Second Opinion: Inside the Injury Report - Week 12
by Jene Bramel
November 21st, 2012

Welcome back to another season of the Second Opinion feature. If you're new to the column, I'll be combining my thoughts and speculations on injuries with analysis on how those injuries will affect fantasy production and the team's likely gameday depth chart. Though this detailed column and fantasy-specific commentary will be reserved for FBG Insiders, I'll be posting a Monday morning injury review and late-week update on the FBG Second Opinion blog. I'll also be commenting on injuries on Twitter and providing quick bulletin-style posts on the blog for critical, breaking news during the week. Make sure you're watching those spaces for the latest developments.

Inside the Injury Report

Rob Gronkowski had surgery for a broken forearm and, although reports have varied, is expected to be out between 4-8 weeks. It's impossible to know which side of that expectation he's more likely to hit without knowing which bone was fractured (or both) and the location and severity of the break(s). NFL players have gone on injured reserve after surgery to fix a broken forearm in weeks earlier than Week 11. But there's also lots of precedent for a return in 5-6 weeks. Paul Posluszny returned in five weeks in 2009, Jason McCourty in five weeks in 2010 and Chris Hope in six weeks in 2011. There's no way to know if those injuries are comparable, however, but history suggests that a six week recovery is more likely than four. We may see Gronkowski return before the NFL playoffs, but it's probably a longshot to see him put up a meaningful fantasy performance again this season. Aaron Hernandez has missed the past two games despite what appeared to be reassuring practice participation. All reports suggest he'll play this Thursday, however, and I see no reason to hold him out of fantasy lineups if he's active.

I'm surprised that the Falcons activated Julio Jones and allowed him to play last week. The medical and training staff absolutely knows that a pre-game warmup doesn't come close to approximating the speed and contact of game action. Jones may have looked good in warmups, but his syndesmotic (high ankle) sprain see last week's column for my arguments on that is an injury that is commonly tweaked with lateral movement and when tackled. Both of those issues were evident last week. Jones struggled to get off press coverage and needed multiple extra steps to get out of breaks in his pass route, then left the field grimacing after a tackle in the third quarter. The best case scenario here is that Jones prolonged his recovery by a full week but didn't make the injury worse and that he'll again try to play after not practicing all week. Unfortunately, it's also possible that his tweak caused a higher grade injury and will result in a longer absence. After seeing Jones' performance last week, I think it's doubtful that the medical staff will clear him to play again this week unless he's able to practice effectively before Sunday. I don't think that's likely. I think it's much more likely that Jones misses both Week 12 and Week 13 than plays this week.

LeSean McCoy is questionable to play this week. Every concussion is different but it's generally accurate to assume that a player who has symptoms lasting longer than 30-45 minutes will take longer to heal / be cleared than a player whose symptoms resolve in less than 15 minutes. That's the case with McCoy, who was reportedly still not himself in the locker room after last week's game. A player cannot start the return-to-play algorithm until his symptoms have fully cleared. If McCoy isn't cleared for light exercise by Wednesday, he'll almost certainly out for Week 12, and possibly beyond.

There's been quite a bit of confusion about Willis McGahee's injury this week. McGahee said he didn't think it was serious after the game and frequently-read news and analysis site Rotoworld suggested that McGahee was being stretched out on the sideline shortly after the injury in the hopes that he could return. It was a surprise, then, to learn that McGahee had suffered a significant MCL sprain and fracture in his leg on Monday. Watching the television replays, however, it was evident that the medical staff was concerned about a ligament injury. One of the routine parts of a knee examination testing the integrity of the ACL could be confused with a stretching maneuver and the mechanism of injury was also worrisome on replay. Also, we shouldn't mistake John Fox's classification of this injury as "non-surgical" as a suggestion that the injury is minor. It's rare to surgically repair any MCL injury, even a Grade 3 injury (complete tear). Based on the early timetable we've heard 4-6 weeks it's likely that McGahee's injury is a high grade sprain. What has me concerned, however, is the fracture. It's not been defined clearly, but Denver beat writers wrote on Tuesday that it's a compression fracture. The timetable suggests that it's a minor complication, but that description has me worried that the fracture could be the more significant injury. If you hear the description "tibial plateau" used to describe this injury in the next couple of weeks, prepare for an even longer absence. Regardless of the extent of the bony injury, I think it's unlikely that we'll see McGahee return in time to have any fantasy value in 2012. If you're looking ahead to 2013, the injury shouldn't be a major concern. His role in Denver (or elsewhere) will be the primary limiting factor.

There's some reason for concern that Percy Harvin missed practice on Monday and later told reporters that he still has some pain in his ankle. Harvin's multi-ligament ankle sprain was expected to take longer to heal and 2-3 weeks isn't unreasonable. That doesn't guarantee that he won't be able to play in Week 12, however. His Thursday and Friday practice participation will be more informative than the early week workouts.

