Week 7 Med Check: Concussions at the forefront of this week's games

Saturday October 23rd, 2010

Concussions are all over the news right now, and rightly so. The problem is most people discussing this have no background in the actual facts. I'm not a doctor, but I know how to get hold of the best in the business. With concussions, that's Dr. Robert Watkins, Jr., orthopedic surgeon and co-director of Marina Spine Center at Marina Del Rey (Calif.) Hospital. I asked Dr. Watkins what happens to the brain when there is a helmet-to-helmet hit. Is being hit by a helmet any worse that a shoulder or knee?

"The brain gets impacted against the skull with any significant blow the head. Spearing with the helmet delivers the strongest blow because the top of the head is in a direct line with the body," Watkins said. "The force vector goes directly from the legs through the trunk and out the head. Incidentally, the tackler who spears with his head is at risk of suffering a spinal cord injury because he absorbs an equal amount of force to the top of his head which gets transferred to his cervical spine."

So it's both dangerous and stupid. I also asked whether concussion symptoms are ever delayed? Can a decision be safely made in minutes on the sideline? "Concussion symptoms can be delayed," he said. "Players, coaches, athletic trainers, and medical staff need to be vigilant in monitoring for neurologic and mental deficits. Decisions can be safely made on the sideline if players with suspected injuries undergo repetitive neurologic exams to monitor for development of concussion symptoms."

So as we head into the first week of games after the NFL threw down the gauntlet on helmet-to-helmet hits, we'll have to see if just being 'on notice' changes anything. Will we see more hits to the head or will we see some big hitter pull up short and cost yardage because he "thought about it"? There's going to be a lot to watch Sunday, so let's take a look at the games:


I guess it's fitting the first listed game this week has only one significant injury -- Dunta Robinson, who has become Patient Zero in the debate on big hits. Robinson has not yet been cleared to play (as of Saturday afternoon) and is unlikely to play a week after his collision with DeSean Jackson. The Bengals have some depth issues in the secondary with Roy Williams out and Jonathan Joseph hurting, but that's it.


The Dolphins' big injury news was putting Jared Odrick on IR, losing him for the year. It's the second time Odrick's finished the IR, but the Fins had already gotten used to him not being there. They will have Karlos Dansby, who practiced despite knee soreness and looks ready to play on Sunday. The Steelers are essentially healthy, though starting OG Trai Essex remains out. It didn't seem to hurt them running or passing last week, but we'll see if the Dolphins defense can exploit the weakness better than the Browns did.


Most of the issue for the Bills is on defense, where there's a couple injuries, including Keith Ellison. Ellison's knee injury is more about depth than the actual loss of Ellison, but any weakness is going to get exploited. Expect lots of Ray Rice at the weak center of the Bills defense. The Ravens aren't sure yet if Todd Heap will be ready to go. He's listed as questionable with a neck injury, suffered after that frightening hit last week. Yes, the team is calling it a neck injury and Heap himself insists there was no concussion. I'm not so sure, but we'll go with it. The Ravens are going to be without Tom Zbikowski. He has a heel bruise that slows him down, but it even with Ed Reed activated, it's still unclear how much Reed will play and how much he'll affect the defense. That might means a slight upgrade for the Bills passing game, but I'm not sure enough in it to list it above.

SUNDAY UPDATE: Todd Bouman gets the start, as expected

UPGRADE: Maurice Jones-Drew DOWNGRADE: Mike Sims-Walker

Todd Bouman. That's who'll get the start after the top two QBs are knocked out. There's some hope Trent Edwards will be ready by Sunday, but sources say that's a longshot after he looked "terrible -- couldn't throw, couldn't take the snap" on Friday. None of them are great fantasy options, but they will affect Mike Sims-Walker, who's had a terrible season so far. He got more targets last week, largely because the Jags were behind all game, but a shoulder injury was the cost. He'll play, but there's no certainty he'll be able to have a normal week. The fantasy hope is that the same imbalanced score forces the same kind of offensive strategy, but with the QBs out, that's not a great scoring threat. The only significant injury on the Chiefs side is to Chris Chambers, who missed last week with a finger injury. He was still wearing some protection in practice, but participated. He'll play and get his normal targets this week.

