Written by Tom Christ, PT, DPT, OCS, FAAOMPT
@FantasyInjuryT
Two weeks to go until the fantasy playoffs begin! These last two weeks are pivotal for many, and the week 13 fantasy football injury update is as important as ever! As the season becomes long, we see injury rates increase. This follows the traditional pattern across all sports. Fatigue is a major factor in injury rates. The past two weekends have been plagued with injuries to key players, and while I hope this doesn’t continue, history suggests it will. Now is the time to fortify your rosters, pick up handcuffs off waivers, and make your championship run! As always, more detail can be found on the Fantasy Injury Team Podcast, available on all major platforms, including Apple and Spotify!
Week 13 fantasy football injury update: Quarterbacks
Aaron Rodgers
Rodgers miraculously has been playing since week 5 with an avulsion fracture of his throwing thumb and now also has a rib and oblique injuries. The thumb injury is amazing. Say what you want about Aaron Rodgers, but this man is a dog. A thumb fracture is going to impact a quarterback’s ability to grip the ball. Gripping is vital for accuracy and avoiding fumbles. Since the injury, Rodgers has only fumbled four times and has a 64.8% completion percentage on the season. The thumb injury has not impacted his game.
The ribs and oblique injury are another story. Many casual fans may not understand the mechanics of the throwing motion and how involved the ribs are. The ribs are directly linked to the thoracic spine (upper and mid back). When throwing, a quarterback’s thoracic spine rotates up to 50°; this is where a lot of the torque for a throw comes from. When the thoracic spine rotates, the ribs also rotate slightly. Additionally, several muscles involved in throwing attach to the ribs. These include the obliques, which strongly contract to rotate the torso. Other major muscles include the lats and pec major, which are power generators for the throw, as well as other muscles such as the intercostals and paraspinals.
The combination of the movement of the ribs and several muscles that attach to the ribs contracting will limit motion and speed during the throw. Throwing power is impacted without a full range of motion and full speed. Think about the physics equation for velocity. Velocity = change in displacement / change in time. Meaning that in order to generate velocity on a pass, the quarterback must undergo a large amount of rotation and do so quickly. Pain during the follow-through will also affect accuracy.
The thing about Rodgers, though, is he lives his life with a chip on his shoulder. He will do everything he can to be on the field and play at a high level. He is one of the most cerebral quarterbacks we have and very often wins a play with his mind before it starts. Because of this, Rodgers can still be effective, but I find it hard to believe that he will have the same power and accuracy that we are accustomed to. He is a risky start this week.
Justin Fields
Fields has practiced in a limited capacity this week as he returns from a left AC joint injury. This type of injury would not impact his throwing since it is not his throwing arm. Justin Fields’ fantasy value, however, comes from his legs. Fields has run for 834 yards and 7 touchdowns on the season. That is outrageous!
In order to protect their franchise quarterback, Chicago may elect to call fewer designed run plays. The AC joint injury can easily be aggravated with just one wrong hit. Fields injured his shoulder when he was tackled directly onto it. This is the classic mechanism for an AC joint injury. A similar hit would likely re-injure him. Chicago has nothing to play for this season other than developing their quarterback. He already is an elite runner, it makes sense for them to help him improve his pocket passing over the final stretch of the season. Without his running upside, Fields is a low-end QB1 at best.
Matthew Stafford
Stafford remains in the concussion protocol as he deals with his second concussion of the season as well as a neck injury. The Ram’s season is lost, and McVay has stated they may shut down Stafford for the season. The QB26 on the year, he has not had fantasy value as is and no longer has any viable weapons to throw to.
Week 13 fantasy football injury update: Running Backs
Christian McCaffrey
McCaffrey is dealing with a vague knee irritation that kept him out of practice to start the week. Knee irritation can mean a lot of things, but reports suggest patellar tendinopathy. This means either inflammation or minor degeneration of the patellar tendon. Degeneration sounds scary and is by far my least favorite medical term because it does not paint the true picture of the condition. I can just about guarantee that all NFL players have patellar tendon degeneration if we assessed them with an ultrasound. It’s often not an issue.
