Week 4 Med Check

10:50 a.m.

CLE: Reports from Cleveland indicate that Peyton Hillis looked very ill and has left the stadium. He was not on the field at the beginning of warmups. Montario Hardesty expected to start and get RB1 touches.

10 a.m.

ARI: Chris Wells told reporters on Saturday that he would be at full speed despite a mid-week hamstring injury. While still technically a game-time decision, this is a good sign for Wells and a major downgrade for Chester Taylor.

CLE: Peyton Hillis is dealing with strep throat and a fever. He will be a game-time decision based on how he's feeling, but Montario Hardesty is going to pick up carries in any scenario. Downgrade Hillis as well, because strep is no joke.

HOU: Sources tell me that Arian Foster will be given a chance to show he's ready to play today during warmups. Ben Tate is still the starter and the guy you want in fantasy.

IND: Dallas Clark is expected to play tonight, though his sore foot will be tested at game time. The lack of options at TE factors here and I think targets will shift outside.

PHI: Michael Vick will start, as expected. He is wearing new padding inside his helmet from Unequal. He's a good start in all formats.

SD: Lots of eyes on Antonio Gates. HIs foot could have him out this week, according to reports, but the team has not confirmed this as yet. Look for a Plan B now however. Todd Heap and Fred Davis are two late-game options available in many leagues.

SF: With Antonio Gates out, some are looking to Vernon Davis as a great fantasy option. I'm told that Davis still isn't "integral" to the game plan, even after his talk with Jim Harbaugh.

UPGRADE: Rob Gronkowski

DOWNGRADE: Stevie Johnson, Patriots D/ST

The Pats go 18 deep on the official injury report this week, losing two players (Dan Koppen and Myron Pryor) to the injured reserve. It's some key guys they'll be missing, including Aaron Hernandez, Patrick Chung, and Sebastian Vollmer. Albert Haynesworth is a GTD, but get used to that. There's a lot of depth issues on defense for the Pats, which leaves just enough of an opening for the Bills if they can make some big plays. The Bills are relatively healthy, with Johnson looking like he'll play despite an iffy groin and Roscoe Parrish out. This could end up a shootout.

UPGRADE: Marcedes Lewis

DOWNGRADE: none

The story of the NFL season has been Cam Newton, but he left last week in a protective boot. It was a precaution, and he's been at practice every snap, just as he will be in the game. The Jags are also healthier than they have been. They think they'll get Lewis back and Jason Hill will be a game-time decision. Don't be confused by Maurice Jones-Drew being listed as missing practices -- the Jags have taken to resting him a bit. With Blaine Gabbert taking over at QB, the Jags hope that Jones-Drew will have a few less defenders in the box, which would be as big a help as skipping practices.

UPGRADE: Vernon Davis

DOWNGRADE: Alex Smith

Colin Kaepernick got more reps this week as Smith waited to pass his concussion tests, but Smith looks ready to at least start the game. Smith was back at practice on Friday. He should have Michael Crabtree, whose foot is still a real problem and can't run all routes normally yet. Braylon Edwards is out after surgery, meaning there's some uncertainty that could move Davis up in the fantasy ranks. The Bengals' only concerning injuries are a toe problem for A.J. Green and a shoulder issue that will have Robert Geathers as a game-time decision.

UPGRADE: none

DOWNGRADE: Reggie Bush

Between Bush and Brandon Marshall, two key Dolphins have two good groins between them. That's never a good sign, but both practiced and seem ready to play. Speed guys with any sort of leg problems are always worrisome, and Bush is certainly not looking like the "every-down back" he said he'd be in Miami. The Browns have some minor injuries, but the key one -- Mohamed Massaquoi -- is likely to play, just like last week. The Browns figure to copy/paste last week's game plan as they focus on power. There is late word that Peyton Hillis is dealing with an illness. The Browns hope he will play, but we may see more Montario Hardesty this week.

