NFL Week 4 Med Check: Spiller, Jackson, Nicks among downgrades

DET: Mikel Leshoure will play, according to multiple reports. How much he plays is still a question. Fantasy key is whether he keeps the goal line touches.

BUF: Fred Jackson will play today. CJ Spiller is also likely to play, but remains a GTD. Downgrade Tashard Choice if both are active.

OAK: Darren McFadden will get the start and his normal touches today, absent some unforeseen injury. The shoulder is "easily handled," I'm told.

TEN: Kenny Britt will be a GTD, but the Titans may have him active no matter what. There's a decoy factor at play. Nate Washington and Kendall Wright are good plays with Britt and Jared Cook limited.

MIA: Game time decisions often mean just that. When it's a late game, as with the Dolphins today, it makes fantasy decisions harder. I'd avoid Reggie Bush today unless you just don't have a better option.

KC: Dwayne Bowe will play today. Expect him to get his normal targets for the Chiefs.

JAX: Laurent Robinson has been cleared to play after a concussion. It's expected he will play, if not start.

NYJ: The Jets will get Dustin Keller back this week. How much he plays is more a question for Rex Ryan.

NYG: Hakeem Nicks is out for Sunday night's game. Ramses Barden and Domenik Hixon will get the targets.

ARZ: With Beanie Wells out, Ryan Williams is going to have to take on nearly the full load. LaRod Stephens-Howling is not likely to play with a groin strain. With no valid RB behind him, the Cards are likely to throw a bit more.

NE: Rob Gronkowski is expected to play. He won't be 100% and the game plan is likely to adjust. He's a risky start. Ironically, Kellen Winslow would have gotten more playing time this week. Daniel Fells is a speculative play.

CHI: Sources continue to indicate that Matt Forte will play on Monday. He is still expected to be on the low end of a role/split with Michael Bush.

WAS: A final determination will be made within the next hour, but early indications are that Pierre Garcon will play today. He is likely to be limited both physically and in terms of both snaps and targets.

UPGRADE: Jonathan StewartDOWNGRADE: none

This could be a shootout and if so, the Falcons will need Julio Jones. Jones' lacerated hand shouldn't affect him much, but it could cost him in the red zone. If so, Tony Gonzalez gets a bump. It will be impossible to say even in-game, so don't overshift your expectations on either. The Panthers should have Jonathan Stewart back, which puts their RB situation back to it's more normal but unpredictable split.

UPGRADE: Tashard Choice, Wes WelkerDOWNGRADE: CJ Spiller, Julian Edelman

The best way to think about CJ Spiller is like Ryan Mathews. A RB might run with his legs, but he leads with his shoulders. The AC sprain could have been a lot worse -- and looked it at the time -- but Spiller has made enough progress that he's not yet been ruled out. He's a GTD-, but probably not a good play, as the Bills will need to be careful with him (and are likely to be playing from behind, forcing more passing.) The same is true with Fred Jackson, who is closer to playing normally. The knee is still not 100% and his lateral mobility remains a question. That leaves Tashard Choice as the most likely RB to get the most touches here. Rob Gronkowski was a late add to the OIR and at questionable, it's very concerning. I'll be watching that one very closely Sunday morning and hope to have better info by then. The Pats have some issues up front, with OLs Logan Mankins and Sebastian Vollmer hurting, which could affect both the running and passing games. Aaron Hernandez is making progress but is very unlikely to play this week. With Julian Edelman out, Wes Welker has to get more looks, right? Deion Branch could factor in as well.

UPGRADE: Jerome SimpsonDOWNGRADE: Mikel Leshoure

The Vikings had a couple big named on the OIR -- Christian Ponder, Kyle Rudolph, and Jared Allen -- but all are expected to play normally. The Lions have a longer list and more problems. Matthew Stafford is dealing with an upper leg/hip strain that could keep him off the field. He's a GTD+ and if he plays, I expect him to put up normal numbers. It could push a few more touches to the running game, but it might not shift to Mikel Leshoure. A groin strain continues the worry that his fragility will wipe out his talent. It won't. The DBs are still an issue for the Lions, which makes all the Vikings WRs a better play, especially Jerome Simpson, who will give the Vikings a vertical element they've lacked throughout the Ponder era.

UPGRADE: Kenny BrittDOWNGRADE: Arian Foster, Jared Cook

It's hard to say a guy with nearly 80 carries is someone to worry about, but between the workload, a nagging knee injury, and his history, Arian Foster is someone I'm watching. He's not a "sell high" guy -- you can't do that with a first rounder -- but I do think that Ben Tate is a near must-have pairing if you are counting on Foster. Gary Kubiak is going to have to find a way to keep him healthy and laying off touches on Tate could be it. The Texans have an extensive injury list, but most shouldn't affect the game, including Matt Schaub and Andre Johnson. The Titans should have Kenny Britt at near-normal despite missing practice, but Jared Cook will be a GTD+ and won't see his normal sets. They'll protect his shoulder by keeping him out of the biggest blocks, but watch for the Texans to test him with blitzes early.

