June 6, 2022

COMEBACK STORY: LATE-SEASON ACL INJURIES & THE RETURN FOR 2022 FANTASY FOOTBALL

Never trust the player. Always trust the doctor. That’s what I heard in my first MLB spring training in 2006 when discussing players returning from injuries. Because the players are trained and programmed to perform from an early age, and when the playing field is taken away because of injury, the drive to get back on the field can make a player be overly optimistic about the prospects of returning to action. Often too optimistic.

Jameson Williams suffered a torn ACL in the National Championship Game in January.
Is it too optimistic to expect him to contribute much in the 2022 NFL season?

The medical professionals are more pragmatic, and will trust in the science, research and previous results for how long the return from injury takes. They plan for the proposed timeline, but are ready when setbacks happen. And setbacks happen way more often than not.

I once interviewed a player for a proposed cover feature story during my Dodger days. The player was rehabbing and getting close to returning to action, but there were still some medical hurdles that needed to be jumped over before the start of the season. He’d missed a good chunk of the previous season, but I could feel his excitement to get back on the field. A big part of me wanted to believe his enthusiasm, and I bought in. He was a fan favorite, and someone whose return was highly anticipated. Turns out, he had a setback right before the start of the season, and another upon his return. His season was cut short after only a handful of games. This is why I trust the doctors who know more than overly optimistic athletes.

I don’t think there’s anyone in the fantasy industry whom I trust more than Dr. Edwin Porras. Mi amigo known on Twitter as @fbinjurydoc is one of the best injury experts in the fantasy industry. He’s so good, the Minnesota Twins scooped him up to join their medical staff. So he’s following in the footsteps of Bo Jackson and Deion Sanders as a two-sport star. 

The idea for this YouTube interview and, subsequently, this article, spawned initially from the glut of late-season ACL tears that pass catchers had in 2021. I really wanted to have the chat after hearing and reading all the speculation surrounding Jameson Williams, formerly of Alabama and, most recently, the 12th pick in the NFL Draft by the Lions. Williams got hurt during the Crimson Tide’s National Championship loss to Georgia on Jan. 10. In the runup to the draft, there was all this talk that he was ahead of schedule in his rehab and that he was ramping up to start running routes in the spring. I even heard one member of the national media mention that some players have been coming back from ACL surgery in six months. 

That just seemed ill-informed and irresponsible. Yes, ACL tears used to be career-ending, and now they’re pretty predictable in returning to play. Similar to Tommy John surgery in baseball. But the rehab is something that cannot be rushed. Just like Tommy John surgery. That’s why I reached out to El Doctor, so he could shed some light on the return to play on the rash of ACL tears that happened primarily to WRs throughout the latter part of the 2021 regular season.

As we’re here a little less than two months out from the opening of NFL training camps, I wanted to give an overview of the players and their expected returns to the field of play. What these players have in common, other than being pass catchers, is that they were all injured from November 2021 onward. What’s important to note about this is that even the players who got hurt during the days leading to Thanksgiving, it would be about 10 months until kickoff to the 2022 season. That’s about the earliest that Porras has seen any prominent skill player not named Adrian Peterson return from an ACL tear – AP came back eight months after surgery to rush for 2,097 yards in 2012, proving that he’s an alien. Cooper Kupp is an example who returned in 10 months after his torn ACL in 2018. Others with a similar recovery time that Porras mentioned were Allen Robinson, Courtland Sutton and Keenan Allen. Remember, trust the science, not the player.

“People get carried away with how quickly they think these athletes recover,” Porras said. “Yes, they’re high-level athletes. Yes, they get the best medical care possible and they get it around the clock if they want it. But at the end of the day, they are biological animals just like you and I. Tissue healing takes a while, and it takes a while for every human.”

Keeping in mind that these men are human is very important. Porras said that while there are some players who return after about 9 or 10 months, that is the soonest and often it takes longer. He noted that the ACL surgical graft is usually fully healed within about 12 months from surgery, even if they are able to play much earlier. That’s why there are so many players who appear back to normal in Year 2 post-surgery, after they’ve had a full year to recover plus a normal offseason to train and not rehab.

