Fantasy football Week 3 injury report, analysis on Romo, Brees, Lacy

Tony Romo

One week after losing wide receiver Dez Bryant to a broken foot, the Cowboys' injury woes continued as quarterback Tony Romo suffered a fractured left clavicle (collarbone) in a win over the Eagles.

The injury occurred to Romo's non-throwing shoulder when he was taken down by defensive end Fletcher Cox. Romo's left shoulder hit the turf and the weight of linebacker Jordan Hicks compounded the fall, sending a large amount of force through Romo's body and creating the perfect scenario for a collarbone fracture. The mechanism of injury is called an axial load and often generates enough force to break the middle portion of the collarbone. Romo is familiar with this situation, previously fracturing this same bone on a remarkably similar play.

Week 7 of 2010, the Giants' Michael Boley slammed Romo and his left shoulder to the turf with the linebacker's weight increasing the amount of force placed on the shoulder. While Romo missed 10 games following the injury, there's no reason to believe it factored into his current issue. Bone heals well and is one of the rare tissues that returns to full, and potentially better, strength following injury.

Romo's injury is an isolated fracture, meaning the two shoulder joints that involve the collarbone were not affected. The bone did not shift and remains non-displaced, allowing the four-time Pro-Bowler to avoid surgery. According to reports, the team is preparing for him to miss the next eight weeks, but let's look at what precedent and other examples suggests about the injury to get a better timetable on Romo.

While Romo did miss 10 games in 2010, Dallas' poor overall record that year likely influenced the Cowboys' decision to place him on injured reserve. Aaron Rodgers broke his non-throwing shoulder following a play strikingly similar to Romo's in 2013. The Packers quarterback did not need surgery for the fracture and returned after missing seven games. Last year, former Eagles and current Rams quarterback Nick Foles missed the team's final eight games with a collarbone fracture. The Cowboys can even look to an in-house comparison as Hall-of-Fame quarterback Troy Aikman missed five games in 1998 with a fractured left collarbone.

Furthermore, a 2010 study examined 19 collarbone fractures of NFL players. The injuries were treated both nonoperatively and surgically with the average time of healing for non-surgical breaks coming in at 7.3 weeks while those treated surgically needed an extra 1.5 weeks to heal.

Given these facts, the eight-week window for Dallas appears realistic, though the situation, of course, remains fluid. The team will address the issue on a week-to-week basis, but it looks like Brandon Weeden will quarterback the Cowboys until mid-November. Weeden won't make a monster impact on the boxscore but he could be used as a fill-in once the bye weeks begin. Expect Terrance Williams, Jason Witten and the Dallas running backs to be negatively impacted by the injury.

Drew Brees

Brees is dealing with a shoulder injury, though conflicting reports regarding the severity of the injury have surfaced. We do know he has bruising around the rotator cuff and experienced pain and weakness during a Week 2 loss to the Buccaneers. There's an elevated level of concern with Brees given that he underwent an extensive shoulder surgery prior to joining the Saints in 2006. In the procedure, renowned orthopedist Dr. James Andrew repaired a massive labrum tear as well as damage to the rotator cuff. Brees also dealt with shoulder problems at the conclusion of last season.

Anatomically, the shoulder is one of the more complex joints of the body compromised of four joints and articulations and multiple ligaments and muscles, including the rotator cuff. The cuff is actually a group of muscles designed to stabilize the shoulder and aid in various motions at the joint. Rotator cuff injuries are common in throwing athletes but generally develop with repetitive motion or a violent pulling motion. A direct blow, like one Brees sustained on Sunday, can result in bruising of the area and cause a functional limitation. Fortunately, an MRI on Bree's shoulder revealed the cuff muscles to be intact.

The focus for fantasy owners simply shifts from what happened to what does it mean for his availability. We know Brees plans on meeting with Dr. Andrews for further evaluation and that the current plan is to treat the area with aggressive rehab. If the nine-time Pro Bowler responds well to the treatment, he could start Sunday against the Panthers. However, any lingering symptoms or limitation in the area would result in him remaining on the sidelines. This may not seem ideal initially, but an ineffective Brees wouldn't help any invested parties. Closely monitor the situation throughout the week, but I'd lean toward starting another quarterback.

Eddie Lacy, Davante Adams

Both Lacy and Adams sustained ankle sprains in the team's win over the Seahawks. The Packers running back made a brief appearance in the game before spraining his ankle on his third carry. He was taken off the field and further testing revealed the bones were intact and the severity of the ligament damage was given a low grade. Grade I sprains mean the injured ligament or ligaments have accrued damage on a micro-level. Lacy managed a right ankle sprain for a majority of the 2013 season but did not miss a game. He will be evaluated before Thursday's practice at which time his availability for Monday's game against the Chiefs will become clearer. Lacy owners should add backup James Starks in case Lacy can't play.

The team is taking a similar approach with Adams. The receiver played following his ankle sprain, though his productivity suffered as he had just one reception. Adams' injury also appears to be mild, but he too will be a risky play this week.


Jay Cutler: The Bears quarterback will miss at least two weeks after suffering a hamstring strain in the team's loss to Arizona. For a quarterback, the hamstring is important during weight transfer while going through the throwing motion. Given Cutler's recent struggles the team might be inclined to provide him with extra rest to insure he improves mentally and physically. Jimmy Clausen takes over in Chicago, though a tough matchup against the Seahawks significantly hinders potential value.

Dez Bryant: It wasn't shocking news that Dallas opted to proactively treat Bryant's fractured fifth metatarsal surgically. However, it was surprising to see reports surface that the Pro Bowler receiver underwent a surgical implant AND a bone graft. Grafts are rarely used on the initial surgery and are instead utilized following a complication like a failed union or improper healing. However, it appears the Cowboys wanted to get ahead of the recovery process and used the bone graft hoping it would reduce the likelihood of a re-fracture or hardware failure. As a result, the initial four-to-six week window provided by the team becomes even harder to stomach, and I maintain the belief that this injury will cost Bryant at least seven more weeks and could keep him out until Thanksgiving.

Jason Witten: With Bryant and Romo out for an extended period, the Cowboys can ill-afford to lose their future Hall-of-Fame tight end. Witten has missed just one game in his professional career but will receive plenty of rest prior to Week 3 after spraining both his ankles and a knee on Sunday. It's uncertain if he will play in Week 3. If healthy, he will serve as a nice security blanket for Weeden.

Stotts works as a Certified Athletic Trainer (MAT, ATC, PES, CES) and is a former winner of the Best Fantasy Football Article from the Fantasy Sports Trade Association.

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