The long list of Los Angeles Rams injuries begins with the impending placement of receiver Puka Nacua on injured reserve and gets longer from there.

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

McVay initially said Nacua was a “likely” candidate for injured reserve, but then clarified: “He will be placed on the injured list.”

Nacua left Sunday night’s 26-20 loss at Detroit in the second quarter after landing on his knee. He was examined by medical personnel in the blue tent on the sideline and then attempted to return to the game before ultimately leaving the field at halftime. He did not return. Nacua was the top receiver on the Rams’ offense in 2023, breaking the rookie receiver record with 105 catches for 1,486 yards and six touchdowns.

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Tyler Johnson and Jordan Whittington have backed up Nacua throughout training camp and the preseason and did so again Sunday night. Fourth-year receiver Tutu Atwell may also get more playing time.

The Rams will also be without offensive lineman Steve Avila for at least four games as he recovers from an MCL sprain. Avila is also a candidate for Injured Reserve (teams only get eight “return” designations), according to McVay. In his rookie season as a starter in 2023, Avila didn’t miss a single snap and was proud of it. He tried to get back on the field Sunday night after his injury, McVay said, and medical staff had to take him out of the game.

Rookie center Beaux Limmer will permanently step into the starting position after serving as a backup 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 every time he got a chance,” McVay said.

The Rams signed Jackson to a three-year, $51 million contract this spring to play left guard, but then moved him to center two weeks before the opening game and moved Avila, who had practiced at center all spring and summer, back to the left guard position. The idea was to bolster the left side of the offensive line, as the Rams are also without left tackle Alaric Jackson. Jackson is serving a two-game suspension for violating the NFL’s conduct rules.

However, backup left tackle Joe Noteboom left Sunday’s game with an ankle injury and was diagnosed with a lateral sprain. He will play week-to-week, McVay said. Practice squad tackle AJ Arcuri came in for Noteboom but cost the team a touchdown on a flagrant holding penalty in the red zone.

Second-year tackle Warren McClendon has filled in for right tackle Rob Havenstein, who is also out with an ankle injury. McVay was unsure if Havenstein will return this week, saying the Rams are taking it “day by day.” McVay and the Rams’ front office are still working out who will play left tackle on Sunday in Arizona.

Right guard Kevin Dotson left the locker room Sunday night in walking boots. McVay said he has a lateral ankle sprain, but Dotson is “living day by day” and expressed hope that Dotson will be ready to play.

Cornerback Cobie Durant has a toe injury, McVay said, and his condition will fluctuate from day to day. Durant is filling in for cornerback Darious Williams, who is on the injured list with a hamstring injury.

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

“Basically, we didn’t play our game plan,” McVay said. “We had to change the game plan in the middle. When there are unforeseen things, we go with guys you trust and know. I think the way the drives unfolded, with long breaks in between, reflected how that was reflected in our rotation of running backs and tight ends. … We want to get Ronnie involved a little bit more, we want to get Blake involved, too. … The way the game unfolded, it was very unique for a lot of different reasons.”

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(Photo: Gregory Shamus/Getty Images)