Injury outlook: Expectations for key players returning from injuries

There is no denying the wealth of talent that exists among NFL skill position players, talent that can ultimately translate into fantasy football rewards. But fantasy managers can only reap those rewards if the talent sees the field, making injury and associated lost time perhaps the most pervasive threat to fantasy opportunity. While there is no crystal ball when it comes to predicting injuries, it is well established that past injury is one of the greatest risk factors for future injury. Understanding that not all injuries — or rehabs — are created equal, it is worth taking a closer look at where key fantasy players who suffered injuries last season are on their road to recovery as the 2022 season approaches.

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Within the spectrum of NFL injuries, anterior cruciate ligament (ACL) tears represent the single greatest injury burden in the NFL. When an NFL player tears his ACL, it immediately ends his season and potentially compromises the following one.

The 2021 NFL Health and Safety data shows there were 71 ACL injuries last season across the preseason and the regular season, 20 more than the previous year and a double-digit increase over each of the past six seasons. In other words, while surgical and rehab techniques continue to improve, ACL tears in the NFL aren’t going away.

Given the numbers and the impact on fantasy players, it seemed appropriate to give them their own section here. Plenty of stars are members of the ACL rehab club heading into 2022 and, as usual, their outlooks are as varied as the injuries themselves. While the average time to return to play following an ACL injury hovers around nine months post-surgery, that timeframe can vary. Return to play, however, is NOT the same as return to performance, and it can take a year — or longer — for an athlete to return to his prior level of function following ACL surgery.

Multiple variables can influence the recovery timeline ranging from associated injury (other ligaments, meniscus, cartilage, bone) to graft type and surgical approach. Along the course of rehab, hurdles such as lack of motion, persistent swelling, delayed strength return of the quadriceps or hamstrings or an overly accelerated return to high-level activity can slow a player’s recovery enough to impact the timeline, level of performance or both.

Additionally, the mental aspect to recovery cannot be ignored. Confidence in the surgically repaired leg can be slow to come by for an athlete. Even if the base physical metrics are restored, an unwillingness to trust the leg when maneuvering on the field or fear of contact to the previously injured knee can translate to an altered style of play, impacting performance.

While the overall success rate of returning NFL athletes to sport following an ACL tear is high, there is no guarantee when it comes to any individual athlete, as each player’s experience is unique. With that in mind, here are some of the athletes returning from ACL injuries we are monitoring heading toward the start of the 2022 season.

J.K. Dobbins, RB, Baltimore Ravens

Dobbins quickly became the face of the debate about how much preseason playing time starters should see when he tore his left ACL the week before the regular season got underway. After undergoing surgery last September with Dr. Neal ElAttrache, it seemed logical to expect Dobbins’ return by Week 1 of 2022, but coach John Harbaugh’s suggestion in March that Dobbins might start the season on the physically unable to perform (PUP) list indicates he might not be ready. Although Harbaugh sounded slightly more optimistic in May about Dobbins being available by Week 1, the team still moved forward with the signing of Mike Davis. These injuries are particularly tough on players whose position and style demands both power and speed — in his rookie season (2020), Dobbins was fourth in the league in average yards after contact — and no timeline is guaranteed. Dobbins’ progression through training camp will be key.

Gus Edwards, RB, Ravens

See J.K. Dobbins. In an unbelievable stroke of misfortune, the Ravens’ running back who was expected to step up his role after Dobbins’ injury succumbed to his own ACL tear just two weeks later … in practice. The two backs shared a surgeon (Dr. Neal ElAttrache) and have been on a similar rehab timeline. Harbaugh also noted Edwards might begin the season on the PUP list and, as with Dobbins, his progression during training camp will be key.

Maxx Williams, TE, Arizona Cardinals

Williams’ season ended in Week 5 in a gruesome manner when he took a hit to the inside of his right knee that forcefully bowed it out beyond its normal range (think: Jaylon Smith injury). These types of injuries are complex, and the recovery process is highly individual. While his one-year re-signing with the Cardinals is encouraging, it is worth noting they also signed Zach Ertz — who came to Arizona following the loss of Williams — to a three-year deal. They also selected Trey McBride in the second round of the NFL draft. Expectations for Williams’ return should be tempered until he is doing football activity, but he does not hold fantasy value at this time.

Robert Woods, WR, Tennessee Titans

When a player as unselfish and hard-working as Woods goes down in practice with a season-ending injury, it reverberates around the organization. The silver lining for Woods was his ability to stay with the Rams’ top-tier rehab staff where he could remain involved with his teammates throughout their journey to the Super Bowl. His progress inspired enough confidence for the Titans to sign him in the offseason. Woods participated in OTAs, doing route running and pass-catching and is expected to continue to increase his football activity in training camp. He appears to be headed for an on-time start to the season presuming all goes well in camp.

