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Week 11 Fantasy Football Injury Update

Written by Tom Christ, PT, DPT, OCS, FAAOMPT

@FantasyInjuryT

I must apologize to the fantasy football community. In last week’s article, I clearly put a jinx on the NFL, as we saw one of the most involved injury weeks in week 10. “Overall, we survived week nine from an injury standpoint! For the most part, at least.  No major season-ending injuries to high-profile fantasy players for once.  Surely, my saying that right now will put a curse on the entire NFL for week 10, so I apologize in advance for that!” With that, the week 11 fantasy football injury update is very involved.

Damn. This week we lost marquee players, such as Cooper Kupp, Dallas Goedert, and Zach Ertz, for several weeks. We also saw a number of players suffer what appeared to be significant injuries, but luckily it does not sound as if they will be out long. It’s officially time to make your playoff push in fantasy football, and with that, let’s get into the week 11 fantasy football update! As always, you can find more information on the Fantasy Injury Team Podcast on Apple and Spotify!

Quarterbacks

Kyler Murray

Murray is iffy for week 11 with the hamstring injury that kept him out in week 10. The difficulty here is Murray, and the Cardinals play Monday night. A hamstring injury would impact Murray both in the rushing game and potentially the passing game.

Week 11 Fantasy Football Injury Update

Hamstrings impact top-end sprint speed, of which Murray is elite. This season Murray is averaging 6.5 rushes/game for 40 yards/game. The Cardinals would likely reduce the number of designed runs for Murray if he plays this week, limiting his fantasy upside. Additionally, if it is his right leg that is injured, the hamstring injury would impact his ability to generate maximal throwing power. The hamstring is a powerful hip muscle, and the power for a throw always starts from the legs. If Murray plays this week, it’s likely that he is not at full capacity.

With Arizona playing Monday, fantasy players who are considering sticking with Kyler must have either Colt McCoy or Jimmy Garoppolo on their bench ready to sub in if Murray ends up not playing.

Josh Allen

The elbow injury did not appear to limit Allen’s game in week 10. He will continue to be on the injury report for the next several weeks, as the UCL injury won’t fully heal until he can rest it in the offseason.

Week 11 Fantasy Football Injury Update

It was surprising to some degree to see Allen play so well last week. The UCL, which connects the humerus and the ulna bones of the elbow, is highly stressed with the throwing motion. The UCL helps stabilize these bones together, particularly making sure the forearm travels in a uniform manner with the upper arm during a throw. When the UCL is torn to the point of developing laxity (increased mobility) in the joint, this can impact the throwing accuracy. Clearly, his UCL is intact enough to allow him to throw effectively. This still remains at high risk for re-injury at any point in the season, but for now, he clearly can play well enough that fantasy players can trust starting him.

Matthew Stafford

Stafford is on track to play this week after missing week 10 with a concussion. The NFL, as it should, is very strict on its return to play-protocol following concussions. Understanding the physiology of a concussion helps this make sense.

With a concussion, there are changes in the blood flow and neuron activity within the brain. The damage to brain cells (neurons) leads to inflammation within the brain. However, there is decreased blood flow to the brain. The inflammation and blunted blood flow typically last 7-10 days and is a major part of concussion symptoms. The injury to brain cells can cause the symptoms of impaired alertness, concentration, sensitivity to light and sound, and a variety of other symptoms.

The NFL’s 5-stage return to play protocol is as follows:

Phase 1 – Light Activity: Simple stretching, light aerobic activity without the onset of symptoms

Phase 2 – Aerobic Exercise: 10-20 minutes of light to moderate intensity exercise on a bike or treadmill

Phase 3 – Sport Related Exercise: Sprinting, jumping, agility drills

Phase 4 – Non-Contact Team Drills: All Non-contact drills for the duration of practice

Phase 5 – Full Clearance: Full return to practice without the onset of symptoms.

We sometimes will see a player who has returned to full practice but does not get clearance to play. This is confusing but is explained above. In some instances, a player will engage in phase 5, full clearance practice, but they develop some degree of concussion symptoms during practice. This means they have not cleared the protocol and will be held out of the upcoming game. Stafford practiced in full on Wednesday, and there were no reports of setbacks, putting him in line to play this week.

Running Backs

Ezekiel Elliot

Zeke was limited in practice to start this week as he returns from an MCL sprain and quad bruise during week 7. The MCL gets good blood flow and typically heals well. NFL running backs average missing 3.2 games due to an MCL sprain, and Elliot is just about at that mark. With three weeks to heal, Elliot’s MCL is likely intact enough that it will not lead to any major instability at the knee joint. The MCL’s job is to assist the ACL in stabilizing the inside of the knee joint, preventing the knee from collapsing inward. This is why you often see MCL injuries when a player gets hit in the knee from the outside.

