Managing Injury Risks: 2023 NFL Running Backs

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Running back is the single most brutal position in the NFL. Injuries are prevalent, and many fantasy players are adopting the safer “zero RB” or “hero RB” approaches to mitigate loss due to injury. In 2023, several NFL running backs are returning from injuries that hampered their 2022 seasons. This article will help manage injury risks, by navigating their injury history and how this may impact their future.

2023 NFL Running Backs Returning From Injury

Jonathan Taylor

Injury History

Analysis

Age: 24

Taylor was fairly scratch free heading into 2022. Things changed fast as the top RB scorer in 2021 missed six games, finishing 2022 as the RB 34. Taylor dealt with the notorious high ankle sprain all season long, and apparently, this is still affecting him. Taylor underwent a debridement or clean-out surgery in January but is still seeking treatment for his ankle.

Managing injury risks

High ankle sprains are a pain in the ass. Full details on what a high ankle sprain is can be found on our high ankle sprain page. In short, the injury creates separation between the two shin bones, the tibia and the fibula. This does not allow proper congruency of the ankle joint, making it harder to push off to create power when running and cutting. Additionally, it is tough to get these bones to move back in place, recreating the congruency. With grade II-III sprains, sometimes the bones never properly align back together. This is why the tightrope procedure has become common, and it literally pulls the bones together. It’s unclear why Taylor did not have this procedure, but it is clear that he is still dealing with the lingering effects of this injury.

We also have reports that Taylor is dealing with a back injury. We do not have much detail, but in my clinical practice, I constantly see back injuries due to mechanical compensations from a mistreated ankle injury. Right now, Taylor is a major red flag heading into 2023. I would not be surprised if he ends up getting another surgery on his ankle, causing him to miss significant time. If he does not get surgery, he may deal with the lingering effects of his ankle injury into the season. I am personally avoiding him at cost.

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Tony Pollard

Injury History

Analysis

Age: 26

The 26-year-old steps into the lead role in Dallas after Zeke Elliot’s departure. Pollard is coming off a fairly severe injury, with concurrent fibula fracture and high ankle sprain requiring tightrope surgery. It appears Pollard did not need surgery for the fibula fracture, indicating it was mild enough that routine bone healing could take place. Not requiring surgery for his fibula speeds up the rehab process. The tightrope procedure is highly effective, and athletes often return quickly to their prior production level.

Pollard is an elite playmaker. In a shared role, Pollard has averaged 5.1 yards per carry in his career and has caught 39 balls in each of the past two seasons. Pollard has been practicing in full all camp, and his injury does not appear to hinder his athleticism. While this injury may slightly elevate his risk for future injury, I do not believe the risk outweighs the reward of his massive upside. Pollard has legit RB1 overall potential.

Breece Hall

Injury History

Analysis

Age: 22

Hall was off to an elite start to his career, amassing 681 total yards and five touchdowns in six and a half games. Hall tore his ACL in week seven and missed the remainder of the season. With ACL rehab, four main factors influence if a player will be ready to go week one of the following season: age, time of surgery, number of tissues involved, and elite athleticism. Hall has many of these factors working for him. At 22 years old (21 at the time of injury), age is entirely in his favor. This is the prime age for proper, swift healing. Hall’s surgery was roughly 46 weeks before week one, which is enough time to be ready. We know that Hall also suffered a meniscus injury, but it is unclear if this needed to be repaired. If not, and only his ACL was repaired, this significantly speeds up rehab. Lastly, it is safe to say Hall is an elite athlete.

Hall has many factors in his favor. What is not in his favor is that since 2017 no running back has met or outperformed their pre-injury points-per-game in the first year after an ACL tear. In fact, RBs average 35% PPG below their pre-injury average in year one after an ACL tear. Additionally, the Jets just added star Dalvin Cook to the backfield, who will undoubtedly take touches from Hall.

Fantasy players should expect Hall to start slow as the Jets ease him back into his workload. I expect by mid-season Hall will be performing close to his pre-injury baseline, but typically this takes a whole year and changes to fully return to prior function.

