The 2022 season is over, and to my disappointment, the Kansas City Chiefs are once again the Super Bowl Champions after defeating my Philadelphia Eagles. Every year, several key players see their seasons cut short due to injury. I am here to provide the off-season injuries to monitor and provide the best prediction for when these players will be available and return to their prior production level.
Obviously, it is March, and it is far too early to know how many of these guys will respond to rehab. Every person responds differently to surgery and rehab. This article will provide the typical timelines for each surgery. It will be interesting to look back in September to see how players progressed compared to the norms.
The pesky ACL injury bites several crucial fantasy players each season. With an ACL injury, several key factors play a role in determining when a player will be ready to go the following season. Some main factors include the timing of surgery, concurrent tissues injured along with the ACL, and the player’s age.
This past season we saw examples of how a multi-tissue injury can extend a player’s absence from the field. Ravens running back JK Dobbins suffered an ACL, LCL, meniscus, and hamstring injury in the pre-season of the 2021 season. Dobbins was only 22 at the time of injury, so age was not a negative factor, and his injury timing was well over a year before the start of the 2022 season. However, the challenges of rehabbing from a multi-tissue injury pushed his eventual return to 56 weeks after the injury. To make matters worse, he was not at full function when he returned and required an additional surgery a few weeks later, sidling him six more weeks. Fortunately, in the later portion of the season, Dobbins did appear to regain his pre-injury burst and should be primed for a great 2023 season.
We also saw the negative influence of returning to play too soon. Chris Godwin returned to play in only 38 weeks, and Michael Gallup in only 39. Both players struggled significantly compared to their baselines to start the season. Godwin suffered a hamstring injury in week 1, which is HIGHLY common when returning from ACL. He returned from the hamstring in week 4, and from weeks 4-10, he averaged only 10.4 ppg, 3.4 points below his 2021 average of 13.8. Gallup never caught his stride in 2022, finishing as WR 67, averaging only 4.7 ppg. Godwin did show signs of a return to complete form towards the end of the season, which is precisely what we would expect. Traditionally, players across the board (QB excluded) struggle to produce fantasy numbers in the first half of the season after an ACL injury.
Now that we understand several factors are at play in predicting performance after an ACL injury, I will break down each fantasy-relevant player returning from an ACL injury situation.
Murray went down with a text-book non-contact ACL injury on Monday night in week 14. Murray underwent surgery on January 3rd, 2023, which puts him eight months and seven days (36 weeks) out from week 1 of 2023. Research shows that returning to play from ACL surgery before nine months significantly increases the risk of re-tearing the ACL or another injury (see Chris Godwin). This timeline alone puts Murray’s week one status in serious doubt but also curbs the enthusiasm (all-time great show) for his availability in the first quarter of the 2023 season.
What Murray does have going for him is that his injury was an isolated ACL tear with no other structural damage. When a player injures the ACL and other structures such as the meniscus, MCL, or LCL (just to name a few), the rehab timeline slows down considerably. More on this can be found on our ACL page.
Also going in Murray’s favor is the data (small, inconclusive sample size) does not appear to show nearly as much negative influence on a QB’s fantasy production when they return from ACL surgery, as compared to RBs and WRs, who are significantly hampered.
However, most of the QB data is on pocket passers. Kyler Murray is an outstanding fantasy QB because of his legs. This injury will undoubtedly slow him down when he returns. Following an ACL injury, regaining top speed, agility, and running confidence is very challenging. I forecast a decline in his rushing attempts and designed runs in the first several weeks he returns. This, combined with his top receiving option DeAndre Hopkins asking for a trade, makes Murray’s 2023 outlook cloudy at best.
Hall was off to an electric start to his career, amassing 681 total yards and 5 TDs in just seven games! Unfortunately, the 21-year-old tore his ACL in week seven. Reports also stated Hall suffered a meniscus injury, but it is unclear if his meniscus was repaired or not. This makes a huge difference. Subsequent meniscus repair delays rehab by several weeks.
Hall has several factors in his favor. He was only 21 at the time of the injury. Youth is the most significant upside for a quick and full recovery. While his surgical date is not clear in the media, his injury occurred 46 weeks before the start of the 2023 season. With this timeline, he can potentially be ready in week one, but he will not likely be at 100%.