Robert Tonyan, TE, Green Bay Packers

The loss of Davante Adams could present a big opportunity for Tonyan to earn even more of Aaron Rodgers’ targets, if he can return to his pre-injury form. A torn left ACL on a Thursday night in Week 8 ended Tonyan’s 2021 season prematurely, but there has been optimism since early this year about his recovery. Although he did not participate in OTAs or minicamp because of his rehab status, the Packers must be encouraged with his progress given they signed him to a one-year deal in mid-March. A strong 2022 season for Tonyan — even if it starts after Week 1 — could yield benefits for both parties.

Jameis Winston, QB, New Orleans Saints

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Winston’s injury reminds us just how vulnerable quarterbacks are when they are on the move outside the pocket. In Week 8, as Winston was pulled down from behind, a twisting hyperflexion mechanism resulted in a torn ACL/MCL in Winston’s left knee. His rehab workout videos have kept us apprised of his progress, and he remains on track to start the season on time, a notion further reinforced by the Saints granting him a two-year extension in March. The only question remaining will be how he handles traffic around his surgically repaired knee when he has to face real opponents. Joe Burrow worked his way through that mental hurdle during training camp and went on to have a banner season in 2021. As long as Winston can get the preseason exposure necessary to give him confidence in the knee, he should be in good shape when the season opens.

Logan Thomas, TE, Washington Commanders

In just his second game back following a seven-week absence due to a right hamstring injury, Thomas tore his left ACL, ending his season in Week 13. After suffering the two injuries most responsible for missed time in the NFL in the same season, the standout tight end is at increased injury risk in 2022. (According to Thomas in a radio appearance on 106.7 The Fan in April, surgery addressed not only his ACL but also his MCL and both menisci.) A Week 1 return is not a lock for Thomas, but it is not out of the question, either; much depends on how his progression goes through August. Hamstring injuries the year following ACL surgery are not uncommon, providing all the more reason for Washington to be cautious in ramping up Thomas’ football activity this summer.

Chris Godwin, WR, Tampa Bay Buccaneers

A torn right ACL and MCL in Week 15 against the Saints led Godwin to reconstructive surgery with Dr. James Andrews in the first week of 2022. In March he signed a three-year extension with the Bucs, a hint at the team’s confidence in his progress and his ability to return to pre-injury performance levels. The three-year deal also proves the team is invested in Godwin for more than one season, so there is no reason to rush his return. He could very well begin camp on the PUP list and, if so, it remains to be seen whether that designation will carry into the start of the 2022 season.

Michael Gallup, WR, Dallas Cowboys

In January, Gallup proved he was the consummate pro when he managed to secure an impressive catch AND a touchdown while simultaneously tearing his left ACL. He underwent reconstructive surgery with team physician Dr. Dan Cooper in February, leaving a tight window before the 2022 season. It’s worth noting Gallup missed seven games due to a calf strain earlier last season, and there should be no incentive to rush his return, especially given the team’s long-term investment. Cowboys owner Jerry Jones seemed to echo the sentiment in March telling reporters, “Optimistically, I expect him to give us a question mark around the first game.” Given the timing of Gallup’s injury/surgery, it would appear unlikely that he will start the season on time.

Odell Beckham Jr., WR, free agent

Beckham’s case is most unique in that he is planning a comeback from a second ACL surgery (revision ACL) on his left knee. While there are several NFL players who have returned from multiple ACL surgeries on the same knee (quarterbacks Carson Palmer and Sam Bradford come to mind), there are no elite wide receivers on that list. Keep in mind that Beckham suffered his latest injury during the Super Bowl; surgery was not until late February. It was Week 7 of the 2020 season when he originally tore his ACL and he did not return to competition until Week 3 of 2021. More caution is warranted during recovery from a revision ACL than following a standard ACL reconstruction, typically resulting in a longer return-to-play process. A delayed start to the season is not in dispute, but when he will return and to what level are uncertain.

Running Backs

Christian McCaffrey, RB, Carolina Panthers

After a trifecta of injuries derailed his 2020 season by causing him to miss the first games of both his collegiate and pro career, it could have been considered a run of bad luck. But what to say now after a 2021 season where hamstring and ankle injuries resulted in only seven games played? McCaffrey still has plenty left in the tank, as evidenced by his continuing to average more than 100 yards from scrimmage per game last season, but the risk factor goes up due to recent history. The dilemma with McCaffrey is that the very thing that puts him at risk for injury is the thing that makes him exceptionally valuable in fantasy: He rarely leaves the field. Increased exposure equals increased risk, which, combined with his recent history, elevates that risk even further. Still, he remains arguably the best at what he does, and the Panthers have shown little evidence that they will alter his usage.

