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Factoring health in QB rankings

It used to be that a QB was almost an afterthought in fantasy leagues. There were enough elite guys to go around that you could pass on the top couple and still give your team a chance.

In the NFL of today, there's a distinct stratification at the position, but changes to the ways RBs are used has made it possible -- some would argue necessary -- to draft a QB much higher. The thinking went that the difference between QB No. 1 and QB No. 12 was always smaller than the difference between RB No. 1 and RB No. 24. In 2010, using standard rules (non-PPR), the difference was 83 points between Michael Vick and Matt Cassel. For the RBs, it was a huge 185 point swing between Arian Foster and Thomas Jones, but if you take out the flukish Foster total, the difference between the No. 2 RB, Adrian Peterson, and Jones was just 106 points. It's close enough that yes, you could consider drafting a QB over a RB, if you have the confidence.

We saw less injuries to the top level QBs last season, an adjustment that seems to be above what would be expected. There may be a return to more historical levels, where we'd expect to lose two game-seasons among the top 12 QBs.

Here's a look at the top 10 ranked QBs (as of SI's August 1 rankings) with injury questions and how fantasy players should adjust those rankings based on those questions. This isn't an "avoid" list. For some, the injury questions will end up a smart fantasy owner's best friend. If your fellow owners are backing off Peyton Manning because of his off-season neck surgery or haven't adjusted for Michael Vick's injury risk, that's an opportunity for you. Let's take a look:

Michael Vick -- Eagles (SI.com Rank: 2)RISK ADJUSTED RANK: No. 4

Vick is being talked about by many as a potential No. 1 overall pick in many fantasy leagues. He's exciting, but pause a second. Where did he go in last year's draft? Oh that's right -- he didn't. That was clearly wrong, but like most things, the truth lies somewhere in between. Vick proved he was still a valuable NFL QB, putting up huge points in just 11.5 games ... but there's the issue I have. Vick has only played one season where he didn't miss a game and showed last year that it only takes one hit to knock him out of the lineup. He's 31, which suggests his physical skills are going to be on the decline at some point. (I'd bet that's not going to show up this year, however.) Vick's excitement factor and fantasy value is wrapped up in his running, the very thing that makes him risky. If he does it even slightly less, he ends up in the second tier of fantasy QBs and if he does it the same or more, there's simply too much chance that we end up seeing how Vince Young fits into the Eagles offense. I can't recommend taking Vick as the first QB off the board, let alone the first player.

Tony Romo -- Cowboys (SI.com Rank: 4)RISK ADJUSTED RANK: No. 11

It just took one hit to end Tony Romo's season last year. Romo had been relatively healthy as a QB, despite a scrambling nature and a poor sense of when he was about to get hit. How he landed -- just on the top of the shoulder, with the full weight of the defender adding to the force of the hit -- left Romo's arm hanging and his collarbone snapped. While he can come back from it, it does serve as a reminder that any QB is just one hit away from a long stint on the bench.

Jason Garrett's complex offensive scheme just isn't that good at protecting the passer and seldom holds RBs in to help, leaving Romo vulnerable not only to blitzes, but taking hits on too many plays. Dallas ranked 11th in Adjusted Sack Rate last season, so even adding to the line with draft picks and free agents, it's unreasonable to expect a big jump in effectiveness. That makes it less likely that Romo will stay healthy and means he needs to be moved down our risk adjusted board. It looks like a bigger drop than it really is due to the clump of QBs just below Romo's level and signifies a shift from Tier One to the middle of Tier Two.

Peyton Manning -- Colts (SI.com Rank: 5)RISK ADJUSTED RANK: No. 3

Manning's second off-season neck surgery makes him three for three the past few years when it comes to injuries and surgeries. Manning's nothing if not consistent, which is why you shouldn't worry too much about this injury.

While he's "behind schedule", especially when compared to similar surgery last year, Manning's actually on schedule. He was just ahead last year. Manning showed no sign that his neck was a problem last season and with improvements to the line, he shouldn't take the kind of hits that would cause problems. Manning's vision and quick release aren't affected and those are the kind of things that make Indy's line look better than it actually is. Joseph Addai is back, largely due to his blocking ability, something that Manning was very comfortable with despite the lack of production from the run game. Talk up Manning's neck injury heading into your draft and hope your friends sleep on him just enough to grab him.

Tom Brady -- Patriots (SI.com Rank: 7)RISK ADJUSTED RANK: No. 6

A fractured foot doesn't affect a QB the way it does an RB. Tom Brady and Ben Roethlisberger both played last season with the injury and played well. Brady chose to have off-season surgery, adding a walking boot to his fashionable accessory list. It's hard to see how Brady could be dropped much based on what we know of his injury and his injury history. Even more, the way he was able to play through the injury makes me feel a bit better about his ability to do it again, if necessary. Brady remains an elite level QB and should be drafted accordingly.

Matt Schaub -- Texans (SI.com Rank: 10)RISK ADJUSTED RANK: No. 9

Matt Schaub had a tough time staying healthy his first couple seasons in Houston. Part of it was him and part of it was his line. Both have gotten better and with a credible run game, Schaub's not seeing as many ears-back blitzes. There's a quirky stat in the mix here that concerns me. Schaub was sacked 22 times when the Texans were behind. Playing from behind usually involves more passing situations and more certainty that the defense can max rush the passer. If there's any dropoff from Arian Foster, the Texans could be facing that situation more. Regardless, Schaub's had a healthy two seasons that put him just shy of the elite QB tier. Another 25 TD season would make it harder to say that Schaub doesn't belong there, but the paradox is that the team (and Schaub) would be better off giving some of those passing TDs to the running game.

