This article is part of our Injury Analysis series.
As I killed time waiting for this week's slate of games to begin, my Timehop App reminded me that exactly four years ago the NFL endured an injury-filled Week 2 that took me hours to sift through. Notable injuries in 2016 included Adrian Peterson (torn meniscus), Danny Woodhead (ACL tear), and Jimmy Garoppolo, who sprained his AC joint while subbing for a suspended Tom Brady. The notification would serve as an ominous sign for what I witnessed over the next six hours as numerous NFL stars once again hit the turf with injuries. The final results surpassed the elevated 2016 total and have drastically altered the fantasy landscape.
A large number of these injuries involve one of the stabilizing ligaments of the knee, so before we look at individual players let's examine this problematic joint.
The knee is a hinge joint reenforced by multiple ligaments including the two cruciate ligaments (ACL and PCL) and the two collateral ligaments (MCL and LCL). The ACL and PCL work together to limit excessive forward and backward motion of the tibia (lower leg bone) on the femur (the upper leg bone). The MCL and LCL prevent excessive lateral motion and stabilize the knee during side-to-side movement. Each ligament can be sprained individually with each carrying a unique treatment plan and recovery options.
The Giants running back suffered a torn ACL in the team's loss to the Bears. The 23-year-old was carted off the field after being taken down in the second
As I killed time waiting for this week's slate of games to begin, my Timehop App reminded me that exactly four years ago the NFL endured an injury-filled Week 2 that took me hours to sift through. Notable injuries in 2016 included Adrian Peterson (torn meniscus), Danny Woodhead (ACL tear), and Jimmy Garoppolo, who sprained his AC joint while subbing for a suspended Tom Brady. The notification would serve as an ominous sign for what I witnessed over the next six hours as numerous NFL stars once again hit the turf with injuries. The final results surpassed the elevated 2016 total and have drastically altered the fantasy landscape.
A large number of these injuries involve one of the stabilizing ligaments of the knee, so before we look at individual players let's examine this problematic joint.
The knee is a hinge joint reenforced by multiple ligaments including the two cruciate ligaments (ACL and PCL) and the two collateral ligaments (MCL and LCL). The ACL and PCL work together to limit excessive forward and backward motion of the tibia (lower leg bone) on the femur (the upper leg bone). The MCL and LCL prevent excessive lateral motion and stabilize the knee during side-to-side movement. Each ligament can be sprained individually with each carrying a unique treatment plan and recovery options.
The Giants running back suffered a torn ACL in the team's loss to the Bears. The 23-year-old was carted off the field after being taken down in the second quarter. Reports soon surfaced that manual testing on the knee indicated a serious ACL injury. Manual muscle tests and specific special tests are an important tool of a good athletic trainer or doctor's bag of tricks. These tests stress particular areas of the body and can serve as a fairly reliable and accurate assessment of an injury. For example, the ACL is often tested using a special maneuver known as the Lachman test. When a Lachman test is performed, the tibia is shifted forward while the thigh is held in place. The ACL is designed to prevent this motion. If the ACL is sprained or torn, the examiner will feel an excessive amount of forward movement within the joint. Barkley likely had a positive Lachman test that was later confirmed by MRI.
Unfortunately, the MRI revealed more than just an isolated tear, as Barkley also sustained damage to his MCL and meniscus. This combination of injuries is known as the "Unhappy Triad." The list of NFL players to endure the triad include Adrian Peterson, Tom Brady and Rob Gronkowski.
Barkley will undergo surgery in the near future to reconstruct the ligament tear and address the meniscus tear. The MCL likely will be allowed to heal on its own. Extra care is needed during the early stages of the rehab process, but the overall recovery window will be largely unchanged. The timeline for ACL tears has improved in recent seasons, and Barkley should be able to return for the 2021 season. Dion Lewis and Wayne Gallman will take over in the New York backfield with free agent Devonta Freeman expected to get a look as well.