Chris Carson/Rashaad Penny, RBs, Seattle Seahawks

The baton was passed from Carson to Penny late in 2021, and it is anything but clear as to how things will shake out in 2022. Carson didn’t play after Week 4 and ultimately underwent neck surgery (cervical fusion) in December. He is working toward a return in 2022, but whether he meets that target is uncertain. Penny has dealt with injuries every year — a calf injury in 2021 resulted in only three games played through Week 8 — but he bounced back in enormous fashion to close out last season rushing for 135 yards or more in four of the final five weeks. Even if both are available in 2022 — and Carson’s return at this point is a big if — neither back’s injury history suggests the capacity to sustain a full workload for a prolonged period. Enter the team’s second-round draft pick, Ken Walker III and this situation has uncertainty written all over it.

James Robinson/Travis Etienne Jr., RBs, Jacksonville Jaguars

What do a first-round draft pick and an undrafted free agent have in common? Bad luck in 2021 while playing for the Jaguars, as it turns out. Etienne got only as far as an August preseason game before the rookie suffered a Lisfranc injury in his left foot that required surgery. While Etienne rehabbed, Robinson — who had just come off an incredible rookie campaign of his own the year prior — somehow struggled to secure consistent opportunity to see the field. When it finally looked as if things might change, Robinson suffered a left Achilles tear in late December. Etienne was fully participating in the team’s spring OTAs, earning praise from new head coach Doug Pederson in the process. Barring a setback in camp, Etienne will take on the starting role. Robinson’s recovery timeline is tighter, and it wouldn’t be a surprise if he begins camp on the PUP list. Robinson has posted some video of sub-maximal speed, straight-line running. He has yet to re-integrate football activities and recover his power and explosiveness. His progression through training camp will better inform expectations.

Wide Receivers

Michael Thomas, WR, Saints

Following a delayed surgery to address a severe left ankle sprain that cost him much of 2020, Thomas suffered an injury while rehabbing that required yet another procedure to the same ankle … and he never played a down in 2021. Whether he can return to his elite pre-injury form remains to be seen. After all, he has to return to play first. To that end, Thomas has been a model teammate this offseason, praising the team’s selection of Chris Olave in this year’s draft and working out with his fellow Buckeye alum in California. The unanswered question is how his ankle will fare when engaging in contact football under the workload of a full season. His progression through training camp will be the first test.

Curtis Samuel, WR, Commanders

Samuel was bothered by a groin injury during the team’s June minicamp in 2021, and the effects lingered well into the season. Between the groin issue and a subsequent hamstring injury, he ultimately missed 12 of 17 games and likely needed a full offseason to get right. Still, soft tissue injuries spanning the better part of six months last year translates to increased risk of injury for Samuel this year and may be a reason for the team to limit his workload, especially early in the season.

Adam Thielen, WR, Minnesota Vikings

Despite missing four games due to a left high-ankle sprain that ultimately required surgery, Thielen still managed 10 touchdowns last season. Surgery in December restored stability to the roof of his ankle and gave him ample recovery time. Thielen’s participation in OTAs indicates his ankle should not present a problem heading into 2022.

DJ Chark, WR, Detroit Lions

In Week 4, Chark’s own Jaguars teammate inadvertently rolled over his left ankle, breaking it and ending his season. His recovery trajectory must have satisfied the Lions since they signed him to a one-year deal, including $10 million guaranteed, and he already began working with the team during OTAs. Presuming no setbacks in training camp, Chark should be ready to roll as the season gets underway.

Kadarius Toney, WR, New York Giants

Toney was electric at times early in his rookie season, especially in Week 5 against the Cowboys when he posted double-digit catches for just under 200 yards. Things changed shortly thereafter as a litany of injuries kept him out of seven of the remaining 12 games. The talent is undeniable, but the early injury pattern raises a flag, and having him healthy to start the season is critical. To that end, the Giants limited him to non-contact activity during June minicamp. The expectation is that he will be ready for full participation when training camp opens.

Tight Ends

T.J. Hockenson, TE, Lions

Hockenson’s season ended after Week 13 when he suffered a left thumb injury against the Vikings that ultimately led to surgery. By January, he was already declaring himself close to full healing and preparing for offseason workouts. Hockenson’s last two seasons may have ended with injuries but, luckily for him, they were not the type to carry over into the following season.

Irv Smith Jr., TE, Vikings

Nobody saw Smith get injured in the 2021 preseason finale, but the slight buckling he felt in his knee showed up on an MRI as a significant meniscus injury. Surgical repair of the meniscus meant the forfeiture of an entire season, but probably extended his playing career. The extra recovery time only helps, and the team has been gradually increasing his football activity from OTAs through minicamp. He should be a full participant when training camp begins, which, along with his ample rehab window, bodes well for Smith in 2022.

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