When the tendon becomes irritated, it can create a sharp pain with squatting and cutting, but it often feels better when the player gets warmed up. DK Metcalf has dealt with a similar injury, though his mechanism of injury appeared more severe. Metcalf did not miss any games due to this injury. With counterpart Elijah Mitchell out for the next 6-8 weeks, I expect McCaffrey to play just fine, and see a larger workload.
Elijah Mitchell
I really feel for Elijah Mitchell. So much talent, but he just struggles to stay healthy. I’m sure no one is more frustrated than Mitchell himself, as he has already missed 13 games in his two NFL seasons and is slated to miss another 6-8 with his second MCL injury of the season. I discussed his injury earlier this week in a video that can be seen below. Essentially the MCL helps provide stability to the inside of the knee. This is necessary when cutting, and without this stability, the knee can collapse inward (valgus), which can cause buckling and ACL injury.
Many MCL injuries are minor, with running backs averaging missing 3.1 games. Earlier this year, we saw Ezekiel Elliot miss two games with an MCL injury and score 17.2 points in his first game back. Unfortunately, some MCL injuries are more severe. Mitchell missed 7 games earlier this year due to an MCL injury, and Kyle Pitts just underwent surgery for his MCL injury. As fans, we need to remember there is a wide spectrum of severity for all injuries. Unfortunately, Mitchell is no longer fantasy relevant this season.
Travis Etienne
Etienne gave us a scare on Sunday as he exited the game early with a foot injury. We all remember the first-round pick missed his entire rookie season due to a foot injury that required surgery. His current injury is similar but much less severe.
The ligaments in the foot are essential to maintaining the foot’s function during walking and running. When we push off the ground, the foot morphs its shape as it supinates to become rigid, creating a firm structure to push off the ground with. This allows players to sprint fast and cut quickly. If the ligaments in the foot are not intact, this mechanism does not occur, and instead of having a firm foot to push off with, the foot is floppy, and cutting is less powerful.
Last season, Etienne’s injury was severe enough that the integrity of his foot structure was compromised and required surgery to fix. This season, his injury is not nearly as severe. The ligament integrity in his foot is maintained, and he should not miss much if any, time. I don’t expect this to impact Etienne’s per-play production, but it is possible the Jaguars give more snaps to JaMycal Hasty this week.
Josh Jacobs
Jacobs continues to deal with a calf injury that he went into week 12 with. He clearly was not impacted in week 12, as he scorched Seattle’s defense for 45+ fantasy points! Jacobs is not expected to practice much this week, and it is possible he aggravated the injury during the win. However, it’s hard to imagine this is going to hold him back, as on the very last play of the game, he ran over 80 yards for a touchdown.
A calf injury would impact a runners sprinting speed and cutting. When sprinting, players stay in a plantarflexed position. Plantarflexion is the motion of pointing your ankle downward, like standing on your tippy toes. The calf muscles move the ankle into plantarflexion, therefore, when running, they are constantly contracting. The calf and Achilles complex function like a spring, recoiling to create movement in a very efficient manner. With a minor injury, this does not impact performance. However, only 30% of NFL running backs score at or above their baseline fantasy points in the first game after a calf injury. Jacobs is one of the 30%. He has been elite this season, and if he plays, don’t think twice about starting him.
Michael Carter
Carter is dealing with a minor ankle sprain. He did not practice to start the week, but this is not expected to be significant. An ankle sprain is an injury to the ligaments of the ankle joint. Most commonly, this occurs in the anterior talofibular or calcaneofibular ligaments. Ankle sprains can impact a player’s lateral agility, which Carter is great at.
With significant sprains, players may miss several weeks, but on average, running backs miss 1.3 games, with several not missing any time. We do see a decline of 2 fantasy points on average in the first game after an ankle sprain. Carter is a borderline flex play, to begin with, and fantasy players should monitor his practice reports to determine if he is expected for a full workload this week.
