How to approach players with a history of injury
I'm not a fan of the term "injury prone." It's overused and incorrectly applied.
Some players are undoubtedly prone to injury. Some have bone-on-bone conditions in their knee and are at risk of swelling and pain limiting their potential. Some have asymmetry in their biomechanics -- the quad muscles are weaker on one side or an ankle ligament is looser on one side. Some have a herniated disc or other degenerative back condition their medical staff is actively managing. Some aren't in peak physical condition.
But it's really, really hard to know who those players are.
You can examine past injury histories and try to estimate the risk of injury. But there's no complete data set to generate a player's baseline risk of injury in the NFL. You cannot be certain you've controlled for every variable and arrived at an accurate estimate.
You have no idea whether the medical staff is more concerned than usual about a player's recent meniscus surgery or microdiscectomy or worried about the effects of a player's offseason attempt to lose or gain weight. It's highly unlikely you'll hear a coach or player or trainer discuss those factors.
Even if you could accurately estimate a player's risk of injury, you'd struggle to decide which game presents the highest risk or how to assess cumulative risks. There's good data on aggravation of hamstring strains -- 33 percent of high-level football players aggravate a previous hamstring injury within the first 7-10 days of returning to sport-related activity. There's good data showing players with a history of ACL tear are more likely to sustain another ACL injury than players who have never had an ACL injury.
But those are general data points. They're difficult to apply to specific situations.
Which of the many NFL players with an ACL tear is more likely to sustain another ACL tear this year? When?
Which of the players fighting through a preseason hamstring strain is most likely to suffer an aggravation?
Every NFL team collects GPS data on their players during practice. It helps the medical staff discover subtle biomechanical differences and can suggest which players are fatigued and at higher risk of injury. But multiple teams admit they don't know how to use the data they have.
Don't misunderstand. I think continued efforts to assess injury risk and improve player safety are critical. But it's a highly complex endeavor.
The NFL is more than a contact sport. It's a traumatic sport with multiple dangerous collisions every play.
The bottom line: Every player is injury prone.
Risk assessment in fantasy drafts
Labels aside, it's still correct to consider injury risk when drafting your fantasy roster.
First, understand your risk tolerance. If you're risk-averse, factor all past injury concerns more highly. If you're risk tolerant, examine each situation carefully and adjust your draft board -- if at all -- accordingly.
Second, recognize that some players are already injured or unlikely fully recovered from recent injuries or surgeries. Those players carry increased risk.
With that in mind, let’s examine players likely to be drafted in the first 8-10 rounds who are perceived – rightly or wrongly – to have a worrisome injury risk-reward profile.
I’ll include each player's current overall ADP (using Footballguys consensus ADP list), positional ADP and the range they’re most likely to be drafted. After a profile of their injuries, I’ll provide a risk assessment and a recommendation of where I feel each player can be most sensibly drafted. If you’re willing to tolerate more risk, draft the player a little earlier than my recommendation. If you prefer safer bets in the early rounds, you might consider taking a few of these players off your board altogether.
NOTE: I’ll update this feature frequently over the next two weeks. Any additions will be dated and in red typeface. The publication date of this article will correspond to the day of the most recent update, which will include ADP data.
MOST IMPORTANTLY, CHECK FOR BREAKING NEWS JUST BEFORE YOUR DRAFT. Teams practice at different times of the day. New injuries or aggravations of existing conditions are possible.
Second, recognize that some players are already injured or unlikely fully recovered from recent injuries or surgeries. Those players carry increased risk.
Do Not Draft List | Season-Ending Injured Reserve
- RB Lamar Miller, Houston
- RB Jerick McKinnon, San Francisco
Do Not Draft List | Retired due to injury
- QB Andrew Luck, Indianapolis
Quarterbacks Returning from Injury
Cam Newton | Left Foot sprain
QB8 | ADP 81 | 7th-9th Round
August 24: Newton's foot sprain occurred during the Panthers' third preseason game. After Newton was seen leaving the stadium immobilized in a walking boot, Carolina general manager told reporters the injury was a mid-foot sprain. While that combination might ordinarily raise suspicion for a long-term injury to the Lisfranc joint, video replay was not consistent with a Lisfranc injury and multiple reports suggest the Panthers are cautiously optimistic Newton will play Week 1.
I don't expect Newton to practice this week. The best-case scenario is likely limited practice early next week in preparation for Week 1. It's possible Newton may be listed as a questionable game-time decision. If Newton remains in a walking boot early this week or there are reports of a specialist visit, his timeline shifts into the regular season. Based on current reports, that seems unlikely.
