Could Injury Really Cause A Peyton Manning Led Team To Miss The Playoffs?

November 22, 2014

You can type in “NFL injuries” in any search box and get the details of who is in and who is out, that is the easy part.  The more important questions are how long will they really be out? Will they actually play well when they come back?  What players are at highest risk to get hurt next?  How will one injury affect the performance of other players?  Being caught off guard by any of these issues could derail your fantasy line-up at a time where you can not afford any glitches.  For many, playoff time is coming and for you one-day fantasy players, your time is running out to win the big one.  I will discuss which injuries I see coming and which injuries I see going, and more importantly look at all of the angles that will decide whether you win or lose with your lineup.

Lets go by position:


Some of you have been unlucky and lost your starting QB.  Former fantasy owners of Nick Foles and Carson Palmer are the primary victims here.  For those who took the obvious option of picking up Mark Sanchez immediately after Foles got injured–good job!  I’m not too sure on Stanton and definitely would not feel good with him as my QB down the stretch with the vicious schedule that Arizona has remaining.  It is clear that neither of these QB’s (Foles and Palmer) will be back this year, or at least not in time to have a fantasy impact.

If you were not able to get in the Sanchez sweepstakes, then my suggestion would be to look at Shaun Hill as he is now injury free and the Rams have endured a tough schedule that will now lighten up just a little.  Another not so obvious option would be Zach Mettenberger, who I do not think is great by any stretch, but he has a great selection of defenses to face to close the season and a monster arm.  Last but not least is a stretch for most, but I believe Colt McCoy will finish the Washington Redskins season as a starting QB.  McCoy is also not the greatest but he will literally be playing for his NFL career, he has a ton of weapons, and he has good match ups.  I would spend a little time telling you how McCoy gets that job, but if you have a TV, a phone, or any type of electronic device I am sure that you have seen the train wreck that is RG3.

My bet is you can get any of those 3 players today and even if they just sit on your bench while you have another borderline QB playing, you will not end up in the back of the waiver line if they get hot.

Fantasy owners and Peyton Manning may miss the RCA dome as this season goes down the stretch.

As for the great Peyton Manning, he is being hit by the injury bug indirectly.  With his number 1 and 2 running backs out, Julius Thomas’ status being unclear at Tight End, and his number 2 Wide Receiver Emmanuel Sanders just being cleared from concussion protocol; the future Hall of Fame QB may have the deck stacked against him.  Combine the injuries with the fact that his next 4 opponents all currently rank in the top ten for total defense and that 3 out of those 4 games are likely to be played in cold weather, and you may just have given the ingredients for the kryptonite recipe.  The only thing that may be missing is whipping winds and a few snow flurries.  In any case, those who pay close attention know what bothers Peyton.  When he is pushed off his spot, he is obviously uncomfortable.  When he has to hold the ball, he is uncomfortable.  With these defenses and bad weather coming, I project some sub Manning like numbers.  Now I am not talking Alex Smith mediocrity, but chances are that Peyton is carrying your fantasy team in any league play and he is eating up your salary cap in any one-day play; so you absolutely need him to put up Manning like numbers.

While I do not see a day in which I tell you to sit Peyton Manning unless it is for Andrew Luck or Aaron Rodgers, I think Manning owners should prepare for a more conservative output and therefore be aggressive with the remainder of the roster.  For Peyton and the Denver Broncos, I see very little chance of not making the playoffs, but for my fellow fantasy players this tough stretch falls right at a crucial time in regard to fantasy playoffs.  In the end start Peyton as usual, unless you see wind and snow in the forecast; then I may look for one of the QB’s I listed above to hold the fort for one week.  This is the closest I will get to betting against Peyton Manning and frankly it feels a little uncomfortable.  Lets see what he does over the next month.

Running Back

Running Back becomes very important in November and December as many of the outdoor teams will start to slow it down with hand-offs and short dump off passes.  However as these running backs have their workload increased you may also see more injuries.  I predicted way back in the first half of the season that DeMarco Murray would not make it through the entire season and now that its week 12, some may think I was wrong……NOT!  All of you DeMarco Murray owners better have a back up plan, because it’s coming.