It's rare that the two players with the best ADP in fantasy drafts suffer significant injuries in the same week, but the carnage of Week 2 claimed both Barkley and McCaffrey. While Barkley is lost for the season, McCaffrey is expected back this year. Unfortunately, McCaffrey is looking at a multiweek absence thanks to a high ankle sprain. I detailed high ankle sprains last week following Michael Thomas' injury, but here's a quick recap: A high ankle sprain involves a different joint than the common lateral ankle sprain. The ligaments injured in a high ankle sprain are crucial for stability between the lower leg bones, especially while walking and running. High ankle sprains often require longer recovery windows as evident by McCaffrey's estimated timeline of four to six weeks. McCaffrey is hopeful he can return ahead of schedule, though the Panthers are likely to take a conservative approach with the face of their franchise. Mike Davis seems poised to take over as the starter for Carolina.
The 49ers running back started his Week 2 with a 80-yard touchdown run and ended it with a knee injury. Mostert suffered a low-grade MCL sprain in the blowout win over the Jets and is poised to miss time. The MCL sits on the inner aspect of the knee and is intertwined with the medial meniscus, one of two shocking absorbing discs in the joint. Low-grade to moderate MCL sprains can heal without surgical intervention, especially if concurrent meniscus damage is avoided. Mostert may opt to brace the knee when he returns to supply additional support when he moves laterally, like when cutting up field or avoiding would-be tacklers. Jerick McKinnon is the 49er running back to target with teammate Tevin Coleman suffering a serious knee injury of his own.
We've talked ACL and MCL, so let's talk Campbell and the PCL. The lesser known PCL crosses behind its counterpart, the infamous ACL. Together, the two cruciate ligaments stabilize the knee, with the PCL specifically preventing hyperextension of the knee. It also assists in rotation of the knee by creating an axis point. The PCL is stronger than the ACL, but still vulnerable to sprains as evidenced by Campbell's Week 2 injury. The Colts have ruled out the receiver indefinitely with history providing a discouraging precedent. In recent seasons, multiple wideouts have suffered PCL injuries including Steve Smith Sr., Steve Breaston and Breshad Perriman. Each of these players missed multiple weeks after suffering their respective PCL injuries, with Perriman missing an entire season after aggravating the problem during the recovery process.
If the PCL sprain wasn't bad enough, Campbell also sprained his MCL, further complicating the injury. A complete recovery following a multi-ligament injury is crucial for long-term health, making it likely Campbell ends up on the IR and misses substantial time. Michael Pittman and Zach Pascal move up the Colts depth chart opposite veteran T.Y. Hilton.
The Giants aerial attack also felt the sting of injury, as Shepard was lost to a toe injury. The problem has been diagnosed as turf toe, a condition that involves the ligaments that surround the joint of the big toe. Like most sprains, turf toe occurs in varying degrees with the mildest of injuries isolated to the ligament and the associated capsule. Unfortunately, turf toe often requires a substantial amount of time to fully heal and is easily aggravated, especially in running backs and wide receivers. New York is preparing to be without Shepard for "several" weeks and is likely to end up on the IR. Darius Slayton and Golden Tate will become the top receiving target for Daniel Jones, with Damion Ratley and C.J. Board seeing increased usage.
Rams RBs
Both Malcolm Brown and Cam Akers came out of the team's win over the Eagles with injuries. Brown suffered a broken pinkie finger while Akers suffered a rib cartilage injury.
The ribs are connected to the sternum by a specialized type of connective tissue known as costal cartilage. Most costal cartilage injuries occur to the upper ribs, usually closer to the chest. Former NFL quarterback Michael Vick missed multiple weeks while a member of the Eagles after he cracked the costal cartilages of ribs 2 and 3 near the sternum. Rib injuries often elicit sharp pain with simple activities such as breathing and trunk movement. The pain can linger for days, and cartilage is generally slow to heal. Akers is considered day-to-day for now, while Brown is expected to be available for Week 3 despite undergoing surgery to repair his fractured finger. The injuries set the table nicely for Darrell Henderson who should be the feature back for Los Angeles.