I'll have more on Newton in Monday's Injury Rounds article and will continue to update here as new details are reported.
Draft recommendation: Newton is likely safe to draft at his current ADP, especially in two-quarterback leagues. If you're planning to wait on drafting a quarterback in leagues with short benches, Newton falls back to the top of the committee tier.
Running backs Returning from Injury
Todd Gurley | left knee inflammation
RB8 | ADP 15 | 2nd Round
August 24: The comfort level among the fantasy community on Gurley has varied widely over the past 12 months. Until midseason 2018, Gurley was considered an elite every-down running back in a high-powered, productive offense. Unfortunately, knee inflammation hampered him often during the season's final weeks and through the Super Bowl. It's since been confirmed that Gurley has arthritis in his knee and the Rams are planning to manage Gurley's workload to preserve his health through the 2019 season.
That's a scary sentence. And it led -- correctly -- many analysts to worry about Gurley's short-term prospects.
However, degenerative joints are common conditions among elite athletes, especially those in traumatic collision sports like football. While they undoubtedly lead to shortened careers and often require surgical interventions after retirement, many players successfully manage them and return to play at a productive level for a period of time in the NFL.
It's absolutely worrisome to hear the terms "arthritis" and "veteran plan" and "managed workload" and to read Gurley has lost weight this summer to limit further wear-and-tear on his knee. But this isn't an immediate death sentence for his career. Limiting practice reps is the norm for many veterans and targeted weight loss and strengthening of stabilizing muscles does not mean Gurley will never be the same player.
There are two critical unknowns here.
First, it's difficult to predict when Gurley may have recurrent pain and swelling. It's reassuring he's handled training camp without any setbacks. But a hit from an unexpected angle or a quick change of direction movement could start a new cycle of inflammation. Whether it's severe enough to limit his practice and game reps will be a further unknown.
Second, we still don't know how careful the Rams plan to be with Gurley during games. We know the team felt compelled to limit Gurley's usage during the playoffs and Super Bowl last year. There's no reason to think they won't be careful during the early regular season. They made certain the running back depth chart was addressed this offseason by matching an offer sheet on Malcolm Brown and drafting Darrell Henderson.
Our projections show the possible range of outcomes. Jason Wood has Gurley just outside the elite tier at RB5. David Dodds has Gurley at a more conservative RB10. Bob Henry (RB8) and Maurile Tremblay (RB7) are in the same range.
My spidey sense: Gurley is much healthier now than he was in December and January and in condition for Week 1. The Rams will give Gurley at least one series off each half and further limit his workload in the second half of any game where the outcome has been decided.
Draft recommendation: Gurley is a test of your risk tolerance. I believe Gurley is a safe risk at his current ADP, even if his usage decreases. If you'd rather not deal with the possibility of limited practices and unexpected significant drops in usage in some weeks, you should avoid Gurley unless he's available as your RB2 and there are no WR1 options available.
Footballguys will have all the injury angles covered for you during the regular season. In addition to our extensive wiki of players in the news and current injuries compiled and updated daily by Clayton Gray and Joe Bryant each week, we'll have a review of the week’s injuries on Monday, updates after the daily injury reports are released on Wednesday and Thursday, and an assessment of the fantasy expectations of all the key injured players on Sunday morning. My twitter feed -- @JeneBramel -- will also be active throughout the week with breaking injury news and analysis.
Derrick Henry | Left calf strain
RB20 | ADP 40 | 4th Round
August 24: Henry missed multiple weeks with a calf strain before returning to practice last week. The severity of the strain was never revealed but the reports of a walking boot suggest the strain was significant and his absence was more rehab than precaution. We're now in the all-important reconditioning phase when a player is at highest risk of aggravation. If Henry navigates the next 7-10 days without a setback, his risk of re-injury in the first month of the season will be minimal.
Unfortunately, we don't have that data point yet.
Draft recommendation: Henry's RB20 ADP reflects his injury and will likely drift upward if he puts together a string of reassuring practices. In that sense, he's currently a value. Strategically, however, the caliber of running back and wide receiver talent in the same range and the number of upside values at running back in the 5th-9th rounds is compelling. If you thought Henry was an RB1 prior to his injury, he's a great selection at current ADP. Otherwise, you're likely looking elsewhere in the fourth round.
Sony Michel | Left knee inflammation
RB23 | ADP 46 | 4th Round
August 24: Todd Gurley got the bulk of attention this offseason -- reasonably so, as a prospective top-five fantasy selection -- but the medical discussion and expectations for Michel are the same.
