Posted by Tom Christ

Week Four Injury Report

September 29, 2023

Week three was less eventful for injuries than prior weeks; however, we still have a loaded week four injury report. Last week we lost Chargers Mike Williams for the season, but hopefully, we welcome back a number of key players who have been out with injury. Below, we break down the injuries impacting key players and how their injuries may impact their fantasy production.

Week Four Injury Report: Quarterbacks

Patrick Mahomes

Injury: Ankle sprain

Mahomes sprained his right ankle in Sunday’s romping over the Chicago Bears but was able to finish the game. He did not appear bothered by the injury at the moment. Often times with ankle sprains, the adrenaline pumping during the game can mask the pain of a sprain. Typically the second day is worse, and the ankle will swell, limiting range of motion, creating pain, and impairing function. However, Mahomes is not even on the injury report, so his was clearly very minor

week four injury report

Expected Return: Week 4

Fantasy Impact: It is his right ankle; therefore, the ankle he pushes off to create power when throwing. While this has the potential to impact his throwing, Mahomes is simply different than the rest, and it is not expected to limit him at all. Additionally, QBs hardly see any decline in fantasy production after ankle sprains.

Derek Carr

Injury: AC Joint Sprain

Carr finds himself on the week four injury report as he deals with an AC joint sprain to his throwing shoulder. The Acromioclavicular (AC) joint is the junction of the collar bone (clavicle) and a portion of the shoulder blade called the acromion. The joint is held together by ligaments called the acromioclavicular ligament and the coracoid ligament. The term “sprain” indicates an injury to ligaments; therefore, these ligaments are what is injured.

week four injury report

During the throwing motion, the shoulder must rotate, elevate, and come across the body. During any shoulder motion, the AC joint must move slightly. An injury to the AC joint can cause pain and inflammation that can impede this motion, limiting throw power and accuracy. Grade I and II AC joint injuries (which Carr falls into) respond well to rest and rehab.

Expected Return: Weeks 4-5. Rehab will focus on regaining range of motion, reducing pain and swelling, and regaining strength. When he has these factors normalized, he will be able to play.

Fantasy Impact: This is an injury to Carr’s throwing shoulder and, therefore, will likely have an impact on his throw power and accuracy. Encouraging reports came out of New Orleans on Friday, stating that Carr looked good in practice and was able to throw the ball down the field. Still, NFL players are typically rushed back to play before they are fully healed, so I expect a decline in fantasy production in his first game or two when he returns. Specifically, I would expect him to miss some deep balls. With Carr being a fringe fantasy starter anyway, it is better to keep him on the bench in 1QB leagues if he plays this week. In 2QB leagues, if Carr plays, you may consider starting him depending on other options. Re-injury risk is definitely elevated if he plays.

Deshaun Watson

Injury: Shoulder Contusion

Browns reporter Mary Kay Cabot states that Watson’s shoulder injury is a “contusion,” aka a bruise. This matches practice reports and Watson’s own report of it being sore with no structural damage. This type of injury typically will feel better as the athlete warms up, as increasing blood flow and moving the shoulder helps pump out the bruising and soreness.

Expected Return: Week 4

Fantasy Impact: We just saw CJ Stroud last week deal with a similar injury and play just fine. I do not anticipate this negatively impacting Watson’s play this week.

Jimmy Garoppolo

Injury: Concussion

Garoppolo is still in the concussion protocol as of Friday and looks unlikely to play.

Expected Return: Week 4-5

Fantasy Impact: We do not expect any decline in fantasy production when players return from a concussion.

Anthony Richardson

Injury: Concussion

Richardson has cleared the concussion protocol and is on track to play this week.

Expected Return: Week 4

Fantasy Impact: We do not expect any decline in fantasy production when players return from a concussion.

Bryce Young

Injury: Ankle Sprain

A similar analysis to Mahomes above. An ankle sprain to a quarterback’s back leg can impact throw power, whereas an injury to the front leg can impact accuracy as it may cause them to be less stable during the follow-through. History of an ankle sprain renders an athlete 26% more likely to have another ankle sprain.

