Second Opinion: Offseason Review
By Jene Bramel
July 23rd, 2012

Many of the NFL's premier players and fantasy anchors suffered serious injuries last season. While we're still waiting for clarity on many high-profile situations, this offseason review will get you up to speed as we enter the summer months. Remember to read Mark Wimer's injury reports and follow my Second Opinion blog for frequent updates throughout the summer.

Quarterback

Peyton Manning (cervical fusion, Sep 2011)
A promising March throwing session followed by a strong start to OTAs suggests that Manning has finally recovered the arm strength lost prior to the fusion surgery last year. In reality despite all the public relations battles and media questions a six month recovery period was always a realistic expectation. There are still reasons to be concerned about Manning's long term health, but the early reports are very positive.

If Manning is able to regularly practice on back-to-back days during camp without arm fatigue, he can be considered a viable QB1. Should he develop good chemistry with Demaryius Thomas, Eric Decker, and Jacob Tamme, he'll have a good chance of finishing among the top 5-8 quarterbacks at year's end.

Matt Schaub (Lisfranc sprain, Nov 2011)
Schaub had a minor procedure in April to remove much of the hardware from his original surgery. All indications are that his rehab is on schedule and that he'll be ready for the start of training camp. Schaub, a pocket passer, shouldn't be affected by any minor loss of mobility in his foot. Barring an unexpected setback before or during camp, Schaub should carry the same fantasy expectation into 2012 as he did entering 2011.

Sam Bradford (high ankle sprain, Oct 2011)
Reports are mixed on Bradford. Though he admits to still feeling soreness in his injured ankle, neither Bradford nor the team were bothered enough to hold him out of OTAs in late May. That's a good sign, but there are many reasons to be wary of Bradford in 2012. A new coach, new offensive philosophy and continued turnover at the receiver position are just as concerning as whether Bradford will be physically and mentally ready to stand in the pocket and deliver a strong, accurate ball. Taking the OTA reps was already a must for Bradford and he'll need to show something during camp before anyone should be comfortable rostering him as a QB2.

Running Back

Adrian Peterson (torn ACL, torn MCL, torn meniscus, Dec 2011)
Every postseason report on Peterson's rehab after reconstructive surgery is promising. He's running straight-line sprints without difficulty and he's beaten teammate Percy Harvin in a race up a hill. But don't be swayed by the positivity. Peterson's injury was significant. Peterson tore his MCL and had injuries to both his medial and lateral meniscus. It's not uncommon to have a dual ACL/MCL injury, but general practice is often to give the MCL injury a month to heal before ACL surgery to allow for a focused ACL rehab. Peterson elected to have surgery immediately to increase his chances of returning early in 2012. Associated meniscal injuries are also common, but add a degree of long-term difficulty.

While it's certainly possible that Peterson will avoid the PUP list and have a shot at playing in early September, take note that Peterson himself still rates his camp participation at 50-50. The competitive nature of the elite athlete always extends to their rehab period. Tell an athlete that the earliest they'll return to play is six months and they'll do anything they can to return in five. I'm not arguing that Peterson will not return to effectiveness at some point in 2012 it's possible but it's a longshot that he'll do so in the first month of the season. Temper your expectations accordingly.

Jamaal Charles (torn ACL, Sep 2011)
Unlike Peterson, Charles reportedly had an isolated ACL tear without other injuries and has had three additional months of rehabilitation time. Reports of his recovery are positive and he's expected to be ready for training camp. Charles' fantasy success this year will depend on two factors not entirely under his control.

First, the Chiefs signed Peyton Hillis in March. Hillis is clearly not as talented as Charles, but he's still a threat to steal significant touches from Charles, especially in the early weeks of the season. Second, there's more to a full ACL recovery than successful repair of the ligament. The ACL has receptors in it that tell the brain where the knee joint is in relation to the rest of the body. Those receptors are also damaged when the ligament is torn and may take longer than 6-9 months to fully recalibrate. That lost “feel” may be what players who have had ACL tears are talking about when they say it took them as long as 18 months to get back to their pre-injury form. It's reasonable to wonder if players who rely on lateral agility as much or more than power or straight-line acceleration like Charles may take longer to return to form.

