Written by Tom Christ, PT, DPT, OCS, FAAOMPT
The semifinals are here! I hope you all have teams still competing. If not, well you can still read anyway! In week 15 the total number of injuries was low, but the impact could be paramount. The week 16 fantasy football injury update has plenty to offer players fighting to make the championship! As always, those who prefer podcasts can check out the Fantasy Injury Team podcast on all major platforms including Apple and Spotify!
Week 16 Fantasy Football Injury Update: Quarterbacks
This one Hurts (pun intended). This Hurts my soul as an Eagles fan, but it even hurts fantasy players. According to ESPN, Jalen Hurts was the third most frequent player to appear on playoff-bound fantasy rosters, behind just Travis Kelce and Josh Jacobs.
When watching the game on Sunday, I immediately knew Hurts injured his shoulder on the play in the third quarter when he was tackled onto his right shoulder. The mechanism of injury, seen below in the video, is a classic way to suffer an AC joint sprain or a broken collar bone. Fortunately, Xray ruled out a fracture, leaving AC joint sprain as the culprit.
The Acromioclavicular (AC) joint is often termed a “shoulder separation” and is the same injury Bear’s QB Justin Fields had earlier this season. The difference is that Fields injured his non-throwing shoulder. The AC joint is the junction of the part of the scapula (shoulder blade) called the acromion and where it connects to the clavicle (collar borne). The connection gives rise to its name. The AC joint functionally links the shoulder girdle to the torso and is essential for shoulder mobility and stability. The AC joint relies on ligaments (acromioclavicular and coracoclavicular ligaments) for stability.
The AC joint must move during the throwing motion. The injury will do one of two things that influence throwing. 1) Ligament injury creates laxity (too much mobility), altering the mechanics of the throw to negatively influence power and accuracy. 2) Swelling and muscle guarding create pain and stiffness that reduces the range of motion, altering throwing power and pain and negatively influencing accuracy.
Now, Hurts injury does not appear very severe. The fact that coach Siriani won’t rule Hurts out is positive, as well as that Hurts finished the game and played well after injury. Some of his post-injury production can be attributed to adrenalin pumping, dampening pain, as well as swelling not yet setting in.
Hurts did not practice to start the week and is truly questionable for Saturday’s matchup against Dallas. I find it hard to believe Jalen will play this week, as the Eagles are in the driver’s seat to secure a first-round bye. If more were on the table, he would likely suit up, but I do not see the Eagles risking their playoff run for one game.
In the event Hurts does play, we see a steep decline of 6.2 fantasy points from pre-injury baseline in the first game after an AC joint injury in quarterbacks. This stat, however, can be misleading. This was only a sample size of six, not enough to draw conclusions. Additionally, many of the quarterbacks in this sample size are pocket passers who do not have the rushing upside of Hurts. Ultimately, I do not believe he will play, but if he does, you start him.
Jackson sat out of Wednesday’s practice as he continues to manage a PCL injury. PCL injuries are challenging. Athletes can play without a fully intact PCL, however, it is an injury that causes swelling, stiffness, and pain. The PCL does have a stability role within the knee. When it is injured, knee stability is impacted making it challenging to cut with as much ease.
Without full running ability, Jackson’s fantasy upside is limited. Since Lamar Jackson did not practice in any amount on Wednesday, it is unlikely he is close to 100%. Even if Jackson plays this week, I would not expect his typical rushing numbers. I would expect fewer designed runs and fewer yards per carry.
Earlier this season, we saw Julio Jones and Dalton Schultz each miss numerous games with a PCL injury. Each player also had setbacks during the season. Unfortunately, this is characteristic of a PCL injury. Last season Ezekiel Elliot was not the same runner after suffering a PCL injury. The bottom line is that this type of injury is not often season-ending but becomes very annoying and negatively influences the ability to run effectively. I do not expect we will see vintage Lamar Jackson until next season.
Tannehill appears likely to miss the rest of the season with a high ankle sprain. Watching the injury, it is evident that he suffered a high ankle sprain. The defender rolls up on him from behind and the side, a classic high ankle sprain mechanism. This mechanism puts stress on the ligaments connecting the tibia and fibula bones. When these ligaments are injured, a gap between the two bones occurs, impacting the stability of the ankle. Without proper stability, pushing off the ankle when running, cutting, jumping, or even throwing becomes difficult. In addition to the loss of stability, it hurts!