UPGRADE: Dwayne BoweDOWNGRADE: Peyton Hillis, Nate Kaeding

Ryan Mathews and Antonio Gates didn't even make the OIR this week. That's more a symbol than a signal. The Chargers are monitoring the groin strain of Nate Kaeding and have Nick Novak ready to go. (Late word is Kaeding will not play.) They'll make that call late. The only other key injury for the Chargers is Quentin Jammer and it appears he will play. The Chiefs OIR is more extensive. Dexter McCluster is unlikely to play, though the extent of his elbow injury is still something of a mystery. Peyton Hillis is probably out, pushing more to Jamaal Charles, who responded big time last week. Dwayne Bowe will play and get his full targets.

UPGRADE: noneDOWNGRADE: Stephen Hill

Darrelle Revis is out, but not yet on IR. Why? The Jets are giving him a courtesy and really not needing the roster spot just yet. Why not the IR with the could-return slot? That can only be used once a year. Revis is, at best, a miracle away from coming back even in the playoffs; the Jets need to save that slot for someone coming back from a fracture or high ankle or something like that. The defense is a downgrade without Revis, but I'm not sure just how much, since Rex Ryan teams seem to feed on being underdogs and having the "us against the world" mentality. Problem is, it's not just Revis. The Jets go 20 deep on the OIR, including Stephen Hill, who is unlikely to play, Bart Scott, who will but could be hobbled, and Dustin Keller, who is a GTD-. The Niners are watching Patrick Willis, though he's expected to play, while Ted Ginn is not likely to participate again this week.

UPGRADE: noneDOWNGRADE: Steven Jackson

Steven Jackson played last week after not practicing and it looks like this week will be the same. Jackson was a decent option last week, not losing too much to Daryl Richardson as many had worried. The Seahawks, even on a short week, are relatively healthy at the fantasy-relevant positions.

UPGRADE: Reggie Bush, Ryan WilliamsDOWNGRADE: none

Good defenses against good running backs should make for an interesting matchup. Neither team can count on the passing game, so they will have to go with a dinged Reggie Bush, plus Daniel Thomas and Lamar Miller. Miami has a good run defense, but they do have some depth issues at DT, so they could wear down. We'll see whether that helps Ryan Williams. Both Bush and Williams have been injury prone in the past, but they have great opportunities to step up and help their team. The Cardinals are a surprise, but they should have a solid shot at 4-0. Their biggest concern is in the defensive backfield, where Ryan Tannehill hasn't proven he can make a team pay. John Skelton is likely to miss at least this week before returning and fighting Kevin Kolb for the QB slot.

UPGRADE: Willis McGahee, Jacob TammeDOWNGRADE: Darius Heyward-Bey

It's pretty amazing that I can say it was even a possibility that Darius Heyward-Bey could have played this week. He's not running as of Friday, so don't expect him on Sunday. Rod Streater could pick up Heyward-Bey's targets. The Broncos expect to have both Willis McGahee and Jacob Tamme on the field. They have favorable matchups and figure to get normal workload.

UPGRADE: noneDOWNGRADE: Bengals D/ST

The Bengals continue to have all their real injury problems on the defensive side. That opens things up for the passing game and for Maurice Jones-Drew, who feasted on a Colts defense last week that runs a similar scheme to Cincy. Jacksonville has some minor injuries, but none that should affect their game plan or fantasy owners.

UPGRADE: noneDOWNGRADE: Greg Jennings

Marques Colston is dealing with a lingering foot injury that multiple reports and sources have as plantar fasciitis. Yet here we are looking at the OIR and he's nowhere on it. That's curious. I had expected a downgrade given what we saw last week, but given that he practiced fully, it's hard to put him there. (For you, we'll call it a reward for not just scanning this column.) The Saints don't have any fantasy relevant injuries, just some very minor defensive depth issues on the edge.

UPGRADE: Fred DavisDOWNGRADE: Pierre Garcon, Leonard Hankerson

Pierre Garcon is likely to miss Week 4 as his foot injury continues to make very slow progress. The early season has worn on Leonard Hankerson as well. He should play through a sore back, but it's very tough to say how the young WR will respond. That leaves Robert Griffin III targeting down the depth chart to Aldrick Robinson and Fred Davis a bit more, though Griffin really spreads the ball around. The Bucs are healthy and have no fantasy relevant issues.

UPGRADE: Ahmad Bradshaw, Domenik HixonDOWNGRADE: Hakeem Nicks

The recovery is still the issue for Hakeem Nicks. After playing last week, Nicks appears to not be ready this week, despite it being a big divisional matchup. If Nicks is out, Ramses Barden will have another chance to show off his skills, but don't forget about Domenik Hixon, coming back from a concussion. Nicks is far enough out from the foot fracture that this kind of recovery issue is worrisome and may force some corrective action. Reports of a knee issue complicate things; a compensation injury like that would be a major negative. A late bye week (11) doesn't help here. The news is better on Ahmad Bradshaw, who should split carries with Andre Brown. The Eagles will have Jeremy Maclin back, but a quick recurrence is possible with this hip flexor strain. Watch to see if Riley Cooper is active this week. His return would give Michael Vick the tall target he lacks right now.

Notes: Matt Forte is going to be a GTD+, but early indications are that he'll play. He is most likely to get 10-12 carries as the low end of the split with Michael Bush ... Julius Peppers might be a tick slow this week due to his foot injury, but he's likely to play in at least the passing downs ... The Cowboys are hoping for big things from Miles Austin. Sources there tell me his hamstring is "as close to 100% as it every will be" ... Injuries in the Dallas defensive backfield could open things up for Brandon Marshall and Alshon Jeffrey.