Factors going against Hall are the concurrent meniscus injury, which may or may not have been repaired, and the overall data following RBs after ACL injuries. The data is not good. On average, running backs see a marked decline from their pre-injury baseline in the first six games after an ACL injury, and for many, this decline lasts the entire first season back.
Still, Hall’s outlook for 2023 is not entirely bleak. He is a freak athlete, was incredibly young at the time of injury, and was developing a workhorse role in the Jets backfield. Hall will undoubtedly be counted on by New York this upcoming season. It would be naive to expect him to be near his peak in the first half of the season. Unfortunately, it just takes a full year to recover from this injury.
Javonte Williams’s situation is much different than Breece Hall’s. While Williams’s injury occurred in week 4, giving him three more weeks to rehab than Hall, Williams’s injury was much more involved. Williams suffered an ACL injury as well as a posterolateral corner injury. The posterolateral corner describes the portion of the knee that comprises the LCL, PCL, and lateral meniscus. With the injury to all four of these vital structures, the rehab process is very, very slow compared to isolated ACL injury.
Considering the factors influencing ACL recovery, Williams has youth and a favorable timeline with his injury so early in the season. However, the complexity of his injury with four structures injured will likely outweigh both positive factors and put his ability to be ready for week one in serious doubt. J.K. Dobbins is the best example. Dobbins, who was of similar age (22) at the time of injury, also suffered an injury to the LCL, meniscus, and hamstring. Dobbins took 56 weeks to return to the field. Apply this math to Williams; we are looking at a week eight return.
No two people are alike when it comes to healing. Just because Dobbins took 56 weeks does not mean Williams will, though it will likely take Javonte longer than week one to return. When he does return, he still faces the same negative data set discussed above with Breece Hall. It will be very hard to trust rostering Williams this season in fantasy.
Odell Beckham Jr.
Beckham suffered his second ACL injury during the Ram’s Super Bowl victory. The sweet taste of victory combined with the agony of injury all in one night. Beckham missed the entire 2022 season but appeared to be close to ready in the latter portion of the season. Ultimately, no team made a move on him.
Beckham, who will be 30 at the start of the 2023 season, will be fully recovered from this injury. Multiple videos have surfaced in the past week of him working out, looking like his old self, and reports state that he will be working out for NFL teams soon.
Year two after ACL surgery is typically when players regain their proper form. Beckham however, has not been an elite fantasy player since 2016! Every player has an appropriate value on draft day, so Beckham should not be off your boards entirely. Where he lands in free agency will be interesting, but his days as an elite WR are likely over, but I don’t expect it to be due to his most recent injury.
The Giant’s athletic rookie went down with an ACL injury in week 11 and underwent surgery on December 13th. By all reports, this was an isolated ACL injury. Let’s consider the factors influencing recovery here.
Positively influencing recovery are Robinson’s age (22) and this being an isolated ACL injury without other structures involved. The timing does not bode well for Robinson. Week one takes place 39 weeks after Robinson’s surgery, just under the nine-month threshold we hope for. Just because it has been nine months since surgery does not always mean a player is safe to return to sport. There are various performance tests a player must pass that reduce the likelihood of re-injury.
In the NFL, since 2017 WRs average 49 weeks from injury to return. Now, this number is skewed to some degree because of the firm start date of the season, so the true number is likely a little lower. Even if that number of weeks to return to full competition is a few weeks less than 49, Robinson will only be 39 weeks post-op come week one. This compares well to Godwin and Gallup mentioned above, both of whom struggled compared to their baselines when they returned.
Robinson can be a nice value in fantasy still. He is not a top-tier player yet, and, thus, will likely fall in drafts. There is no reason not to snag late in drafts and stash him on the bench for a few weeks to gauge his role in the Giant’s offense.
Shepard, who is now 30, played only three games after returning from an Achilles tear last season before having 2022 end short due to an ACL tear. His ACL tear was completely non-contact at the end of the game, likely secondary to fatigue (a common factor for ACL tears). To add to this hypothesis, this was the same leg that Shepard suffered his Achilles tear the year prior, of which he miraculously returned in 38 weeks, 14 weeks quicker than average.
