NFL Week 10 Start/Sit: Kaleb Johnson, Tyler Shough and Harold Fannin Jr. Are Starts as Puka Nacua Heads to IR

Week 10 lineup decisions start with an injury that changed the Rams' offense. Head coach Sean McVay said Monday that Puka Nacua has sprains of the MCL and PCL in his knee plus turf toe, and on Wednesday he said the Rams will keep Nacua off injured reserve even though he is expected to miss significant time. In Green Bay, Josh Jacobs fractured the ring finger on his right hand at New England and needs surgery, which rules him out of Sunday's game against Minnesota.

Add the Bears, Eagles, Buccaneers and Broncos byes and managers have holes to fill at every position. Below are the Week 10 starts, sits and sleepers by position. Each one is tied to a confirmed role change, a matchup or a quarterback situation.

The injury calls that set the week

These are the situations that drive the most lineup decisions. Statuses are as reported through Wednesday. Thursday and Friday practice reports will settle the rest.

Quarterbacks

Start: Tyler Shough, Saints, vs. Carolina. Shough threw for 265 yards and ran for 51 more in Sunday's 23-22 overtime win over Cleveland, and he won it with a 15-yard touchdown pass to Juwan Johnson on the first overtime possession. That rushing floor makes him a strong bye-week replacement for Caleb Williams, Bo Nix or Baker Mayfield managers. Carolina gave up 27 and 43 points in the two games before Week 9.

Start: Patrick Mahomes, Chiefs, at Atlanta. The elbow is worth watching, but Andy Reid called the injury minor and Mahomes never left the Jets game. Atlanta just let Joe Burrow complete 24 of 29 passes for 271 yards and three touchdowns in Madrid, and the Falcons then traded safety Jessie Bates III to Jacksonville. New slot receiver Josh Downs gives Mahomes another reliable target over the middle.

Sit: Fernando Mendoza, Raiders, vs. Seattle. The No. 1 overall pick makes his first career start after the Kirk Cousins trade, and he faces one of the league's best defenses. Seattle just held Arizona to three points. Mendoza should be on benches in one-quarterback leagues. In superflex he is a last resort.

Sit: Drew Lock, Seahawks, at Las Vegas. Coach Mike Macdonald said Lock's oblique is manageable, and he will start again while Darnold heals. Field Level Media reported Lock is also dealing with an elbow issue. He is playable in 2QB formats but not as a QB1 replacement.

Running backs

Start: Kaleb Johnson, Packers, vs. Minnesota. Johnson ran 14 times for 68 yards and a touchdown after Jacobs went down. With Jacobs out, Johnson is a confident RB2 behind a Green Bay offense that scored 45 points in Week 9.

Start: Jaylen Warren, Steelers, at Cincinnati. Warren ran for a career-high-tying 143 yards and a touchdown in the 27-6 win over Cleveland before the bye, and he ran 17 times for 127 yards against the Bengals in Week 3. He is an RB2 with upside on Sunday night.

Flex: Audric Estime, Saints, vs. Carolina. Estime handled a team-high 15 carries for 72 yards and a touchdown against the Browns, according to waiver trackers. Alvin Kamara had only six carries. In this matchup, the early-down role is worth a flex spot in deeper leagues.

Sit: Ashton Jeanty, Raiders, vs. Seattle. His role has reportedly been shrinking in favor of Mike Washington Jr. Now a rookie quarterback is starting and the Raiders are likely to trail. Jeanty is a low-end flex at best. Also sit Omarion Hampton, Chargers, at Baltimore. Hampton ran 13 times for 60 yards and was not targeted in the 44-22 loss to Houston. Keaton Mitchell and Kimani Vidal took seven carries apiece. With that three-way split, and a quarterback question on top of it, he is a sit in standard leagues.

Wide receivers

Start: Keenan Allen, 49ers, at Dallas. Kyle Shanahan said he did not expect Mike Evans (Achilles tendinitis) back this week, and Deebo Samuel is still working back from a hamstring strain. Allen arrives as a reliable third-down option for Brock Purdy. He is a WR3 if Samuel sits and a flex if he plays.

Start: Josh Downs, Chiefs, at Atlanta. Downs gets a full upgrade at quarterback after posting 33 catches for 354 yards in nine games with the Colts. He has only three practices with his new team, so treat him as a PPR flex this week. His ceiling should rise from Week 11 on.

Sleeper: Tank Dell, Texans, at Cleveland. Dell scored one of C.J. Stroud's five touchdown passes against the Chargers and has the steadier role of the Texans' secondary receivers. He is a WR3 option with Week 10 byes thinning the position.

Sit: Xavier Worthy, Chiefs. Worthy missed Week 9 with a hamstring injury. Downs is now in the slot, and a less-than-full-speed Worthy loses the deep shots that drive his value. Wait for a clean practice week before you start him.

Tight ends

Start: Harold Fannin Jr., Browns, vs. Houston. With Watson expected back, Fannin's ceiling returns. He caught 10 passes for 154 yards from Watson in Week 8 against Pittsburgh, then scored a 39-yard overtime touchdown with Shedeur Sanders in Week 9. He is a TE1 this week.

Start: Pat Freiermuth, Steelers, at Cincinnati. RotoBaller reported that through Week 8 the Bengals had allowed 88.7 receiving yards per game to tight ends, one of the worst marks in the league. Freiermuth is the best fill-in for Colston Loveland or Cade Otton managers.

Stream: Juwan Johnson, Saints, vs. Carolina. He caught the game-winning touchdown in overtime, and Shough is looking his way in the red zone. Darren Waller on the other side of the game is also streamable after his eight-catch, 90-yard, one-touchdown game against Denver.

The Verdexed angle

Most of this week's calls come down to quarterback changes. Watson's return lifts Fannin, Mendoza's debut weakens every Raiders pass catcher except Brock Bowers, and Mahomes' elbow sits underneath the Downs, Rashee Rice and Travis Kelce decisions. When a starter is uncertain, start players whose value holds up with either quarterback. Running backs with goal-line roles and tight ends who draw short targets are the safest choices.

Game environment matters too. Team totals tell you where touchdowns are likely, and the 49ers at Cowboys and Bills at Jets games have some of Sunday's highest totals. For the model's view of every Week 10 game, see the weekly picks board and the game pages at NFL predictions.

What's next

Friday's injury designations will settle Samuel and confirm Mahomes. Remember that the Patriots and Lions kick off in Munich at 9:30 a.m. ET, so players in that game lock before the 1 p.m. inactives come out. With Jacobs out, Johnson belongs in your RB2 spot. If Herbert is limited all week, keep Chargers pass catchers out of your Monday night plans and target the Ravens defense instead.