NFL Injury Report, Week 4: Michael Vick, Frank Gore Expected To Play

PHILADELPHIA, PA - SEPTEMBER 25: Michael Vick #7 of the Philadelphia Eagles sits on the sideline with an injured right hand in the fourth quarter against the New York Giants at Lincoln Financial Field on September 25, 2011 in Philadelphia, Pennsylvania. The Giants defeated the Eagles 29-16. (Photo by Chris Trotman/Getty Images)

As Week 4 of the NFL season approaches, SB Nation Medical Expert Dr. Ali Mohamadi discusses some of the most significant injuries impacting this weekend's games and how they might affect your fantasy rosters:

Quarterbacks

Michael Vick, Philadelphia Eagles (hand)
PHI (1-2) vs. SF (2-1), 1pm

It has been a roller-coaster week for Eagles fans and Vick fantasy owners, following the right (non-throwing) hand injury sustained last week in Philadelphia's loss to the New York Giants. After early reports indicated that Vick had likely broken a hand bone, which could have potentially required surgery and a prolonged absence, early this week Head Coach Andy Reid announced that a CT of the hand revealed no fractures, just a deep bone bruise. This type of injury is essentially a step short of a fracture, and occurs when traumatic force on the bone results in shredding of fibers that make up the outside of the bone. A bone bruise can be accompanied by swelling or internal bleeding, and is often extremely painful. This could cause problems with something as simple as the exchange from center, let alone on direct hits to the hand, so don't be surprised if the Eagles line up from the shotgun more than usual to keep Vick as comfortable as possible.

Running Backs

Frank Gore, San Francisco 49ers (ankle)
SF (2-1) @ PHI (1-2), 1pm

Gore aggravated a preexisting right ankle sprain in the 49ers Week 2 win over Cincinnati and was removed in the second half for backup Kendall Hunter. After the game, Gore himself cast doubt over his ability to play in Week 4, and although he has practiced this week his participation has been limited. Given the high risk of re-injury with even mild ankle sprains, don't be surprised if Head Coach Jim Harbaugh puts the ball in Hunter's hands early and often this week against the Eagles.

Steven Jackson, St. Louis Rams (quadriceps)
StL (0-3) vs WAS (2-1), 1pm

After only taking four carries in last week's thrashing at the hands of the Baltimore Ravens, Jackson seems ready to take the majority of carries for the Rams as they seek their first victory of the season against Washington. Jackson, who strained his right quadriceps on his first carry of the season, has been practicing this week, although Head Coach Steve Spagnuolo admits "he's still not full speed." As with any muscle strain, the risk for aggravation is high - especially with Jackson's injury history. But his return to full-time action will be a huge boost for the struggling Rams.

Ryan Grant, Green Bay Packers (bruised kidney)
GB (3-0) vs. DEN (1-2), 4:15pm

Grant, who suffered a bruised kidney in the fourth quarter of the Packers' Week 3 win over Chicago after a hit to the back from Bears' LB Brian Urlacher, has been ruled out of Sunday's game against Denver. The Packers' RB noted blood in the urine while in the locker room after being taken off the field and was taken to a local hospital for precautionary measures.

The kidneys, which are located in the back of the upper abdomen on either side of the spinal column, are protected by the spine, lower rib cage, and strong muscles of the back. The kidneys, which among other roles filter the blood and remove waste by producing urine, are well-protected for a reason -- they have a large blood supply, and injury can lead to severe bleeding. If subjected to a traumatic force, the patient can develop severe abdominal and/or back pain, blood in the urine (hematuria), or may even stop urinating if the injury is severe enough. Treatment is generally conservative, with rest and pain management, but activity cannot resume until the hematuria has resolved and the pain has subsided, which may take up to 2 weeks.

In Grant's absence, RB James Starks, who has been the Packers' primary running threat thus far anyway, will take on an even greater role in the offense.

Beanie Wells, Arizona Cardinals (hamstring)
ARI (1-2) vs NYG (2-1), 4:05pm

Wells strained his hamstring in practice during Week 3 and missed the Cardinals loss at Seattle. Wells has practiced on a limited basis this week, as was the case last week, and although he is listed as questionable on the Cardinals' injury report, he is expected to start on Sunday. After Friday's practice, Wells declared himself ready to go against the Giants, but given the fact that he gave a similar statement at this time last week, and because this is a hamstring injury, even if Wells is able to play against the Giants, there should be considerable concern that the injury could flare up during the game. RB Alfonso Smith will take the carries for Arizona if Wells cannot play.

