Happy Thanksgiving week and welcome to an early edition of Inside The Medical Tent for Week 12. With three games on Thursday this week, we wanted to get you all of the latest information sooner than later. We had some major injuries happen in Week 11 as well as the release of Melvin Gordon. There is lots of action going on right now creating value heading into the fantasy playoffs. Brian Scott joins me to break down some key injuries moving forward. You can also catch Brian on Sunday morning over on TSS Fantasy for the last-minute updates on injuries.

Justin Fields

Andrew Leduc: Fields played through a dislocated shoulder in their loss Sunday. Is that realistic to expect moving forward, or will he need to miss time?

Brian Scott, MEd, PA-C, ATC-ret:

He apparently dislocated his non-throwing shoulder this past weekend but did not miss a snap. His treatment will hinder on several factors. If this is an isolated incident, meaning the first and only time he had dislocated the shoulder, then it can be managed without surgery. Problem is, once it has occurred the chance of another dislocation goes up exponentially. He almost definitely will be playing with some protective type of stabilization brace on that shoulder. He could require surgery, but I think the Bears’ medical team will do what they can to avoid that at this time. Assuming there was no other major structural damage, it is reasonable to try and play with this injury. Should a second dislocation occur, however, I think that will be the end of his season.

Prognosis:

Justin Fields has been on a fantasy explosion the last few weeks. This definitely scares a lot of managers, but it looks like, for now, they have skated by. I will be curious to see if this injury will affect his willingness to run the football. Fields has taken hits trying to get the extra yards or getting to an opening to break a long run. We could see him pull up and slide for a couple of weeks as he feels his shoulder out. This could have an effect on his points, but he has been throwing the ball well enough to remain a QB1.

Kyle Pitts

Andrew Leduc: Headed to IR with a torn MCL, is the timeline similar to an ACL injury? Should he be able to go for the off-season program?

Brian Scott, MEd, PA-C, ATC-ret: 

The MCL ligament is the most common injury in the knee making up 40% of all knee ligament injuries. It sounds as though he has an isolated MCL injury, which is a relief. In MCL injuries that involve other ligaments, 95% of the time it is the ACL. Grade III isolated MCL injuries are treated with conservative treatment. The fact that he is already on IR and they are doing surgery, tells me a few things. For one, his knee is unstable. It could mean his ligament was torn off the tibial side.

This has less chance of healing without surgery. There could be some concern for a meniscus injury. This occurs in roughly 5% of isolated MCL injuries. I do not think we will see him back by the year’s end. The timetable is not as long as ACL injuries. You can expect he will be out a minimum of 6-8 weeks possibly closer to 12.

Prognosis:

Just when Pitts was starting to put something together this year, he is now officially droppable in redraft leagues. Drake London and Cordarelle Patterson will be the biggest beneficiaries of this injury. Caleb Huntley could see more work if the Flacons feel forced to use Patterson in a more traditional wide-receiver role. I would stay away from that situation though personally. London and Patterson are the only ones that carry any value for this team, alongside Mariota.

Jameson Williams

Andrew Leduc: Williams is designated to return from IR to start his professional career. Has he had the time to fully heal from the ACL injury he suffered at Alabama?

Brian Scott, MEd, PA-C, ATC-ret:

Brian Scott, MEd, PA-C, ATC-ret: He is between 10-11 months out from his ACL reconstructed knee. Reports last year at the time of his injury were that he had an isolated ACL injury. This is ideal as this means that there was no other structural damage to the knee. That would have needed to be addressed at the time of surgery. If this is true, then he should have had ample time to recover. He will need to get himself back into game shape to see some action this season. We should witness his development as time goes by.

Prognosis:

Williams is a desperate play for teams fighting for a playoff spot. He could immediately be a FLEX play the first time he touches the field. He could also need 2-3 weeks to get used to the game speed. I am in a situation where I may be able to use him in a couple of leagues. Being alongside Amon-Ra St. Brown would be an ideal situation for the young receiver though. Jared Goff has been serviceable, but not top-tier this year. Williams could be that extra weapon he needs to get you 15+ points for a few games. So I am looking at Jared Goff to benefit most if Williams indeed comes back soon.

Joe Mixon

Andrew Leduc: Concussions are impossible to project a return from, but can you explain the difference between a mild and severe concussion? Do they typically lead to different timetables?

Brian Scott, MEd, PA-C, ATC-ret:

Concussions can vary in severity and from player to player. Concussions are defined as a mild form of traumatic brain injury. The most common symptom of concussions is headaches. Severe concussions can present with more severe headaches and other clinical symptoms. These can be dizziness, balance problems, nausea or vomiting, sensitivity to light (photophobia), cognitive changes such as forgetfulness or difficulty concentrating, irritability or sadness, and even sleep disturbances. The presence of these symptoms can prolong the time to recovery.

This explains why the concussion protocol is important and why there is variability in the time to get players back. There is a large subjective component to it and there is a lot of variability between players. The transient or prolonged loss of consciousness only occurs 10% of the time in concussions. The 5-stage concussion protocol takes into account all the above-mentioned symptoms. It also tracks the ability to progress through levels of physical exertion symptom-free.

There are no set timetables in the protocol. Predicting the time to return from a mild or severe concussion is literally day to day.

Prognosis:

Not the best news for one of the top running backs on the year so far. Mixon could be cleared for this week, or miss the next two or more. In the meantime, Samaje Perine will step in as the lead role. He caught 3 touchdown passes and scored 30 PPR fantasy points after Mixon’s exit. Don’t expect that ceiling from him as the starter.

I could see Perine being good for around 14 points though depending on your league scoring standards. Either way, this is an offense that will be getting Chase back which could open up the middle of the field a bit for some extra yards if Perine can break an initial tackle.

Kadarius Toney

Andrew Leduc: From what you saw, does this look like all of the other hamstring injuries we have seen this season, or could this be something more?

Brian Scott, MEd, PA-C, ATC-ret:

He injured his hamstring again. They have not reported on whether it was his left or his right, but he injured both this year while he was on the Giants. This led to him missing a significant amount of time before he was traded to KC. Unfortunately, this is not surprising with hamstring injuries. We have seen it with Keenan Allen, who missed almost 10 weeks. He will have to seriously adjust his offseason conditioning and training to account for any muscle weakness or imbalances which may be predisposing him to repetitive hamstring strains.

The only thing that separates this from the other hamstring injuries we have seen this season in other players is the fact that he has injured and re-injured both sides at different times of the season. This raises suspicion that he possibly never fully recovered at any point in time.

Prognosis:

The Toney hype train has come to a screeching halt. You hate to see a season goes this way for a young player, but now we will see what he does to counter in his preparation for next year. Toney could end up being a bargain come fantasy drafts for next season given his injury concerns.

The Chiefs did show an early willingness to get him involved though which should hopefully carry over to next season. At this point though, we should just want to see him get fully healthy and change his conditioning to prepare for next season. Look for JuJu Smith-Schuster to retain his current role and for Mecole Hardman to step back into the success he was having for a few weeks as well.

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