Another running back to beware of is Arian Foster.  Earlier this season, I compared Foster to Steven Jackson as he is an oversized back who gets injured regularly.  He is living up to this comparison and if he does not do something different this off-season ( I would suggest some type of Yoga/Pilates blend and a very clean diet), I think you should think long and hard before drafting Foster early.  As you can see, when you need Foster most he will not be there for you.  At this point, I don’t think anyone will get caught off guard with Foster being out as he seems to be on the injury reports on a weekly basis.  The important thing is to not get your hopes up with this “game time decision” talk.  I do not see him making it back in an effective way this week as he is only been out for 2 weeks with a groin injury that should likely take at least 3 weeks to heal.   We explained the nagging groin strain a few weeks ago when predicting Monte Ball needed 3-6 weeks off before returning.  As most of you know, Monte Ball did sit out for 6 weeks and then re-injured his groin on his first game back.  Hopefully that lets you and Arian Foster know how serious this injury can be. The easy fix is to keep Alfred Blue on your bench no matter what. If you do own Foster or Murray or maybe even had Ronnie Hillman or Ahmad Bradshaw, there are a few options out there for you to consider:


C.J. Anderson could not have timed it better in regard to fantasy playoffs.  With Ronnie Hillman down for at least another 2 weeks with a foot sprain (that should take a total of 3 weeks to heal) and Monte Ball out again with a strained groin , C.J. Anderson will basically have the backfield to himself.  I expect Hillman to come back by week 14 and I expect Ball to be a non factor for the remainder of the fantasy season as his re-injury tells me he really needs to give that groin another 3 weeks  or more to heal and then return slowly (I don’t expect him to play until the NFL playoffs).  Furthermore, Peyton plus the cold means more running plays and more short passes.  The only fear is that the volume that Anderson receives in the next few weeks will get him injured too.  The good news on that front is that this is almost like game 4 for Anderson, as he has not played much this season.  In my opinion he is the top running back to pick up down the stretch.  Do anything you can to get him for your leagues and one-day players should spend whatever he cost to get him in the line up.

Another back who’s fantasy value just got a big boost is Trent Richardson.  I say this reluctantly as prior to this injury, I literally considered him a bottom 10 back that I would never consider starting.  However, the bottom line is Ahmad Bradshaw and his fractured fibula means he is done, and for now Trent will get all the goal line carries as well as a likely 20+ total carries per game.  In a more traditional running back way, I think this will actually help Trent Richardson, who has the potential to be a wear on you/hard to stop at the end of the game back.  The final kicker is really to look at the Colts remaining schedule.   There are some blowouts coming and you know who will be killing that clock, even if it is 3 yards at a time.  Look for some fantasy numbers in the form of 25 carries for 72 yards with 2 touchdowns with 2-3 catches sprinkled in.  I think many of us can live with those 20 + fantasy points.

Giovani Bernard appears to be ready to return for week 12 and based on reports of a hip pointer and a clavicle issue, he appears to have taken the proper time off.  For some, this may seem to be a good thing, but I look at this as a lose-lose situation for fantasy owners.  Jeremy Hill showed the ability to be a fantasy stud while Bernard was out and Bernard was a stud before he got hurt.  When you put two fantasy studs in one backfield, unfortunately they turn into one half a stud each.  If you already have Bernard and are in a PPR format, he is definitely worth keeping, but I do not see the Bengals taking Hill back to his previous role of simply spelling Bernard.  I see a backfield that will almost be half and half which is a disaster for fantasy owners.  If you can trade either of these player based off of name value, now would be a good time.  Jeremy Hill owners may consider sitting tight for a couple of games, as Bernard is undersized and as the cold weather sets in, he may be in line for another injury.  If I could pick, I would much rather the style of Hill to carry me to the fantasy playoffs, but by no means would I wish injury on any player.

Wide Receiver

It appears that the wave of wide receiver injuries is over with Megatron, A.J. Green, Andre Johnson, and Odell Beckham Jr. all back and healthy.  Despite this abundance of health at the position, there are some injuries that will make some receivers more attractive than others.

ty hilton

T.Y. Hilton is already a must own everywhere but for you one-day fantasy players who are comparing T.Y. to Dez or Megatron or Jordy Nelson on a weekly basis, here is the reason why T.Y. might have eclipsed many of them.  With the injury to Ahmad Bradshaw, the Colts have lost their only receiving back.  Additionally, the Colts have an injury to their best tight end Dwayne Allen.  Allen is listed as day-to-day with an ankle injury but I expect him to miss at least one game or at the very least see less time on the field.  This means more Coby Fleener during the competitive portion (there will be garbage time for Trent Richardson to get his!) of the Colts games; it means less running as Allen is the obvious running game tight end while Fleener is the passing game tight end.  T.Y. is by far the most targeted player for Andrew Luck and these injury developments likely just increased his targets.  As we hit the stretch for the fantasy season, I think T.Y. Hilton will be as good as it gets at the receiver position.