Like Gurley, Michel has a known degenerative condition that's required surgical procedures, inseason practice management, resulted in lost game reps and prompted his team to bolster the running back depth chart in the offseason. Like Gurley, Michel has been productive in camp, handled the team's prescribed practice workload without difficulty, and looks primed to enter the season healthier than expected.
And like Gurley, there will be a risk of recurrent pain and swelling throughout the season.
Draft recommendation: Michel is safe to draft at his current ADP.
Kenyan Drake | Right foot injury
RB30 | ADP 71 | 6th-7th Round
August 24: The Dolphins have provided no information on Drake's injury and there have been no actionable national or local media reports. Drake himself suggested he'd be fine shortly after the injury. Now out of a walking boot within a week of the injury, Drake's declaration would seem to be trustworthy.
Draft recommendation: Based on current injury and health, Drake is a reasonable risk at an RB30 ADP. The upside of the Miami offense and lack of clarity on the running back depth chart are more compelling factors to consider.
Derrius Guice | Hamstring strain / ACL reconstruction
RB33 | ADP 76 | 7th-8th Round
August 24: Guice missed much of offseason workouts with a hamstring strain and was only recently cleared for contact. Local observers reported Guice looked more confident in drills recently and his strong performance during Washington's third preseason game was eye-opening. Guice isn't yet ready to be a 20+ touch per week player and Adrian Peterson remains ahead of him on the depth chart. But the signs for a productive return from ACL reconstruction and a post-surgical infection are positive.
Draft recommendation: Guice is safe to draft at his current ADP.
Wide receivers Returning from Injury
Odell Beckham | Hip injury
WR5 | ADP 12 | 1st-2nd Round
August 24: Beckham hasn't been participating in team drills due to a hip injury. The team has expressed no concern, national beat writers have not reported anything of concern, and Beckham has -- per usual -- routinely been wowing observers with one-hand catches in individual drills. Barring an unexpected report this week, Beckham will be ready for a full Week 1 workload.
Draft recommendation: Beckham is safe to draft at his current ADP.
Antonio Brown | Foot condition
WR9 | ADP 22 | 2nd-3rd Round
August 24: Instagram photos of Brown's feet were eye-opening but a case of "looks worse than it probably is." The Raiders quickly activated him from the non-football injury list in early August and cleared him to practice. A report of a specialist visit prompted speculation of a more worrisome condition but Brown's feet were apparently never a high concern.
Draft recommendation: A dispute over his preferred helmet kept Brown out of practice for much of the preseason and most fantasy analysts are worried about his chemistry with Derek Carr, his upside in the Oakland offense, and whether there are further distractions to come. From a medical standpoint, Brown's feet are a non-issue and should not prevent you from considering him at his current ADP.
Keenan Allen | Ankle injury
WR11 | ADP 25 | 3rd Round
August 24: Allen has an ankle injury of unknown severity. Anthony Lynn raised concern for a more severe injury than previously reported after suggesting surgery might still be an option if Allen's rehab didn't progress quickly. But Allen has since returned to individual drills and an early report from Adam Schefter included a clear and direct expectation for a healthy Week 1 return.
Draft recommendation: Allen is safe to draft at his current ADP. I'll update immediately with new information.
Amari Cooper | Plantar fasciitis
WR13 | ADP 32 | 3rd Round
August 24: The Cowboys have held Cooper out of practice for much of the preseason with a heel injury. It's been reported as a heel bruise, plantar fasciitis, and a muscle strain. While each of those conditions is slightly different, the overall picture is the same. Cooper is having pain on the bottom of his foot near the heel and the Dallas medical staff believes he's better served by rehabbing than practicing. Cooper has said he's played through a similar injury before and will do so again. There's a risk of aggravation and some risk of a reconditioning injury here but the risk is very likely less than if Cooper was dealing with a leg muscle strain.
Draft recommendation: Cooper is safe to draft at his current ADP.
Julian Edelman | Left thumb fracture
WR15 | ADP 38 | 3rd-4th Round
August 24: Edelman fractured his thumb before training camp. He was expected to be cleared to play in Week 1, has been activated from the team's NFI list, and is participating in practice.
August 31: Edelman fell on his thumb during the Patriots' fourth preseason game but did not re-injure himself. He's expected to be ready for Week 1.
Draft recommendation: Edelman is safe to draft at his current ADP.
