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Injury Analysis: Week 11 Injury Analysis

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.

A rough Week 11 insured the majority of owners will not be able to be grateful for a healthy fantasy team this Thanksgiving. Several marquee names are expected to be sidelined for several weeks including another member of the New York Giants receiving corps.

With Steven Smith already sidelined with a torn pectoral muscle, the Giants will now be without the services of Hakeem Nicks as he recovers from surgery needed to treat acute compartment syndrome in his lower right leg. The distal aspect of the leg (below the knee) is divided into four individualized compartments that each contains blood vessels, nerves, and muscles. Each compartment is incased by a type of connective tissue known as fascial sheath. To better visualize the fascial sheath, imagine the casing that surrounds a tube of luncheon meat like baloney. The fascia must be extremely durable and as result does not expand or stretch. If an athlete takes a significant and direct blow to one of the lower leg compartments, the compartment can swell as blood and other fluids fill the area. The fascia then confines the excessive swelling within the compartment, placing high amounts of pressure on the blood vessels, nerves, and muscles. The pressure disrupts blood flow and damages nerve cells and can cause significant muscle and nerve damage, including paralysis and limb loss, if not treated.

Nicks underwent a procedure known as a fasciotomy on Monday afternoon. In a fasciotomy, an incision is made in the skin and fascia to relieve the tension and pressure in the effected compartment. Nicks is expected to miss a minimum of three weeks as the wound heals. The Giants medical staff will closely monitor the site for infection and will insure the swelling does not return when Nicks is able to once again participate in football-related activities. While the injury is fairly uncommon, defensive end Jason Taylor underwent a similar procedure in 2008 and missed two games.

The injury not only affects the fantasy value for Nicks, specifically since he could miss the beginning of the fantasy playoffs, but also the value of quarterback Eli Manning. With Smith and Nicks out, the Giants will rely more on Ahmad Bradshaw and Brandon Jacobs and less on the arm of Manning. When he is forced to throw expect Manning to hone in on Mario Manningham.

The team the Giants will face in Week 12 could also be without their primary receiving threat, as Jacksonville's Mike Sims-Walker remains hobbled. Sims-Walker sat out Week 11 with a high ankle sprain and his availability for Week 12 remains in doubt. Keep in mind high ankle sprains often result in more instability and tend to linger longer than garden-variety inversion ankle sprains. The loss of Sims-Walker hampered Jacksonville in Cleveland. While the managed to get a win, David Garrard could not get anything going deep and was forced to rely on Maurice Jones-Drew, Mike Thomas, and Marcedes Lewis on quick looks. Sims-Walker did not even practice last week and remains a risky play going forward.

Cleveland quarterbacks know all about high ankle sprains, as both Seneca Wallace and Jake Delhomme have been inactive since Week 5 dealing with the ailment. Wallace was healthy enough to serve as Colt McCoy's backup last week and Delhomme feels his ankle is nearing 100 percent. One of the two will be called into action in Week 12 as McCoy is now nursing an ankle injury that appears to be a high ankle sprain as well. It would make sense that Cleveland looks to Delhomme as they take on his former team the Panthers but coach Eric Mangini remains noncommittal on the issue. Look for the Browns to gather more information on McCoy and make a decision later in the week. While Carolina's defense doesn't instill fear in many opponents they have been respectable against the pass, ranking seventh in the NFL. That number should just be enough to scare away any fantasy owners considering starting one of the Browns gimpy signal-callers.

Miami's Brandon Marshall did not participate in practice on Monday and remains a question mark entering Week 12. Marshall aggravated a hamstring strain in Thursday's loss to Chicago. A strained hamstring is a particularly troublesome injury for receivers. The hamstring muscle group plays a key role in running and acceleration as it slows the leg as it extends backwards. They also are utilized in the beginning of hip motion from a standstill position. Strained hamstrings can linger and are easily aggravated especially by an athlete with strong quadriceps muscles. As an athlete attempts an explosive movement like sprinting off the line of scrimmage, the powerful contraction of the quad will overstretch and strain the muscles of the hamstring. Monitor Marshall's workload throughout the week before plugging him into your lineup.

The Titans intend to place quarterback Vince Young on the injured reserve with a torn flexor tendon in his throwing hand. Young was injured after slamming his hand into the helmet of a Washington defender following an attempted pass. In the hand, the majority of flexor muscles are located in the forearm with the tendons extending into the hand and connecting to the bones of the thumb and finger. Two muscles, the flexor pollicus longus and brevis, control flexion of the thumb. If these tendons tear or rupture, an athlete is unable to flex the thumb and properly grip a football. Young will undergo surgery sometime in the near future and is no longer fantasy relevant this season. Rusty Smith will take over the starting quarterback responsibilities as Kerry Collins recovers from a calf injury.

Tony Romo's chances of returning in 2010 took a minor hit when an X-ray recently revealed his left collarbone is still broken. The injury is mending but the Dallas quarterback remains at least three weeks away from returning, right in line with the initial diagnosis of six-to-eight weeks. The Cowboys won't rush their franchise player back, largely in part to surprising play of Jon Kitna. In four starts he has thrown for 1,032 yards and eight touchdowns including two wins with Jason Garrett as the head coach. Romo owners hoping to stash him in hopes for a late season would be wise to consider Dallas' tough remaining schedule including two games against Philadelphia.

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