Demaryius Thomas may also get a little bump up from his already superstar status after The Dnever Broncos lost Emmanuel Sanders and Julius Thomas in week 11 to injuries.  Sanders went down with a concussion and looks to be probable for week 12, however there is evidence out there that correlates concussions to poor performance shortly after recovery from said concussion.  As for Julius Thomas, he appears to have a simple low ankle sprain but he likely will miss a couple of weeks.  This sets up for Demaryius to have an even bigger role in the Broncos pass game.  We may even get a Wes Welker flash back for my fantasy league players who are desperate for a short-term play at receiver.

Brandin Cooks thumb fracture has effectively ended both his fantasy and real football seasons.  This means someone who is healthy on the Saints likely gets more targets as Cooks was the second most targeted player on the team to Jimmy Graham, and the most targeted receiver on the team.  This is a tough call between Marques Colston and Kenny Stills, but I would take a chance on Colston as Drew Brees targets him more than Stills, and Brees and Colston have more history.  This must be a cautious play as Cooks injury may actually just lead to Colston, Stills and who ever replaces Cooks to split the targets by 3, which would make no one happy.  This may be one to take a look at for a week or two before making a move.

Now this one has nothing to do with an injury per say, but those who read my work often know that I split my skilled players into Freaky Talented and Supremely Skilled.  Around this time of season the Freaky Talented group will start to slow down as the weather elements may not be ideal for their talents to fully shine.  Additionally, it is my theory that these Freaky Talented athletes need pit stops to rejuvenate as they max their bodies out while utilizing all of their god given talent.  But if I can get one of the most Freaky Talented players in the league with completely fresh legs at this point in the season, I am all over that!.  Josh Gordon is exactly that.  Not only does the physical play in his favor, but the mental sounds like it is ready too. One of the first quotes given to from Gordon was “I’m going to tear this league up”.  If your league is anything like the one I am in, Gordon has been owned all year despite not playing…he is that coveted.  If there is any way to get him, I would go for it.  For one-day fantasy players, this may be the only week you will get him cheap.  After he faces the worst pass defense in the league down in Atlanta, my guess is that his price will be right up there with the elite wide receivers where it belongs.

Marqis Lee is a low-level benefactor of the foot fracture that Allen Robinson suffered.  This consideration is more for the one-day fantasy players who have the bare minimum to spend on a flex player that has the chance to actually do something.  The two things I think I know is that Lee will now be on the field in all 3 wide receiver sets (with Robinson out) and that Lee has lots of talented.  Everything beyond that is a gamble….your choice.

Tight End

As I mentioned earlier, the Dwayne Allen injury may officially push Coby Fleener to the TE1 conversation.  Fleener has been inconsistent despite being Andrew Luck’s teammate in college, but now he appears to be ramping up.  1-2 weeks of Allen being out may generate a role for Fleener that will become a little more permanent int the Colts offense.  Additionally, if Trent Richardson does not take advantage of his opportunity like I think he will, you may see the Colts just turn into a pure passing team in which Fleener stays on the field a bunch more as run blocking would not be needed.  I would keep my eye on Fleener in fantasy leagues and pick him up if a roster spot is available.  He is also a good one-day play if you don’t want to spend on one the big three of Gronk, Graham, or Thomas.

Some of you may be waiting for Jordan Cameron to be cleared from the concussion protocol and are ready to plug him in as your starter.  I would look in another direction.  Again, performance after concussions can be tricky and with the reports indicating Cameron having some long-term concerns, I would simply stay away from Cameron this year.  Any return will be on egg shells and the likelihood of poor performance or another concussion is a very real possibility.