Cooper Kupp | ACL reconstruction
WR21 | ADP 51 | 4th-5th Round
August 24: Kupp's recovery from his November ACL tear rivals some of the most successful in the NFL to date. While players may be cleared for contact within 6-9 months, full recovery of the ligament takes much longer. Players are at high risk of soft tissue injury, joint inflammation, and another ACL injury during that time frame. Kupp, fortunately, has sailed through rehab without concern. He started camp on the active roster and his participated in practices without a setback. A recent story about Kupp's rehab reported glowing test results, suggesting Kupp's athleticism was even better than prior to the injury. That doesn't remove all risk of re-injury but it argues strongly that Kupp can return to his pre-injury production quickly.
Draft recommendation: Kupp is safe to draft at his current ADP.
A.J. Green | Left ankle injury
WR24 | ADP 58 | 5th-6th Round
August 24: I wrote extensively on Green in early August. While there remain unanswered questions about Green's injury and surgical procedure, the comments from Dave Lapham shortly after the injury remain the best data we have. Lapham believes Green will recover and he strongly suggested the most reasonable target for his return is the Week 4 Monday night game in Pittsburgh. Without knowing more about the injury, it's difficult to assign a risk of aggravation or recurrence and it's difficult to say whether Green will be ready for a full workload in Week 4.
I'd err on the side of pessimism here. It's hard to believe Green will have shown he's full strength and outside the window of aggravation until Week 6 or beyond. If he does reach that goal, he should outperform his current ADP and produce at a higher rate than WR24.
Draft recommendation: Green's current ADP feels reasonable. He's a better fit if you've constructed your roster with high-floor, lesser-risk players in the first five rounds.
Sterling Shepard | Left thumb fracture
WR37 | ADP 91 | 7th-9th Round
The Giants likely took some unnecessary risks allowing Shepard to catch passes in live team drills with a no-contact jersey soon after his thumb was surgically fixed. Shepard has since been cleared for contact and he looks probable for Week 1.
Draft recommendation: The Giants' passing offense has many question marks, but Shepard is healthy enough to consider at his current ADP.
Tight ends Returning from Injury
George Kittle | Calf strain
TE3 | ADP33 | 3rd-4th Round
August 24: Kittle was adamant his calf strain is minor and his missed practices were only precautionary. He's technically still within the window of possible aggravation but his return to practice suggests no concern.
Draft recommendation: Kittle is safe to draft at his current ADP.
Jordan Reed | Concussion
TE13 | ADP 136 | 11th Round
August 24: Reed suffered another concussion -- reportedly at least the sixth of his career -- during Washington's third preseason game. Reed has previously needed multiple weeks to recover from his previous concussions. If that's the approach with his current injury, Week 1 is possible but unlikely. Sadly, Reed was performing well in camp and had seemingly put his years of soft tissue and toe injuries behind him.
August 28: Washington believes Reed will be cleared for Week 1.
Draft recommendation: Consider Reed a possible backup tight end selection, but there are better upside wide-receiver picks in the 10-12th rounds and similar high-upside tight end options available later.
QUICK THOUGHTS ON OTHER LATE-ROUND PICKS OF CONCERN
Ronald Jones (RB43) -- Jones hyperextended his left knee during Tampa Bay's third preseason game. He has returned to practice but is limited.
Jerick McKinnon (RB58) -- McKinnon continues to deal with knee inflammation as he rehabs from last season's ACL reconstruction. He is expected to be moved to season-ending injured reserve. Remove him from your draft list.
Emmanuel Sanders (WR42) -- Sanders has passed every test asked of him after last season's Achilles' tendon repair. He's currently fully participating in practice and has had no setbacks.
Keke Coutee (WR48) -- Coutee has a mid-grade high ankle sprain and remains questionable for Week 1. Should the Texans allow him to fully recover before returning to play, he'll likely out-perform this ADP.
DK Metcalf (WR49) -- Metcalf had arthroscopic knee surgery recently. A Week 1 return is too optimistic but the team says the surgery did not identify any major issues. His range of outcomes remains variable, but he's safe as a WR5.
Anthony Miller (WR53) -- Miller is recovering from an ankle injury of unknown severity. Matt Nagy has said Miller has work to do to learn the offense when he returns. Miller may not see heavy usage in the early weeks.
Parris Campbell (WR59) -- Campbell aggravated a hamstring strain late in camp but was able to return for the Colts' final preseason game. He was impressive before the injury and is a safe upside risk as a WR5/6
Marquise Brown (WR61) -- Brown was moved to the active roster and played in Baltimore's third preseason game. It's hard to fully trust his quick recovery from Lisfranc surgery and his early-season role will likely be limited.
Check back for more injury analysis throughout training camp and the regular season. Also, follow on Twitter @JeneBramel for breaking injury news, commentary, and analysis of this injury and others around the NFL.
