Week Five Injury Report

Week four hit us with several injuries to big-time fantasy players. With bye weeks starting this week, the week five injury report is here to help fantasy players navigate injuries and better understand which injuries may impact player production.

Week Five Injury Report: Quarterbacks

Justin Herbert

Injury: Left middle finger fracture

Herbert is on the week five injury report fractured his left (non-throwing) middle finger in Sunday’s win against the Raiders. Herbert returned to the game and played just fine, helping seal the Chargers victory.

There are three bones in the middle finger, the proximal, intermediate, and distal phalanxes. It’s unclear which is fractured, but also does not make much functional or prognostic difference. Routine bone healing is 4-6 weeks, and Herbert will likely protect the finger with a splint or heavy tape job in the meantime.

Expected Return: Week 6 (week 5 bye)

Fantasy Impact: This is Herbert’s non-throwing hand therefore should not impact his play outside of potential difficulty with ball handling, taking snaps, and handoffs.

Mathew Stafford

Injury: Left hip contusion

A hip contusion (bruise) occurs when there is enough impact to the hip that muscle or other tissue in the hip bruises. While this can be painful and cause an athlete to move a little slower, it is not a serious long-term injury. Treatment will focus on reducing swelling and regaining range of motion. Stafford practiced all week, suggesting there is no concern for his week five status.

Expected Return: Week 5

Fantasy Impact: This is Stafford’s left hip, therefore will not impact his ability to push off and create throw power. As a pocket passer, this will not impact his play.

Kenny Pickett

Injury: Left knee bone bruise

Pickett suffered a bone bruise on his left knee. What looked like it could have been a more serious injury will not keep Pickett out long. This is similar to the injury Travis Kelce dealt with to start the season, of which he only missed one game.

A bone bruise is a less severe form of bone injury that causes local bleeding and swelling. This is not as severe as a fracture but is very painful. With it being a bruise to either the femur (thigh) or tibia (shin), it will hurt with weight bearing, such as running or cutting. Pain itself can inhibit athletic performance, as can the associated swelling. Swelling in the knee will cause pain and stiffness but also can shut down the quad muscle, which is one of the strongest and most active muscles in athletics.

Bone bruises typically don’t take more than a week or two to settle down. When the pain and swelling resolve, athletic function generally picks up right where it left off. Pickett has been cleared to play in week five.

Expected Return: Week 5

Fantasy Impact: This is Pickett’s left leg, therefore not the leg he pushes off of for throwing power. I do not expect this to hinder Pickett’s production.

Jimmy Garoppolo

Injury: Concussion

Garoppolo has cleared the concussion protocol and will play in week five.

Expected Return: Week 5

Fantasy Impact: We do not expect concussions to have a negative impact on fantasy production.

Week Five Injury Report: Running Backs

Saquon Barkley

Injury: High ankle sprain

With a high ankle sprain, the two shin bones, the Tibia and Fibula, which are typically held together by strong ligaments and connective tissues, can become separated from one another as these ligaments and connective tissue are injured. The severity of the injury determines the level of separation of the two bones. The separation of the Tibia and Fibula leads to instability within the ankle, making it difficult to push off and create power.

Depending on the severity, these bones don’t always neatly realign, and chronic instability can occur, and re-injury rates are high. We saw last season, Jonathan Taylor re-injured his high ankle sprain three times, and he is still dealing with it this year!

Expected Return: Week 5-6

Barkley put forth limited practices all week, making his week five status murky, and will likey be a true game-time decision.

Fantasy Impact: High ankle sprains can make it difficult for a running back to quickly cut and run with power. Because of this, it would not be surprising if we see this impact Barkley’s stat line in his first game or two. That said, he is elite, and we start our elite players.

Jonathan Taylor

Injury: High ankle sprain

For an explanation of high ankle sprains, see the write-up on Saquon Barkley just above. Taylor’s situation is unique, however. Taylor dealt with three high ankle sprains to the same ankle last season, ultimately leading to off-season surgery. We often hear about the tightrope procedure for high ankle sprains. The tightrope procedure is highly effective. Jonathan Taylor did not have the tightrope procedure; he had a debridement (cleanout).

I wrote about my concerns for Taylor in the pre-season before he was placed on the IR. The fact that he was still dealing with this injury 6-7 months after surgery is concerning. Sure, the contract was part of him not participating in training camp, but he would not have been placed on the IR if he was not injured. While it is entirely possible he can play at a high level, I have concerns about his durability secondary to this injury.

Three high ankle sprains in the same year will leave him prone to more. Additionally, high ankle sprains are one of the injuries that can influence mechanics “up the chain” into the knee, hip, back, etc. I hope he can overcome this injury and play well again; that remains to be seen.

Expected Return: Week 5

Taylor has returned to full practice this week and appears set to play in week five.

Fantasy Impact: Having not participated in practice or team activities this season and coming off this injury, I would not be surprised if we saw a hit on Taylor’s production initially. He is only 24, which bodes well for recovery, and there is no question he is incredibly talented. It’s possible Taylor has an impactful season, but injury risk is high.