Tight End is a tough position to pick up late in the season and in most cases the match up should dictate who you play, but there are a few that you may be able to pick up and fill in with.  Zach Ertz had a big buzz at the beginning of the season but that buzz has faded fast.  I am not saying Ertz will win any week for you but I think the addition of Mark Sanchez to the equation allows him to not lose a week for you.  Sanchez and Ertz have a relationship that ranges from preseason as they both had significant 2nd team reps.  Sanchez is definitely looking for him more than Foles did.  Now all Ertz has to do is find a way to stay on the field for more snaps and you may have a decent TE2.

Defense/Special Teams

The Pittsburgh Steelers are about to get real healthy and are likely sitting there waiting to be picked up in most leagues.  With the return of 5 starters including their leader-Troy Polamalu as well as the addition and rejuvenation of the great James Harrison, the Steelers may look like the traditional Pittsburgh Steelers down the stretch.  The tricky thing with these injuries is that when the players make it through and the team stays competitive, the return from injury is that much greater.  The Steelers should have a lot of fresh legs on the field vs. many who are simply worn down from the grind of a 16 game season.

sproles punt
Sproles may be the biggest little reason to start the Eagles DST!

The Philadelphia Eagles should be on everyone’s radar as they are having a near historic year on Special Teams with punt blocks, field goal blocks, and even extra point blocks.  Combine this with arguably a top 3 punt-return man in Darren Sproles and Chris Polk who already has a kick return for a TD and you would think picking them up is a no brainer.  But then the leader of the defense Demeco Ryans goes down and Aaron Rodgers puts up a million points.  I can see how people may get nervous about this being their starting defense.  As bad as the Demeco Ryans injury is for the actual defense, I think the response to the injury by the Eagles is even more telling.  Instead of looking for another linebacker to replace Ryans or even just looking for another defensive player, the Eagles signed Chris Prosinski.  Posinski is a safety from Jacksonville who is primarily a Special Teams stud.  They added him to a Special Teams that already boast Chris Maragos who is arguably the Michael Jordan of Special Teams.  So while losing your middle linebacker is bad, the Eagles may have gotten even better with rushing the quarterback by bringing more speed and agility to the linebacker position with Mychal Kendricks as the new focal point.  The bigger point is that I don’t think any other team in the league takes Special Teams as serious as the Eagles and frankly that is where all the points are coming from rather than the actual defense.  They should be the premiere DST going down the stretch in all formats despite losing the leader of their defense for the remainder of the season.

Good Luck

Week 6 Injuries: Why we don’t always “KNEED” an MRI

October 13, 2014

Week 6 yielded some big KNEE injuries to players that I’m sure are at least active in your fantasy league, if not starting.  Darren Sproles went down with a MCL sprain, Stevan Ridley has a ACL/MCL tear, and Victor Cruz suffered a patella tendon rupture.  

victor cruz modeling
Victor Cruz may have some more time to advance his modeling career while out with a torn patella tendon

The Science

Instead of going through each injury as per usual, I think this would be a good opportunity to show you how we can diagnose a knee injury in less than 5 minutes, and usually come to the same conclusion that the ever so expensive MRI will give a day or two later.

As you may have seen on Sunday, when these player go down the medical staff comes running out to tend to the player.  Typically with a knee injury, the diagnoses for the player is known within the time that the player goes down and the time that the game returns from commercial.  Here is generally what happens during a knee assessment:

Step 1: Ask  and Look.   (30 seconds)

Ask what happen, what did you feel, where does it hurt? Look at the area.  Hopefully the team Doctor or Trainer sees the injury, which can give good insight to what structures may be injured.  In the cases where the injury is not seen, knowing which direction the knee went, where it was hit, and where the pain is, can fill in the blanks.  While the player is talking, examining the knee with your eyes may show some obvious deformities that will guide or sometimes conclude the examination.

Step 2: Check Movements  and Palpate (Feel) for deformities (1 -2 minutes)

By the time you finish step 1, you may have some idea of what may be going on, and now its time to move the knee.  First. the player will move the knee and then you will move the knee for them.  Because the knee-joint is a simple hinge joint, there are 2 major movements to assess–flexion and extension (bending and straightening).  Although simple, there is valuable information in simply assessing whether a player can bend and straighten the knee, and where the pain is during these movements.  A third movement that the examiner may need to assess is patellar (knee cap) mobility, which can also provide valuable information.

