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Nicks' absence from Giants' lineup hints at season-long problem

I'm not a fan of the bye weeks. I understand why it's done -- television revenue -- and accept that as a modern reality, but I don't like the spin that the NFL puts on it. Sold as a break to the fans and players, bye weeks simply don't work. A look through data collected from 2008 through last season shows that there's no quantifiable jump or reduction in injuries in the week following the bye. It's difficult to control for all the variables, including, but not limited to, strength of schedule, team strength, and injuries that had already occurred. While some players get lucky and have the bye fall at just the right time, it's random.

Random occurrences don't help the league reduce injuries or hurry back those who have minor injuries. Other schedule methods don't seem to work either, which seems to imply that external influences have limited effect on reduction of injuries or time lost. That leaves us with on-field measures, which would include rule changes, better protective equipment and more preventative measures from the medical and conditioning staffs.

Week 4 brought another set of new injuries so let's get to it:

UPGRADE: none

DOWNGRADE: Steven Jackson

This game looked like a head-scratcher for national attention when the schedule was announced. Now we have a breakout team in the Kevin Kolb-led Arizona Cardinals. Yeah, I just wrote that sentence. The Cards have succeeded, in large part, because of their defense. They have some injuries here and some depth issues on top of that. If Paris Lenon, Adrian Wilson and Darnell Dockett are on the field and near 100 percent, they should go 5-0. Ryan Williams is again the RB1 and seemed to get more comfortable as the game went on last week. He continues to emerge as a fantasy RB/Flex play. The Rams will go with a banged up Steven Jackson, who could lose some carries to Daryl Richardson. With Rodger Saffold still out, keeping Sam Bradford upright will continue to be a huge challenge.

Back in 2003, I read a book about network science. It changed how I looked at injuries and created a term that carried over from computers to athletics. Athletic bodies, like computer networks, are interrelated systems. If one thing changes, something else will, even if you don't notice it. The best example I have of this is as simple as they come: put a small rock in one shoe, then walk. You'll try to stay normal, but no matter how hard you try, things change. You might limp or take a shorter stride. It's this kind of compensation issue that the body does unconsciously that leads to a failure somewhere down the line. Dr. Barabasi called it "cascading," and I borrowed the term. That's what's going on with Nicks. His injured foot led to some systemic change that has led to a knee problem. The Giants aren't giving much indication what the knee problem is, though signs are pointing to either an arthritic issue or, more likely, a meniscal issue. This is easily corrected, but not quickly. Nicks is a very risky play and could be facing surgery in the upcoming weeks. All that aside, don't forget the initial problem still exists. The foot that started this is still there, part of a recovery issue. Upgrade Victor Cruz, who is further locking in the WR1 slot, and consider both Domenik Hixon and Martellus Bennett as long-term upgrades as well.

It took a lot of tests to put a clinical diagnosis on what most of us knew the minute SantHolmes went down and the ball went up. Holmes has a Lisfranc fracture (and likely a Lisfranc sprain as well -- they don't always go together), found after a second round of scans showed the break. How did they "miss" a fracture the first time around? First, swelling around an injury can make it difficult to get a good scan, which is why you'll often see teams waiting a day or two for the scans. Second, the mid-foot is made up of a complex web of small bones and soft tissue. Unlike an arm or leg, it's difficult to get just the right angle in order to be sure there is a fracture. Finally, fractures come in a lot of shades. A minor break isn't as apparent as a clean or devastating one. The mid-foot, even after a fracture, can stay in line -- what doctors would call "nondisplaced" -- and make the reading even more difficult. Holmes is going to need surgery to fixate the fracture and is done for the season. That puts more pressure on Mark Sanchez at the same time he's lacking Stephen Hill and Dustin Keller. Jeremy Kerley becomes an interesting speculative pickup who's available in most leagues.

I'm about to bring up a point that will worry fantasy owners and cause a freak out among analysts. A few years back, Aaron Schatz at Football Outsiders discovered a trend in which running backs who had more than 370 carries in a season often suffered a major drop-off in the following year. There was an exception, Eric Dickerson, but it was one of those guidelines that was very good to know coming into a fantasy draft. Some of it is wear, some of it is simple regression, but a lot of analysts argued against the suggestion. Mention it in some circles and you get a near-religious argument going. In today's NFL, even though we're just a few years past the point where Schatz noted the trend, few backs approach that number. Through the first four games, Foster is on that pace. Foster is notoriously injury-prone to begin with, but has Ben Tate to take some of the load off. Tate has done that, but the team is generating enough runs that even that isn't "enough." Add in a toe injury that could derail Tate some or shift the secondary role to Justin Forsett, and there's the potential for Foster's carries to increase. Add in a schedule that is very tough -- playing the Packers and Ravens after a Monday night game at the Jets, who remain a very physical team -- and Foster's risk goes up. It's something that his owners have to be aware of. Now is the right time to make sure you have a very solid backup, just in case.