Kyren Williams

Injury: Hip contusion

Similar to his quarterback, Williams is dealing with a bruised hip. This is not a structural injury, and when the swelling resolves, athletic performance returns. It is entirely possible to get the swelling down and function returned by Sunday. Oftentimes times these injuries feel better when warmed up.

Expected Return: Week 5

Williams is off the injury report and is expected to play in week five.

Fantasy Impact: I do not expect this to impact his production.

Javonte Williams

Injury: Hip flexor strain

Javonte suffered a hip flexor injury, also being reported as a quad injury which kept him out for the remainder of Sunday’s win.

If being technical, “hip flexor” refers to a group of muscles that, quite literally, flex the hip. The primary muscles are the iliopsoas and rectus femoris, but there are a few other smaller muscles. These muscles help drive the thigh forward when running. While these muscles are strong and powerful, they are not as important power generators as other muscles like the glutes, quads (though the rectus femoris is one of the quad muscles), or hamstrings.

Where this could get tricky (no reports yet that this is the case) is if the hip labrum is also involved. The rectus femoris muscle has attachments to the hip labrum, and often they are injured together. A hip labrum injury is not always a major cause for concern; it depends on severity.

Expected Return: Week 5-6

Williams was a full participant in practice Friday but remains questionable to play.

Fantasy Impact: While hip flexor injuries can be painful and annoying, they are not primary power muscles with running and cutting. This is an injury that would impact a kicker’s (or soccer player’s) muscle more than a football player’s. Our sample size is too small to make conclusions, but does show a 35% drop in fantasy production and a 45% drop in snap rate for running backs in their first game after this injury. However, while this may impact him for a game or two, it is not likely to affect his play all season.

Rico Dowdle

Injury: Hip contusion

This is essentially the same injury and analysis as Kyren Williams above.

Expected Return: Week 5-6

Dowdle has been removed from the injury list and will play Sunday.

Fantasy Impact: These injuries usually feel better when the athlete gets warmed up. Dowdle is not startable in any format presently, but this injury shouldn’t hinder his production.

Damien Harris

Injury: Neck injury.

Details on Harris’ neck injury are not provided at this time. There are numerous types of neck injuries, and ultimately they tend to impact the ability to move the head and sometimes can impact the shoulder or arm function as well. At this time, there is no indication this injury is anything other than a neck injury.

Expected Return: Week 5

Harris is off the injury report and will play in week five.

Fantasy Impact: When healthy enough to play, this injury should not impact production. Harris has not been fantasy-relevant this year.

Week Five Injury Report: Wide Receivers

Cooper Kupp

Injury: Hamstring injury

Kupp suffered a hamstring injury in training camp, then re-aggravated it again in camp. Two hamstring injuries in one season for a 30-year-old are not how we like to start the season. Recent reports suggest that Kupp may push to play in week five and that the Rams want him at 80-90%. Only 80-90%? That is a low bar, in my opinion. Typically we don’t want players returning to sport until they are testing at 90-95% of the unaffected side on various strength, range of motion, power, and single-leg stability tests.

Hamstrings are notorious for re-injury, especially in receivers and particularly in older receivers. There is no question that Kupp is the cream of the crop of fantasy and real-life football assets, but there is quite a bit of risk built in here.

Expected Return: Week 5

Kupp practiced in full this week and will play.

Fantasy Impact: It’s as simple as if Kupp plays, you start him, but the risk is present. Receivers average an 11% decline in fantasy production and a 16% decline in snap rate after a hamstring. For Kupp, that’s nothing. It’s the re-injury risk that would steer me away from actively trying to trade for him. But if you already have him, get ready to start him.

Amon-Ra St. Brown

Injury: Abdominal injury

St. Brown is dealing with an abdominal injury that kept him out of practice all week. It is unclear exactly what his abdominal injury is, and typically there are two different types, one bad and one not so bad.

A “sports hernia” is the layman’s term for an abdominal injury to the portion of the abdominal tendons that attach to the pubic bone. This injury makes it very difficult to cut and is very stubborn to conservative treatment. Let’s hope this is not what St. Brown is dealing with. Sports hernias usually fail conservative treatment and require surgery.

Oblique injuries are another type of abdominal injury and a totally different outlook. Obliques are abdominal muscles that help rotate the torso and brace the abdomen for contact. These injuries usually do not impact production and heal well conservatively.

While St. Brown did not practice all week, he was seen running full speed on the sidelines, a great sign.

Expected Return: Week 6 or later

Fantasy Impact: As long as this is not a severe injury or a true sports hernia, this should not impact St. Brown’s production. Puka Nacua has been dealing with an oblique injury and continues to dominate.

Tee Higgins

Injury: Rib fracture

Higgins fractured a rib in Sunday’s loss. Rib fractures are incredibly painful and hard to play with but are usually pain tolerance as long as the fracture doesn’t risk penetrating the lung field. Healing takes 4-6 weeks, but with extra padding and just being a tough dude, he could play sooner.

It also needs to be mentioned that several key muscles, such as the lats, pecs, and obliques, attach to the ribs. Fractured ribs can lead to guarding of these muscles, which is functionally seen as difficulty with full shoulder range of motion (especially reaching overhead) and with trunk rotation. Both motions need to be full in order to play.