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J.K. Dobbins

Injury History

Analysis

Age: 24

Dobbins missed all of 2021 and a good portion of 2022 as he recovered from his involved knee injury. Dobbins returned to the lineup in week three of 2022 but struggled with lingering stiffness. With an injury as involved as Dobbins (see above), the initial phases of rehab are very slow, especially with range of motion. Any time a joint has restrictions on range of motion, scarring and stiffness can develop, and it can be near impossible to restore full range of motion. Without full range of motion, athletic maneuvers are very limited, and risk for re-injury is elevated. This is why Dobbins had a second procedure to fully restore his range of motion.

Dobbins started camp on the PUP this season, but it looks like this was due to a contract dispute rather than any lingering injury. Running backs respond much better in year two after ACL (or ACL + other) surgery. I expect Dobbins to look much better this season as he leads the Baltimore backfield.

Dalvin Cook

Injury History

Analysis

Age: 28

Cook enters year seven with a massive list of injuries compiled over his career. While the list is long, if you exclude the 12 games missed in his rookie season due to an ACL tear, he has only missed eight games in six seasons. The often banged-up Cook has been fairly durable in his career. Most recently, Cook finally had surgery to repair his shoulder labrum. A labral tear renders the shoulder prone to frequent dislocation, a problem Cook had been dealing with. Labrum repairs are very strong, and the risk for re-dislocation is dramatically reduced after surgery.

Managing injury risks

What’s more, this being an upper body surgery means it does not impact fantasy production. Fantasy players should view Cook’s outlook just the same they would have if he did not have a shoulder injury last season. The obvious thing fantasy players need to determine is how much they want Cook now that he is 28, and in a presumed timeshare with Breece Hall.

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Javonte Williams

Injury History

  • November 2019: MCL injury
  • October 2022: ACL, LCL, Posterolateral corner tear: Missed 13 games

Analysis

Age: 23

The ACL, LCL, and posterolateral corner combination is a truly devastating injury, typically taking 12-15 months to return from. Somehow, Javonate has defied all odds thus far and is on track to play week one. Factors in Javonte’s favor include his youth and the time of his injury. What we don’t see behind the scenes is certainly an undeniable work ethic that has allowed him to be ready to play.

Managing injury risks

We saw Williams heavily involved in the first quarter of the second preseason game. This type of usage, particularly in the passing game, can help mitigate any decline in physical function as he continues to rehab from his injury. I highly doubt Williams’s physicality will be at 100% at any point this season, but if Sean Payton uses Williams in the passing game as they did in the preseason, Williams may return his draft value. However, fantasy players should still curb their enthusiasm, as since 2017, no running back has performed at their pre-injury baseline in the first year after an ACL (or ACL+) injury. Additionally, re-injury rates are much higher in year one post-ACL.

Rashaad Penny

Injury History

  • August 2018: Finger fracture
  • December 2018: Knee strain – Missed 2 games
  • September 2019: Hamstring injury – Missed 2 games
  • December 2019: ACL tear – Missed final 3 games, and first 13 games of the following year
  • January 2021: Knee strain – Missed 1 game
  • September 2021: Calf strain – Missed 5 games
  • November 2021: Hamstring injury – Missed 1 game
  • October 2022: Fibula fracture and deltoid ligament tear – Missed 12 games, surgery

Analysis

Age: 27

The talented former 1st round pick finds himself in a juicy situation behind the NFL’s top-rated offensive line. Talent has never been a concern for Penny; injuries have been. Penny has missed 38 games in five years, missing multiple games every season. That’s not good! Prior injury is one of the main risk factors for future injury, especially when its lower body injuries, of which Penny has numerous.

Managing injury risks

The most recent injury required surgery of both the fibula and deltoid ligament. This leads to a challenging recovery, in which many never regain the full range of motion of the ankle. Lacking range of motion in the ankle is a risk factor for future injury. The fantasy football community knows they cannot rely on Penny for a full 17-game season, and his ADP reflects this. What Penny does bring is incredible production when he is on the field. As a fringe round 8-9 draft pick, his upside is well worth the risk, just don’t count on him for a full season.

Isiah Pacheco

Injury History

  • October 2022: Shoulder labrum tear – Did not miss time, offseason surgery
  • January 2023: Hand Fracture – Did not miss time, off-season surgery.

Analysis

Age: 23

The bruising back underwent surgery for a labrum repair and a hand fracture in the offseason. Pacheco has been limited in practice this season, but fantasy players should not fear. Both of these surgeries do very well, usually with no lingering effects. Upper body injuries are much less likely to impact production as they do not influence running, cutting, agility, or power.