In the case of Victor Cruz of the New York Giants and fantasy teams everywhere, this was likely the end of the evaluation.  Most examiners would suspect a patella tendon rupture during step 1 as it was obvious where Cruz was grabbing and his reaction to the pain, indicated something serious.  The Patella tendon is directly below the knee cap and it connects the knee cap to the lower leg bone (tibia) which allows us to straighten our leg.  With a rupture, there is a good chance that with your eyes you can see that the knee cap is higher (closer to the hip) than usual which indicates that the tendon is torn.  If this is not visually evident, then feeling the patella tendon area and moving the knee cap should be the only additional info needed to diagnose this. Unfortunately, this injury means surgery and 4-6 months out for Cruz.  Although this is a serious injury, the return to full strength and speed is expected in most cases.

patella tendon rupture
This shows how far up the patella may rise after a patella tendon rupture

Step 3: Check ligaments and structures (1-2 min)

In many cases in which there is not an obvious injury, this is where players have to cross their fingers.  Sometimes players think they hear pops or feel their knee twisted or turned too much, and many fear the most notorious 3 letters in the alphabet for an athlete–A C L.  The Anterior Cruciate Ligament (ACL) is known to take players out for at least a full season and most return from the injury needing some time to re-tune their bodies.  For most players, this injury means a full season of being out with additional time of  being less than their normal selves.

The ACL is only one of the ligaments we test during this step.  The examiner can use a variety of test but some of the more basic test are as follows:

Valgus stress test-checks for medial (inner) instability with a primary focus on the Medial Collateral Ligament (MCL)

Varus stress test-checks for lateral (outer) instability with a primary focus on the Lateral Collateral Ligament (LCL)

Anterior Drawer Test-checks for anterior (forward) instability with a primary focus on the Anterior Cruciate Ligament (ACL)

Posterior Drawer Test-checks for posterior instability with a primary focus on the Posterior Cruciate Ligament (PCL)

In the case of both Darren Sproles and Stevan Ridley, the examination would stop here.  For Sproles, the examiner should have felt some extra motion during the valgus stress test described above.  The extra movement indicates that the ligament has been overstretched and possibly torn, although Sproles was able to walk off and state that he thought he was “ok”.  Ridley was not as lucky.  It is likely that Ridley’s description of the injury in step 1 clued the examiner into what may be wrong as tearing your ACL and MCL is painful, and there was likely and audible pop as it happened.  In his case both the Anterior Drawer and the Valgus stress test would be positive for excess movement.   Unfortunately, the ACL is the death sentence for his season.  With a minimum of 6 months to recover, the ACL tear has earned its reputation.  

The remaining two non ligamentous structures that are important to check, especially if the above test yield no apparent injuries are the medial and lateral meniscus.  Meniscus injuries can be conservatively diagnosed in a variety of ways with the simplest way being to feel the joint lines. Both meniscus lay on their respective sides at the joint line.  The examiner can simply put pressure on the area of the meniscus and if this elicits pain, it typically indicates injury.  In the case of the knee being hit during the injury, this may be more difficult to assess as the entire knee may hurt from the trauma of the hit.  In this case, the examiner can use a Mc Murray test which can be adapted to test both meniscus separately.

This may look like a lot of information, but in real life the examiner is talking, feeling, testing, assessing fluidly.  With an experienced examiner, you can expect an accurate diagnoses right there on the spot.  The MRI simply confirms this assessment in most cases.  This is why reporters can give you information on the injury almost immediately or at least the MRI results are publicized.  See how many test you can identify the next time someone hurts their knee and try to appreciate the skill that it requires to assess an injury that could end a players year in mere minutes.

WARNING: The video below may put you to sleep but it is very informative in regard to the information I just shared.  Please watch when you are wide awake!


Fantasy Implications

For those owner who have Sproles, keep him.  I believe there is a chance he may not miss a game.  WIth the Eagles on a bye this week and his general appearance after the injury, I could see him playing in Arizona in week 8.  If he does not play, hopefully he is not your starter and you can simply wait a week.  I doubt that he will miss week 9, unless more information shows the injury to be more serious.  Despite the outlook for this injury, remember that Sproles was listed as one of our Running Backs running out of time  and at best you can depend on him for spot duty for short periods of time.

As for those who have LeSean McCoy and believe this will boost his touches, I don’t think so.  Chip Kelly and his “Sports Science” approach controls a players touches to get optimal performance, and therefore Sproles being out likely means more touches for the next man up.  My guess is, you see Chris Polk and Josh Huff  take Sproles touches, but neither are viable fantasy options.