Week 11 Fantasy Football Injury Update

Unfortunately for Elliot, running backs see a dip of 3.1 fantasy points in their first game after an MCL injury. This, combined with Tony Pollard asserting himself in the offense and Dallas facing Minnesota’s 10th-ranked rush defense, makes starting Elliot risky.

Khalil Herbert

Herbert is dealing with an undisclosed hip injury and has been placed on the IR, putting him out for 4 games. With Chicago yet to have their bye, this means Herbert will not return until week 16 at the earliest!

Chicago has not revealed what Herbert’s hip injury is, making it hard to analyze. It’s possible it is a labrum injury similar to Ja’Marr Chase, but it also could be a strain to the hip flexor, groin, or many other injuries. When we get more information, I will be sure to break it down. In the meantime, with Herbert out until week 16 at the earliest, if you need the roster space, dropping him is a viable option.

Gus Edwards

Edwards missed week 9 with a hamstring injury. Hamstring injuries are a very common occurrence in players the year after an ACL injury. Edwards was limited in practice Wednesday but appears on track to play this week.

Hamstrings impact players’ top-end speed, specifically when accelerating from 80-100% top flight speed. To get up to 100% speed, a player needs at least 40-50 yards. Running backs hardly ever get 40-50 yards to run, which is the reason they are not nearly as impacted when they return from a hamstring injury as receivers are. In fact, running backs only see a decline of 0.7 fantasy points in their first game after a hamstring injury. Edwards is the lead back on a top-flight offense that is often on the goalline. If he plays, he is a solid start.

Leonard Fournette

Fournette suffered a “hip pointer” in week 10. I personally think this is the dumbest name for any injury in the whole body. That is beside the point. A hip pointer is a bruise to either the glute muscles or the iliac crest (the bone that your rest your hands on when you put them on your hips).

A bruise creates local swelling in the area. Swelling alone can impact muscle function but also creates pain, which impacts function. As soon as the swelling goes down, and with a little rehab, players can quickly return to 100%. Fournette has a bye this week and should be good to go in week 12.

Wide Receivers

Cooper Kupp

It was a sad day for fantasy football on Sunday. Cooper Kupp is beloved by the NFL community and fans. Kupp’s injury was a classic mechanism for a high ankle sprain. Kupp’s foot was secured to the ground (for part of the hit, not all of it), while his leg got hit in a way that rotated the lower leg on a fixed foot. Kupp, unfortunately, suffered a significant high ankle sprain and underwent Tightrope surgery on Wednesday.

With a high ankle sprain, the tibia and fibula bones are pulled apart, creating a sprain to the ligaments that hold them together. This creates instability in the ankle joint and pain. Instability and pain make pushing off to run, cut, or jump a challenge.

With the tight rope procedure, the surgeon drills two holes in each of these bones and essentially loops a rope through the holes to pull the bones closer together. That is a simplified description, but you get the point. With the bones held closer together by the rope, the ligaments can heal, and the ankle can regain its stability.

Tua returned to play 28 days after undergoing the tightrope procedure in college. Tua had a few distinct advantages, though. When he had the surgery, Tua was 20 years old, and Kupp is 29. Tua is a quarterback, requiring much less running and cutting; Kupp is a receiver, requiring a lot of running and cutting. Tua was playing for a National Championship, and Kupp likely will be playing for nothing in four weeks.

I do not envision Kupp playing again this season. The good news is Kupp will be close to 100% at the start of the offseason and will have the ability to train and prepare for next year. He should be 100% at the start of the 2023 season.

Marquise Brown

Brown is now 4 weeks out from fracturing a bone in his foot. Coach Kliff Kingsbury states that Brown may play this week, but let’s dissect the reality of this. Fractures take 4-6 weeks to heal, and they come with extra complications when it is to a foot bone. His foot was immobilized in a cast or boot for much of the past four weeks to allow healing. Along with immobilization comes stiffness and weakness. Brown is just now at four weeks after injury, so healing is present but not 100%. He is likely just beginning full weight bearing without a boot and is now starting to regain mobility and strength.

The challenge of coming back so fast from a foot fracture is multifactorial. As stated, bone healing takes 4-6 weeks. He is at 4 weeks. His bone is likely healed enough to handle daily stresses such as walking, stair climbing, etc., but it is not at 100% strength. Re-fracture risk is high right now. Additionally, the stiffness and weakness take several weeks to improve and return to pre-injury function. Brown is an explosive receiver, and without his full foot mobility and strength, his game will be affected.

I do not doubt Marquise Brown returns to 100% at some point this season, I just think it takes another month. He should be nearing 100% just in time for the fantasy playoffs. With teammate Zach Ertz unfortunately out of the season, Brown could have a nice role down the stretch.

Keenan Allen

Allen has been incredibly frustrating this season. He has returned to practice in a limited capacity this week, and we will have to see if he is able to play. Unfortunately, hamstring injuries have a high likelihood of recurring. A previous hamstring injury increases the risk for another by 2.7x. Allen has already experienced this reality this season.