Tannehill should be 100% ready to go by offseason workouts. I would not expect this injury to impact his production in the future.
Wilson has cleared the concussion protocol and is in line to start this week. We do not typically see a decline in fantasy production after a concussion. However, Wilson was the QB 19 prior to injury.
Unlike Wilson, McCoy has not cleared the concussion protocol and has been ruled out for week 16. Backup Trace McSorley will start in his place. McCoy will have to pass the NFL’s concussion protocol to play in week 17.
White has been ruled out Thursday night as he deals with a rib fracture. The ribs attach to the thoracic spine (mid and upper back). The thoracic spine is where a large amount of trunk rotation during throwing occurs. During thoracic rotation when throwing, the ribs must also rotate slightly. When injured, the ribs may not have the capacity to rotate as well. This limitation will limit the amount of rotation a quarterback has during the windup or follow-through. Restrictions in windup and follow-through will impact throwing power and accuracy.
Additionally, ribs need to move with breathing. Breathing rates increase during sport, causing more stress on the injury site. Another issue is getting hit. Quarterbacks are sitting ducks in the pocket. He can wear all the protective padding he wants; it will not stop the pain from a 300 lbs lineman landing on him.
We will check back in next week for White’s availability.
Week 16 Fantasy Football Injury Update: Running Backs
Taylor will miss the rest of the season with his third high ankle sprain of the year. As explained with Tannehill above, a high ankle sprain occurs when the ligaments connecting the tibia and fibula bones become sprained, causing the two shin bones to separate. For a runner like Taylor, who relies on his ability to cut quickly, the instability from the ligament injury impacts his speed, quickness, and power.
Undoubtedly, Taylor will be 100% ready for next season, but there is cause for concern. This is Taylor’s 3rd high ankle sprain in one season. High ankle sprains tend to lead to chronic ankle stiffness. This stiffness may persist long after the injury has healed and the pain has resolved. When the ankle cannot move through its full range of motion, the mechanics of the entire lower extremity are altered. The ankle is supposed to be a shock absorber. When it is not moving properly, the shock moves up the chain into the knee, hip, back, and so forth. In my practice, I have even seen opposite-side shoulder injuries secondary to a stiff ankle.
Chronic ankle stiffness is not guaranteed, and Taylor and his medical staff must work diligently this offseason to regain as much range of motion in his ankle as possible. The mechanical changes from a stiff ankle predispose a player to future injuries but do not guarantee future injury. I do not believe this makes Taylor enough of an injury risk to avoid next season, but it is something for players to keep in mind.
Ekeler missed some of Sunday’s game with a shoulder injury, but all tests have come back negative. The details of his injury are unclear, but it does not appear to be an issue at this time. Minor shoulder injuries would not impact fantasy production like a leg injury would. This is simply because the shoulder is non-weight bearing and has no influence on speed or agility. It is possible that his shoulder could become aggravated, but that is impossible to predict.
Chubb has not practiced this week ahead of Cleveland’s Christmas Eve matchup against the Saints as he deals with a foot injury. Specifics of his injury are unclear, but any foot injury has the potential to impact a runner.
Chubb is great because of his one-cut, downhill, power-running style. A foot injury can negatively influence every aspect of running, including speed, acceleration, agility, and power. The degree to which these attributes are impacted depends on the severity of the injury and how well the training staff can support the foot.
A minor injury is unlikely to have any impact. However, a moderate-severe sprain of a foot ligament would lead to laxity in the foot, making it harder to create power when pushing off. We’ll have to monitor reports this week, but not practicing Tuesday or Wednesday is not a great sign. Despite this, it is hard to sit Chubb if he is active.
Walker remains on the injury report due to his ankle, which was initially injured in week 13. There are no reports of any setback, and Seattle is likely just giving the rookie some rest as he missed practice Wednesday. I wrote a few weeks ago about Walker’s injury and how it differs from a traditional ankle sprain. An ankle impingement, which is likely what Walker is dealing with, would not have the same negative impact on production as a sprain would. A sprain will impact a player’s sensory awareness of where their foot is in space, affecting cutting and landing. An impingement would not.
Walker played on 75% of snaps last week, and I expect a similar workload this week.
Jeff Wilson Jr.