UPGRADE: Calvin Johnson

DOWNGRADE: Percy Harvin, Brandon Pettigrew

The Vikings are selling that Harvin isn't having migraines again, so for now, we'll take them at their word. They've been limiting Harvin's playing time, with one source saying it's a "hit count" rather than a play count. We'll see if he's able to play this week. He's a real game-time decision. The Lions don't have the same worries about Johnson. While limited in practice, he'll be ready to go normally. The shoulder injury to Pettigrew may limit him some, but mostly in the passing game. It could open some targets for Titus Young if the Lions elect to spread the field more without their TE.

UPGRADE: Drew Brees, Matt Schaub, Ben Tate

DOWNGRADE: Saints D/ST, Texans D/ST

The length of a team's injury list seldom has much to do with ... well, anything. The way the new official injury report works is that it's better to list everything at the start of the week and walk things back when official designations come out on Friday. It's those designations that really count, once we learn how to read them. The Texans go 14 deep on the list, and the Saints have 11, but there are only a couple names that matter. Arian Foster is unlikely to play this week, though he was at practice and seems to be pushing to at least share carries. The Texans might get Kevin Walter back, though they'll watch him closely in practice before putting him into the game plan. He'll be a fourth or even fifth option at best this week, so monitor him, but don't play him. On defense, DeMeco Ryans and Jonathan Joseph are both big game-time decisions that would upgrade the Saints passing game if missing. The Saints might have fewer on the list, but there are bigger names and more serious injuries. Marques Colston is out, but Lance Moore appears in. There are a lot of issues on defense, with Tracy Porter, Jonathan Vilma, and Roman Harper all game-time decisions. This week's injury situation points to a high-scoring shootout.

UPGRADE: Victor Cruz

DOWNGRADE: none

Michael Vick is coming back off a concussion. He passed all the required tests early in the week. He's likely to be an official game-time decision, but all signs are that he will play normally. Vince Young is also ready to go this week, just in case, though it's unclear whether he or Mike Kafka will be the QB2. There are a lot of probables on the Eagles this week, but all should play normally. I wouldn't rely too much on Steve Smith, even against his old team. His knee isn't back to full-go just yet, though he should play. The Giants have issues at WR, with Domenik Hixon lost for the season and Mario Manningham coming off a concussion. Manningham did not practice this week and has not cleared all necessary steps. He's out after not being allowed to travel. Hakeem Nicks is healthy this week and will be joined by Cruz. Travis Beckum is probable at TE but isn't thought to be a big part of the game plan. Osi Umenyiora is out again this week.

UPGRADE: Willis McGahee

DOWNGRADE: Eric Decker

The Broncos have a lot of issues. On the injury front, things look better on offense than defense. Brandon Lloyd and Knowshon Moreno should be back in the mix, but Moreno is still in a timeshare at best. Lloyd will see his full targets, which hurts Decker slightly as he'll move back to the WR2 slot. On the defensive side, D.J. Williams and Champ Bailey are both game-time decisions. Sources are mixed on whether they'll play, but all agree that neither is back to 100 percent. The Titans have a couple big names on the injured list, but Kenny Britt and Chris Johnson will play normally. Chris Hope is the only starter who's doubtful, which could be a problem if powerful McGahee breaks through the front seven.

UPGRADE: Denarius Moore, Kevin Boss

DOWNGRADE: Shonn Greene

The Jets' big worry is their big man in the middle, Nick Mangold. His combo ankle sprain is unlikely to let him play, though they'll give him every chance to show he can right up to game time. If he can't, the running game suffers. Santonio Holmes is likely to play, as are the rest of their fantasy-relevent players, though Holmes does bear some watching. The Raiders are very thin at WR, with Jacoby Ford, Darrius Heyward-Bay and Louis Murphy hurting. Only Heyward-Bey practiced so far this week. Darren McFadden was held out some with a sore shoulder but will play. Don't worry about Jason Campbell, though he was held out with a sore foot. Boss is a game-time decision but expected to play for the Raiders. If he does, he'll be a bigger part of the offense.