UPGRADE: Josh Cribbs DOWNGRADE: none

First the Steelers, now the Saints -- welcome to the NFL, Colt McCoy. McCoy played well enough to make the Browns give Jake Delhomme and Seneca Wallace another week off to heal their ankles. Unfortunately, he did lose his top two WRs last week to James Harrison's hooliganism. One of them, Josh Cribbs, gave Harrison some cover with this quote, which to me proves he hasn't gotten over the concussion yet. Cribbs has been cleared to play and is listed as probable, thought Mohamed Massaquoi is out. Cribbs is likely to get some Wildcat work as well. Peyton Hillis is still dealing with his quad strain, but practiced normally and will get his normal touches. On the defensive side, Shaun Rogers isn't healthy enough to do more than the spot duty he had last week. That opens up the middle for some running. I'm not a guy who's bought into Chris Ivory - he was injured while at Washington State, then injured after he transferred to Division II Tiffin, then injured again in the preseason. All that said, Pierre Thomas' continued absence makes Ivory a decent enough play. It won't help this week, but the Saints seem to think that Reggie Bush could be back as soon as next week's Halloween game against the Steelers. The Saints defense is still banged up, but the majority will play. The defensive backfield is thin, until Tracy Porter returns.

SUNDAY UPDATE: Mike Sellars isn't a big fantasy player, but his presence will help Donovan McNabb. Hearing that he'll play despite being listed as questionable.

UPGRADE: none DOWNGRADE: Chris Cooley

Mike Shanahan loves the "questionable" designation. He's used it with Donovan McNabb, even when everyone knew McNabb was going to play. This week, Shanahan proves he hates fantasy players by listing everyone -- seven players -- as questionable. OK, he did list Clinton Portis as out, but that's hardly fair or as intended. Most of the questionable players will play, but Chris Cooley really is a bit questionable. He did get cleared and practiced fully on Friday, but it seems the team is being rightly reluctant to rely on Cooley just yet. The defensive players should all play, including Rocky McIntosh, LaRon Landry, and DeAngelo Hall. The Bears don't have any significant players out, but at LB, both Lance Briggs (ankle) and Brian Urlacher (groin) might be a half-step slow. Unfortunately, Ryan Torain isn't the kind of back that can exploit that issue.

UPGRADE: Steve Smith DOWNGRADE: none

It's really kind of simple: Steve Smith just heals faster than normal people. Some of it is pain tolerance and the willingness to go out on the football field with injured parts that could get re-injured, but deep down, Smith has some ability, likely genetic, that allows him to come back quickly. He's done it again and again and no, I don't think it's a trick of chemicals. Smith won't be 100%, but I think that Matt Moore will be going to him early and often to see just what he can do. The Niners only major issue is Vernon Davis. His knee held up well in practice and he should get his normal targets. Josh Morgan is banged up as well, but is really about the fourth or fifth option anyway.

UPGRADE: Josh Freeman, Kellen Winslow DOWNGRADE: none

The Rams' season has been defined, in ways, by injuries. In Week 7, they have a long list of them, but mostly on defense. As with most defensive injuries, it's a depth issue more than a "changes everything" type of problem. Outside of a very small group of defensive game-changers, the scheme and the matchup is the thing. Without much of a running game, that leaves Josh Freeman to try and find some way of keeping up with Sam Bradford. Granted, Bradford's running out of guys to throw it to, but there's enough out there and he has a luxury Freeman doesn't -- an elite running game. The Rams WR ills are still going on. Mardy Gilyard is unlikely to play and Laurent Robinson doesn't seem to be all the way back from his foot injury. If Danario Alexander can stay healthy -- something he's never done -- it seems like Bradford likes throwing to bigger targets like Alexander and the TEs.

SUNDAY UPDATE: As expected, Michael Vick is the inactive third QB. Vince Young is the QB2, with Kerry Collins getting the start. Kenny Britt won't start, but expect him to get "near his normal" targets.