Rashard Mendenhall (torn ACL, Jan 2012)
Most players with torn ACLs complete their rehab within 6-9 months. That timetable puts Mendenhall like Peterson right on the cusp of being ready for opening weekend. In March, Mike Tomlin said that he expects Mendenhall to start camp on the PUP list. Presumably the team will re-evaluate Mendenhall's readiness and conditioning in August and make a decision from there. Mendenhall doesn't have the elite talent of Peterson or Charles and he'll need a full recovery to be successful at any point in 2012. Any loss of agility, balance or position-sense in his knee will make it very difficult for him to be effective and earn enough touches to be more than a flex play this year.

Darren McFadden (Lisfranc sprain, Oct 2011)
Though McFadden's sprain wasn't severe enough to warrant surgery, he still needed every bit of an eight-week, non-weight bearing period last year before returning to practice. Ultimately, he wasn't able to return. McFadden fully participated in Oakland's OTA sessions in mid-May and there does not appear to be any immediate pain or range of motion issues. The Raiders' depth chart strongly suggests a 300+ touch season for McFadden, but it's hard to overlook his inability to play a full 16-game season. Buyer beware as always.

DeMarco Murray (fractured ankle, high ankle sprain, Dec 2011)
Murray is practicing without any limitations and last season's injury will not affect him in 2012. He looks primed to return to his full time role in Dallas and can be projected, ranked and drafted accordingly.

Matt Forte (torn MCL, Dec 2011)
Forte's MCL injury wasn't severe enough to keep him out of the Pro Bowl in late January. It's a non-issue. But rumors that the Bears have concerns about Forte's knees in the longer term have fantasy owners wondering how risky Forte may be. Though he has had ligament issues (torn PCL, torn MCL), this is the first indication that Forte may have a cartilage condition that could lead to a decline in production. Since Forte was healthy enough to gain 4.9 yards a carry in 2011, finished with more than 50 catches for the fourth straight season and immediately dismissed concerns, it's hard not to see the team's statements as anything more than a media negotiation tactic. You should be more worried about the team's plans for Michael Bush than the current health of Forte's knees.

Fred Jackson (fractured fibula, Nov 2011)
Like Murray, there's no reason for concern about Jackson's 2011 injury. Unlike Murray, Jackson will have significant competition for touches as C.J. Spiller looked very capable down the stretch last year. While the injury won't limit Jackson to less than 250 touches this year, the presence of Spiller likely will.

Ahmad Bradshaw (metatarsal stress fracture, bone marrow injection, Feb 2012)
Bradshaw returned to effectiveness and his usual role after missing more than a month while recovering from a complication near a screw in his fifth metatarsal last season. Faced with the choice of another surgery this offseason, Bradshaw elected to have a bone marrow injection to stimulate healing instead. Whether that procedure is effective remains to be seen, and it does not eliminate the possibility that Bradshaw could have another injury near the screw site necessitating a surgical revision. Proceed with caution here as usual.

Chris Wells (knee surgery, Jan 2012)
You can read more of my thoughts on Wells at the Second Opinion blog here. In short, there's reason to worry that his January 2012 surgery was more than a minor clean-out procedure. While players with similar knee histories Maurice Jones-Drew and Marques Colston come immediately to mind have been effective after multiple surgical procedures, Wells isn't without risk this season.

Ryan Williams (torn patellar tendon, Aug 2011)
You can read the tea leaves either way on Williams. Reports that his rehab has gone well, the fact that Arizona didn't add depth at running back, and the ongoing knee troubles for Chris Wells suggest that the Cardinals are pleased with Williams' recovery and believe he can be an impact player in 2012. Unfortunately, a torn patellar tendon is an extremely difficult injury for a running back. Strength in Williams' quadriceps muscle may never fully return, and there are also range of motion and explosiveness concerns. Williams acknowledges that he's no lock to be ready by opening week despite the encouraging rehab thus far. Consider Williams a boom-bust pick, with his value ultimately to be decided by how effective he and Wells are in camp.