Considering his prior Achilles injury as a factor in his ACL injury is not out of the question. His ACL injury happened at the end of the game with no provocation from any defender; his knee simply buckled. Buckling is often due to fatigue. As Shepard was still recovering from his Achilles injury, his injured leg was likely much less conditioned than his unaffected leg, increasing the risk of a fatigue-related injury.
Unfortunate for a reliable player to suffer two consecutive significant injuries. Shepard will have his work cut out to be ready for 2023. Factors negatively influencing his prognosis for 2023 include his age, injury history, and even the timing of surgery. Notice I said the timing of surgery, not injury. The ACL rehab timeline does not start until surgery. Shepard did not have surgery until October 25th, putting him 10.5 months out from week one. This is typically borderline to be ready for week one.
Considering all the factors above, it will be difficult to rely on Shapard this year in fantasy.
The 25-year-old speedster suffered an ACL tear in week three, ending his season. Guyton, who has emerged as a nice deep threat for Justin Herbert, had not yet declared himself a reliable fantasy asset.
Guyton’s youth, the timing of his injury (49 weeks before 2023 week 1), and his being an isolated ACL injury all bode well for his availability in week one. However, receivers typically take the first quarter of the season to begin to return their prior fantasy numbers. With Guyton as a fringe WR4-5, you likely don’t need to draft him this season.
Patrick went down during camp on August 2nd, 2022. The former undrafted free agents injury was an isolated ACL with no other structures involved. Patrick, now 29, does not have the age factor in his favor. Still, the early injury (will be 13 months by the start of 2023) and his injury being ACL only provide a favorable prognosis for his week one availability.
As mentioned, receivers traditionally struggle out the gate after ACL, but by mid-season, they begin to regain their pre-injury form. I expect Patrick returns to his prior production level, of which he averaged 9.6 fantasy points in 2021, no later than mid-season. Patrick has never been a star fantasy player but has been a valuable roster stash as a bye-week fill-in and could be worthy of drafting in the latter rounds.
Ertz suffered a somewhat involved ACL and MCL tear in week 10 and underwent surgery on November 18th, 2022. The standout tight end, and one of my favorite players, is now 32 years old and faces an uphill battle to return to his prior production level.
Unfortunately for Ertz, all the factors we discussed above that influence return from ACL injury are against him. He is 32, which is old by NFL standards, he suffered a multi-ligament injury, both ACL and MCL, requiring surgery, and his injury occurred later in the season.
Ertz is looking at 42 weeks from the time of surgery to week 1 of 2023. Going back to 2017, tight ends average 40 weeks to return to NFL action, but this is a tiny sample size and, thus, does not provide us with much historical evidence for the position. What we do know is the addition of the MCL surgery slows the early phases of rehab, as does age.
In Ertz’s favor is the nature of his position. Tight ends are not expected to be nearly as explosive as running backs or receivers. Ertz stands at 6 feet 5 inches and has utilized his big body, vision to find the hole in the defense, and reliable hands to land himself at number 12 on the all-time tight end receiving yards list. Additionally, the tight end landscape in fantasy is scarce. After the first top six or seven are off the board, we are really just looking for guys who can fall into the end zone.
I do have concerns about Ertz’s ability to be ready for week one, and it is highly unlikely he will ever produce pro bowl numbers again, but he could be valuable in the second half of the upcoming season as a predominantly touchdown-dependent tight end.
Numerous types of injuries can occur to the foot and ankle and are managed and rehabbed unique to the specific injury. I will clarify each player on this list’s injury and provide insight unique to that particular injury.
All that said, surgeries to the foot and ankle have similar challenges when rehabbing. Fortunately, for almost all foot and ankle surgeries, the length of the NFL offseason is more than enough to fully recover from; therefore, timing of the injury is less of a factor here compared to ACL injury. Tony Pollard is an example of a player who suffered an ankle fracture in the divisional round of the playoffs but should still be full go for the start of camp.
A major challenge when returning from any foot or ankle surgery is the inevitable stiffness that occurs after being immobilized in a cast or boot. Often after surgery, a period of immobilization lasting anywhere from 2-6 weeks takes place. Whenever any joint is immobilized for a prolonged period of time, the tissues adapt, and become stiff, as well as muscle atrophy (loss of size/strength) occurs. Muscle atrophy is easy to regain with rehab; stiffness can be tricky. It is not impossible to regain full range of motion (ROM) after immobilization; however, many never regain full ROM in the ankle or foot. This creates altered movement patterns that can influence injury risk in the future.