Victor Cruz owners may be able to snag Odell Beckham Jr., if available.  His stock should go way up with Cruz out and I think he has the chance to be a stud if his hamstring does not stand in the way.  As for Eli Manning, there may be a temporary adjustment period without his most consistent target; but if he can get comfortable with Beckham Jr. he may even see his numbers improve.

Stevan Ridley owners have probably been done a favor, as predicting what Belichick will do from game to game is nearly impossible.  Starting a New England Patriot player really does feel like playing roulette.  I guess this bumps Vereen’s value up a little, in theory.  Brandon Bolden is an option, but I would look elsewhere like in San Diego for Oliver or Tennessee for Sankey to find a new running back.

Trade A.J. Green Today!

A. J. Green is out with a toe injury that is being described as “a little bit more than turf toe” by the Bengals.



Figure 1: The structures listed on the right side of this picture are the problem for A.J. Green



The Science

Lets start by saying that “turf toe” is awful.  “Turf toe” is just a quick term used to describe a Metatarsophalangeal joint (MTP joint) strain/sprain injury.  Without making it complicated, an MTP sprain/strain is very much like any other joint sprain/strain injury that we have talked about in the past, in terms of the science.  The injury is graded as a 1, 2, or 3; with 1 – indicating over stretching with swelling and pain; 2 –  indicating small tears to the structures as well as pain, swelling and possibly some instability and loss of strength; and 3 –  indicating a complete tear.  The grade on Green’s toe has not been publicized, but I think it is safe to say that it is beyond a grade 1, as he is seeing multiple specialist and likely to miss the game this week.  It is also safe to say it is not a grade 3 as this would have caused a more definite time-table for his return and may have required surgery.  Therefore, I come to the conclusion that we are dealing with a grade 2 sprain/strain injury for his big toe.

While I say that this is still a sprain/strain injury similar to those that occur at other joints such as your knee or ankle,  the difference with “turf toe” is that the joint and its ligaments/tendons are  small enough to make adding support very difficult, but important enough to hinder almost everything you do on a football field.

The Plantar plate in figure 1 actually represents the ligament in this area while the Flexor hallucis represents the tendon in this area.  This is why we can consider this a sprain/strain injury, (remember sprains are for ligaments and strains are for muscle and tendon) as in most cases both of these structures are suffering as well as the actual joint.  If you put your hand on the ball of your foot on your big toe side and go forward just a little until you hit the crease that separates the ball from your toe, you can feel the area that is irritated with this injury.  If you then stand up and walk, you will  notice how much bend and push-off you get from that joint.  Hopefully from doing this you can somewhat appreciate how this injury can make walking painful and difficult, but now imagine running at the speeds of an A.J. Green.

turf toe active
Figure 2: Here is an illustration of what happens during walking and running during the push-off phase

The functional issue comes down to push-off (Illustrated in figure 2) which is powered at the MTP joint and by the Flexor Hallucis Longus which crosses the joint.  Most of us don’t think about walking as a sequence or pattern, but it is.  In short, we do a number of things during walking that we take for granted and one of the crucial stages of gait (walking) is pushing off of the balls of our feet and toes to allow our foot to propel off the ground into a swing forward motion to take a step.  Without this action, your walking would be dysfunctional and you would either be walking with a limp or with an assistive device like a cane or a walker.  Running is just a faster and more forceful version of walking; and this same push-off is essential.  In theory, these freaky fast athletes are creating more force in a shorter amount of time during their push-off as compared to the non  athletic population.  This may be a gift and a curse as the force that their talent produces on their joint, ligaments and tendons is not alway supported by these structures.  I believe this is why the most elite, most talented athletes are at higher risk for injury.  Similar to the cars driven in Nascar being at higher risk for malfunction, these athletes are built better than the norm; they receive more attention than the norm; but just like those cars they are pushed to the limit and therefore repairs are needed often.

Sticking with the car analogy, A.J. has a busted tire and unfortunately he does not have the option to switch tires.  Similar to most other sprain/strain injuries, he should be looking at about a 3-6 weeks to heal.  His attempts to play through the injury have already failed and if he comes back too quick again, he may risk missing the rest of the season or at least under performing for the rest of the season.

