The Los Angeles Rams’ long injury list begins with the impending placement of receiver Puka Nacua on the injured list and continues thereafter.

Nacua has a sprained PCL, head coach Sean McVay said Monday. He will miss at least four games as he recovers. McVay added that the current injury is an aggravation of an injury Nacua suffered during a joint practice against the Chargers during training camp (he said Nacua hit a bursa in his knee), which caused the star second-year receiver to miss several weeks this summer.

McVay initially said Nacua was a “likely” candidate for injured reserve, before clarifying that “he’s going to IR.”

Nacua left Sunday night’s 26-20 overtime loss in Detroit in the second quarter after falling to his knee. He was evaluated by medical personnel in the blue tent on the sideline and then attempted to return to the game but was eventually taken out before halftime. He did not return. Nacua was the Rams’ leading receiver in 2023, breaking the rookie receiving record with 105 catches for 1,486 yards and six touchdowns.

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Tyler Johnson and Jordan Whittington have supported Nacua during training camp and the preseason, and did so again Sunday night. Fourth-year receiver Tutu Atwell also could see more snaps.

The Rams will also be without starting interior offensive lineman Steve Avila for at least four games as Avila recovers from a sprained MCL. Avila is also a candidate for injured reserve, McVay said (teams are only allowed eight “return” designations). Avila didn’t miss a snap in his rookie season as a starter in 2023 and has been proud of it. He attempted to return to the field Sunday night after suffering the injury, McVay said, and medical staff had to pull him out.

Rookie center Beaux Limmer will assume the permanent starting role after being inserted as a substitute following Avila’s injury and the subsequent move of starting center Jonah Jackson to left guard.

“I thought (Limmer) did a great job, he responded to the bell every time he had the opportunity,” McVay said.

The Rams signed Jackson to a three-year, $51 million contract this spring specifically to play left guard, but switched him to center two weeks before the season opener and moved Avila, who had been training at center all spring and summer, back to left guard. The idea was to help the left side of the offensive line, since the Rams are also without starting left tackle Alaric Jackson. Jackson is serving a two-game suspension for violating the NFL’s personal conduct policy.

However, reserve left tackle Joe Noteboom left Sunday’s game with an ankle injury and was diagnosed with a lateral sprain. He is week-to-week, McVay said. Practice squad tackle AJ Arcuri entered the game in Noteboom’s place but cost the team a touchdown due to a flagrant holding penalty in the red zone.

Second-year tackle Warren McClendon has replaced starting right tackle Rob Havenstein, who also has an ankle injury. McVay was unsure whether Havenstein will return this week and said the Rams would take it “day by day.” McVay and the Rams’ front office are still trying to figure out who will play left tackle Sunday at Arizona.

Starting right guard Kevin Dotson left the locker room Sunday night in a walking boot. McVay said he has a lateral ankle sprain, but that Dotson is “day to day” and expressed hope that Dotson will be available to play.

Cornerback Cobie Durant has a toe injury, McVay said, and is day-to-day. Durant replaces starting cornerback Darious Williams, who is on the injured list with a hamstring injury.

The number of injuries in such quick succession along the offensive line dramatically changed the Rams’ plan against the Lions, McVay said. That included more snaps for more experienced pass protectors in running backs Kyren Williams and Ronnie Rivers, and tight end Colby Parkinson. Rookie running back Blake Corum didn’t get any offensive snaps.

“We really didn’t work with what our game plan was,” McVay said. “We really had to change in the middle of that game plan. When things are unforeseen, we go with guys that you trust and you know. I think some of the ways that those drives unfolded, with long breaks in between, I think that’s why you saw our running back and tight end rotation as such. … I want to get Ronnie involved a little bit more, I want to get Blake involved as well. … Based on how the game unfolded, it was very unique for a lot of different reasons.”

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(Photo: Gregory Shamus/Getty Images)