Najee Harris
Harris did not practice Wednesday as he deals with an oblique injury. Obliques can be tricky, as they are impossible to offload fully. The obliques are involved in literally every movement we do as humans. The obliques help rotate the trunk and help stabilize the core. Functionally, when running, our torso is constantly rotating side to side; the obliques help with this. Also. when reaching out to catch a pass or bracing for contact, the obliques engage to stabilize the core.
To further explain the oblique’s role, we must use the classic soda (or beer) can analogy. Our core functions very similar to an unopened soda can. The can has walls on all sides, and so does our core. The roof of our core is the diaphragm muscle, the bottom is our pelvic floor muscles. The front, sides, and back are the abdominal muscles (including the obliques) and the multifidi muscle. An unopened soda can is very firm because the pressure from the carbonation pushes outward on the firm walls. As soon as any wall is compromised, via opening the lid or shotgunning the can, you can instantly crush the can. With our core, if a muscle such as the oblique is not functioning efficiently, it is similar to the can losing its firmness when you poke a hole to shotgun. Now, it’s not always this dramatic of a loss of stability. I don’t expect Harris to fold over like a crunched-up can, but depending on the severity of his oblique injury, he may have difficulty breaking tackles and issuing stiff arms.
This is also the type of injury that can get worse easily. Harris has been okay at best this season but is playing well below his ADP, as he is currently RB20. Jaylen Warren, who is likely to return this week, has seen more involvement and may continue to take Harris’s work. Harris is startable if he plays, but don’t expect a major output.
Damien Harris
Harris is dealing with a thigh injury and has already been ruled out for Thursday night’s game against Buffalo. If Harris returns next week, running backs see a decline of 2.3 fantasy points in the first game back from this injury.
Jaylen Warren
As mentioned above with Najee Harris, Warren is likely to return this week after missing last week with a hamstring injury. Hamstring injuries are the most common injury in football and have a high recurrence rate. A previous hamstring injury increases the risk of a second by 2.7x. However, running back production is hardly impacted at all. Running backs only average a decline of 0.7 fantasy points when they return from a hamstring injury. The load on the hamstring increases dramatically when a runner increases speed from 80-100%. This requires a lot of space to do so. Running backs rarely get enough room to run fast enough to stress their injured hamstrings.
Warren’s production likely hinges on Najee Harris’s health. Fantasy players will want to monitor the status of both heading into week 13.
JK Dobbins
Dobbins has been designated to return from the IR after missing 5 games due to an arthroscopic procedure on his knee that he injured last season. This does not mean Dobbins will play this week, but the Ravens have 21 days to elevate him to the active roster.
The arthroscopic procedure is performed to clean out the knee. It is unclear what was being cleaned out, but often it is meniscus tissue or cartilage, and they may drain fluid as well. The good news is that no tissues are repairing, other than the skin from the small incision. This means his only restrictions were pain and swelling. Pain and swelling can take some time to subside after these procedures, but by now, they should both be under control.
Dobbins practiced on Wednesday, and it’s not impossible he plays this week. Dobbins struggled this season before getting injured, as he continues to rehab from an ACL, LCL, meniscus, and hamstring injury suffered in the 2021 training camp. We routinely see running backs struggle in their first season after an ACL injury. With Dobbins’s struggles early this season, this second procedure, and a fairly crowded backfield, it’s hard to trust Dobbins in fantasy until he proves otherwise.
Joe Mixon
Mixon is progressing well through the concussion protocol after missing last week. Fantasy players should monitor his practice reports to see if he will play this week.
Leonard Fournette
Fournette missed week 12 due to a hip pointer. A hip pointer is a bruise to the glute muscles or the part of the hip bone called the Iliac Crest. You rest your hands on this prominent bone when holding your hips. This bruising impacts the muscles’ ability to function properly, making it difficult to run and cut. When the swelling goes down, with a little bit of rehab, the function should return to normal. I was a bit surprised Fournette was not able to play in week 12. We will keep an eye on practice reports for his week 13 outlook. If he plays, his per-play production should not be impacted.
