Buffalo Bills RB injury update

Fred Jackson sprained his left MCL in Week 4 but managed to play in the Buffalo Bills' following contest against the Cleveland Browns just four days later. Last Sunday, Jackson looked to be in great discomfort at several points during the game after aggravating the injury, but he managed to get through it.

It really should come as no surprise that Jackson was given Wednesday off to rest his knee. He was back at practice Thursday and appears on track for the game against New Orleans this week. The expectation is that Jackson will play Sunday, just as he has every week this season.

The bigger question has to do with Jackson’s counterpart, C.J. Spiller, the running back most projected to have the larger role in the Bills’ running game this year. Instead, injury has limited Spiller’s ability to be productive, and now his coach is wondering aloud whether Spiller should indeed take a breather. Spiller has said for some time that he expected to be dealing with soreness in his ankle up until the bye week (Week 12) but has maintained that his ankle continues to improve in the interim.

His performance would suggest otherwise, likely prompting coach Doug Marrone to consider whether the best thing might be to hold Spiller out for a week (or more). As it is, Spiller did not practice Wednesday and was limited to just individual drills Thursday.

This is always the challenge with in-season injuries. The broken legs are obvious, as are the torn ACLs; certain injuries force an absence. Virtually everything else becomes a matter of how well the player can function while not compromising his long-term health. Compromising health usually refers to the risk of exacerbating an injury to the point where it might cost a player multiple weeks. (Obviously if there were a risk of serious bodily harm by playing, the decision to sit the player is a no-brainer.) Some injuries are described as the type that “can’t be made worse.” Even if the particular structure involved is not likely to deteriorate further or the stability of the joint is not threatened, there is always a risk that an injured player trying to press through pain, weakness or restricted motion will compensate in some way that results in another injury.

But if every player with an ailment were forced to sit until that particular problem was 100 percent healed, there would not be enough players to field a team. Any team. If one were to survey all 32 teams and remove every player dealing with some sort of ailment from the equation, there would likely be fewer on the field than on the sideline, especially at this point of the season.

That brings the discussion around to performance. A player may be feeling better, noting improvement in his range of motion and strength or in more subtle areas like quickness and agility, but he still may not be playing to the level that allows him to be who he is when healthy. Spiller appears to be that guy right now. He can be believed when he says he’s “10 times better” this week, because he no doubt can see -- and feel -- subtle improvements.

But those improvements may not be enough to translate to visible changes in game situations. Consequently, Marrone is also to be believed when he says he sees that Spiller’s ankle is “probably not as well” this week as last. As ESPN.com’s Mike Rodak notes, Spiller even seems to acknowledge that playing each week is likely slowing the overall healing process. That doesn’t mean he agrees with his coach’s assessment.

It is clear Spiller wants to continue to play. But when Marrone says, “We need to make a good decision this week,” it certainly hints at the possibility that Spiller will not get his wish.