Heading into last week, both of the Bills' primary backs had about 50-50 odds of playing. The Bills split carries with those two, indicating pretty accurately where they were physically. Both were decent, but far from their normal production. The key is that both were able to come back more quickly than expected, play at an NFL level, and come out of the game no worse than they entered it. Check all the boxes for the Bills' medical staff. Both Jackson and Spiller aren't yet 100 percent, but they are close enough to it that it's time to start thinking of them as back to the normal split. Spiller was the breakout star of fantasy until his injury, but going back to a split hurts his value in the short term. There's a chance to sell high on him right now if you're playing for the now.

The phrase "no structural damage" is a pretty phrase that has lost it's meaning. It's not quite as bad as some -- "it's not a tear, just a sprain" is the one that makes me tear my hair out most -- but it's used more as an excuse than a precise medical term. The vague phrase gets its fog from the ephemeral definition of structure. In the NFL, it can be downright Clintonian. Locker's non-throwing shoulder dislocated again on a tackle, but it's not clear from video what caused it. Most of these happen when the quarterback is driven to the ground, but this wasn't the classic mechanism. Locker's initial injury was on a tackle, where an extra force on his fully extended arm popped it out of the normal configuration. If the shoulder was loose due to ligament, tendon or muscle damage, it would certainly explain why it could have recurred. Locker will eventually need surgery, but right now, the Titans will try to get him by with rehab, strengthening and perhaps a brace. How he responds will determine when he returns to the starting role. It won't be this week and there are some early indications that it won't be quick.

The bye week is supposed to help teams get healthy. The Steelers got their week off early this year, something that most teams dislike, but with several key injuries, it might have been just the right time for Mike Tomlin. The running back situation has been a disaster, with none of the options either healthy or productive in the window before Rashard Mendenhall was ready to return. That time appears to be now. Mendenhall was "close" in Week 3, but the bye week pushed the team to hold him back and be sure that the knee was ready to take the workload. Mendenhall won't get a full workload back in his first game action, but expect him to get the bigger share of a split. The fantasy key will be whether or not he gets the goal-line touches, but he didn't get those last year, either.

The defense gets both Harrison and Polamalu back. Harrison is returning from preseason knee surgery, as well as two recent back surgeries and a fractured orbital bone, near his eye. He should be back to normal after an extended rehab, but we'll have to see how much the toll on his body has taken. The same is true with Polamalu. He's lost a step over the past few seasons, using his experience and instinct to make up for it. Injuries could sap even more of that speed, leaving him and the Steelers defense vulnerable. Look for Dick LeBeau to make some minor adjustments to his defense over the next few weeks to reduce their dependence on Polamalu. There's some discussion that Polamalu will be put on a play count in hopes of keeping him healthy for the playoff run.

Lost in all the discussion of concussions is one fact: given enough time to heal, almost all persons suffering a concussion will return to normal function. That's not to say that having them is good or that repeated impacts, concussive and sub-concussive, don't have devastating consequences down the line, but that single basic nature is seldom discussed. Why? Because it goes against the very nature of sport, and in football, with it's macho posturing and "beast mode" mentality, it's hard to say "sit out." Enforcing timelines, as several sports have tried to do, lead only to under-reporting. Players find ways to hide their concussions and teams have incentive to do the same. Robinson had a concussion in Week 3 and was cleared to play after going through all the necessary testing and exams. Week 4 brought another concussion and this time, well, we don't know yet. The team has not ruled him out and Robinson has not yet taken the tests to be cleared. The cumulative nature of concussions is one that is widely debated, but the Jags and Robinson are going to have to make some hard decisions over the coming weeks.

Michael Vick suffered a knee contusion Sunday night. Nothing more than a simple bruise ... Mikel Leshoure is still having trouble with his groin. The injury-prone player is a tantalizing talent but will have to prove he can hold up before he gets any fantasy consideration besides spot starts ... Greg Jennings is likely to miss at least this week after re-straining his groin. Re-injuries are often worse and always get more focus from the medical staff ... Julio Jones was limited last week by his lacerated hand. It looks like it could be the case this week. Is it enough to make a start-every-week kind of guy not a starter? No, but it does amp up Roddy White again ... Kenny Britt was held out last week in large part so that he'd be ready for Week 5 and beyond. Things look to be going to plan for the Titans in this regard ... Lance Moore got 15 targets and a strained hamstring next week. He's going to bear watching at practice this week ... Darrius Heyward-Bey is cleared to return to practice. The Raiders' bye week helps him a lot as he continues to recover from that scary concussion ... Scott Chandler returned to practice on Wednesday. The Bills have been very careful in never calling this a concussion ... Dwight Freeney was back at practice for the Colts, but will likely be spotted in if he is able to play ... Word was that Nate Kaeding could be headed for the IR. Instead, he was back out on the practice field. He's still very iffy for Week 5, but he's not done either.

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