One of the most important things to understand with this injury is that healing occurs in stages.  While with knee or ankle sprain/strain injuries, I have supported athletes returning early; when it comes to this injury, an early return could spell disaster.  The 3 stages of healing are inflammation, repair and remodeling.  With those knee and ankle injuries, it is not always essential to get to the remodeling phase before the player returns to play, as the injured structure can be still healing while I send the player out with a tape job or a very supportive brace that will replace the function of the injured structure.  In the case of turf toe, I need the entire healing process to run its course as bracing or stabilizing the joint is not an effective option at this level of athleticism as it takes away the push-off that makes A.J. Green the fast and explosive receiver that he is.  One of the hardest things to manage with this injury is that the mechanism of injury occurs during a motion that IS supposed to happen, although not to the degree of force and range that is encountered  during the injury.  When you compare this to other ligament or tendon injuries that occur during motions that are not supposed to happen at all, you can see why stabilizing or bracing against those motions is a more straight forward approach.   “Turf toe” gives us the unique task of limiting a joint movement to a very precise range that optimizes performance but prevents injury.

If this all sounds confusing then use this analogy:

Problem: You want to stop eating potato chips.

Option A: stop eating them by simply not buying any at all.

Option B: stop eating them by buying a bag of chips but stopping at 5 chips per day(for the sake of this analogy, lets say that eating 6 or 7 would cause an all out disaster in your body)

I think most of us would choose option A as an easier and more realistic option as stopping at 5 chips with an entire bag in front of you is tough (or maybe its just me).  The point is, in order to play on a “turf toe” injury you would be asking the ligaments and tendons of the MTP joint to do the same thing that option B ask you to do.  Your toe would have to extend to just the perfect point (5 chips) and then stop before crossing the threshold of stretching and irritating the ligaments, tendons, and joint (6 or 7 chips).  With a knee sprain to a ligament like the MCL, I can use option A by simply using a brace with extra medial support to stop the knee from receiving valgus force (outer to inner) on the knee which in turn would significantly protect the MCL from receiving any motion that would stress the area (0 chips).  I give this analogy to simply say that managing this injury while the athlete continues to play is very difficult and likely unsuccessful, similar to option B with the chips.  Therefore, A.J. Green is likely on the option A path, which means not playing at all.

The NFL has all types of interventions to help Green heal at an optimal rate, but if I am the Bengals, I expect him out for at least a month.

What You Need To Know

deions toe
Deion Sanders suffered turf toe on his second toe. Hopefully A.J. can avoid this type of deformity.

Two Hall of Famers come to mind when I think of “turf toe”.  Jonathan Ogden the hall of fame Offensive tackle went out with turf toe, but athletically that doesn’t quite relate to A.J. Green.  However, the second, who in my opinion is the greatest athlete of all time (on the football field)  was also chased out of the game because of his toe–Deion Sanders a.k.a. “Prime Time”.  Now, Sanders was near the end of his career anyway, but my guess is that before the “turf toe” Deion was still in the top ten in regards to speed in the league and still a top defensive back.   The injury simply took him out after failed conservative management followed by a failed surgical attempt.  I say all of this to say that even though it is a toe injury, it is a very serious threat to a receiver that relies on his athleticism.

aj green hurt

I do not see a risk of Green retiring from this injury, but I do think that after trying to play through this injury he will have a healthier respect for the injury and sit out for a good while.  I would be surprised if Green played before week 10 and even when he returns, I expect he will be rusty.  Keep in mind that resting this injury stops him from nearly all weight bearing activity on that foot which is a very big deal.  So for fantasy owners, I am expecting that A.J. Green will not be his normal self until deep into the season and barely ready for fantasy playoffs.  With that said, I would trade him now!  There is a good chance that this story will look scarier to your fantasy league after all the Doctors visits are done and A.J. starts missing practices and games; and then you may have a hard time trading him.  If you trade him now, there is a good chance that many  devalue the significance of this injury and give you good return for him.  If it had been a little earlier in the season, I might say keep him but I just don’t think anyone is worth a roster spot if they can not produce for 4 weeks or more, as we know it doesn’t take much to fall out of playoff contention.  A.J. Green will be of no use to you in week 11 or 12 if you are already mathematically out of the playoffs.   In any case, the roster move is your choice; but the chances of a productive A.J. Green before week 10 at the Browns is slim.