Turf Burns
Davante Adams: Packers fans may be the only fan group that can breathe a sigh of relief this week, as Adams' hamstring injury is not considered serious. Adams wanted to reenter the team's Week 2 win over the Lions, but Green Bay opted to keep him out as a precaution. The move is a wise one, especially when you consider the rash of hamstring injuries that have plagued this young season. Look for Adams to see limited action in practice but be available for Week 3 against the Saints. Adams' inherent risk of injury will be slightly elevated, but his overall value remains largely the same.
Nick Bosa: Like Barkley, the 49ers defensive end suffered a torn ACL and will be lost for the season. This marks the second time in his career that Bosa has torn his right ACL. He previously suffered the injury as high school senior in 2015. The surgical technique utilized for his second reconstruction will be the same but the location of his graft will likely change. This won't make a considerable impact on his recovery, and he should be back for the start of the 2021 season. The same goes for 49ers defensive tackle Solomon Thomas who also tore his ACL Sunday.
Jimmy Garoppolo: Four years after spraining his shoulder, Garoppolo is back in my column for a sprain on the opposite end of his body. Garoppolo suffered a mild high ankle sprain in the Week 2 win, an injury later confirmed by MRI. The team is calling his situation "week-to-week" and, despite some lingering optimism from the Niners, I'd prepare for Jimmy G to miss at least one week. Nick Mullens will take over a San Francisco offense that remains beset with injuries.
Chris Godwin: The Tampa wideout has completed the league's mandated concussion return-to-play guidelines and will be able to participate in this week's practices. Barring some unforeseen setback, look for Godwin to take the field Week 3 at Denver.
Julio Jones: If you have previously invested in Jones, then you know he constantly appears on Atlanta's injury report but rarely misses games. It's more of the same in 2020, with Jones' current problem a hamstring strain. He appeared limited throughout the loss to the Cowboys and was seen stretching the area throughout the game. Look for Atlanta to limit his reps in the week ahead in anticipation of him suiting up on Sunday.
George Kittle: The 49ers hope Kittle will be back to provide Mullens with a big target. Kittle hyperextended his knee in Week 1 and was ultimately diagnosed with a MCL sprain. He seems to have avoided a more moderate sprain, and any potential meniscus damage, making a one-week absence a possibility. However, Kittle's availability may come down to pain and symptom management. Look for him to be handled carefully throughout the week ahead and be a game-time decision for Week 3 against the Giants.
Drew Lock: Denver's quarterback is expected to miss time with a shoulder injury. The issue was originally believed to be an AC sprain, but further testing revealed a more problematic injury to the glenohumeral (ball-and-socket) joint of the shoulder. The injury involves damage to the stabilizing labrum and the rotator cuff muscle group. Lock is expected to miss at least two weeks at which time he will be reevaluated. However, based on the severity of the injury, look for Lock to be sidelined longer than that estimated timeline with an IR designation possible. Jeff Driskel will take over for Lock but has a limited fantasy ceiling.
Courtland Sutton: After missing Week 1 with an AC sprain, Sutton has now been lost for the year with a torn ACL in his knee. Sutton will undergo surgery and faces a similar recovery timeline as discussed with Barkley and Bosa.
Michael Thomas: Thomas did not play in Monday's blank over the Raiders and is on track to miss additional time. A two- to four-week recovery has been suggested, though Thomas does appear to be ahead of schedule in his recovery. Look for Thomas to be a question mark entering Week 3 against the Packers, with a return in Week 4 more probable.
Tyrod Taylor: Taylor was sent to the hospital on Sunday after experiencing shortness of breath and chest pains, The complications were linked to a pain-killing injection he received to address a lingering rib injury. Chargers coach Anthony Lynn continued to show confidence in Taylor and insists he will remain the starter if healthy. He will be day-to-day for now, with rookie Justin Herbert waiting in the wings should Taylor be forced to miss additional time.
