Inglewood, CA, Sunday, Sept. 10, 2023 - Los Angeles Chargers running back Austin Ekeler (30) on the sideline before a game against the Miami Dolphins at SoFi Stadium.
Robert Gauthier/Los Angeles Times via Getty Images

Injuries to Watch in NFL Week 4

The latest on players dealing with injuries for Week 4, including Colts quarterback Anthony Richardson and two 49ers wide receivers.

If it feels like injuries are up, you're right. Sometimes the perception of injuries is worse if it's a big player. More people know Aaron Rodgers than a David Bakhtiari. Glamour positions just get noticed more. Overall, the injuries are only up slightly, there's no real pattern to suggest something is drastically wrong, and they're following the general pattern of the last couple years. Putting in significant changes during the pandemic really hid results, but 2022 was relatively normal. We're seeing injuries stay in line, but happen later and more consistently through the season than being front-loaded. In other words, buckle in because this is going to keep happening. Let's take a look around the league:

NICK CHUBB, RB CLE (sprained knee)

TLDR: Nick Chubb got good news, but won't be back this year.

The issue with Nick Chubb comes down to one misused, overused word: torn. Look, every sprain is a tear. A sprain is simply the medical term for an injury to a ligament. Sprains are graded one to three in terms of significance. A three is a full or near-full tearing of the ligament. If it is full, the proper term is a rupture. Many people use the colloquial term "tear" in place of "rupture, because "I can tear the piece of paper in half" is proper usage, but not precise in medical terms.

Chubb ruptured his MCL, but had a Grade II sprain of his ACL. There was lesser damage to other ligaments.  When he has surgery, the surgeon will determine whether or not the ACL needs to be reconstructed. The additional damage is less significant, because he had so much damage when he had his more significant knee injury in college. Regardless, the damage he does have will keep him out the rest of the year, but the rehab and expectations for the future are positive.

DEEBO SAMUEL, WR SF (bruised ribs)
BRANDON AIYUK, WR SF (strained shoulder)

Brock Purdy is fine, but his receivers have some issues. Brandon Aiyuk is still dealing with a shoulder issue that's clearly going to be managed rather than fixed, but Deebo Samuel's injury is a bigger issue. Samuel came out of last week's game with sore ribs, not uncommon, but a knee listing mid-week created more confusion. By the end of the week, it was back to just ribs, so ... typo? Something really transient? That's an unknown. Samuel will likely wear additional protection, but rib injuries come down to safety - are they structurally sound enough to hold up? - and pain tolerance.

Brandon Aiyuk is expected to play with the Niners' medical staff working to maintain the shoulder and keep him functional. They can't brace it so much that he can't use his arms. One armed catches look cool, but wouldn't work outside the highlight reel. It comes down to finding a treatment plan and some sort of bracing or strapping that helps, as well as some pain tolerance on Aiyuk's part.

AUSTIN EKELER, RB LAC (high ankle sprain)

Fantasy darling Austin Ekeler is doubtful for this week, but you can put those doubts away. He'll miss his third game with a sprained high ankle, though his limited practices give some positive vibes for a Week 5 return. By Thursday, it was clear that Ekeler simply couldn't cut on the ankle. It's better, but not where it needs to be for him to be productive. I'm told both days were tests, both of the ankle's function and some bracing that the Chargers were trying to see if they could get him back.

Next week's practices will be much the same, with two more weeks (Week 5 is the Chargers' bye) of treatment and healing that should be enough to push him back into the lineup. Once he's back, Joshua Kelley should slide back to his normal role, but that first week back is often on a play count and carries a recurrence risk. The bye should eliminate that and the hope is that Ekeler can stay healthy, giving the Chargers a big boost offensively.


After missing a week, Anthony Richardson is in the last step of the concussion protocol. He practiced fully on Thursday and past the final step on Friday. While HC Shane Steichen hasn't said that Richardson goes right back to his starting role despite a solid performance by Gardner Minshew, that's what's coming. The downside for Richardson is that Ryan Kelly didn't pass the test, Bradon Smith missed all week with a wrist issue, and Quentin Nelson is struggling with turf toe. Three of his offensive linemen out isn't good for a running QB going up against Aaron Donald. (There's late indications Smith could play, but still.)

While Richardson should, like most people that have a concussion, make a full recovery and not have any deficits now, that's not to say there won't be concern with a second concussion. We saw that last year with Tua Tagovailoa and with this year's concussion weirdness - Jimmy Garropolo went back to practicing despite a reported concussion and Justin Fields was never put in it despite being so wobbly on field that his best receiver pulled him off - who knows what might happen. Richardson needs to learn to take less big hits, though the idea that mobile QBs have more injuries was disproven. (Just read The Science of Football!)

*Teams have a tendency to test on Friday for the final step of the protocol. It's not because that's when the independent neurologist comes by, but because of the re-test rule. If a player were to fail, he can't be retested by the IDC for 48 hours. If a player failed on Saturday, he'd be out for Sunday.

DAVID CARR, QB NO (sprained shoulder)

David Carr has an acromioclavicular sprain. The AC joint - you can see why it's often abbreviated - is a small joint between the clavicle (collarbone) and the shoulder joint (specifically, theacromion process). The strong ligament between those is overstressed and tears, hence a sprain. This is often referred to as a separated shoulder, but on a lower grade sprain, there's no actual separation in the space, just ligament damage.