This article is going to start with the player who is furthest out in his injury timeline. Robert Woods got hurt during practice on Nov. 12, 2021, coincidentally the day after the Rams signed Odell Beckham Jr., who we’ll talk about later. Woods missed the LA Super Bowl run, and was traded to the Titans earlier this offseason. From the injury date, that’s almost 10 months to the day when Tennessee will kick off the season on Sept. 11. 

At the time of this interview, there had not been much reported on Woods’ injury or even the surgery date, and it still hasn’t been reported. In the early days of OTAs, Woods was seen running routes with a knee brace. Keep in mind that the 10-month return date is on the most optimistic side, but it still has Porras feeling good about Woods’ value in redraft. Currently, he’s the WR48 on Fantasy Points rankings.

“I honestly think that he’s still a guy you should invest in,” Porras said. “Maybe he won’t have a ceiling year. Maybe he won’t be Cooper Kupp and have had the best year of his career up to date after his ACL. But you see these guys go through this injury, you see them return to form. He’s a little older on the age spectrum. I wouldn’t say you’re going to expect a Top 12 season from him, but I definitely think he can still be a steal in redraft.”

There were a pair of receivers who got hurt toward the tail end of the season, and both were pending free agents. Chris Godwin got hurt on Dec. 19, 2021, and didn’t have surgery until Jan. 3. Michael Gallup got hurt on New Year’s Day, and ended up waiting to have surgery on Feb. 10. The surgery date is when you want to go off for when to determine the recovery timeline. What is also telling is that each player got hurt going into free agency, and their respective teams – the Buccaneers (Godwin) and Cowboys (Gallup)  – re-signed the players. That is good for the outlook for each player long-term, though it might not bode well for the 2022 redraft season.

“You’ve got to give these guys at least nine months, nine months is when we know retear rates drop,” Porras said. “Even if you just look at it from a purely legal-liability standpoint before nine months, you’re putting yourself at risk for retear. You have to look at least nine months. If there’s meniscus involvement, you know, there was at least a period after the surgery of about three or four weeks, maybe two or three where they couldn’t put any weight or put very minimal weight through the knee that sort of slows down the rehab process a little bit. 

“I know that these reports get us excited. You also have to consider the definition of what it means to be back, as in running routes on air and shorts and a helmet. You have to be patient with these guys. You have to understand and get a good, clear understanding that it’s going to be at least nine months from the surgical date, knowing that you can’t reverse engineer what you’re willing to put into an investment, because then it could even take another three or four weeks for them to get their sea legs under them. So it could be an opportunity where you say, screw it, I’m going to take a gamble elsewhere. Or it could be an opportunity where you patiently wait, you strike when the iron is hot.”

Godwin is ranked WR22, just ahead of Gabriel Davis, Mike Williams and D.K. Metcalf, all healthy. Gallup is going at WR51, ahead of a group of rookie receivers and JuJu Smith-Schuster. With Godwin’s 10-month mark from surgery being early November, and Gallup’s being the second week in December, I’m fading those players unless they’re really falling in redraft and even best ball.

The next pair of players have yet to take NFL snaps, but are already rehabbing with their new teams. Jameson Williams’ injury was noted above. John Metchie got hurt in the SEC title game in early December. I’ve already talked about the hype around Williams’ injury recovery, and Metchie being a Round 2 pick at #44 overall to the Texans definitely has less fanfare surrounding him. While the players should be drafted in dynasty with optimism for full recovery, the fact that they got selected by rebuilding teams likely means many precautions will be taken in 2022. That should be kept in mind for redraft leagues.

“You’re also missing a lot of team time, and I think that for wide receivers, that’s super important,” Porras said. “Understanding what route, what your route tree is, understanding what a film session looks like. And it’s not like they’re skipping them all together, but they’re not getting the live reps right there in rehab. So I think that we should definitely temper expectations because unless you’re Ja’Marr Chase, unless you’re Justin Jefferson, which we don’t necessarily think these guys are. It’s not like we’re saying they’re bad, but we should probably temper expectations because they need those live drills. They need those mental reps. They need to be fully engaged in the process, in my opinion, from a skill acquisition standpoint, to make that leap from college to the pros. I think we take it for granted, but it’s not like you can’t just flip a switch and be a pro. It takes these guys work. It takes these guys time and it takes development on the coaches’ side. So I would definitely temper expectations because indirectly that the surgery and the injury and subsequent rehab are going to take away from that skill acquisition time.”

