Every year, injuries play a part in determining fantasy championships in every sort of league, whether it is a neighborhood "trophy league" or a big money contest like the National Fantasy Football Championship. In order to make good decisions regarding players and their injuries during both the draft and in-season, it is necessary to have a grasp of the different sorts of injuries that regularly occur among the NFL players during any given year.

There is a huge variety of possible injuries, from very minor ones like bruises, to a catastrophic paralyzing or fatal injury like a broken neck. One could have enough space to write a textbook on injuries and still not cover every specific sports injury. Therefore, the article that follows has been arranged by grouping similar sorts of injuries - then, examples of current, fantasy-relevant players who are rehabilitating such injuries are presented. Not every NFL player who was injured during 2004 is listed - instead, the aim is to provide the reader with the tools to evaluate players' injuries - present and future.

Concussions

One of the most common injuries suffered in the NFL is the concussion. Football is a collision sport, and sometimes a player's head gets slammed into the turf (or another player's helmet) hard enough to traumatize his brain. The aftereffects of concussions include problems like nausea, dizziness, and memory loss - repeated concussions can lead to brain damage. A big red flag should be raised in your mind by players with a history of multiple concussions - Wayne Chrebet of the Jets is one example. Sometimes players are forced into retirement due to a susceptibility to concussions. Steve Young of 49ers fame was one such player forced from the league by concussions.

Neck/Spinal Column Injuries

Neck and spinal column injuries (pinched nerves (stingers/burners), bulging disks or herniated disks in the spine) are injuries that can cause a player ongoing problems. Stingers/burners tend to recur, and can lead to numbness in a player's extremities (which will often sideline a player). Damage to the disks (the flat, gelatinous cushions between back/neck bones that allow the spine to flex) is painful and can be dangerous, sometimes costing a player his season. Last season Robert Ferguson was knocked out of the Packers' lineup in December due to a head/neck injury resulting in a temporary loss of sensation in his lower extremities. The injury was a severe strain of the neck - he's said to be fine now, after corrective Lasik surgery eliminated lingering headaches. DE Brady Smith of the Falcons was recently knocked out of the lineup for training camp and possibly part of the regular season after a neck surgery to correct persistent pain (the procedure was described as a cervical-region, nerve-root decompression procedure).

Broken Bones

Some broken bones can be played through (the Jets' Laveranues Coles plays on a broken big toe because doctors have told him corrective surgery could end his career). Many players play through stress fractures, which are a small crack in a bone. However, other breaks cost players their seasons (Panther Steve Smith missed last season due to breaking a leg in game 1 of the season - he's said to be ready for training camp). The key is to determine how serious and complex a particular break is - if a player needs surgery with plates/pins inserted to stabilize the broken bone, he's likely to miss a lot of time. Another factor is whether the break's location is critical to his position (defensive backs and linemen can sometimes play with a cast on their hand, for example, while wide receivers can't).

Ligament/Tendon Injuries

Ligaments and tendons are known collectively as connective tissues; they hold skeletons together and the muscles to the skeleton. Ligaments are tough bands of tissue that connect bones together. When you hear someone report that their elbow or knee is "sprained" or"strained" they mean that the connective tissues have been stretched, which causes discomfort and swelling in the joint. A common injury is dislocation of the knee cap, which may cause tears in the ligaments attaching the kneecap to the leg, and may also generate "loose bodies" - chips of bone and cartilage - that irritate the joint and cause pain and swelling. The commonly heard term "arthroscopic procedure" refers to a surgery to remove loose bodies which relieves the pain and swelling. Players usually return fairly quickly after a joint is "scoped", as long as there are no complications.

Turning specifically to the knee joint, there are 4 ligaments in the knee. The anterior cruciate (ACL) and the posterior cruciate (PCL) are in the middle of the knee and provide stability to the joint, while the medial collateral ligament (MCL) is a broad ligament on the inner knee and the lateral collateral ligament (LCL) is the ligament on the outer part of the knee. ACL tears are generally the worst news, and need surgical repair and a long rehab - some players say it takes up to two years to get back to full speed. Chicago's QB Rex Grossman is returning to action in 2005 after missing most of 2004 with an ACL tear. Tears of the other ligaments sometimes require rest and braces to heal; other times they require surgery - Jacksonville's Fred Taylor is recovering from MCL and PCL tears that were surgically repaired earlier in 2005. (The elbow has its own set of ligaments that are subject to similar injuries, but they don't occur as often as knee injuries, since the legs bear the body's weight).

Looking at the shoulder, this joint has four muscles and their tendons which connect to the arm-bone/collarbone. The term "rotator cuff" applies to the set of muscles and tendons surrounding the shoulder. A tear of the rotator cuff means that one (or more) of the tendons has partially or completely separated from the bones or that the muscles have torn, or both - this can be cured by as little as a few weeks of rest or may require surgery and a long recovery. There are also ligaments in the shoulder which hold the bone in the socket. When someone has a dislocated shoulder, it means that the bone has squeezed out past the ligaments/socket, and needs to be popped back into the socket. Because the shoulder has a wide range of motion, the ligaments are stretchy - a dislocated shoulder does not automatically mean that the ligaments have been torn. However, if torn, the ligaments tear at the labrum, and have to be reattached. The Jets' Chad Pennington is a player who is recovering from surgery to repair a torn rotator cuff - he only recently began light throwing exercises, but the team hopes to have him back in time for training camp.