The foot and ankle function as human shock absorbers. We all took science class once upon a time and know Newton’s 3rd law; every action has an equal and opposite reaction. When a 200lbs running back strikes the ground while running, the ground strikes back with the same force the running back hits the ground with. A foot and ankle with adequate ROM can distribute this force in a manner that does not overload the limb. However, when the foot or ankle are not moving properly, the shock absorption property is lost; now, the force goes “up the chain,” as we call it, to the knee, hip, back, etc.
It is imperative that players and their training staff focus on regaining ROM as soon as possible after surgery. Youth plays a big role here. The younger a player is, the less prone they are to stiffness. Fortunately, every player on this list is young (outside of Cooper Kupp), and as long as they are rehabbing hard, they should be able to gain back most of their ROM, but this is not a guarantee.
Now let’s dive into each player’s situation.
Cooper Kupp missed the last eight games of 2022 with a high ankle sprain that required the tight rope surgery. Somehow, Krupp still finished as WR23. Kupp is 29 now, which hinders healing expectations, however he has the entire offseason plus the last two months of the regular season to rehab.
Following this surgery, there is no reason to expect impaired performance. A possible concern would be the development of chronic ankle stiffness that commonly occurs after ankle surgery mentioned above. Kupp is a hard worker and gifted with one of the NFL’s best training staff, which should allow him to regain as much range of motion in his ankle as possible. This injury may contribute to future injuries, but his production level should not be impacted one bit.
Jimmy Garoppolo broke his left foot in week 13 and missed the rest of the season. Fresh off a new contract to be the Raiders starting quarterback, Garoppolo has had more than enough time to fully recover from this injury.
Yes, I wrote above how these injuries can chronically change mechanics that can influence future injury, but Garoppolo is a pocket passer; he doesn’t run much. A stiff foot or ankle is much less influential as a pocket passer. Additionally, this is Garoppolo’s left foot. As a right-handed QB, he pushes off his right foot for power. I see no reason for this injury to impact Garoppolo going forward.
In contrast to former teammate Garoppolo, Lance’s injury does have potential to influence him going forward. Lance suffered a broken right fibula with ligament damage as well, both requiring surgery. The combination of the fibula fracture with liagmament damage as well increases the likelihood of developing chronic stiffness. This is Lance right ankle, the one he pushes off for throw power. Additionally, Lance is a runner.
The above paragraph sounds pessimistic and does not accurately depict my outlook for Lance’s career. I acknowledge that his risk for future injury may be higher than if he did not have this injury, but this is not a guarantee. He is only 22 years old, so his potential to regain full range of motion is much better than that of a 30-year-old. Additionally, just because his ankle may be stiff does not mean it will impact his performance. He should still be able to run and throw just as he did pre-injury. However, the ankle’s shock absorption property may be affected, which could feed future injuries.
Often times after surgery, the patient is immobilized and non-weight bearing for up to 6 weeks. This will lead to stiffness and muscle atrophy. As mentioned throughout this article, stiffness can be a challenge to regain, strength is easy. After the initial 6 weeks of immobilization, regaining ROM will be the primary focus, as well as strength and balance.
Return to running will begin around weeks 8-12, typically starting in a pool or alter-G treadmill. Pollard will begin sport-specific training and gradually return to full activity over weeks 12-16 post-op. This timeline will allow him to be fully ready to go for camp. Pollard is an emerging star in this league, and I do not expect this injury to halt his production. As mentioned many times above, future injury risk is a concern if he can’t regain full range of motion at the ankle, but productivity should not be hindered.
Like Pollard above, Penny suffered a broken fibula in week five. The analysis for Pollard applies completely to Penny. The difference is that Penny has an extensive injury history. In Penny’s career, he has suffered multiple hamstring injuries, an ACL tear, a hand fracture, a calf injury, and now this.
The biggest predictor for future injury is the previous injury which has been highlighted in the research repeatedly. Penny has great upside when healthy, but it is hard to expect a full season.