UPGRADE: Jeremy Maclin DOWNGRADE: Vince Young, LeSean McCoy

The Eagles did the right thing in shutting down DeSean Jackson. While it will hurt their passing game some, Jeremy Maclin showed he's a solid enough target for Kevin Kolb. Jackson now gets this week plus the bye to heal up while Jason Avant slides up to the WR2 role. Speaking of Kolb, he gets the start with Michael Vick as the QB2. Vick is unlikely to play unless Kolb gets hurt, so hoping he gets even Wildcat looks is off. Andy Reid is going to get to change his mind of QBs a couple times during the bye. Brent Celek is also likely to get his normal targets, perhaps a bit more since Jackson tends to be the crossing route guy, something Celek can also do. LeSean McCoy is healthy, but given the way that the Titans play and the way they shut down Jones-Drew, I'm wondering if this week is the test for his ribs we thought last week might be. Vince Young is a GTD, though most indications are Kerry Collins will get the start. Young's ankle is the bigger issue, though his knee was also injured. Sources tell me unless Young comes out Sunday morning with full mobility, Collins starts. The question will be whether Young is the backup or the QB3. That's important since Collins has a swollen middle finger on his throwing hand that left the Titans with Rusty Smith running things at times. Whoever is at QB, the WR situation will be a problem. Kenny Britt is a question mark after some off-field issues while Justin Gage looks like he'll play, but be less than 100%.


The Cards are hoping to upgrade their offense with a couple returns from injury. Unfortunately, they may have to wait another week to be upgraded. Both Early Doucet (groin) and Steve Breaston (knee) weren't able to practice fully this week and will be GTDs. Breaston looks a little more likely to play, but a Saturday workout only told the Cards that he'd be "available", not that he'd be ready for a full load. He could end up something of a decoy for Larry Fitzgerald. The Seahawks are relatively healthy coming into Week 7.

SUNDAY UPDATE: Antonio Gates will play, but might be more limited than originally thought. Look at your TE situation.

UPGRADE: none DOWNGRADE: Philip Rivers

The Chargers have some issues at WR and, with Malcolm Floyd out, Legedu Naanee unlikely, and Vincent Jackson MIA, that leaves Patrick Crayton and Richard Goodman as the starting WRs. It really depends on how you look at Philip Rivers as to whether you downgrade him based on his WRs or upgrade them based on his play. Given the line play and a Pats team that needs the win, I'll downgrade Rivers here. Sure, Peyton Manning got along fine with a former practice-squadder, but I'm just not buying that this offense will work as well. Worse, Antonio Gates is also questionable heading into the game and will be a true GTD. If he plays, Gates will go back to the 2008 form he had with a similar toe issue, where he lost targets but kept up his red zone looks. The big hope is that he puts up one of those "2-for-10, 2 TD" lines. Ryan Mathews is as healthy as he's been all season, but he still looks to be splitting carries with Mike Tolbert, a situation that exists in hopes of keeping the rookie RB healthy. Bill Barnwell had a great stat about Norv Turner -- none of the 22 players he's listed as "doubtful" have ever played in a game that week. The Pats only major issue is Julian Edelman, who suffered a concussion last week. Fred Taylor remains out, but the team has adjusted well with it's committee approach.

UPGRADE: Jason Campbell, Demaryius Thomas DOWNGRADE: Broncos D/ST

The Raiders major issues seem to be righting themselves - well, on the injury front that is. Jason Campbell made enough progress from his knee injury to get the start, while it looks like Darren McFadden will at least be active this week. He's still the RB2, but he should see some level of touches. It's still not enough to put him in unless you're crushed by bye week absences and even then, don't expect anything. The Broncos secondary is really banged up, with Champ Bailey a GTD -- and the healthiest of the starters. If Bailey is out, I'm not sure that changes the Raiders gameplan much. On the offensive side, Eddie Royal is also a GTD and as a late game, that's a tough spot for a lot of people. I'd look to Demaryius Thomas to get the targets Royal gives up, no matter how many that is.

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