Expected Return: Week 4-5

Fantasy Impact: Young has practiced in full this week and does not appear to still be hampered by this injury. Furthermore, we hardly see any decline in QB fantasy production after ankle sprains. Young is a talented prospect but has not yet made himself fantasy-relevant.

Week Four Injury Report: Running Backs

Saquon Barkley

Injury: High Ankle Sprain

We finally got clarity from Barkley himself that his injury is a high ankle sprain. A high ankle sprain is worse than a traditional lateral 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.

week four injury report

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: Weeks 4-6. Running backs averaged missing 2.5 games, with a range of zero to six games missed. Barkley has logged limited practices on Thursday and Friday, which puts his week four status as a true toss-up.

Fantasy Impact: As mentioned above, a high ankle sprain can lead to loss of stability of the ankle, making it harder to cut and create power. If Barkley returns too quickly, I expect his production to take a notable hit. Based on practice reports, he is clearly not 100% but is progressing well. With superstars like Barkley and with a scarce running back pool, you probably will be forced to start him if he plays, but I would anticipate limited snaps and a big dip in production from his norm.

Austin Ekeler

Injury: High Ankle Sprain

The same analysis for Barkley above can be said about Ekeler’s high ankle sprain. Ekeler returned to practice on Wednesday but is now listed as doubtful for week four.

Expected Return: Week 6. Ekeler is doubtful for Sunday’s game. The Chargers have a week five bye; he will have another two weeks to rehab and be ready to play week six.

Fantasy Impact: Similar to Barkley above, I expect Ekeler to struggle with cutting and power in the first game or two back after this injury, which will likely impact his stat line.

Miles Sanders

Injury: Groin

The groin muscles are involved in running and single-leg stability. Groin injuries are common in football and carry up to an 18% recurrence rate. Sanders dealt with this injury in the preseason, and it is unclear if this is an aggravation or just a continuation of the management of this injury. Oftentimes times lower body soft tissue injuries don’t fully heal during the season but are managed throughout the year.

Expected Return: Week 4. At this time, it does not look like Sanders week four status is in jeopardy.

Fantasy Impact: The groin is involved in straight-line speed and single-leg function, but less so than other hip muscles. Lateral cutting relies on the outside of the hip muscles (glutes) more than the groin. Because of this, we see no dip in fantasy production for running backs as they return from a groin injury. Start Sanders as you would.

James Conner

Injury: Back

Conner was on the injury report on Wednesday with a back injury but has since been removed. He is good to go.

Expected Return: Week 4

Fantasy Impact: We do not expect this to have any negative impact on his production.

Kareem Hunt

Injury: Groin, ribs

Hunt started the week on the injury report with groin and rib injuries. He has since been removed and is good to go.

week four injury report

Expected return: Week 4

Fantasy Impact: Neither groin nor rib injuries typically impact running back fantasy production. Since Hunt is no longer on the injury report, it is likely he was simply dealing with soreness from his first game contact of the season.

Gus Edwards

Injury: Concussion

Edwards is off the injury report and is ready to play this week.

Expected Return: Week 4

Fantasy Impact: We do not expect any decline in fantasy production when players return from a concussion.

Week Four Injury Report: Wide Receivers

Mike Williams

Injury: ACL tear

Mike Williams is on the week four injury report with a devastating ACL injury. This prolific Chargers offense will be without one of their key pieces for the rest of the season. When it comes to being ready for the following season after an ACL tear, there are several factors we need to consider.

  • Age: Williams is 28. At 28, age is not working in his favor for quick healing, but it is not necessarily working against him.
  • Time from surgery to week one: We do not know when Williams will undergo surgery, but hopefully, it’s this week. Every week over nine months post-op is favorable for week one availability.
  • Number of tissues repaired: At present, it is only reported that Williams has an ACL tear, nothing else. If this holds true, this is beneficial for his 2024 outlook.
  • Freak athlete? Mike Williams is elite at high-pointing the ball and, overall, a really impressive athlete. This bodes well for his recovery; however, it will be a challenge for him to fully regain this athleticism that makes him special.