Bateman sat out the second half of the season after undergoing surgery for a Lisfranc injury. We saw this past season that athletes can return from this surgery and play at a high level. Travis Etienne produced a 1,000-yard rushing season and finished as RB 17 on the year after undergoing a similar procedure last season.
The data on fantasy numbers after this injury is scarce, and thus we cannot draw conclusions. However, it appears a trend is developing where young players are able to successfully return to a prolific career, whereas older players cannot. Bateman is only 23, and should be just fine next season.
Duverney suffered a Jones (5th metatarsal) fracture. This is a fracture to the outside bone of the foot. With an offseason to heal, there is no reason this should impact his readiness for week one.
See a trend so far in this article? To this point, every injury discussed involves the lower body. There’s a reason professional athletes don’t skip leg day. Lower body injuries create so many more challenges to return from than do upper body injuries. Not only does a lower-body injury influence the athlete’s ability to run, cut, jump, etc., but the mechanical changes that can occur secondary to a lower-body injury have the potential to influence future injury. Upper body injuries, on the other hand, are much less influential on a future injury because they don’t influence movement nearly as much (of course, there are exceptions).
Lamar Jackson never had surgery, but his injury is still worth discussing. Brock Purdy recently underwent a unique, newer version of UCL surgery, and I will explain this in detail.
Jackson missed the last five weeks of the season with a PCL injury. I wrote extensively every week after his injury about how this would likely end his season or at least significantly hamper his production. Fortunately, Jackson’s PCL injury was not severe enough to warrant surgery, and he should have most of the offseason to train at max capacity.
The PCL is tricky because it usually does not heal. The rehab process includes allowing the swelling to subside, which can take time (clearly), regaining the strength of the quad muscles, and regaining proprioception. Proprioception is a sense that I wrote quite a bit about during the season. Essentially proprioception is our body’s ability to understand where its limbs are in space without looking. For you video game players, think of it as how you know exactly where your thumbs are moving to strike the different buttons on the controller without looking down. This is a nice example; only for Jackson, proprioception works on a much larger scale by allowing him the awareness of where his legs are when running and cutting to enable him to quickly and confidently cut.
By week one of next season, I expect no issue with Jackson’s knee. Where he plays is a different story that will continue to unfold over the next few weeks.
Purdy underwent surgery on March 10th to repair his torn Ulnar Collateral Ligament (UCL) with an internal brace, a fairly newer surgical procedure. The repair with an internal brace is advantageous to a UCL reconstruction (Tommy John) surgery as it cuts the return to play time in half (repair average of 5 months vs. reconstruction average of 11.6 months).
The repair with an internal brace utilizes a collagen-treated brace to anchor the surgery, allowing the native tissue to heal. In contrast, the reconstruction requires harvesting tissue from other parts of the body and is a much more involved surgery. With the repair using the internal brace, the athlete can progress through rehab much quicker due to the increased stability of the surgery and fewer tissues healing overall. While advantageous to reconstruction, the repair is still a long rehab process.
Purdy will not begin throwing until 12 weeks post-op. In the meantime, he will focus on regaining elbow range of motion and reducing muscle atrophy (weakness). Twelve weeks, however, is not when he will be cleared for full throwing activity. Per the rehab protocol, Purdy will begin with a gentle progressive throwing program at week 12, typically starting with only throwing 45 feet initially. Over the next eight weeks, this will progress to full range, but slowly. Of importance is that prior to initiating the throwing protocol Purdy has full range of motion, no pain, no laxity into elbow valves (excess movement that should be restrained by an intact UCL), and demonstrates adequate strength at various upper extremity regions. By 20 weeks post-op, which in his case is July 28th, he should be at full strength for throwing.
While this timeline allows Purdy to be 100% by the start of week one, let’s consider his situation. He played great in relief of Trey Lance and Jimmy Garoppolo last season but did not command the starting role for the 2023 season. His competition, Lance, missed almost the entire 2022 season with an ankle fracture. Lance will have the entire offseason to train and prepare for the training camp battle vs. Purdy. Purdy, however, will not. Purdy won’t even begin throwing in any capacity until June 2nd. As it stands, I give Lance the leg up to win the job simply because he has much more time to train and prepare for camp.