Ask Your Fantasy Football Doc: Scott Peak of Dynasty League Football

"Athletes who focus on quad strengthening over hamstring increases risk. Quads overextend if hammies weak."

Don’t ask him to look at your rash. He is Scott Peak, or the Dynasty Doctor at the fine site Dynasty League Football. I was personally offended by two of my studs, Jimmy Graham and Dez Bryant, getting hurt so I wanted to get a few notes from an authentic neurologist.

How did a doc like you end up in a place like DLF? I started playing dynasty formats four years ago. A friend of mine, Pete Benavides, suggested I give dynasty football a try. He recommended DLF as a great resource to learn the format. I started posting in the forums, which I think are very good resources for all players, and added comments to articles posted by DLF writers. Ken Kelly approached me about my interest in writing an article in the Members’ Corner of DLF. My first article was written on concussions in football, posted February 2013. I enjoyed writing that article quite a bit, and DLF offered me a spot on their staff as a writer. Injury analysis seemed to be a natural fit for me. I’m lucky to be part of a great group of writers and dynasty football players at DLF. [Zach note: They’re smarter than us and they’re playing our sport. Good thing most doctors don’t really look like the dudes on Grey’s Anatomy.]

Is a football player getting an epidural injection ever good during the regular season? Can you go into detail regarding why a player would get an epidural (like Dez Bryant) and what it means. Great question. The answer to this question depends on perspective. It’s definitely not good for a player to need an epidural injection, as that suggests back pain that is not responding to conservative measures. If a player gets back pain, such as from a herniated disk or narrowing of the exit point for nerves (neural foramen), irritation of the nerve leads to pain, sometimes quite severe. [Zach note: Like starting Dez Bryant in the week before the bye].

Conservative measures are tried first, like non-steroidal anti-inflammatory medications (aspirin, naprosyn, ibuprofen) and oral steroids. Physical therapy can help, mainly by strengthening muscles on both sides of the spinal column, to improve stability and hence reduce pain. If that doesn’t work, then epidural injections are the next step. An epidural injection is usually a combination of a numbing agent and a steroid. Epidural injections reduce inflammation and pain, helping a player return to play faster. Epidurals usually work relatively quickly, and published data shows players miss 2-3 practices before it kicks in. Pain control is achieved in 90% of patients treated, and it typically lasts 2-3 months. The American Academy of Neurology posted a summary statement on epidural injections, and it is available online for anyone to review. If epidural injections don’t work, then surgery is usually the next step. As for Dez, my best guess is the epidural injection should help him finish off the fantasy season, barring a setback, but whether or not he needs surgery in the off-season remains to be seen. Certainly, single-level disc surgeries are not a career-ender, based on published literature and examples such as Rob Gronkowksi. It’s never desirable for any dynasty asset to have back problems, but I think Dez is still an elite asset in dynasty formats. [Zach note: I think “Hey baby, you’re an elite asset” is another bad pick-up line based on fantasy football.]

Have we ever seen as many close ups on a player’s foot and ankle as Peyton Manning’s last Sunday? Haha! Good one. We did see quite a few shots of Manning’s socks, which was kind of strange. It was interesting to see how high up his lower legs were wrapped. High-ankle sprains involve separation of the lower leg bones, the fibula and tibia, and tearing of ligaments that results in pain. I suspect Manning had his legs wrapped up to mid-shin to help support both the fibula and tibia, and thus reduce pain with contact or movement. But, I don’t think the network needed to show it more than once. Thankfully Manning didn’t have a groin injury, or that would have been extremely weird.

Is there one injury in particular that is relatively common for football players that makes you cringe the most? I still get grossed out when I watch a shot to the knee, like with Marcus Lattimore. There is something about watching a knee bend the wrong way that makes me cringe. I’ve watched Lattimore’s injury several times, and it’s still hard to see his leg twisting in the wind while he’s about to hit the ground. Terrible injury for sure.

Is Jake Locker’s Lisfranc injury a really bad sign in terms of him being an effective scrambler in the future? We can ignore the rest of his injuries for now. Lisfranc injuries can be debilitating, especially given he needs surgery for it, suggesting a more significant and unstable injury. Still, athletes can return to sport after surgery for it. Matt Schaub had a solid year in 2012, one year after his Lisfranc injury, throwing for 4000+ yards, 22 touchdowns and 12 interceptions. [Zach note: That’s right kiddies. There was a time when Matt Schaub didn’t make the entire city of Houston boo.] That is good for his third best year ever. I don’t think this will impact Locker’s mobility that much, although it’s not going to help for sure. Locker is a mobile quarterback, but he’s not exactly Michael Vick in his prime. Locker can get extra yards with his legs, and I doubt this injury will keep him from doing so in the future. Still, whether or not Tennessee will want him as its franchise quarterback is a different story. Locker can’t stay healthy, and this team needs consistent production and leadership from the quarterback position. It will be an exciting off-season in Graceland for sure.

