Week 4 in the NFL was a rough one for many fantasy owners and a perfect example of how the dreaded injury bug can do damage to a fantasy team. Houston receiver Andre Johnson was inactive with a high ankle sprain and Baltimore running back Ray Rice was ineffective as he played through a knee contusion and a physical Steelers defense. Two prominent quarterbacks, Jay Cutler and Michael Vick, left their games early with injuries while several running backs including Clinton Portis and Darren McFadden didn't finish either. Fortunately for some the bye week has arrived or is right around the corner, providing time for treatment and rehabilitation.
Johnson was a late scratch from Houston's win at Oakland, as his injured right ankle would not allow him to play. Coach Gary Kubiak is optimistic Johnson will return Sunday against the Giants but said the Pro Bowler will not practice until Thursday at the earliest. Remember high ankle sprains, also known as syndesmotic sprains, are different than your more common lateral ankle sprains and generally take longer to heal. Often it is harder and more painful to bear weight on a syndesmotic sprain, making running and jumping difficult. Keep an eye on Johnson's availability toward the end of the week and have a backup ready just in case he is unable to take the field.
While the Baltimore running back continues to state he's fine, the injury Ray Rice suffered in Week 3 may have forced the Ravens to revert back to their running back by committee approach. Rice, Willis McGahee, and Le'Ron McClain each got a chance on Sunday with McGahee getting the bulk of the carries. Rice insists the knee injury is behind him now and it is likely he will resume the starter's role in Week 5 when the Ravens welcome the Broncos. However the damage may have already been done and fantasy owners should temper their expectations of Rice until he proves he can fend off the injury and the lurking presence of McGahee and McClain.
When a quarterback is subjected to hit after hit an injury is inevitable. Just ask Chicago's Jay Cutler. Cutler was sacked nine times in the first half, the last coming from a tackle by Giants cornerback Aaron Ross. As Ross took down the quarterback, Cutler struck his head on the synthetic turf of New Meadowlands stadium. He displayed concussion symptoms at halftime and was removed from the game. Concussion-related symptoms can be a variety of things including dizziness, blurred vision, or memory loss. Cutler was clearly disoriented and will now enter the new, stricter concussion protocol put in place by league officials.
Cutler will be evaluated throughout the week and will be subjected to brain function testing known as ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing). The ImPACT Test is utilized by all NFL and NHL teams and throughout the MLB and NBA. The test is carried out on a computer and analyzes the individual's current status through neuropsychological tests that include memory recall and matching. It can also compare the data collected to baseline information gathered prior to the concussion. Each athlete reacts to a concussion differently and ImPACT testing allows for each individual to be properly screened. If Cutler is able to pass the ImPACT evaluation and is cleared by an independent neurologist he could be ready to play in Week 5 against Carolina. However if the porous Bears offensive line does not improve, Cutler could be in line for another short day especially when you consider that once an individual has been concussed they are more likely to suffer a subsequent concussion. Cutler's backup Todd Collins also departed early with a stinger leaving Caleb Hanie as the healthiest quarterback in Chicago. Fantasy owners should consider other options at this point.
Mike Vick has yet to be officially ruled out for Sunday's contest against the Colts but it appears Kevin Kolb will get another shot as Philadelphia's signal caller. Vick suffered a rib injury in the first half of his team's loss to Washington when he was sandwiched between two Redskins defenders. X-rays were taken and came back negative but a MRI performed on Monday revealed a cartilage injury. The rib cage is made up of 24 ribs (12 on each side), the sternum (known by most the breastbone), the thoracic vertebrae, and a type of connective tissue known as costal cartilage. The costal cartilages of ribs 1 through 7 attach directly to the sternum and the manubrium and body of the sternum. Vick has suffered a crack in the costal cartilages of ribs 2 and 3 near the sternum. Vick is fortunate he did not suffer a broken bone but a costochondral injury is still a very significant injury and can take longer to heal. Sharp pain is normal and often the individual reports a stabbing pain for several days after the injury occurred. The injury often causes pain with breathing, sneezing, and trunk movement.
Given the information provided, it is highly unlikely Vick would be well enough to throw a football by Sunday. Coach Andy Reid has already called the injury a "week-to-week" issue and it could keep Vick out until after the Eagles bye week in Week 8. Hopefully Vick owners handcuffed him to Kolb and have an adequate substitute for the immediate future.
Vick's teammate LeSean McCoy is also dealing with a rib injury as he fractured a rib late in the first half. Like Vick, McCoy has not been officially ruled out for Week 5 but his status is uncertain. If McCoy does suit up he will most likely be required to wear a flak jacket to protect the area. Keep in mind this extra padding protects the injury site but is bulky and tends to increase a player's propensity to fumble. Mike Bell would start for the Eagles if McCoy sits.
Darren McFadden saw his hot start cooled by a right hamstring strain. The Arkansas-alum missed part of training camp nursing a left hamstring strain and says the latest injury is unrelated. He is considered day-to-day with teammate Michael Bush, completely healed from thumb surgery, ready to assume to starting role.
Clinton Portis is not expected to be available in Week 5 after suffering a strained groin. The Redskins are awaiting the results of a MRI but Portis said he wants to take some time to insure the injury heals. Ryan Torain is the most likely candidate to become the feature back.
Jeff Stotts is a Certified Athletic Trainer, MAT, PES and the Injury Analyst for Rotowire.com. You can follow him on twitter @RotoWireATC.