This common QB injury is the result of two things: the defenders and the lack of protective gear. Sure, there are shoulder pads, but there's no support in the lateral plane. Shoulder pads were designed for a game where players put their head down and used their shoulders as plows. You can look at pictures from Knute Rockne to Earl Campbell to understand how they worked. (Seriously, just look at the size of the pads on Campbell!) For a QB, that's nice, but it really offers no protection when they're thrown down, spun down, or when a player falls on top of him, driving the shoulder to ground. Something has to give - the joint or a bone. This same mechanism often leads to a broken clavicle, such as Tony Romo or Aaron Rodgers in the recent past.

A QB can't have a big iron bar over the back of his shoulders. Short of Tony Stark loaning his suit to some one, there's really nothing available or on the horizon. While QBs do get special protection by rule, it's these seemingly simple tackles and hits that they do take that show why. For someone like Carr, he'll miss a couple weeks if the Grade II sprain heals well and he gets back to function, ie throwing the ball well.

DESHAUN WATSON, QB CLE (sprained shoulder)

News is less positive for DeShaun Watson. Sore shoulders are the result of a couple things in most cases and often in combination: throwing and hits. QBs aren't like baseball pitchers, who can injure themselves with high pitch counts. The biomechanics of a football throw are different, and the ball is heavier. There's still some stress, especially if there's an underlying issue that they're playing through, and data does show that there's some apparent fatigue in late game, showing up as slower throws. (It also suggests last play hail mary's should be the most stressful, but I can't think of an instance where a QB has been injured on one!)

DeShaun Watson has an AC sprain, just as Carr does, but it's lower grade. He can throw, but it's uncomfortable and perhaps even a bit unstable. Watson showed he can make short passes, but a defense like the Ravens will figure out quickly if he can't make the deep passes. Dorian Thompson-Robinson was good enough in camp for the Browns to trade away Joshua Dobbs, but if he's forced to start, it's a huge downgrade for an offense that is still trying to find consistency and even an identity early in the season. A final decision on Watson should come early Sunday, but even if he plays, expect some limitations and even some issues in the late part of halves.


It happened again. Twice. After last week's issue with Anthony Richardson, the NFL finds itself with two more instances, one happening on national TV. It was clear that Justin Fields had taken a big hit and was wobbly, so clear that his teammate took him off the field. Even Taylor Swift probably saw it. (Yes, we're all required to mention her in every story now.) Fields went to the tent, was there for a very short time, and returned to the game. There was no explanation and admittedly, Fields seemed fine after the game. The rules of the NFL — which you can read for yourself — indicate that ataxia alone is a disqualifying condition if observed. Fields will play against a Broncos defense that just got historically torn up, so he's risky in every sense.

With Jimmy Garropolo, he's in the concussion protocol after self-reporting symptoms after the game. I am told there were clear signs then, but that video review didn't point to one big hit nor did he seem to have any problems in game. That can happen, but Garropolo is in the concussion protocol now. He practiced two days and could clear the final step of the concussion protocol ahead of Sunday's game. If so, he's a normal play with a very good matchup on Sunday.

Let's just say the concussion system didn't cover itself in glory this week and that they should go back and read the article Matt Lombardo and I wrote just last week.

MAXX CROSBY, DE LV (inflamed knee)

The Raiders pass rush is in a bit of a mess. Max Crosby has a knee injury, while Malcolm Koonce - forced to step in when Chandler Jones went off the reservation - has a groin strain and will be limited if he plays. Facing the Chargers and Justin Herbert, we could see a big downgrade of the pass rush the Raiders will need to slow a battered but explosive offense.

Crosby's knee injury is a bit of an unknown. He made it through Week 3's game and there's no specifics. That usually means that it's inflammation and perhaps something of a maintenance issue. Crosby did practice fully on Friday, a positive sign, and while my sources couldn't give me detail on what the injury is, they do think the Raiders will let Crosby convince them to let him play with a good Sunday workout before the game. If Crosby is out, the over and Herbert props get pretty good, but will shift quickly with the news.

Bumps and Bruises:

Joe Burrow and the Bengals took a risk with his strained calf last week. The hope is a week of treatment has him closer to what we expect from Burrow, but it's still very risky ... Saquon Barkley is said to be a GTD ahead of the Monday night game, but high ankle sprains often take longer, especially for someone that has the push Barkley needs to be useful. I'm wary here ... There's whispers that Jonathan Taylor will pass his physical and be ready to practice with the Colts come Monday. I can't speak to the second part, but I can tell you that two sources told me the first part isn't nearly so simple ... Expect Miles Sanders to play Sunday, but be on something of a play count due to his groin strain ... Bryce Young will be back for the Panthers as well after missing last week with an ankle sprain ... Odell Beckham was ruled out early for the Ravens, as his ankle sprain made little progress. Rashod Bateman is also out, so Nelson Agholor becomes a real option ... Joey Bosa is expected to play, but on a play count much like last week ... There was surprising positivity for Cooper Kupp late this week. The Rams medical staff and Sean McVey both seemed far more upbeat late in the week, per sources. Kupp could come back in Week 5, but was expected to take longer ... David Bakhtiari went on IR and had a scope done of his knee. We don't often see exploratory surgery anymore, but this was a clean up to get rid of symptoms ahead of a bigger, as yet unknown to us surgery coming. His season is over ... Treylon Burks is out for Week 4, but the previous two weeks, his snap count was already below that of Nick Westbrook-Ikhine. Emergence alert! ... Jaelan Phillips will miss Sunday with an oblique strain. That's more a baseball injury than football, but it can take weeks to heal ... DeForest Buckner is a true GTD for the Colts. Expect him to be limited if he does play at all ... Seems a bad week to have a name starting with "B". Good luck out there.

MORE: NFL's Solution to Detecting Concussions Already Exists, They're Just Not Using It