Jay Cutler -- Bears (SI.com Rank: 12)RISK ADJUSTED RANK: No. 18

Let's talk about that knee injury in the playoffs. The Bears assured everyone that his MCL sprain was serious enough to keep him out and if you look to the tape, no one from the medical staff seems to be protesting. Cutler was walking shortly after with no brace, so let's move past that situation to this year and note that even if the MCL was ruptured, he'd likely be ready for training camp.

Early in camp, Cutler is showing no issues with mobility. Some are even noting that Cutler seems to be in good shape, adding a bit of bulk to his frame. Cutler's always been healthy, but the Bears have no credible WR1 and let the anchor of the line, Olin Kreutz, leave. It's not the knee injury from last year that worries me with Cutler. What does worry me is the hits he took, like the one that put him on the sidelines in January. I don't think he can take as many as he's going to get this season.

Matthew Stafford -- Lions (SI.com Rank: 17)RISK ADJUSTED RANK: 20

Two years and two major shoulder injuries. Stafford has one more chance to prove himself ... or at least prove himself healthy. He showed signs of being the QB that the Lions thought he would be before a big hit took him out. It's the same kind of hit that took Tony Romo out, so it's not like he's "fragile". His numbers compare pretty well to Kevin Kolb over the past couple years and in almost every league, Kolb will be the one to go first. Stafford has the receievers to help him if he's healthy, but he also should have the line. The Lions' OL was ranked fourth last season in adjusted sack rate, but then again, it only takes one. Instead it's the running game that would really help Stafford. Mikel LeShoure was brought in to add some beef (and some pass blocking) to the backfield and his integration will be key to Stafford's season. Stafford is very risky, but valued correctly, he could be a solid QB2, especially if you miss out on one of the elite QB1's.

Tim Tebow -- Broncos (SI.com Rank: 46)RISK ADJUSTED RANK: No. 26

Tim Tebow has a lot of things that have made him a cult hero. One of those thing is his willingness to use his big body when running, taking big hits. Tebow held up in his late season chance at the QB1 job, but it's still unclear if he can hold up under a full season of those kind of hits. It only takes one encounter with Ray Lewis or James Harrison, or worse, one wrong hit from a DB forced to try and take out his legs to derail Tebow's upside. Tebow is good because he's risky -- he runs, he scores TDs, and his arm is to some extent secondary. To reduce his risk wouldn't work, because he's likely a below-average pure pocket guy, the same way Michael Vick was. You take the good with the bad and if you're taking Tebow, you'll have to take a tip from Tebow: pray a lot.

Donovan McNabb -- Vikings (SI.com Rank: 27)RISK ADJUSTED RANK: No. 30

McNabb is just going to try and forget all about his year in Washington. He's going to go Bobby Ewing and just pretend it was all just a bad dream. The problem is that in ways, it's not going to get much better for him in Minnesota. Sure, he could just turn around and hand the ball to Adrian Peterson. That would be the smart thing, but McNabb isn't going to morph into a play-action guy at this point in his career. Instead, we have to worry about the hits he'll take and the runs he'll make, albeit less frequently than early in his career. The Vikings were slightly better (20th) than the Redskins last year (22d) in terms of adjusted sack rate, but McNabb's a bit more mobile than the guy they had last season. He's not more mobile than Tarvaris Jackson though and Jackson was knocked around. That's the part that worries me, along with his age and the lack of a WR1.

Cam Newton -- Panthers (SI.com Rank: 31)RISK ADJUSTED RANK: No. 32

Newton's risk adjusted rank doesn't shift down much and at this level, behind such luminaries as Rex Grossman and Alex Smith, there's a lot more upside than either ranking shows. However, Newton has the same risks as Tim Tebow with none of the protection. Newton has a better arm than Tebow, but less experience. Despite that, he'll be thrust into the starting role for a bad team with a line that allowed 50 sacks last year. Add that up and it's likely that Newton will revert to running in many situations. More runs means more hits and more risk. I think Newton would make a good speculative, late-round QB2 pick behind a very solid QB1, but nothing more. Then again, one long-time NFL reporter asked me how Newton's situation coming into this year is significantly different from the one Michael Vick had coming into last year. I'll admit I didn't have a good answer.

(List is based on SI Rankings, as of the date of this article, and adjusted for risk based on that projection. This is not my suggestion for a draft list. I only go as deep as is necessary to get 10 interesting risk/injury cases.)

-- TIER ONE --

1. Aaron Rodgers2. Drew Brees3. Peyton Manning4. Michael Vick5. Philip Rivers6. Tom Brady7. Matt Ryan

-- TIER TWO --

8. Ben Roethlisberger9. Matt Schaub10. Josh Freeman11. Tony Romo12. Joe Flacco13. Eli Manning14. Sam Bradford

-- TIER THREE --

15. David Garrard16. Jason Campbell17. Tarvaris Jackson18. Jay Cutler19. Colt McCoy20. Matthew Stafford21. Ryan Fitzpatrick22. Matt Cassel23. Kevin Kolb24. Mark Sanchez25. Rex Grossman26. Tim Tebow27. Alex Smith28. Matt Hasselbeck29. Andy Dalton30. Donovan McNabb31. Chad Henne32. Cam Newton

ORDER NOW: Sports Illustrated's Fantasy Football 2011 issue tells you where all the free agents landed and what their fantasy impact will be, along with the critical draft strategy and stats analysis you need to win your league. Available in mid-August.

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