Wilson has returned to practice after missing week 15 with a vague hip injury. Apparently, he was close to playing last week, making him likely to play this week. Any hip injury could influence lateral agility and sprinting, though, with Wilson close to playing last week, it is unlikely this will be much of a negative factor.
Huntley suffered an Achilles tear in week 15 and will undergo season-ending surgery. The Achilles remains the single most significant injury a player can endure. Running backs perform miserably after this injury. Cam Akers and James Robinson are the two most recent examples of how no running back ever has played well in the first season after an Achilles tear. D’Onta Foreman is the only running back in NFL history to return to a prominent role after this injury, and it took him five seasons. Huntley was likely only rostered in deep dynasty formats and can be safely dropped.
Week 16 Fantasy Football Injury Update: Wide Receivers
Lockett suffered a fracture of his second metacarpal (hand bone) last week and underwent surgery this week. Pete Carrol, who is just awful at giving medical reports, claims that Lockett may be able to return before the end of the regular season.
Lockett had a spiral fracture of the second metacarpal on his left hand. A spiral fracture is when the bone cracks in a twisting pattern, somewhat like a corkscrew. This creates more of a challenge with surgery, as there is a greater surface area of bone that must be stabilized.
The good news for Lockett is the surgery will completely stabilize the fracture. If he returns quickly, playing would be unlikely to worsen his injury. The challenge will be regaining the dexterity in his hand. As a pass catcher, his hands are his money makers. Anytime there is surgery, significant swelling, stiffness, and weakness occur as Lockett rehabs over the next few weeks focus will be on decreasing swelling, improving mobility, and regaining strength. It is unlikely he will be ready to go by week 17, but we will continue to monitor.
Cooks returned to practice in full capacity on Wednesday, putting him on track to play in week 16. Cooks has missed three games with a calf injury. The calf is highly involved in sprinting, cutting, and jumping. When we sprint, we stay on the balls of our feet. This is an efficient way to move quickly. In this position, called plantarflexion (foot pointed downward), the foot remains rigid, making it powerful to push off. The calves function like a sprint, creating significant power to run and cut quickly.
With a calf injury, the spring-like mechanism is impacted, and creating the same speed and quickness is challenging. This is likely why we see a significant decline in fantasy production from receivers after a calf injury. Receivers score 5.3 points below their pre-injury average, with only 6% meeting or exceeding in their first game after a calf injury. Simply put, you cannot trust Cooks this week.
Sutton was limited in practice to start the week as he returns from a hamstring injury. Hamstring injuries impact players at their top speed. The load on the hamstring increases dramatically when increasing sprint speed from 80-100%. This is why a hamstring injury will impact a deep-threat receiver more than any other position. Sutton is a deep-threat receiver. If he does play, I expect to see some decline in his production. Receivers average a drop of 2.8 points from their pre-injury baseline when returning from a hamstring injury.
Olave has not practiced yet this week as he deals with a hamstring injury. Like Sutton above, Olave is a deep threat, meaning this injury would likely impact his production.
Burks has returned to practice, but has not officially cleared the NFL’s concussion protocol. He will need to continue to progress through the protocol ahead of his Saturday matchup against Houston. With Tannehill sidelined the rest of the season, it is hard to imagine Burks being valuable with Malik Willis at QB.
Collins remains sidelined with a foot injury. Like Nick Chubb, a foot injury can influence speed, acceleration, agility, and power. If Collins does play this week, it is hard to trust him in the fantasy playoffs.
Duvernay will miss the remainder of the season with a foot fracture. We don’t know which bone was fractured, but he will undoubtedly be immobilized in a boot for several weeks.
Duvernay has plenty of time to be ready for next season. The concern is that foot fractures have the potential to lead to long-term stiffness in the foot which can influence mechanics. Duvernay and his rehab team will have to focus on regaining full mobility within the foot in order to avoid any negative mechanical consequences.
Week 16 Fantasy Football Injury Update: Tight Ends
Goedert is ready to go after missing five games with a shoulder injury. The video of his injury looked like an anterior dislocation, almost always in conjunction with a labrum tear. Surgery is sometimes indicated with this type of injury but can often be rehabbed successfully. If this injury would respond well to rehab, five weeks is plenty of time to train the rotator cuff muscles enough to compensate for the injured labrum.
I do not expect this to impact Goedert’s productivity in any way negatively. He is a tremendous route runner and run after catch tight end, and he should pick up right where he left off. The fear would be re-injury, as re-dislocation rates are high.