendation would be to sit out until symptom free for a month with normal neuropsych tests. Ladell Betts has an ankle sprain but ran the ball beautifully last week for over 100 yards!!!! He practiced this week and will be needed against a Dallas D that is sure to get to Jason Campbell several times. 

Albert Haynesworth is questionable with an ankle sprain. He is expected to play per reports from the team. He will be needed to help stop the run, rush the passer, etc.

The Cowboys are certain to be fired up after losing to end their win streak last week.  They are at home, this is a big rivalry, and I am nervous for the Skins. However, the Redskins have a history of beating good Cowboys teams when losing to the sorrier teams in the league. (reference when the Cowboys won the superbowl in 1995, Redskins beat them twice but finished season 6-10)
 
Cross your fingers Redskins fans.
 
Mackie Shilstone analysis:

With week 11 of the N.F.L. season upon us, it is a good time to revisit N.F.L. injury research to see how it is holding up for this season. In May, the N.F.L. owners and executives were presented with a study that used data compiled from team medical staffs to determine the number of players missing games each week from 2003-2007. The study found that the high point of players missing games was at week 10, when an average of slightly more than three players per team missed due to injury.

The average for the regular season was 2.7 players per team missing a game each week and 1.2 players missing games in the postseason. The concept here is that players tend to play hurt during the postseason, when everything is on the line.

Football Outsiders.com developed a "metric" to analyze injuries -- H.G.L. or History-Adjusted Games Lost, which uses data compiled from 2001-2008 to "assign each game missed by a player a numerical value of injury cost based on a set of variables." According the Football Outsiders, those variables include the player's role on the team, previous Pro Bowl appearances, and the historical effect of injuries sustained by a player of a similar caliber.

Among a list of conclusions was that "[i]njuries, or their absence, have a drastic effect on a team's success and the injury report does not matter." Of note, those players listed as "probable" play 89.9 % of the time, those listed as "questionable" play 54% of the time, and those who are "doubtful" play 7.7 % of the time.

In addition, the Football Outsiders says that "injuries to starting halfbacks do not affect the running game, and offensive injuries are more significant than defensive ones." So with all this research, let's go see what this week holds in the N.F.L., based on who's in and who's out.

The Saints, who are still undefeated, have been hit by the injury bug on defense. When the Saints played the Rams, last Sunday, they were without Kendrick Clancy, Sederick Ellis, Jabari Greer, and Darren Sharper. Now add Tracy Porter to the list who was injured in the game. Porter is scheduled to miss four to six weeks with a sprained media collateral ligament- "a stretch or tear, or complete rupture of the ligaments that join the thighbone and larger shine bone ( tibia) on the inner side of the knee joint. They are classified according to severity : first,second or third degree."

The Saints' secondary has lost three starters in the past two weeks to injury. Saints' defensive tackle Sederick Ellis worked on a limited basis Wednesday. Of note, Ellis also sprained his MCL against Miami on October 29, as did Sharper. As my fellow analyst Dr. Gardner has stated in past week's analysis, the MCL sprain seems to be one of the injuries of choice in the N.F.L. this year.

I have to wonder whether it is related to the synthetic turf and/or the shoes each injured player was wearing when the injury occurred.

By the way, Jabari Greer injured his groin. Looking at the research, "groin injuries are a hindrance, with players missing 30 more games than expected." The Saints are hoping he is back for the Monday night home game against the Patriots on November 30th.

Also with a knee ligament injury is Raven linebacker Terrell Suggs who will miss the game this week against the Colts. He was injured by an illegal chop block by Cleveland quarterback Brady Quinn following an interception last week.

Eagles running back Brian Westbrook sustained his second concussion in three weeks in Philadelphia's loss at San Diego. He visited two concussion specialists, Wednesday, in Pittsburgh.

Denver quarterback Kyle Orton, who injured his ankle against the Redskins, did not practice in preparation for the Broncos game against San Diego this Sunday. His status is unsure. Remember the Anquan Boldin story of trying to come back to quick from an ankle injury. It hurts.

Keep an eye on Bengals' running back Cedric Benson who injured his hip, last week, in the win over Pittsburgh. As noted last week, the hip injury (hip flexor or labrum) is becoming another injury of choice in the N.F.L. Benson may have trouble cutting.

Pittsburg safety Troy Polamalu reinjured a left knee in the game against the Bengals. It is the same knee that he had previously injured that had him sit out four games. Look for a brace on his knee. And, he should be slower to react, if he plays.

Falcon's running back Michael Turner sprained his right ankle against Carolina last week. The ankle sprain is "a stretch or, a tear or a complete rupture of one or more of the ligaments that hold the bones of the ankle joint together." As with many other injuries, the ankle sprain is classified according to severity.

Dallas lost right tackle Marc Colombo with a broken left leg and will lose safety Ken Hamlin for at least three weeks with a sprained ankle -- another epidemic N.F.L injury.

Miami lost its leading rusher when Ronnie Brown was placed on injured reserve because of a foot injury, which is his second season ending injury in three years.

Finally, the Rams lost wide receiver Keenan Burton for the rest of the season with -- you guess it -- a knee injury against -- you guessed it -- the Saints who have their share of knee injuries, as well.

I recently asked a N.F.L. team orthopedist if we are seeing more injuries league wide this year. He told that injuries in the N.F.L. seem to peak at midseason. I am not sure if we have reached our peak yet, even surpassing what research seems to say.

By Emil Steiner  |  November 20, 2009; 7:13 PM ET  | Category:  Fantasy Check Up , Fantasy Football Save & Share:  Send E-mail   Facebook   Twitter   Digg   Yahoo Buzz   Del.icio.us   StumbleUpon   Technorati  
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