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Injury Analysis: The Latest on Peyton Manning

Jeff Stotts

Jeff Stotts

Jeff Stotts works as a Certified Athletic Trainer (MAT, ATC, PES, CES). He won the 2011 Best Fantasy Football Article in Print from the Fantasy Sports Trade Association.

Peyton Manning
The 2011 season is off to a precarious start, as the league's leading active Iron Man seems poised to miss Week 1. Manning continues to recover slowly from offseason neck surgery to repair a bulging disc in his neck. The issue is not with the disc itself but with the associated damaged nerves. The location of the disc, the cervical region of the spine, is the gateway to the body for a majority of an individual's nerves. Nerves spread out to the periphery of the body, intervating organs and muscles. For Manning it appears the problem is in his C7 nerve root. This nerve divides as it moves toward the shoulder and ultimately supplies information to the triceps muscle. The slow-healing nerves have yet to adequately regenerate into the muscle, causing Peyton's strength in the muscle to peak. The triceps, responsible for extending the elbow and moving the shoulder inward, is critical for delivering an adequate pass with the proper velocity. The situation is complicated by the development of back pain that began bothering Manning over the weekend. Doctors have instructed the quarterback to stop practicing and the Colts are doubtful he will play against the Texans. Veteran Kerry Collins would assume the signal calling duties with Manning out.

While the focus for Manning is currently on Week 1, fantasy owners must begin to consider the long-term situation. This problem is going to persist for the immediate future and Manning's availability for the first several weeks of the season has to be questioned. Nerves take a great deal of time to heal and even when he does return he will be vulnerable to reinjury if subjected to a hard hit to the area. With additional surgery rumored, this dark cloud is likely to follow Manning for the remainder of the season.

Colts Receivers
If it wasn't enough to be without Manning, Indianapolis' stable of receivers is looking just as suspect. Austin Collie (foot and knee), Blair White (back), and Anthony Gonzalez (hamstring) all have missed time over the last few weeks and all three appear likely to be listed on the injury report. Collie is the most likely to play after returning to practice while Gonzalez has yet to participate in any kind of practice or preseason activity in nearly a month. White was just recently activated from the physically unable to perform (PUP) list but his back injury is still a problem. Reggie Wayne is the only reliable wideout but with Manning sidelined even his value takes a hit. The Indy medical staff clearly has their hands full and it may be wise to steer clear of the Colts for the time being.

Matt Cassel
Though Manning is dominating the headlines, the Chiefs are dealing with an injury to their starting quarterback as well. Cassel continues to nurse a rib injury suffered in Kansas City's final preseason game. He was injured after Green Bay defensive lineman Howard Green landed on top of him compressing him into the ground. Cassel was a full participant in practice Monday, wearing a flak jacket to protect the area. Although it seems very likely Cassel will suit up, the extent of the injury remains a mystery and could ultimately cost Cassel a start. Rib fractures are difficult to pick up on the initial x-ray and can frequently be missed. CT scans are more accurate but it often takes the presence of bone remodeling to clearly detect a break. Plan on utilizing Cassel in Week 1 but closely monitor the situation in the days leading up to Sunday to insure his status remains the same. Tyler Palko would start against the Bills if Cassel were out.

Tony Moeaki
Even when he does play, Cassel will be without one of his top weapons for the remainder of the season as Moeaki suffered a torn anterior cruciate ligament (ACL) in his knee. Moeaki was emerging as a sleeper tight end but hold no value for the 2011 season. The timing of the injury is somewhat fortunate as he should be able to return next season. However his absence will directly effect the fantasy production of both Cassel and running back Jamaal Charles. Last year Moeaki set the Kansas City rookie record for receptions with 47 and served as a reliable option for Cassel. Furthermore Moeaki has earned a reputation as a capable blocker and the KC offensive line will have a void to fill as they look to clear a path for the elusive Charles. Veteran Leonard Pope assumes the top spot on the depth chart.

Arian Foster
The Texans are hopeful Foster will be ready to take on the injury-depleted Colts in Week 1. Foster has been slowed by a hamstring strain that he aggravated in preseason action. 2010's leading rusher tweeted a picture of his most recent MRI early last week showing indications of muscle fiber damage. However the information is a lone picture in series of pictures, making it difficult for the image to provide an accurate diagnosis. Regardless, the nature of Foster's injury is a difficult one to manage. It seems likely he will play but remember his inherent injury risk remains elevated.


Turf Burns:

Miles Austin: After working out with Dallas' athletic training staff Austin returned to practice Monday. Given his preexisting rapport with Tony Romo, Austin's hamstring injury shouldn't set him too far back.

Marion Barber: Barber's status remains day-to-day after he suffered a calf strain in a preseason outing against the Titans. Barber has a history of lower leg injuries, including a previous calf strain. With Chester Taylor in Arizona, Matt Forte could see an expanded workload in Week 1.

Lee Evans: Evans returned to practice Monday and said the protective boot he has been wearing was purely a precautionary move.

Marshawn Lynch: Lynch is expected to return to practice and should be available for Week 1 after resting his injured ankle over the last week.

Sidney Rice: The outlook isn't as clear for Lynch's teammate as a troublesome shoulder injury continues to keep Rice sidelined. The Seahawks have already lost tight end John Carlson to season-ending shoulder surgery and will exhibit extreme caution with their big offseason acquisition.

Wes Welker: The Patriots continue to operate in secrecy but Welker's name did not appear on the list of sidelined players for Monday's practice. Brady should have his top target in uniform for Week 1.

Jeff Stotts is a Certified Athletic Trainer, MAT, PES and the Injury Analyst for Rotowire.com. You can follow him on twitter @RotoWireATC.