The Titans defense had its first real "bad day" against the 49ers two weeks ago. If the Titans are going to prevent a similar performance from the Rams then a few guys will need to step up. These are the players I think the Titans need most.
In 2012, McCarthy looked like an exciting linebacker that made plays when the Titans needed him. In 2013, he has looked slightly confused and out of place often. I am still a big Colin McCarthy fan, but now that he has taken all the first-team reps for three straight weeks it is time to step up.
The Rams will plan to attack the middle of the field whether that means Tavon Austin or Jared Cook (haha) and Colin McCarthy will need to make some plays to force them to reconsider. If C-Mac can force the Rams to throw outside against the talented Titans corners, then that offense will collapse on itself.
Speaking of talented outside corners, Alterraun Verner has been excellent this season and the Titans need that to continue. Whoever Verner lines up against, if he could force Kellen Clemens in to a mistake early it could set the tone for the day. The defense doesn't have a particularly tough matchup, and a dominant performance could really force a lopsided victory for the Titans.
The Titans need help against the run this week with the Rams using a backup QB. If the Titans can prevent any cut-back or bounce out runs for the Rams, the game will really be one-sided and the Titans defense can thrive. If anyone can help prevent a cut-back run it is Pitoitua who can bull-rush an offensive tackle and protect the edge.
Another thing Pitoitua has done really well this year is get to the pass rusher when the backend holds up. If the Titans can force Clemens to hold onto the ball they should be able to make some huge plays on passing downs.