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Injury Analysis: Will Ray Rice Play This Week?

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.

Reggie Bush
Bush was a last-minute scratch in Week 3 after suffering a left knee injury the previous week in a loss to Arizona. The former Heisman winner did everything in his power to convince the coaching staff that he was ready to play but head coach Jim Schwartz elected to play it safe and rest the speedy running back. It sounds like stability wasn't necessarily the primary concern for Bush as he appeared more worried about his ability to take a hit.

Regardless of why it occurred, Schwartz's decision is sound especially when you consider the list of injuries that Bush's left leg has endured since entering the NFL. Since 2007, Bush has suffered a sprained ankle, a partial tear to his posterior cruciate ligament (PCL), a medial collateral ligament (MCL) sprain, and microfracture surgery all on his left leg and knee. While Bush was convinced he was ready, holding him out ensures an extra week of rest and reduces the odds of a significant injury occurring.

Joique Bell's performance against the Redskins could lighten Bush's workload moving forward but could also insure he's available on a week-to-week basis. Bush is already proclaiming he will play in Week 4, despite the coaching staff's cries for patience. Monitor Bush's availability in practice but all signs point to him playing against a stingy Bears defense.

Andre Johnson
For the second straight week Johnson was unable to finish the game. After suffering a concussion in Week 2 the Pro Bowl receiver was sidelined for the conclusion of his team's Week 3 win after getting kicked in the shin. X-rays on the bone were negative for a fracture and the team is officially calling the injury a shin contusion.

It is likely Johnson's injury is not simply a soft tissue contusion but instead a periosteal bruise or bone bruise. The shinbone, better known as the tibia, is vulnerable to this kind of injury as it is poorly protected due to a lack of muscle and fat in the area. Most bones, including the tibia, have a thin layer of bone tissue that is reinforced by an outer membrane known as the periosteum. The makeup of the tissue in this layer is dense as to provide strength to the bone. The periosteum is broken when a true fracture occurs but if just a few fibers are damaged a bone bruise or contusion occurs.

Like a "normal" bruise, bone contusions are accompanied by swelling and pain. However they often require a longer amount of time to heal based on the necessary steps needed to repair the area. The body's natural healing process treats bone contusions just as it would a complete fracture. Specialized cells known as osteoblasts must create and lay down new bony tissue to fill in the gaps created during the injury. This process takes time but does a good job of returning the area to its previous strength.

The Houston medical staff will treat the area and use various modalities to stimulate the healing process. It is likely Johnson is limited early in the week but a return to practice at some point seems likely. However the twice-limited receiver will be lined up against Richard Sherman and the Seattle defense, a challenge that could be harder to overcome than a shin contusion.

Ray Rice
Rice was another running back whose availability wasn't determined until early Sunday morning. However Rice has made strides in his recovery from a strained left hip flexor and coach John Harbaugh say he could play this week against the Bills. Rice's injury remains straight forward as the muscle responsible for flexing the hip joint has been strained. This type of injury would leave Rice limited in accelerating, running, and making sudden stops. A hip flexor strain can be supported by a hip spica but the powerful muscles in the area have to heal to insure a muscle imbalance does not develop.

Rice's long-term health may benefit from the emergence of Bernard Pierce, just as Detroit's Bush should benefit from the presence of Bell. However the assurance of less wear-and-tear does comes at the cost of snaps and touches. Rice remains a must start when he is active but handcuffing him to Pierce continues to be a sensible strategy.

Turf Burns

LeVeon Bell: The Steelers are preparing to active Bell for their Week 4 game against the Vikings. Bell has yet to play this season after suffering a mid-foot sprain during the preseason. While he has potential, this type of injury can be difficult to manage and will remain an issue for the immediate future. Given the injury, the Pittsburgh's offensive line struggles, and the lack of exposure to the speed of the NFL, Bell remains a long-shot pickup at best.

Eddie Lacy and James Stark: A Week 4 bye should provide the Green Bay running backs much-needed rest. Lacy did not play in Week 3 after sustaining a concussion in Week 2. He will continue to progress through the NFL concussion protocol until he is cleared. If he does improve in time for Week 5, he would remain atop the depth chart. Starks' knee sprain suffered in the loss to the Bengals may have knocked him down a spot as Johnathan Franklin performed admirably in his place.

Lamar Miller: Miller was spotted wearing a shoulder harness Monday following the team's win over Atlanta. While no injury is currently being reported, it is definitely worth mentioning. Miller underwent surgery on his left shoulder prior to the draft and even a small amount of damage could be a big issue. The harness was likely precautionary but keep a close eye on the Miami injury report for further details.

Terrelle Pryor: The Oakland quarterback was removed from the team's final series and has been diagnosed with a concussion. He will be placed in the NFL concussion protocol and cannot return until cleared. Matt Flynn would start if Pryor were unable to play.

Rashard Johnson: The Arizona safety suffered a gruesome injury Sunday as the tip of his middle finger was torn off inside his glove. The defender was stitched up and will be monitored for infection.

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