The good news for Allen is his game is not speed or deep balls. As I wrote above, the hamstring is stressed more with top-end speed, making speed receivers more vulnerable. Receivers average a decline of 2.8 fantasy points when they return from a hamstring injury. With the recurring nature of this injury, Allen is hard to trust this season until he proves otherwise.

Mike Williams

Williams also was limited in practice Wednesday as he returns from a high ankle sprain from week 7. Week 11 is 4 weeks out from injury for Williams, and receivers average missing 4.4 games due to a high ankle sprain. This timeline is about right for Williams to play this week or next week.

A high ankle sprain is going to impact a receiver’s explosiveness. For Williams, this means cutting while running routes, but also his ability to jump. Williams LOVES jumping to make acrobatic catches. This could be impaired in the next few weeks as he returns from injury. Receivers average a decline of 2.4 fantasy points in the first game after a high ankle sprain. Like his teammate Keenan Allen, he is hard to trust this week.

Jerry Jeudy

Jeudy was carted off the field, but it was quickly determined his injury was not too severe. Reported as an injury to the back of the ankle but not the Achilles.

Thank goodness it was not an Achilles tear! Behind the ankle, we have the three calf muscles (medial and lateral gastrocnemius and soleus), the flexor hallucis/digitorum longus (inside back of the ankle), the tibialis posterior, and the fibularis longus and brevis muscles. Most likely, this is a soleus injury and thus could be classified as a calf injury. The soleus is one of the calf muscles that plantarflexes our foot (points it down like pressing the gas pedal). Our calves are constantly working with running, cutting, and jumping and need to do so very powerfully. An injury to the calf can really slow down a receiver. NFL receivers see a MAJOR decline in fantasy points after a calf injury. In the first game after a calf injury, receivers score 5.6 points below their pre-injury average, with only 6% (1/16) meeting or exceeding their pre-injury average.

We will continue to look for reports confirming or denying this speculation of his injury being a calf injury. If it is confirmed, Jeudy is a major risk to play this week.

Juju Smith-Schuster

Juju did not practice Wednesday as he recovers from a concussion. A description of concussions and the return to play protocol is listed above with Matthew Stafford. We will have to keep monitoring his progress to know if he will play this week. If Juju play’s, there is no reason to expect a decline in production due to the injury.

AJ Brown

Brown came up lame in the first drive on Monday night but still logged 78% of snaps. Dealing with an apparent ankle sprain, Brown does not seem to be in danger of missing week 11. Receivers see a mild decline of 1.4 fantasy points after an ankle sprain. To a player of AJ Brown’s caliber, this is a non-factor. You can start with confidence. 

Tight Ends

Zach Ertz

One of my personal favorite players in the NFL; it saddened me to see Ertz being carted off the field. A second opinion on tight end Zach Ertz’s knee confirmed that he will need to undergo season-ending surgery.

The Cardinals have not revealed what Ertz’s injury is yet, but initial testing did not suggest an ACL injury. ACL field tests called the Lachman’s, and Anterior Drawer tests are typically reliable. Numerous other tissues in the knee would require season-ending surgery. A PCL repair, meniscus repair, tibial plateau fracture, and sometimes even a severe MCL sprain would require surgery with lengthy rehabs. We don’t know what Ertz is dealing with, but his season is over.

Dallas Goedert

Goedert suffered a left shoulder injury on a blatant facemask tackle on Monday night. The Eagles have not disclosed what Goederts injury is but have placed him on the IR, and he will miss at least four games.

Looking at the video, an anterior shoulder dislocation is a possibility. We can see the defender lands hard on the back, the top part of Goederts shoulder. This is where the ball of the shoulder joint is. We can also see the defender’s arm is on the front part of Goederts bicep area. This could create a lever where the humerus bone is forced anterior (front) out of the socket.

The timeline (4 weeks on IR) agrees with this injury. Often with a shoulder dislocation, there is also a labrum tear. The labrum holds the humerus in the socket; therefore, when the bone is displaced out of the socket, it tears. This does not always require surgery (think Dalvin Cook). Four weeks is a reasonable timeline to rehab via physical therapy and return to playing very well. Goedert would, of course, be at risk for future dislocations. I can’t say for sure this is his injury, but it is possible.

David Njoku

Njoku is 4 weeks out from a high ankle sprain. The original timeline for Njoku was 2-5 weeks, and tight ends average missing 4.6. Njoku did not practice Wednesday, and playing this week seems like a stretch. He is unlikely to be quite as impacted as Mike Williams when he returns, as tight ends can rely more on their size and less on their athleticism, but Njoku is a very athletic tight end. He will likely be limited in some capacity when he returns. Tight ends average a decline of 3.7 fantasy points when they return from a high ankle sprain.

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