Week 10 Fantasy Injury Guide: Puka Nacua Hits IR, Mahomes Is Day-to-Day and the Pickups That Matter

Week 10 arrives with one of the longest injury reports of the season, and some of the biggest names on it play for teams that fantasy managers count on every Sunday. The Rams lost their top receiver, the Chiefs are watching their quarterback's throwing elbow, New England's backfield is thin, and Arizona is turning to a rookie under center. Here is what the reporting says, what it means for your lineup, and where the smart pickups are before kickoff.

The biggest blow belongs to Los Angeles. Puka Nacua suffered sprains of the MCL and PCL in his knee, along with turf toe, on the final offensive snap of the Rams' Week 9 win over Washington, ProFootball Talk reported. He was hurt on a 5-yard run on third-and-11, and the team is placing him on injured reserve.

That means Nacua will miss at least the next four games, and PFT reported the earliest he can return is the Dec. 20 game against Dallas. Early reports said the injury was not believed to be season-ending, which is good news for anyone hoping to have him back for the fantasy playoffs.

Nacua was having another strong year, with 70 catches for 715 yards and four touchdowns, and he caught 14 passes for 150 yards in the Washington game alone. Making matters harder for the Rams, Davante Adams is already on injured reserve.

Yahoo Sports listed Konata Mumpfield and TuTu Atwell as the receivers who step into bigger roles, with tight ends Tyler Higbee, Colby Parkinson and Davis Allen also in line for more looks. NBC Sports pointed to Higbee as the most likely remaining target for Matthew Stafford. Yahoo also suggested the Rams may lean more on the running game with Kyren Williams and Blake Corum, and recommended a downgrade for Stafford while Nacua is out. The Rams face Arizona in Week 10.

Abby's advice: Keep Kyren Williams in your lineup with confidence, since a run-heavy plan only helps him. Treat Stafford as a matchup play rather than an every-week starter. If you need a tight end, Higbee is a reasonable short-term stream. Mumpfield is the receiver to watch on the waiver wire, but don't spend big on him until we see how targets shake out.

In Kansas City, Patrick Mahomes left the Week 9 game against the New York Jets with an elbow injury to his throwing arm but returned to finish a 35-12 win, completing 23 of 31 passes for 242 yards and two touchdowns, Yahoo Sports reported. NBC Sports reported that an MRI showed no significant damage and that coach Andy Reid called him day-to-day.

The Chiefs face Atlanta in Week 10. If Mahomes were to sit, Yahoo noted Justin Fields would start, which would mean a downgrade for Rashee Rice and Travis Kelce and a heavier workload for running back Kenneth Walker III.

Abby's advice: Start Mahomes unless the team rules him out. A player who finished the game and came back from an MRI with no significant damage is a player you trust. Watch the practice reports late in the week, and if you roster Fields as a backup, hold him for now.

The Patriots' running back room is the trickiest situation on the board. Rhamondre Stevenson left the Week 9 loss to Green Bay early with a knee injury, and an MRI was scheduled for Monday, according to Yahoo Sports. NBC Sports, citing ESPN's Adam Schefter, reported that Stevenson is expected to miss a short period of time.

TreVeyon Henderson has missed the last two games with an illness after being hospitalized for what Yahoo described as unexplained neurological symptoms. Beyond football, we're keeping him in our prayers and hoping for a full recovery.

If both backs sit, Corey Kiner is the likely lead runner. He carried eight times for 55 yards and a touchdown against Green Bay, though Yahoo noted most of that came on a late drive in a lopsided game. Lan Larison is next in line, and Yahoo noted New England could add a back. The Patriots play Detroit in Germany in Week 10.

Abby's advice: Kiner is a worthwhile pickup and a fair FLEX option if Stevenson is ruled out, but temper expectations. A tough opponent, a new lead back and the possibility of a fresh signing make this a situation to handle with care. If you have a steadier option, use it.

The Cardinals took two hits in their Week 9 loss to Seattle. NBC Sports reported that quarterback Gardner Minshew suffered an elbow injury feared to be a torn UCL and is likely headed to injured reserve, with rookie Carson Beck set to start the rest of the season. Receiver Michael Wilson's season is over because of a neck injury, according to the same report.

NBC Sports noted that Trey McBride becomes the primary target in the passing game. Arizona's first test with Beck comes against the Rams in Week 10.

Abby's advice: McBride remains a must-start tight end. Young quarterbacks tend to lean on a big, reliable target over the middle, and he is exactly that. Minshew and Wilson can be dropped in most leagues. Beck is only a stash for deep two-quarterback formats.

Green Bay: Josh Jacobs fractured a finger in the win over New England and did not return. NBC Sports reported he faces surgery and a possible stay on injured reserve, while Yahoo noted coach Matt LaFleur suggested Jacobs might try to play through it. Kaleb Johnson ran 14 times for 68 yards and a touchdown in his place and is a strong waiver add this week. The Packers face Minnesota in Week 10 before their bye.

Seattle: Sam Darnold is out for Week 10 against the Raiders with quad and rib injuries, according to coach Mike Macdonald, and Drew Lock is expected to start after his oblique tests went well. Lock is a reasonable streaming option in two-quarterback leagues.

Dallas: George Pickens missed Week 9 against Indianapolis with a hamstring injury, and CeeDee Lamb responded with 10 catches for 195 yards and a touchdown. If Pickens can't go against San Francisco, Yahoo suggested Ryan Flournoy as a flex option.

Cleveland: Deshaun Watson returns as the Browns' starter against Houston after missing a week with a concussion. Keep expectations modest. Watson has been sacked a league-high 33 times, and the Texans are tied for the NFL lead with 29 sacks, though Houston ranks 27th against the pass.

Injuries are part of the game, and the managers who win in November are the ones who stay calm, read the reports and react with a plan instead of panic. This week, that plan looks like this: start Mahomes and Kyren Williams with confidence, keep McBride in your lineup, add Kaleb Johnson if he's available, and treat Kiner, Mumpfield and Lock as useful depth rather than must-starts.

Check the final injury reports before your lineups lock, because Friday and Saturday designations can change everything. And if you want another way to enjoy the week, the free Liberty Bell Fantasy games are waiting at /fantasy. Set a lineup, invite a friend or two from church or the office, and enjoy the competition. Nothing to buy, just good fun around the game we love.