As a Chargers fan, do you have to self-medicate (with beer, naturally) to get through the season? Haha. I’ve watched the Chargers since I was a kid. I remember watching Air Coryell get grounded in the Ice Bowl against Cincinnati in 1982. Wind chill was -37 degrees Fahrenheit. Dan Fouts had icicles on his beard and frostbite after the game. That was depressing. I still believe a Chargers versus Forty Niners Super Bowl would have been epic. As a Chargers fan, I’ve gotten used to failure. Then again, my father was a Chargers fan from Philadelphia, so we got used to abuse and torture. Whether it’s Bobby Beathard wrecking the franchise with crazy trades, Beathard vs Boss Ross, or AJ Smith vs Marty Schottenheimer, the Chargers just can’t seem to get anything right. Watching them choke against the Patriots in 2006 was truly an epic melt down. I still haven’t forgiven Marlon McCree. [Zach note: That was the game in which Tom Brady thew the game-losing interception but Troy Brown forced a fumble.] Still, I’ll always be a Chargers fan. I grew up in San Diego, so Go Bolts!

What are your thoughts on the NFL’s concussion protocol? I know the NFL gets criticized a lot, and some of it is deserved. I do think the concussion protocol is an improvement in safety for players compared to years past. The NFL has to educate players and fans about violence in the game. We root for our team and get angry when a flag is thrown for a helmet-to-helmet hit, or when a face-mask gets tugged, but those penalties exist for player safety. The concussion protocol may not be perfect, but it’s a lot better than sending players back out to play when they can’t think or walk right.

I think safety is paramount, but we also have to realize football is an inherently violent sport. There is only so much that equipment or rules changes can do. In fact, it may surprise many that data exists to show concussions are increasing in frequency, despite advancements made with helmet technology. Studies show leather helmets may actually be LESS frequently associated with concussions compared to modern varsity helmets. Why is that? Varsity helmets are heavier, and this leads to greater neck motion, hence more concussions. Also, strap a leather helmet on Brandon Meriweather, and the next time he leads with his helmet, he won’t do it anymore.

Tackling technique needs to be addressed, and players need to realize their body armor won’t prevent injuries, and could ironically lead to more injuries. In fact, Edgeworth Economics recently conducted a study of NFL injuries, commissioned by the NFLPA and NFLISS (NFL Injury Surveillance System), and injuries are rising compared to 2005, not falling. This data is freely available online.

Helmets do reduce risk of skull fractures and lacerations, so that’s good. Still, when two large men crash into each other wearing body armor, laws of physics cannot be avoided. NFL tackles can generate 50 to 150 units of g-force, and that’s a lot. Simple rules of inertia will be applied as such impacts are passed through the brain housed in a very hard skull. Until someone invents a helmet that can absorb all force, athlete’s brains will continue to get impacted by each hit. This is how Chronic Traumatic Encephalopathy arises, after years of hits and not only concussive but sub-concussive hits. [Zach note: Chronic Traumatic Encephalopathy sounds like a great metal band.] It’s a complicated issue, but we as fans have to understand these players are playing a game that is inherently violent and not good for their health. Players need to realize it as well, and I think many of them admit to it. Lastly, the NFL should do a MUCH better job of providing financial support and health coverage for retired players injured from playing the game we all love.

Is the term “injury prone” a myth or are there players who just aren’t built for the rigors of a serious contact sport? I don’t think it’s a myth, and I believe in it. There is not much research into this interesting issue, but I found some evidence to suggest it is true. There are articles published describing players with certain psychological profiles, mainly risk-takers, who are more likely to be injured. High-foot arches may lead to greater risk of foot injuries. Plenty of data exists to show certain players have a natural “valgus” landing, which is basically when a player jumps, and lands with his/her knees bent inward. This places more stress on the anterior cruciate ligament, and hence increases risk of rupture. It is also the reason why most ACL ruptures are non-contact injuries. Females are more prone to ACL ruptures as well, so injuries may also be gender-based. These are a few examples to show not all athletes bodies are created equally. I try to avoid players with a history of repeated injuries whenever possible. [Zach note: You could have just answered “Darren McFadden”.]

How has Jonathan Stewart broken your heart, and is there any hope of recovery? Oh man, this question is a red-light alert for me. Stewart seems like a nice guy, so I don’t dislike him personally. But, I will never, ever trade for him, acquire him in any capacity, or own him on any future teams. I don’t have any hope for recovery and Stewart is done as a fantasy asset in my opinion. I’m not touching him ever again.

Now that Twitter and the DLF site have outed you as a fantasy medical man, do you get more questions about fantasy players or real-life injuries? Haha. I’ve received a few questions about real-life injuries, mainly from friends on Twitter. I’m happy to help whenever I can, but I can’t provide specific advice for each person, as that wouldn’t be fair or good practice without accessing their medical records. I’ve been on both sides of it, as patients may have friends or family members who mean well, but don’t have the full picture of what’s been going on in the plan of care. That uncertainty makes it hard to provide the best recommendations. Still, I try to provide information whenever possible, to help them understand a medical problem better. By far the majority of questions are related to sports and fantasy football, and I think almost everyone I’ve interacted with online or personally has been most interested in how injuries impact their fantasy football teams.