Raheem Mostert
Mostert was limited in practice Wednesday as he deals with a knee injury. The Dolphins have not stated what his knee injury is, making it hard to analyze. Any knee injury will impact a runner’s agility and possibly straight-line speed. Speed and agility are Mostert’s game. We will continue to monitor practice reports.
Week 13 fantasy football injury update: Wide Receivers
Ja’Marr Chase
Ja’Marr Chase continues to rehab from his hip fracture and labrum injury. Chase recently acknowledged that he originally injured his hip in week six against New Orleans and still went on to play in week seven against Atlanta and put up 31 fantasy points.
The fracture is likely healed at this point, as it has been 6 full weeks. The labrum does not have as great of a healing capacity but does not always need to heal. The labrum job is to help hold the femur in the hip socket. A loss of labrum integrity does make maintaining the congruency of the femur and the hip challenging, but the muscles that rotate the hip can make up for it. With hip strengthening, balance, and reactive training, these muscles can often fully compensate.
Chase has stated that he feels close to 100% and that he is no longer experiencing any pain. This bodes well for his rest-of-season outlook, though re-injury remains a risk. If Chase was able to put up 31 fantasy points in the height of this injury, he certainly can do the same on the back end of this injury. I would not be surprised if the Bengals ease him back into the game flow, and we may see reduced snaps in his first week, but he is locked and loaded for the fantasy playoffs!
Allen Robinson
Robinson will be out for the season as he recovers from surgery for a stress fracture on his navicular bone. The navicular is one of the main bones of the arch of the foot. It is a common bone for stress fractures, as its role in the arch means it takes on great amounts of force with walking and running.
Stress fractures occur due to overload. This often is due to some mechanical flaw in one’s walking or running gait. Surgery is usually indicated for a stress fracture when rest alone is unlikely to provide adequate healing. The navicular is a unique bone in which fracture can disrupt its blood supply. When a bone does not have a sufficient blood supply, necrosis (bone death) can occur. This is why Robinson needs to undergo surgery.
As he is rehabbing, his rehab team should be evaluating his foot posture, walking, running, and jumping mechanics to determine the mechanical flaw that predisposed him to a stress fracture. Often improving arch muscle strength and glute strength or providing a custom orthotic can help prevent a recurrence.
Darnell Mooney
Mooney suffered a significant ankle injury that required season-ending surgery. Based on the video, it looks like Mooney suffered either a high ankle sprain or a medial/low ankle sprain. A high ankle sprain would be an injury to the anterior tibiofibular ligament, the posterior tibiofibular ligament, or the interosseous membrane. This is the same injury Cooper Kupp has, and the tightrope procedure would likely be the surgery Mooney would undergo. A medial ankle sprain is an injury to the deltoid ligament, similar to Michael Thomas a few years back.
Mooney will have adequate time to rehab and be ready for week one next season. The challenge is a significant ankle surgery like he is undergoing often leads to chronic ankle stiffness. The ankle is designed to be our primary shock absorber. When it becomes stiff, less force is attenuated from the ankles, and more force is taken on by the knees, hips, back, etc. This contributes to soft tissue injuries. It is not a guarantee that Mooney won’t regain all of his prior mobility, but it is very common for people to lack full ankle range after surgery. The good news is ankle stiffness does not usually impact performance, just injury risk.
Kadarius Toney
Toney continues to sit out of practice as he deals with another hamstring injury. I went into immense detail about my concerns with recurring hamstring injuries and the importance of testing the sciatic nerve in last week’s article.
Mike Williams
Williams is not practicing to start this week as he deals with a re-aggravation of his high ankle sprain. Receivers average missing 4.3 games with a high ankle sprain, so it would not be surprising to see him miss some more time. Williams relies on his elite jumping skills to make big plays down the field. This is exactly the type of skill that is impacted by a high ankle sprain. We already saw this be the mechanism for re-injury for Williams. It’s tough to trust him in the next few weeks, but he could be back in time for the fantasy playoffs.