I especially like Williams’ talent, but I can’t recommend him for the 2022 season. He may get some run late in the season, to get some live action in a game. But I can’t imagine the Lions will risk injury by rushing him back to the field in a season that is still a rebuild. Same thing for the Texans and Metchie.

There were a couple TEs who tore ACLs late in the season and need to get their return dates under some scrutiny. Robert Tonyan was hurt on Oct. 28, 2021, while Logan Thomas was hurt a little more than a month later on Dec. 4. I asked Porras specifically about Thomas, who measures 6-6 and 250 lbs. I wanted to know if because TEs are larger human beings, if that impacts the recovery time. â€śThe bigger body is something that’s gonna take a little time to get accustomed to,” Porras said. “But if he stays on top of it, if he’s good with everything else. If there’s nothing else that’s hindering him and you can continue to progress them through the same criteria as you generally would, then you absolutely go for it. So the short answer is no, you don’t automatically make an exception for somebody because of their body size, body type.”

These two players are going to get plenty of coverage in any training camp media offerings. Tonyan is TE16 and Thomas is TE21 in current ADP, so there is likelihood that either or both will go undrafted in most shallow leagues if they’re trending toward starting the season on the PUP list. If that’s the case, when they return keep an eye on snap count, target-share percentage and routes run. These players could be second-half help that could vault them into the top 10 TE realm. Especially Tonyan, who has shown rapport with Aaron Rodgers and with all the open targets in Green Bay.

The last WR that Porras and I talked about was OBJ. The timing could not have been worse for his injury. He had caught 2 of 3 targets for 52 yards and a score during the Super Bowl. He really looked unstoppable in the game, up until he pulled up after making a cut on the SoFi Stadium turf. Torn left ACL, the same one he injured on Oct. 28, 2020. After that injury, OBJ returned 11 months later. There is, however, some sense of optimism for recovery for a player who remains a free agent, and it’s partly because of the previous injury.

“You also have to consider that he’s got to have no setbacks,” Porras said. “You’ve got to have no issues with the graft taking again. He’s got to go through this entire process again. And does it help that he’s been through it once? Yes, it does, but his body doesn’t necessarily care. His body’s going to do what it’s going to do. It’s going to go through this. Like it’s a brand-new issue once again, and it’s going to go through it just the same way that he went through it before. He doesn’t get to take any shortcuts because it’s the second time around. So, unfortunately, from like a redraft perspective, it’s highly unlikely that you’re going to see much from Odell Beckham, Jr.”

The uncertainty on his return date is playing a large role in why OBJ has not signed with a new team. On Feb. 22, OBJ announded on Instagram that he’d already had successful surgery. He can continue to rehab and when he’s close to returning he can then practically pick his team for a late-season ride, if he’s progressing with no setbacks. “Late season” is most important to keep in mind, as 10 months from his injury is around Christmas, which is Week 16. Though it’s hard to expect him to get back earlier than his previous injury on the same knee. I’m fading him in redraft, until I find it’s getting close to his return date. Porras did a recent interview with Dr. Deepak Chona on the INJURY (PRO)NE FANTASY FOOTBALL PODCAST and they talk about the real possibility that OBJ misses most, if not all of 2022, but does make a recovery in time for 2023.

If this article is an exercise in anything, it’s to remind us that injuries and surgeries need time to rehab and the body to heal properly. And when it comes to the ACL repair, even if the player returns within a year, there is likely still more healing that is taking place. The good doctor sums it up just right.

“The research shows about 18 months is where we start to see a plateau and functional outcomes, and strength and the size of muscle hypertrophy,” Porras said. “You see these plateaus for high-level athletes for the general population. It takes about 12 to 15 months for the ACL graft to fully (heal). That is really the sweet spot.”

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