Mikel Leshoure (torn Achilles tendon, Aug 2011)
I've argued since Leshoure's injury that he'll be a fascinating test case. Many have jumped to the conclusion that an Achilles injury is a death sentence for a running back. But there's never been a first round talent with an open depth chart like Leshoure who's had an Achilles repaired with the latest microsurgical techniques and rehabbed with the latest aggressive schedules. Many defensive players and, more recently, Demaryius Thomas have returned to effectiveness after Achilles repair. Leshoure, especially since his running style is not built on lateral agility and quick-twitch explosiveness, stands a good chance of success. Unfortunately, off-field issues and a possible substance abuse suspension may limit the number of chances he gets. I still think he's a buy-low, boom-bust pick this year, and I'm looking forward to watching him closely in camp.

Jahvid Best (concussions)
After missing the last two and a half months of 2011 with another concussion and spending much of that time fighting post-concussion symptoms and visiting multiple specialists, it's reasonable to conclude that one more head injury will end his career. Though he's not been formally cleared for full contact as of early June, Best has said he's not concerned about his concussion history and fully expects to play in 2012. It's difficult to say how prone Best will be to suffering another concussion this season, but he's the very definition of a red flag for fantasy purposes. I would avoid drafting him until his value is as undeniable as his risk.

Mark Ingram (knee surgery, May 2012)
Ingram needed surgery to treat the turf toe condition that ended his 2011 season (after missing games earlier in his rookie year with a heel injury). It's possible that he elected to wait until May to have surgery on a minor knee condition to focus on rehabbing his toe. But that would be an optimistic view. This isn't the first procedure that Ingram has had on his knee and there were reports that some teams took him off their draft board in 2011 due to worries that Ingram had a chronic condition. The surgery has been called a clean-up procedure, and Ingram is expected to be ready for camp. Still, it's hard to rank Ingram above the flex/RB3 tier given the durability concerns and the way in which he was used in 2011.

Wide Receiver

Hakeem Nicks (fractured metatarsal, May 2012)
I covered Nicks' injury on the Second Opinion blog in May. Nicks could return to full football activities in eight weeks, but the 12-week estimate originally suggested is more likely. If Nicks makes it through the final four weeks of rehab without a compensatory injury or conditioning issue, he can be considered a safe, elite WR1 in late August drafts.

Kenny Britt (torn ACL, Sep 2011)
Britt's rehabilitation was complicated by scar tissue that was removed surgically in mid-May. Scar tissue is a relatively common complication, even with early rehabilitation to prevent range of motion issues. The procedure will extend Britt's rehab, but it shouldn't prevent him from participating in camp. Like Charles, Britt will have to work through position-sense recovery issues to return to full effectiveness. If he's able to run crisp routes, win 50-50 balls, and high-point deep passes well in camp, the risk in drafting him drops significantly.

Andre Johnson (knee surgery, May 2012)
Johnson struggled to recover from a significant hamstring strain last season. There's some reason for concern that scar tissue could be a problem for him in that leg it was argued last season that scar tissue from a previous injury contributed to the severity of last year's strain but that's impossible to predict. The late spring knee surgery likely won't limit him in camp, but it raises questions about whether Johnson has had cartilage issues in that knee for some time or he suffered an injury after the season ended. More likely, it's the former and something to put in our memory banks should Johnson show signs of decline this year.

Tight End

Rob Gronkowski (high ankle sprain, Jan 2012)
Though he was able to take snaps in the Super Bowl, Gronkowski's high ankle sprain was severe enough to need surgery in February. Most players take 8-10 weeks to recover from surgery, and it shouldn't be a major red flag that the Patriots would hold Gronkowski out of OTAs in late May. If he's still limited during the upcoming minicamp and training camp weeks, there will be cause for concern. For now, chalk his “slow recovery” up to the perks that an established veteran gets at the tail end of his rehabilitation process.

Thanks for reading. Remember to follow the Second Opinion blog and my Twitter feed @JeneBramel for frequent updates during minicamps and training camp. You can also reach me by email at bramel@footballguys.com.

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