Injury Analysis: Jeff Stotts Breaks Down the Key Injuries

The preseason is coming to an end with the majority of teams resting their ailing starters in their final exhibition contests. Final roster cuts are being made, and we are a week away from the beginning of the 2010-2011 season. It's time to begin making decisions on who will and will not be an active participant in Week 1 with several marquee names nursing injuries.

After finally deciding to return for his 20th season in the league, Brett Favre's troublesome left ankle is already bothering him. The Minnesota quarterback underwent a debridement procedure this past offseason to remove loose pieces of cartilage and scar tissue floating within the joint. Famed orthopedic specialist Dr. James Andrews carried out the arthroscopic procedure and re-examined the ankle a month ago. Dr. Andrews discovered an osteophyte, or bone spur, has already reformed within the ankle. To aid Favre in his preparation for the season opener, a rematch of the NFC Championship Game against the Saints, the quarterback recently received a lubricant injection. These injections are commonly used in people suffering from arthritis or osteoarthritis but can be used by an athlete to help with ailing joints. When cartilage in a joint breaks down or when the body's natural lubricant, known as synovial fluid, dries up, the joint is unable to move as smoothly as normal. This can cause the athlete pain and stiffness and lead to chronic inflammation. To combat these adverse reactions, a synthetic lubricant known as synvisc can be injected into the area. Synvisc acts like healthy synovial fluid allowing for the joint, in Favre's case the ankle, to properly move and absorb the various amounts of stress and strained placed throughout it. The drug has also exhibited anti-inflammatory properties and may help prevent further cartilage breakdown. Another notable athlete, Texas Ranger outfielder Josh Hamilton, recently received a syncvisc injection in his knee and returned to action several days later.

Favre's ankle is likely to be an issue throughout the year and could affect his mobility in the pocket. Fantasy owners investing in the soon to be 41 year old as their starting quarterback would be wise to stash a productive backup on their bench in case Favre misses a game or two.

Another veteran quarterback is dealing with ankle issues as Redskin QB Donovan McNabb suffered a sprained left ankle in a preseason game against the Ravens. McNabb has not practiced for almost two weeks as he battled swelling and soreness in the ankle. Teammate Clinton Portis is also nursing a sprained right ankle. While both men have similar injuries the amount of stress placed on the joint is different based on their respective positions.

As a quarterback McNabb relies on stability and strength in his left ankle while throwing a pass. It's his lead leg, and it must remain sturdy throughout the various phases of passing. If the ankle ligaments are sprained, stability is compromised and the ability to accurately deliver a pass is negatively affected. If he is forced out of the pocket his lateral movement is also diminished leaving him susceptible to big hits. While running backs like Portis must also be able to avoid would-be tacklers, they do not need to worry about passing. Instead they are much more dependent on being mobile. The medial and lateral ligaments of the ankle must be able to withstand a great deal of stress while cutting and running routes. Backs like Portis are also called upon to block and must be able to generate lower leg force to hold back defensive players. Both Redskin players will undergo treatment that will likely include position-specific exercises intended to strengthen the injured ligaments. Portis has already returned to practice, and McNabb is expected back next week. Both should be available for their Week 1 matchup against the Cowboys.

Steelers quarterback Byron Leftwich will be out after suffering a Grade II medial collateral ligament (MCL) sprain in his left knee. The MCL is a primary stabilizer of the knee responsible for supporting the knee in side-to-side movements. A Grade II sprain means the ligament has been moderately over-stretched or has an incomplete tear leaving the knee joint lax. Fortunately the MCL often does not require surgical intervention to repair but the injury could sideline Leftwich for up to four weeks. This is bad news for fantasy owners hoping to capitalize on Ben Roethlisberger's suspension. Dennis Dixon will be the likely candidate to assume the starting quarterback position with veteran Charlie Batch also in the mix.

Oakland running back Michael Bush underwent surgery to repair a broken left thumb. Bush suffered an injury known as a Bennett's fracture in a preseason loss to San Francisco and had surgical screws inserted to fix the displaced joint. A Bennett's fracture occurs when the first metacarpal bone breaks at its base. Here the bone connects to the carpal bone known as the trapezium forming the carpometacarpal (CMC) joint. When the CMC joint is unstable, athletes have a hard time grasping objects while performing a motion known as opposition. The screws Bush had inserted will stabilize the joint but should sideline him for an extended period of time. Upon his return, Bush may have difficulty catching passes and holding onto the football. Expect Darren McFadden, deemed fully recovered from a hamstring strain, to get the majority of reps while Bush is out.

Cleveland rookie Montario Hardesty will likely miss the entire season after suffering a significant knee injury in the preseason finale. Early reports indicate he has suffered a torn anterior cruciate ligament (ACL), but he will undergo further testing to confirm the damage. If the ACL is in fact torn then surgery will be needed to repair the damaged ligament. The timing of injury is unfortunate for this year but Hardesty will have plenty of time to rehabilitate the injury and be ready for next season's training camp. In the meantime expect Jerome Harrison to remain the Browns' feature back with Peyton Hillis and James Davis moving up the depth chart.

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