Med Check (cont.)

Washington at St. Louis

UPGRADE: Donovan McNabb
DOWNGRADE: Steven Jackson

After a 400-yard passing day, the 'Skins decided that they didn't need to keep McNabb on the injury report. The ankle was never as much of an issue as was made of it. This week, it's a knee that has McNabb a little worried. Trent Williams has done a solid job protecting McNabb while the QB's mobility might have been down slightly. Williams passed all the tests this week, but the Rams are sure to give him a couple more tests with bull rushes and stunts to test his knee's effect on his lateral mobility. Clinton Portis had a bruised wrist last week, hit hard enough that he lost some grip strength. That's a bit odd symptomatically, and reports that he had a stinger match up better with what we saw. He'll play, but he'll likely get something less than a 100 percent workload. The 'Skins D/ST will have a lot of game-time decisions, including LaRon Landry. If Landry is out or limited, Sam Bradford will be looking to take advantage. Unfortunately, all of his tight ends are on the injury report this week, negating that. Landry's problem is a wrist, not his legs, so going over the top isn't an option. With Jackson's knee an issue and playing on turf, that's not much of a sure thing either. Look for the Rams to try to vary things with different looks, but there's really no injury-based advantage to be found for this young squad.

Dallas at Houston

UPGRADE: Jason Witten, Jacoby Jones
DOWNGRADE: Tony Romo
UPDATE (10:30 a.m.): Dez Bryant is going to get his normal looks at wide receiver and on special teams. The ribs "can be protected." Still some risk.

It might look odd up there with the tight end up and the quarterback down, but let me explain. Romo has looked terrible, even with an offensive line that's ranked No. 1 in pass protection. Romo's been taking more heat than his advanced measures would show, leaving me to wonder if the problem isn't the playcalling more than the play. This week will be a real test for both as Mario Williams and the rest of the Texans' aggressive front will be focused on rattling Romo. That quick rush could lead to a "front to back" progression and a lot of quick routes. That's Witten's forte. Witten, seen last week screaming at the medical staff after suffering a concussion, should be thanking them this week. His treatment perhaps made it possible for him to be playing just a week later. (Greg Easterbrook had a great take on concussions this week, including the contrast in how Witten and Stewart Bradley's concussions were handled.) The Texans have two major injuries that will impact them Sunday. Andre Johnson is a game-time decision and listed as questionable, but sources tell me that Johnson's ankle sprain is "manageable" and that he's expected to play. He could be used as a decoy, but expect Jacoby Jones to get the looks that Johnson can't. Owen Daniels is listed as questionable as well, though he's doing this every week as he continues to manage his return from ACL reconstruction. He was on the field for more than 60 plays last week, so it's safe to say he's fully recovered.

San Francisco at Kansas City

UPGRADE: Jamaal Charles
DOWNGRADE: None

The Chiefs -- my surprise pick of '10 -- don't have any significant injuries. They have some players listed, including Tamba Hali, but all starters should play. On the Niners sideline, they'll definitely be without Ted Ginn, but that shouldn't affect much besides special teams. The biggest worry for Mike Singletary is, oddly enough, his middle linebacker, Takeo Spikes. His knee has kept him out of practice, but as a game-time decision, one would think that Singletary has some insight into whether or not Spikes can get the job done. Charles' speed and shiftiness would be a challenge for anyone, let alone on a shaky knee, so we could see a bit more of him and Dexter McCluster this Sunday, whether Spikes plays or not.

Philadelphia at Jacksonville

UPGRADE: Brent Celek
DOWNGRADE: none

There's not much of an injury story for the Eagles, but all eyes are focused on Michael Vick anyway. It's no secret where I stand on this issue, whether from a pro-animal view or an injury standpoint. The Eagles have everyone back, including Kevin Kolb and Bradley, both returning from concussions. The Eagles also have Celek healthy, and we know that Vick likes throwing to the tight end. The Jags have only Maurice Jones-Drew as a significant player on the injury report, but he's been playing through issues so far and looked fine in practice. He's a must-play either way, though he'll need some help from the rest of his team. Luke McCown's season-ending injury forces the Jags to go with David Garrard, like it or not.

