This article is part of our Injury Analysis series.
The Dolphins running back established himself as a top fantasy option last year and will look to build on his breakout success in 2017. Unfortunately, he was helped off the field on Monday and later evaluated for a concussion. The team has yet to confirm an actual diagnosis, but the situation does provide the opportunity to reexamine the NFL's return-to-participation protocol following a concussion before we get too far into the swing of things.
Last season, nearly 250 concussions were documented in the NFL. Upon confirmation of the injury, each of these players immediately enters the league's mandated order of procedure. The protocol is broken down into five steps. For the most part the steps are completed on a day-to-day progression, though players have advanced through multiple steps in single day. Step One is the Rest and Recovery phase. To progress to step two, the injured athlete must be symptom-free while at rest and have the scores of advanced neurocognitive testing return to their individualized preseason baseline status. This test, known as ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) is first carried out by each NFL player prior to the start of the season. The test is a computer-based program and analyzes the player's neurocognitive function by challenging their ability to correctly perform various tasks including shape and color recognition, delayed memory recall and matching. ImPACT testing allows for each player to be properly screened, an important step for an injury with a wide range of signs and
The Dolphins running back established himself as a top fantasy option last year and will look to build on his breakout success in 2017. Unfortunately, he was helped off the field on Monday and later evaluated for a concussion. The team has yet to confirm an actual diagnosis, but the situation does provide the opportunity to reexamine the NFL's return-to-participation protocol following a concussion before we get too far into the swing of things.
Last season, nearly 250 concussions were documented in the NFL. Upon confirmation of the injury, each of these players immediately enters the league's mandated order of procedure. The protocol is broken down into five steps. For the most part the steps are completed on a day-to-day progression, though players have advanced through multiple steps in single day. Step One is the Rest and Recovery phase. To progress to step two, the injured athlete must be symptom-free while at rest and have the scores of advanced neurocognitive testing return to their individualized preseason baseline status. This test, known as ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) is first carried out by each NFL player prior to the start of the season. The test is a computer-based program and analyzes the player's neurocognitive function by challenging their ability to correctly perform various tasks including shape and color recognition, delayed memory recall and matching. ImPACT testing allows for each player to be properly screened, an important step for an injury with a wide range of signs and symptoms.
Step Two is the introduction of Light Aerobic Exercise. Once symptom-free, the player can begin cardiovascular exercise under the supervision of a member of the team's medical staff. Other activities like balance training and dynamic stretching may be performed. If at any time the individual's symptoms return, the step stalls and the previous step restarts.
Step Three is titled Continued Aerobic Exercise and Introduction of Strength Training. Players who reach this level may begin low level sports-specific exercises and incorporate strength training into their routine. Step Four integrates Football Specific Activities into the previous step, although the drills must remain noncontact.
Once the player is able to complete the first four steps without displaying any concussion-related symptoms, he enters the final step needed to return to play. In Step Five, Full Football Activity/Clearance, a team physician followed by an independent neurologist will examine the player. The player can finally return to the team's next football-related activity if the Independent Neurological Consultant (INC) signs off on his health and determines the protocol has been properly completed.
This protocol has been utilized for several years without any drastic changes. However, this season a new wrinkle is being added to the evaluation and determination of concussions. Previously, when a player was flagged for a potential concussion he was removed from the field of play and taken into the locker room for a more thorough examination. While the in-depth locker room evaluation remains in play, new sideline medical tents will allow members of the medical team to perform initial concussion screenings as well special tests for other injuries in an isolated and private setting.
Ajayi has not yet entered the protocol and is currently being evaluated to determine the extent of his injury. An update should be made available soon, which could easily initiate the previously detailed procedure. Kenyan Drake would be the biggest beneficiary from an extended Ajayi absence.
Turf Burns
Joe Flacco: The Ravens quarterback continues to deal with an undisclosed back injury. The injury has been referred to as soreness and tightness, although these terms describe symptoms and not true injuries. There have been whispers that Flacco's injury is disc-related, though no confirmation has been provided. The reported timeline has also varied, but it appears he will sit out at least a week. Flacco's value was already limited in most standard leagues, and the ambiguity surrounding his health only hurts. Consider healthier options for now.
Matt Forte: I've been warning about the associated risk surrounding the veteran running back for years now. His productivity has gradually diminished as high usage in his early career, age and injuries have begun to take their toll. Now Forte is dealing already with a new ailment after "tweaking" a hamstring in Monday's practice. He suffered a similar injury during last season's training camp and went on to have the fewest rushing yards of his career. The injury isn't going to drastically alter his ADP, but it does further strengthen Bilal Powell's case as the starting running back for the Jets.
Jordan Reed: A stretch of sustained health could easily vault Reed into the top-tier of fantasy tight ends. Unfortunately, that continues to seem unlikely as he's already nursing a new injury. Reed has been placed on the PUP list with a toe injury, however, the decision is being deemed "precautionary." Despite Washington's optimism, this won't help Reed gain the trust of fantasy owners. The former Pro Bowler has missed 18 games during his first four seasons in the league due to an assortment of injuries including an AC sprain, hamstring strain and multiple concussions. Additionally, toe injuries can be particularly problematic for receivers and tight ends further complicating the situation. If you do opt to gamble on Reed's upside be sure to invest in a reliable backup in later rounds.
Sammy Watkins: The Bills continue to manage Watkins' health conservatively as he works his way back from broken foot. He wasn't a full participant to open camp though he was able to take part in several team drills. Fifth metatarsal fractures are increasing common in wide receivers, and several players including Julio Jones, Julian Edelman and Dez Bryant have needed multiple procedures to address similar problems. After attempting to rush Watkins through an abbreviated recovery last season, it only makes sense that the Bills slow play the situation this season. Having the wideout healthy when it matters is in the team's and Watkins' best interest, especially when you consider this is a contract season. The success rate for Watkins' injury is high, but it does elevate his level of risk. Still, I like Watkins' upside at his current ADP and would even consider taking him a tad earlier.