Another injury that can occur in the shoulder is separation of the A/C joint (where the collar bone meets the shoulder), which causes weakness in the joint (Atlanta's Michael Vick has had problems with his A/C joint in years past) and problems elevating the arm. The collarbone can also be fractured like any other bone (Detroit's Charles Rogers is recovering from his second, season-ending broken collarbone coming into the 2005 season).

A familiar ligament injury in football is the sprained ankle. Occurring when the foot is "rolled over" - bent beyond its natural range of motion - one or more of the many ligaments in or around the ankle are over-stretched or torn. Once a player suffers a sprained ankle, they are more likely to occur again. Many NFL players sprain their ankles during a typical season - recovery time can range from a week to months, depending on the severity of the sprain/tear.

A high ankle sprain is a sprain/tear of the large ligament above the ankle that holds the two bones of the lower leg together. There are numerous examples of high ankle sprains suffered during 2004 - New Orleans' Deuce McAllister is one. Recovery time from this injury is usually longer than for a simple sprained ankle (depending on whether the person needs to wear a boot or cast immobilizing the injury (usually about 6 weeks) or if they need a screw inserted to stabilize the tendon (3-4 months)), but varies depending on the sprain's severity, how fast a player heals, and the player's pain tolerance.

An uncommon foot injury which can keep a player from placing any weight on the injured foot is the Lisfranc sprain, which is an over-stretching or tearing of a ligament in the foot. The injury can range from a mild sprain, treated by rest, to fracture-dislocations that require surgery and a long recovery.

Hernias

Hernias are an injury of the groin. In severe cases, the abdominal muscles tear and the internal organs (intestines) exude out through the tear, which can cause intense pain. A serious hernia needs to be surgically repaired immediately, while less serious hernias (when the intestine can be pushed back into the body) aren't emergencies but will still require surgery to repair. Any hernia surgery would likely to cost a player most or all of a season.

Sports hernias are a chronically painful muscle tear in the area next to the pubic bone, and the buildup of scar tissue due to the injury can cause persistent pain if the player continues to practice/play in games. Rest can correct the condition, but as soon as heavy activity resumes, the pain usually returns. Treatment with medication or other procedures can help a player play despite the pain. Eventually, surgery will probably be required to repair the condition, with a recovery period measured in months. The Bengals' RB Chris Perry has struggled to make it onto the field due to a persistent problem with a sports hernia.

Pulled Muscles/Hamstrings

Another common injury in the NFL is the pulled hamstring. The hamstring is actually a group of muscles that run from the back of the thigh to the shinbone, and function to make your knees flex/straighten while running. The injury is a tear of the muscle, ranging from a microscopic tear (Grade I, least serious) all the way to a rupture of one or some of the muscles (Grade III, most serious). Symptoms include bruising, swelling, muscle spasms or an inability to contract the muscles. A player afflicted with a grade III tear or rupture may be unable to use his leg at all. Last year, Oakland's Randy Moss had a troubling (but not Grade III) hamstring pull that kept him out of several games.

Other muscles are subject to tearing/rupturing - biceps, triceps and pectoral muscles are often torn by offensive and defensive linemen. Sometimes the tendon that attaches a muscle to bone is torn free - these sorts of serious muscle injuries will often require surgery to correct.

Meniscus Injuries

The meniscus is a plate-like slab of gelatinous cartilage that cushions the knee(there are two in each knee, actually), keeping the bones from banging together. If the meniscus is torn or ruptured, "loose bodies" - bits of cartilage and/or bone chips - can irritate the knee joint causing swelling, pain, or even "locking up" the knee. Arthroscopic surgery removes the loose tissue from the knee, reducing swelling and pain. St. Louis' Marshall Faulk suffered from "loose bodies" in his knees during 2004, and may be subject to the problem again if his meniscus continues to degenerate.

Conclusion

There is a reason that depth and good waiver-wire transactions are crucial to winning fantasy championships - injuries occur in the NFL often enough that you are sure to need more than just your starting lineup in the course of the season to win your league.

A few years back, Footballguy Doug Drinen undertook a statistical study of NFL players (those who had a reasonable fantasy value - only players who played at least 8 games and averaged at least 6 fantasy points per game were included in the study) during 1988-1998 (go here to read his whole analysis) giving us a statistical picture about the reality of injuries in the NFL. Running backs that played 16 games in one year have about a 50% chance to repeat that feat the next year - if they do not play in 16 games, they should, statistically speaking, manage about 14. Previously injured running backs have only a 30-35% chance to play a full 16 game schedule, and can be expected to play in 12-13 games. Results for WRs and QBs are included in the table below (there was some potential downwards skewing in the QB data, thus the question marks).

Clearly, it is critical to have solid backups on your fantasy roster, and to know when an injury is going to cost a starter playing time. Many experienced fantasy football owners draft the backups to their top draft picks as injury insurance, depending on their particular league's roster size and rules.

One thing is almost certain - at some point during 2005, your team will suffer a key player injury. Being prepared to fill the gap with another solid player will increase your chances of taking home the league trophy. On the other hand, failing to actively manage your roster of backup players (or missing out on a hot waiver-wire pickup due to some other owner's injury woes) could very well knock your club out of contention.