Wide Receivers

Dez Bryant, Dallas Cowboys (quadriceps)
DAL (2-1) vs. DET (3-0), 1pm

The second-year Cowboys' receiver has been bothered by a quadriceps injury since Week 1 and returned to action last week in the team's victory over Washington after having missed the previous week's game. Bryant missed practice most of this week, including Friday,, and seems once again to be a game-time decision for Sunday's game against Detroit. Injuries to muscles of the upper leg are often nagging ailments that can easily be re-aggravated, and for this reason the week-to-week uncertainty over Bryant's playing status should not come as a surprise. The team's Week 5 bye will serve as a welcome respite for Bryant and his many injured Cowboys teammates.

Marques Colston, New Orleans Saints (clavicle)
NO (2-1) @ JAC (1-2), 1pm

Colston fractured his clavicle (collarbone) in the 4th quarter of the Saints' 42-34 loss to the Green Bay Packers on Thursday, September 8. This type of injury usually requires 4 weeks for a complete recovery, but Colston is listed as questionable on the team's official injury list, and early reports indicate he has a good chance of playing tomorrow. If he is able to return ahead of schedule, two concerns would be 1) whether Colston has complete range of motion of the affected upper extremity and 2) whether movement of that extremity results in any significant pain .If he is able to play, Colston would likely need to wear a protective covering over the injured side, which itself shouldn't significantly impact range of motion

Vincent Jackson, San Diego Chargers (abdomen)
SD (2-1) vs. MIA (0-3), 4:15pm

Jackson, who has been suffering from an abdominal muscle strain, returned to practice for the Chargers yesterday, which was a significant improvement from Thursday, when he missed practice and was considered a legitimate possibility to miss Sunday's game against Miami. Jackson, however, remains listed as questionable on the Chargers' injury report.

The abdominal wall is made up of several muscles. These include the rectus abdominis over the front of the abdomen, and the internal and external obliques, which wrap around the sides of the body. An abdominal muscle strain or pull is an injury to one of these muscles that occurs when it is stretched too far, causing tears to varying degrees. Most commonly, a strain causes microscopic tears within the muscle, but occassionally, in severe injuries, the muscle can rupture from its attachment. In the majority of cases, rest is the hallmark of treatment, but the time to recovery can last from days to weeks depending on the severity of the injury. By all accounts, Jackson's was mild enough to at least give him a reasonable chance of taking the field tomorrow.

Tight Ends

Antonio Gates, San Diego Chargers (foot)
SD (2-1) vs. MIA (0-3), 4:15pm

Gates missed Week 3's victory over Kansas City and hasn't practiced at all this week after reaggravating the right foot injury that has plagued him since the 2010 season. Gates tore the plantar fascia of the foot early in the 2010 season but played through the injury into December. After seemingly having healed in the offseason, by report in Week 2 Gates tore some of the scar tissue that had developed at the site of the original injury, causing him significant pain.

The plantar fascia is a band of fibrous tissue that begins at the inside of the heel and runs along the bottom of the foot up to the toes. The plantar fascia supports the foot and flexes with movement, giving stability when walking and ensuring there is proper heel-toe contact with the ground. Injuries such as Gates's can cause severe pain upon placing the heel on the ground, often preventing normal walking. Treatment includes rest, elevation, and anti-inflammatory medications and can take weeks to heal. As Gates proved last season, it is possible to play through the injury, but this is no easy feat. There is no clear timetable for the All-Pro TE's return to action, which would seem unlikely to occur this week.

Defensive Ends

Mario Williams, Houston Texans (knee)
HOU (2-1) vs. PIT (2-1), 1pm

Williams hyperextended his right knee in the third quarter of the Texans' Week 3 loss to New Orleans and has been limited in practice this week. Williams's knee was injured when teammate Antonio Smith fell on his right leg, and the Texans' OLB limped off the field and left the game briefly before returning to action. With ligament damage having been ruled out, Williams's greatest challenge is dealing with the swelling and pain associated with a hyperextended joint, which is unlikely to keep him from taking the field against the Steelers but could potentially limit his playing time.

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