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NFL Injury Analysis: Three Stars Back After 2015 ACL Tears

Jeff Stotts

Jeff Stotts works as a Certified Athletic Trainer (MAT, ATC, PES, CES). He won the 2011 Best Fantasy Football Article in Print from the Fantasy Sports Trade Association.

Jordy Nelson, Kelvin Benjamin and Jamaal Charles

Each of the aforementioned players is a big time talent who missed a portion of the 2015 season following a torn anterior cruciate ligament (ACL) in the knee. Now with Week 1 on the horizon, each individual finds himself facing various challenges on different phases of the recovery process.

Nelson and Benjamin are the two easiest to compare. Both play the same position and tore their ACLs within days of each other last August. Both receivers underwent surgery the following month in September, a normal occurrence for these types of injuries. As a result, Nelson and Benjamin are slated to take the field in Week 1 roughly one year after going under the knife.

Timing with these two is key, as the final phase of healing is likely complete. The grafts used in ACL reconstruction undergo three various stages of healing. Early graft healing occurs first and generally concludes four weeks after surgery. During this phase the cellular content of the newly constructed ACL is manipulated to prepare for the next, more elaborate phase, the proliferation phase.

Proliferation is marked by a period of intense cell activity that includes an increase in cellular protein concentration and revascularization of the graft. These changes actually leave the graft vulnerable to mechanical failure and increase the risk of reinjury. Fortunately, both Nelson and Benjamin are long past this point as proliferation is usually complete 12 weeks post-op.

The final phase is known as ligamentization and involves a constant remodeling of the reconstructed graft designed to give it the same biological properties and strength of the original ACL. Most grafts reach their maximum potential roughly one year following reconstruction.

For Benjamin his return to the field will occur Thursday against the Broncos, though he may do so in a somewhat limited fashion. He admittedly struggled with his conditioning in the early phases of training camp and could be under a snaps limit in the Super Bowl 50 rematch. Head coach Ron Rivera said getting Benjamin 35 snaps in Week 1 was the initial goal, though the situation remains fluid. The Denver secondary also presents a challenge, making a monster return for Benjamin difficult. However, given his relatively young age and the lack of complications in his recovery, the 25-year-old receiver should have no problem reemerging as a legitimate fantasy weapon.

Nelson’s recovery didn’t go quite as smoothly, as the Packers veteran missed additional time with tendinitis in his nonsurgically repaired knee. This is fairly common following ACL reconstruction as the injured individual can develop an overreliance on the “healthy” limb. Nelson was able to successfully rehab that injury, and Packers head coach Mike McCarthy recently declared his wide out “100 percent” for Week 1 against the Jaguars.

While I fully expect Nelson to be productive fantasy option, I’m still leery of taking him in the first two rounds. To start, Nelson is six years older than Benjamin. While Nelson’s age shouldn’t have an overall profound effect on the healing rate of his ACL, he’s entering the age window when NFL wide receivers begin to decline in productivity. The situation is further complicated when coupled with Nelson’s previous list of injuries that includes recurring hamstring problems and hip surgery. As a result, I would advise scaling back your expectations for the former Pro Bowler.

I’m treating Jamaal Charles in a similar fashion. My initial hesitation with the Chiefs running back is purely based on time. Charles’ ACL tear occurred roughly two months after Benjamin and Nelson. While this timeline does allow for the ligamentization process to have begun, he’s not going to be quite as far along as the other two. Furthermore, Charles plays a position that can be a bit more physically demanding, requiring additional time for complete return for a running back.

I initially though Charles’ familiarity with the rehab process could allow him to be back by Week 1, but coach Andy Reid quickly dashed those hopes when he stated, “it would be a stretch” for Charles to play on Sunday. Instead it appears as though the Chiefs are taking a conservative approach, much like the Rams did last season with Todd Gurley.

A capable group of running backs, including Spencer Ware and Charcandrick West, gives Reid to luxury of not having to rush Charles’ recovery. Instead, he can gradually increase Charles’ workload throughout the early portions of the season until he’s capable of playing without restrictions. Even then, it looks like Ware is going to see a healthy dose of carries throughout the season and is worth a roster spot in all formats.

Teddy Bridgewater

It was a scary scene in Minnesota when Bridgewater suffered his severe knee injury. The Vikings quarterback suffered a noncontact injury in practice that left him with a dislocated knee, torn ACL and other extensive damage. The important thing to note here is that Bridgewater’s injury was not a patella (kneecap) dislocation but a more severe knee dislocation, meaning the bones of the lower leg were forced out of their normal alignment with the femur. It’s not surprising for multiple ligaments to tear in this type of injury, as they are the primary structures designed to prevent this motion. Unfortunately, the level of stress was simply too high, and Bridgewater will now miss the entire season. Given the complexity of the injury there’s even a chance this carries over into the 2017 season or longer. Minnesota’s decision to trade for Sam Bradford is a clear indicator that any type of recovery window would be a complete estimate. As a result, Bridgewater’s value in one year and keeper leagues is drastically reduced.

Turf Burns

Jimmy Graham: The odds of Graham playing in Week 1 are slowly diminishing though Seattle is confident he is near a return. Graham ruptured his patellar tendon during his first season with the Seahawks and has spent the last nine months recovering. While he has been active in practice, the team plans on carefully monitoring his return to play as he works his way back from what can be a career-altering injury. Look elsewhere for Week 1.

Julio Jones: Matt Ryan’s favorite target was a limited participant in practice Monday but is still planning on playing in Week 1. The Pro Bowl receiver is still recovering from a mild ankle injury sustained in preseason action. Jones has historically been able to play through minor lower extremity issues, but a midweek return to full practice would help ease the minds of his concerned owners.

Matt Jones: Washington was happy to welcome back Jones to practice Monday. The presumed starting running back hadn’t been available since suffering an AC sprain in his left shoulder during the team’s second preseason contest. He didn’t take hits in practice Monday but hopes to be full-contact by Wednesday or Thursday. Should he continue to progress as planned, Jones will start Week 1 against the Steelers. The game isn’t until Monday, which gives Jones an extra day to prepare though that could put fantasy owners in a precarious position. Closely monitor Jones’ availability throughout the week to get a better gauge on how things will play out in Washington.

Tony Romo: Dallas’ decision to keep Romo on the active roster and off the injured reserve suggests he could return on the early end of his estimated recovery timeline. Romo was initially expected to miss six to 10 weeks with the compression fracture in his lower back. The Cowboys will run Romo through a myriad of tests in the next few days to get better insight into his healing before making the final decision. Dallas’ bye week comes in Week 7, meaning a trip to the short-term IR would keep him out until Week 9.