Expected Return: 2024

Fantasy Impact: Receivers see a dip in fantasy production in the first season after an ACL tear, especially at the beginning of the season.

week four injury report

Jaylen Waddle

Injury: Concussion

Waddle is off the injury report and ready to play this week.

Expected Return: Week 4

Fantasy Impact: We do not expect any decline in fantasy production when players return from a concussion.

Deebo Samuel

Injury: Rib injury

Saumel is on the week four injury report with a rib injury. Ribs can be tricky. Luckily, he does not have a fracture, which can be very difficult to deal with. Understanding rib anatomy helps explain how ribs can impact fantasy production.

As we breathe, the ribs must expand and recoil. When a rib injury is present, this hurts, and often the body’s response is to shorten the depth of the breath to lessen the motion of the ribs. When we are competing in athletics, the respiration rate increases, and the frequency of rib motion increases, which can be painful.

Several key athletic muscles attach to the ribs, including the lats, pecs, obliques, and several more. When reaching up to catch a ball, the lats are being stretched, and the obliques are either contracting to contort the body or bracing to absorb the hit. If the rib injury is near the attachment of these muscles, this can hurt but also limit shoulder or trunk motion.

Expected Return: Week 4-5. Deebo practiced in a limited capacity on Friday. It will be important to monitor his status ahead of Sunday.

Fantasy Impact: Practicing at all is a good sign for Samuel. Of course, fantasy players need to check his status before game time, but if he plays he should be able to do so at a high level. This comes down to pain tolerance, and few are tougher than Deebo. We just saw DK Metcalf play very well after dealing with a similar injury.

Brandon Aiyuk

Injury: Shoulder injury

Aiyuk missed week three with a shoulder injury but was able to practice Thursday. Initial testing was looking at the clavicle (collar bone), which fortunately was ruled out for fracture. It is possible he is dealing with an Acromioclavicular (AC) joint injury. With shoulder injuries in wide receivers, the re-injury rate will be elevated slightly, but since the shoulder is not a weight-bearing joint, it does not impact athleticism like sprinting, cutting, jumping, etc.

Expected Return: Week 4-5

Fantasy Impact: As long as he is healthy enough to play, this should not impact his per-play production. However, we see a dip of 10-15% snap rate in receivers in the first game after a shoulder injury.

Rashad Bateman

Injury: Hamstring

The hamstrings are powerful muscles highly involved in sprinting. The load on the hamstring increases dramatically when an athlete increases their speed from 80% to 100% top speed. This is why we see hamstrings impact receivers so much; they are the only offensive position group that routinely has enough space to get up to top speed.

Hamstring recurrence rate is very high, especially for receivers. Receivers average missing 1.8 games with a hamstring injury.

Expected Return: Week 5-6

Fantasy Impact: Bateman is a speed receiver, so it is reasonable that if he returns before he is truly 100%, this could impact his explosiveness. Receivers average a decline of 11% fantasy points compared to pre-injury baseline when they return from a hamstring injury. Bateman has not been productive this year and will not be startable in the first game back from injury.

Treylon Burks

Injury: Knee

We know Burks injured his LCL in the preseason, but coach Vrabel states this is not the same injury. We have very little clarity on what the injury is, but any knee injury can impact sprinting, acceleration, cutting, and jumping.

Expected Return: Weeks 5-7. Vrabel stated that Burks would miss “maybe a few weeks or so”

Fantasy Impact: He is absolutely not startable until he proves otherwise.

Week Four Injury Report: Tight Ends

Logan Thomas

Injury: Concussion

Thomas has cleared the concussion protocol and will return in week four.

Expected Return: Week 4

Fantasy Impact: We do not expect any decline in fantasy production when players return from a concussion.

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