Darren Sproles was held out again last week, presumably due to continued soreness and swelling in his hand. While there was hope that Sproles could return sooner than the 4-6 weeks it generally takes a fractured bone in the hand to heal, he's not been healthy enough to be effective even with a splint. Sproles will be four weeks removed from his injury this week and should be very close to returning. However, it's best to plan on using another option until we hear with certainty that he's able to practice and play. When he is cleared to play, he should be safe to use as a RB2 in PPR leagues immediately.

Another week, another less than optimistic report for both DeMarco Murray and Maurice Jones-Drew. The lesson here is simple. A midfoot sprain, especially in a skill position player, whether diagnosed as a Lisfranc injury or not, should be treated as an indefinite absence until we see the player return to practice effectively. Seeing that the player has been allowed to weight bear or no longer needs immobilization are promising signs, but do not suggest that the player is on the verge of returning. That's not to say that a player with a similar injury won't return sooner than 6-8 weeks, but you should plan on a lengthy absence until proven otherwise. Murray has all but been ruled out this week and there's no evidence that Jones-Drew is close to returning. Felix Jones may be on the doubtful side of questionable, too, after missing practice on Tuesday with lingering knee issues. He'll need to practice on Wednesday to be a trustworthy Turkey Day play.

It's still uncertain whether any of the three quarterbacks still recovering from a Week 10 concussion will be able to play in Week 12. Jay Cutler, Michael Vick and Alex Smith had yet to be cleared for contact early this week. Cutler was the only one to address the media and seems the most likely to play. Andy Reid said that Vick was improving, but acknowledged that he failed his most recent IMPACT test. Vick will have an extra day to recover the Eagles play Monday night but it's always a concern when a player hasn't returned to baseline seven days after the injury. We'll know more on both later this week. Smith wouldn't talk to reporters Monday and Jim Harbaugh seemed to be leaning toward giving Colin Kaepernick another look this week, suggesting that Smith may not start even if he's cleared to play.

Byron Leftwich broke ribs and injured his throwing shoulder, but played through both injuries last week. He's expected to be out for an extended period. And while reports continue to swirl that Ben Roethlisberger could return in 2-3 weeks, there's truly no timetable for him yet. Though it seems more likely that Roethlisberger only partially dislocated his first rib, he'll still likely need at least four weeks to heal sufficiently to be cleared for contact. Though the injuries are to different structures, expect Roethlisberger to be treated as cautiously as Danny Amendola was due to the dire complications possible with a re-injury. I think Week 14 is the earliest we'll see Roethlisberger, and it could be longer if he feels any discomfort in his throwing motion.

Around the Training Table

Fred Jackson is expected to be cleared for contact by mid-week and back at practice. It's very possible he would have been cleared to play for last week's game had it not been a short week / Thursday game. It's safe to assume that he'll take his usual workload this week.

Though he was active and caught all three of his targets last week, Pierre Garcon is still struggling. None of his targets were on downfield passes and he's clearly too limited to separate consistently from defensive backs. He's also said that he's not sure he'll be able to play on anything other than natural grass. Leave him on your bench until he shows he can be effective in a larger role.

Dwayne Bowe is questionable with a neck injury that may also have a head injury component. If he's not practicing by Thursday, he may not be ready to play this week.

The Cardinals will activate Chris Wells this week. He's had enough time to fully recover from his turf toe injury and the continued rest and rehab for his knee issues should also be helpful. Given the number of injuries at the running back position across the league, Wells can be considered a RB2 option immediately, but the Arizona offense will limit his upside.

Darren McFadden is very unlikely to play this week. A return to practice and limited usage in Week 13 is possible, but we may not see him at full strength until Week 15 and possibly beyond.

Cedric Benson said this week that he felt only 65% recovered from the Lisfranc injury he suffered in Week 5. It's no surprise, then, that he is now reportedly planning to return in Week 15, 10 weeks after the injury. If you've been holding him with the hope he'll be back for your fantasy playoffs, continue to do so. But it's looking much less likely that he'll be able to contribute meaningfully in Weeks 14-16.

Watch the practice participation reports for more information on Jonathan Stewart (ankle), Isaac Redman (concussion), Dennis Pitta (concussion) and Danny Amendola (foot) closely. All have injuries that could keep them out of this week's games. Amendola in particular seems to be more questionable now than he was after last week's game ended.

Though this will be the most extensive and detailed Second Opinion feature each week, I'll also be writing a Monday morning injury review and a Sunday morning update on the FBG Second Opinion blog and doing segments on the Tuesday waiver wire and Thursday Live Audible podcasts. We welcome all suggestions and feedback to bramel@footballguys.com. You can also follow me on Twitter @JeneBramel. Thanks for reading.

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