UPGRADE: Le'Ron McClain

DOWNGRADE: Mike Tolbert, Antonio Gates, Malcom Floyd

Assuming Tamba Hali plays, the Chiefs have no significant injuries ... at least on the active roster. We all know they're missing three key players and will try to replace Jamaal Charles this week with a combo pack of Thomas Jones inside and Dexter McCluster outside. One source with the team also told me not to forget about McClain. "[The coaching staff] doesn't want to wear down Jones, so McClain might end up with the jumbo and red-zone carries," he told me. The Chargers have more injuries, with Gates the biggest question mark. Gates is usually held out of practice, but this week the foot is more problematic. He's on that edge of dropping out of the first tier if they can't get the foot under control and that could take some time off. Tolbert has a minor calf strain. He'll play, but he's not the automatic red-zone back this week, so downgrade him slightly. Floyd is listed as doubtful, which means out for the Chargers, so Vincent Jackson is going to draw more targets and more defenders.

UPGRADE: Steven Jackson

DOWNGRADE: Lee Evans

Most of the Ravens' issues are on defense, where it's mostly a depth issue. Jimmy Smith is the more worrisome of the injured CBs -- Chris Carr is the other. Evans' ankle has him out this week, which should give Torrey Smith the start, if you're looking deep on the waiver wire. The targets will spread around, with most going to the TEs. The Rams' big worry is at RB, where Jackson is coming off a quad strain. He'll be a game-time decision, but the Rams are leaning to playing him. Cadillac Williams has a hamstring strain and might not be ready to go regardless of Jackson's status. Jerious Norwood is the third-stringer, but he's not ready yet to take a full load, so there could be a lot of passing if Jackson's limited.

UPGRADE: none

DOWNGRADE: Jay Cutler

All the Packers' significant concerns are on defense. All of them, including Ryan Pickett, are expected to play. With Gabe Carimi out, the edge rush could really be an issue, forcing Cutler to hold in a TE or RB and maybe roll, which is tough against the speedy Packers. Earl Bennett is likely out this week, but Roy Williams looks ready to play. The target roles are very confused still for the Bears passing game.

UPGRADE: Sidney Rice

DOWNGRADE: Beanie Wells

Wells was a late-week add to the official injury report, but he was back at practice, on at least a limited basis, Friday. He'll be a game-time decision, which means Chester Taylor will see an increase in carries either way. It's also a tough play for Wells owners since he's a late game. The Cards defense is a bit banged up, but only Daryl Washington is iffy to play. The Seahawks' big injury is Rice. The big-dollar WR hasn't made his regular-season debut yet but should this week. Pete Carroll and his staff are hoping that having Rice back will help Tarvaris Jackson, who's on a very short leash. Robert Gallery is also out again, which doesn't help the running game.

UPGRADE: none

DOWNGRADE: none

The Falcons come into Week 3 banged up, but the offense is relatively healthy. Matt Ryan and Roddy White will play normally. Across the ball, the Bucs are very healthy, with no fantasy-relevant players on the injured list aside from Kellen Winslow's normal spot there. He'll play.

UPGRADE: Rashard Mendenhall

DOWNGRADE: Dallas Clark, Colts D/ST

The Steelers come in with no major injuries. They did rest several players this week, but all are expected to play aside from Brett Keisel. He's out this game and several more with a PCL sprain. Ben Roethlisberger is notably not on the injury report despite his knee being problematic into mid-week. There's some worry that he has a very low grade sprain and some meniscus damage from getting rolled up early last week. He can clearly play through it, but the Steelers want to keep that knee from getting tested. With Freeney and Mathis, the Steelers will look to run early and often to try and keep them from getting runs at Roethlisberger. The Colts have a ton of injuries besides Peyton Manning. Gary Brackett and Melvin Bullett will not play, leaving the team vulnerable to the run again. Dallas Clark missed Friday's practice with a minor foot injury, but that Friday practice tends to be telling for the Colts. Have a Plan B ready, if you're even starting Clark. Jacob Tamme has been cleared to play after a concussion, but the Colts have no fully healthy TE, so they could use more three- and four- wide sets.