Expected Return: Week 5-7

Higgins says he won’t be out long. Technically, as long as the fracture does not pose a risk of penetrating the lungs, this would be a pain tolerance thing. At 1-3, it might be more painful for Higgins to watch from the sidelines. Higgins logged a limited practice Friday and remains questionable.

Fantasy Impact: If he returns this week, I would expect Cincinnati to limit his snaps to protect him. I would not recommend starting him in fantasy if he plays.

Mike Evans

Injury: Hamstring injury

Evans is on the week five injury report, as he suffered the notorious hamstring injury in week four. As of this writing, we are awaiting MRI results, but the Bucs do not appear to think his injury is severe.

The hamstring’s force increases dramatically when an athlete’s speed increases from 80-100% top speed. This is why hamstrings are such a problem for receivers. In order to get to top speed, it takes 30-40 yards, a distance only receivers run routinely in games. Hamstrings have a very high recurrence rate, which compounds the concern when receivers have this injury.

Expected Return: TBD

Fantasy Impact: Hamstring injuries for wide receivers are a pain in the ass! Receivers, on average, see a decline of 11% fantasy production and 16% snap rate on the first game after injury. For a player like Evans, these numbers are not enough to scare us off from starting him when he returns. It’s the high risk for re-injury, especially at age 30, that is a bigger concern.

Davante Adams

Injury: Shoulder injury

Adams missed part of week four with a shoulder injury but was able to “nut it up” and return. We do not have the specifics of his shoulder injury yet, but he has mentioned that it does not feel good. Specifics will be helpful with analyzing the injury, as different shoulder injuries have differing re-injury risks.

Expected Return: Week 5-6

Adams did not practice Thursday or Friday ahead of their Monday night game. Saturday practice report will be telling for his availability.

Fantasy Impact: While shoulder injuries are upper body, thus do not impact the ability for a receiver to run, cut, and get open, we often see teams limit snaps to prevent aggravating the injury. We see a nearly 20% drop off in snap rates when receivers return from shoulder injuries. From a per-play standpoint, I would not expect this to hinder Adams.

Rashod Bateman

Injury: Hamstring

Bateman missed four with a hamstring injury. As a speed receiver, hamstrings have the potential to impact Bateman more than other positions. This is because the force on the hamstring increases dramatically at top-flight speed. Therefore, a hamstring at less than 100% could plausibly slow him down, and of course, there is the risk of re-injury.

Expected Return: Week 5

Bateman practiced in full this week, putting him on track to play.

Fantasy Impact: Receivers see an 11% drop in fantasy production and a 16% drop in snap rate after a hamstring. Considering Bateman’s utility as a speed receiver, it is plausible that he may not play up to his ceiling this week. Bateman has not been startable thus far this season.

Week Five Injury Report: Tight Ends

Pat Freiermuth

Injury: Hamstring injury

Freiermuth is on the week five injury report as he is expected to miss time with a hamstring injury. As mentioned above with Mike Evans, the hamstring is a powerful force generator that is utilized during sprinting and blocking. With sprinting specifically, it takes several yards for athletes to get to top speed, where the hamstring is most stressed. Tight ends tend to run shorter routes than receivers, which is likely why we see no fantasy drop-off for tight ends when they return from hamstring injuries.

Expected Return: Week 7-8

Freiermuth will not play in week five. The Steelers have a bye in week six.

Fantasy Impact: On average, tight ends show no dip in fantasy production but a 12% decline in snap rate in the first game after a hamstring injury.

Dalton Knox

Injury: Quad injury

The quads are big strong, powerful muscles that are highly involved in running, cutting, and jumping. With a more severe quad injury, athletic performance can be hindered tremendously. Knox has been removed from the injury report and will play.

Expected Return: Week 5

Fantasy Impact: Tight ends see a 12% decline in fantasy production and a 7% decline in snap rate in the first game after a quad injury. With Knox being a fringe starter anyway, this may discourage fantasy players from starting him.

Donald Parham

Injury: Wrist sprain

X-rays were negative on Parham’s wrist, indicating he is dealing with a sprain. Wrist sprains can nag and linger. For a tight end, there is absolutely no way to offload the wrists as they are constantly engaged with blocking. Typical healing time for ligaments (sprain indicates ligament) is 2-4 weeks. It remains to be seen if Parham will miss time to allow healing or if he will heavily tape his wrist and play through it.

Expected Return: TBD

Fantasy Impact: Parham is not fantasy-relevant, but for long shots in DFS, this should not impact his receiving ability.

Juwan Johnson

Injury: Calf injury

Johnson, who has already dealt with a calf injury this season, has once again injured his calf. The calf is pivotal in running and lower body power generation like blocking. Recurrence rates in sports are as high as 14-16%, and tight ends average missing two games. The severity of Johnson’s injury remains to be seen.

Expected Return: TBD

Johnson will not play in week five.

Fantasy Impact: Calf injuries will impact sprinting speed, change of direction, and cutting. Tight ends average a dip of 8% in fantasy production when they return from a calf injury. Typically that is not enough to scare us off, but Johnson has simply not been startable this year.