Indianapolis at Denver

UPGRADE: Reggie Wayne, Colts D/ST
DOWNGRADE: Kyle Orton
UPDATE (10:30 a.m.); Knowshon Moreno is out (hamstring strain), but Correll Buckhalter isn't a great option despite the start. His back issues remain, and he's unlikely to get a feature load on Sunday. Joseph Addai will get the bigger portion of a 60-40 split with Donald Brown this week. His pass blocking keeps him in the game more.

The Broncos running back situation is tough all around. Knowshon Moreno strained a hamstring in practice, not the one that cost him the preseason. (Is this another example of a player "needing" training camp to get in football shape? Possibly.) Moreno's absence combined with minor injuries to Correll Buckhalter and Laurence Maroney leave Orton exposed, just when Dwight Freeney and Robert Mathis come calling. With Ryan Harris out and Ryan Clady still slowed by his knee injury from the spring, this is a dream scenario for the Colts pass rush. The Colts prepped for an appearance from the "Wildhorse" formation, which may be needed. The Broncos defense is also hurting precisely where they wish it wasn't. Champ Bailey is a game-time decision against Peyton Manning, and his likely matchup with Wayne. Wayne is a must start, whether Bailey goes or not. On the Colts side, injuries to Pierre Garcon and Anthony Gonzalez clear up the wide receiver situation and make Austin Collie a must-play opposite Wayne. He's really the third option behind Dallas Clark, so don't expect blowout numbers. Joseph Addai will play and get his normal carries, though Donald Brown will also get his share of touches.

Oakland at Arizona

UPGRADE: Michael Bush
DOWNGRADE: Larry Fitzgerald

Fitzgerald was a high draft pick, often the first receiver off the board, but so far, he's been this year's biggest disappointment. A knee injury and poor quarterback play have kept his numbers down. Now, he's dealing with a wrist injury as well. Combine that with Steve Breaston's knee issue, the continuing absence of Early Doucet, and you get Fitzgerald isolated by the defense. If Breaston can't go -- and he's a game-time decision -- then the Cards will be forced to go with one of a pair of rookies at the other starting spot. Fitzgerald would be a WR3 or flex option if he was anyone else, but as it is, few have the fantasy depth to bench him. Derek Anderson could be a bad half away from watching Max Hall (who could be a nice waiver wire pick if you have the room and some patience.) Chris Wells will make his season debut after getting back on the practice field this week, but don't expect much more than 10 touches. Across the field, Bush should also make his debut. Bush and Darren McFadden are complementary in style rather than one and two the way Tim Hightower and Wells are. Bush should get the goal-line looks at worst. The Raiders offense hasn't been great, so we'll have to see whether the team tries to protect Bruce Gradkowski with more running than expected.

San Diego at Seattle

UPGRADE: Legedu Naanee, Chargers D/ST
DOWNGRADE: Malcom Floyd

The Chargers offense has some real issues, with Ryan Mathews out and Floyd hobbled by a hamstring. While not officially out, the Chargers have prepped for this week assuming that Mathews would be unavailable. Mike Tolbert just isn't trusted, I'm told, to be a real No. 1 running back and will split the work with Darren Sproles. That isn't to say that Tolbert won't put up similar numbers to last week, just that he won't get 30 touches or much work in the passing game. Floyd's hamstring does have him slowed, and while he'll play, expect Antonio Gates to be the No. 1 option and more looks for Naanee. The Seahawks' only significant issues remain on the line, but they've been adjusting, mostly by using a tight end cover and schemes to protect Matt Hasselbeck. So far, it's worked, but the Chargers have gotten a look at this program and could test it with stunts and overload blitzes.