2023 NFL Running Backs Injured In Camp

Kenneth Walker III

Injury History

Analysis

Age: 22

Walker enters his second season as the lead back in Seattle and is expected to share time with rookie Zach Charbonnet. We all remember Walker missing time in his rookie training camp due to a hernia repair. Alarms we going off at the time, but he ended up only missing one game due to the injury. Walker put together a prolific rookie campaign, finishing as the RB 16.

Early in camp this year, Walker suffered a groin injury. Of course, fantasy Twitter has gone crazy over this. Walker has returned to full practice and should not be feared in fantasy this season. Historically running backs see no decline in fantasy production after groin injuries. Recurrence rates, however, are seen as high at 18%. This is where Zach Charbonnet helps Walker. Seattle will likely utilize a committee this season, which will reduce the total load on Walker.

Zach Charbonnet

Injury History

Analysis

Age: 22

Pete Carrol gave us a scare in July, stating that Charbonnet is “out indefinitely.” Indefinitely turned out to be about a week or so, and Charbonnet appears to be back in full strength. Without knowing the details of the shoulder injury, it’s impossible to give a re-injury analysis. The meniscus trim from 2019 does provide mild concern, as removing meniscus tissue is never good. But this should not affect him for several years. At present he appears good to go with no elevated risk.

Miles Sanders

Injury History

Analysis

Age: 26

Through four NFL seasons, Sander has missed eight games due to a variety of injuries. That’s not bad for a runner who has amassed 863 touches. Sanders is currently missing time in camp with a groin injury. As mentioned above with Ken Walker, recurrence rates are 18%, and running backs average missing 1.9 games, but otherwise, this injury does not appear to impact production negatively.

Sanders does have a lengthy list of lower body injuries, including three ankle sprains, two hamstring injuries, and a few knee sprains. All of these have been minor to date and occurred when he was young, making them less likely to influence future injury, but they still could be a risk factor to some degree. The overall level of concern for Sanders is low.

Elijah Mitchell

Injury History

  • September 2021: Shoulder injury – Missed 2 games
  • November 2021: Rib injury – Did not miss time
  • November 2021: Finger fracture – Missed 1 game
  • December 2021: Concussion
  • December 2021: Knee sprain – Missed 3 games
  • August 2022: Hamstring strain – Missed time in camp
  • September 2022: MCL sprain – Missed 7 games
  • November 2022: MCL sprain – Re-aggravation, missed 5 games
  • August 2023: Groin injury – Has not been practicing

Analysis

Age: 25

Mitchell has struggled tremendously in his short career to stay on the field. The talented runner has missed 18 games in two seasons due to five injuries and is currently not practicing due to a groin injury. When we start to see a player suffer multiple lower body injuries that force him to miss significant time, it’s time to throw up a red flag. So far in his career, Mitchell has given us no indication that he can stay healthy in this league. While you are not sacrificing much draft capital on Mitchell, the risk is high, and the reward is limited due to Christian McCaffrey.

Kendre Miller

Injury History

Analysis

Age: 21

Miller injured his MCL, and we think his meniscus on New Year’s Eve, requiring surgery. MCL repair surgery carries about a 6-month return to play timeline, and Miller was practicing in full in training camp before sustaining another sprain to the same knee on August 13th. Initially thought to be more serious, Miller has since returned to practice.

We don’t like to see a second injury to a repaired knee, but this does not appear too serious. Miller is very young, at 21 years old, which will substantially help his healing process and contributes to his ability to have regained his burst after surgery in January. At this point, I do not have much concern for Miller heading into 2023. He will not be given a heavy workload initially, as Jamal Williams and Alvin Kamara (suspended 3 games) will get their share as well. Miller has high upside in dynasty leagues.

De’Von Achane

Injury History

  • November 2022: Foot injury – Missed 2 games
  • August 2023: Undisclosed shoulder injury

Analysis

Age: 21

With his 188 lbs frame draft, analysts fear that Achane may have a difficult time holding up in the NFL. In the second pre-season game, Achane suffered a shoulder injury, of which we do not have details at the time of this writing. The mechanism was consistent with an AC or SC joint injury or a collarbone fracture. If minor, I do not expect this to impact his production this season.

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