Is dynasty fantasy football the best brand of fantasy football? That’s an easy yes for me. Fantasy football is lots of fun in all formats, but dynasty is by far the most challenging and most interesting format. Isn’t the purpose of fantasy football supposed to be owning and managing a team, like a real NFL general manager? That’s what dynasty is, owners building a team and watching it grow every year. I still see the value in re-draft leagues, but why build a team then throw players back each year? I’d rather build a team and watch it perform every year. Plus, I want to simulate the NFL experience as closely as possible, and that is what dynasty is all about. Dynasty formats will continue to grow exponentially and eventually will be the dominant form of fantasy football in the near future.

If you have trades still open, are there players that you’re trying to pick up on the cheap to help your team in future years? I love Dwayne Allen and think he could be acquired for a very cheap price. Coby Fleener has been inconsistent and unable to seize control over the tight end position, despite having almost every advantage. He has his former offensive coordinator at Stanford calling plays in Indy, Allen got hurt and Andrew Luck was his college roommate. If Fleener can’t seize the job given such advantages, Allen will take it next year. Travis Kelce is a talented player and can be acquired for almost nothing. I think his microfracture surgery is a bit over-blown, and he could probably be acquired for a late round pick. Take the chance on his talent. Kansas City has nothing ahead of him, and Andy Reid loves his tight ends. [Zach note: And burnt ends, to throw a KC BBQ reference in there.] I still love the talents of Markus Wheaton, and think he could really rise up in Pittsburgh. Soon-to-be free agent Emmanuel Sanders has a potentially serious foot injury, and Wheaton is such an explosive athlete. His owners may be down on him, so swoop in and grab him while he’s still cheap. I also like Jermaine Kearse in Seattle, Michael Floyd in Arizona, Justin Hunter in Tennessee and Ladarius Green in San Diego. In devi leagues, Brett Hundley is my man-crush!

Does your wife/girlfriend/sig other have any issues with your football obsession? She thinks I’m crazy but has gotten used to it. When we were first married, she couldn’t understand why I needed to spend all-day Sunday watching football, but she has adapted well to it. Besides, she gets to go shopping on Sundays, so it’s all about compromise in relationships!

Football or sex: which do you think of more? Definitely sex. No doubt about it. Although, I have thought about football during sex. Does that count?

Where are you on the usual football Sunday? I assume there’s a man cave. In my living room watching football on a 50 inch plasma TV. I have a big sectional sofa with lots of space. I have my laptops in front of me, my iPhone to the side, and my remote ready to flip through games.

Tell me about a hobby/interest outside of football. I love playing sports with my four year old son. We spend lots of time in our backyard, playing basketball, football and tee ball. I watched him shoot a basketball and swish it 15 feet out. He’s got a great arm, too. We were playing in the park recently, and he threw a tight spiral 20 feet away, no joke. Other kids and parents were like, what the heck was that? Very cool. I’ve got him listed as my #1 quarterback prospect ahead of Teddy Bridgewater in devi leagues. I also enjoy writing, and I’ve built a website,, to help provide free content written by experts in neurosurgery, neuro-oncology and radiation oncology for patients with brain and spine tumors.

Which football writers are on your must-read list? I love reading anything written by Matt Waldman, whether it’s on his site at, or the RSP he writes every year. Any fantasy football player has got to purchase the RSP Waldman writes. Great information and lots of learning material. Pro Football Focus has an incredible library of data and information. I like all the writers at Dynasty League Football. Ryan McDowell writes great stuff on developmental players, a must-read for anyone in devi leagues. Chris Brown at is where I go to understand the NFL game better. Lance Zierlein is a must follow on Twitter and I’m always perusing his site,, for great nuggets on the NFL and fantasy football. I love writers who not only understand fantasy football, but the NFL in general, and are willing to share their experiences to help me understand how the game works. Ryan Riddle is a great follow on Twitter. Shane Hallam is incredibly helpful and his site,, is a must for draftniks and dynasty players.

Is there anything I failed to ask that you’d like to address? Let’s reform healthcare but in a logical manner, not in a wasteful, disorganized mess typical of Washington bureaucracy. That’s my soap box.

Tell me about any plugs that you’d like. Sites, podcasts, projects, anything.

DLF Podcast with Jarrett Behar and Tim Stafford is fantastic.

Footballguys’ The Audible Podcast is comprehensive and full of information.

For anyone interested in resources for brain and spine tumor patients, check out my website

I’ll turn and cough for Scott anytime. Check him out on Twitter.

Want to support the site or just like reading about fantasy football experts? Then buy my book There Still Is No Off Season: Interviews 51-100 of the Ask Your Fantasy Football Expert Series. If you want to know more about the experts I interviewed, and what they’re up to lately, check out the experts page.

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