2013 injury outlook: Running backs
A preseason injury outlook on fantasy-noteworthy running backs. This column will be updated throughout the summer, and the latest information will appear toward the top of the column:
Andre Brown, New York Giants: Brown can't seem to catch a break. Or maybe he catches one too many. During the Giants' fourth preseason game Thursday, Brown absorbed a blow from a defender's helmet while being tackled, fracturing his left leg. This is the same leg Brown broke last November, an injury which ultimately ended his season. Last year, Brown required surgery and had a plate inserted to stabilize his broken fibula, the skinny bone on the outside of the lower leg. Based on Brown's reaction after the game, this injury -- at least initially -- sounds less serious and may not cost him nearly as much time.
According to ESPN New York's Ohm Youngmisuk, Brown was encouraged after the game. "Spirits are high, I'm positive," Brown said. "And I'm looking forward to coming back this season. It's not as serious as it was last year." Brown told reporters that he had "a little crack right above" the area where his plate was inserted last year (which would signify an injury to his fibula) and that he will not need surgery.
Although Brown says there are more tests to be done, there is certainly reason to be positive. If indeed this is a small crack of the fibula and no surgery is required, it's feasible to think Brown could return to action within a month. A move to injured reserve/designated to return would require him to be out for at least eight weeks, but Brown is already anticipating a much quicker return. "I feel I can come back from this within a couple of weeks, and that's how small it is," Brown said. "We are definitely looking at it positively."
Fantasy owners who have drafted Brown should not be panicking to unload him. Fantasy owners who did not draft Brown may want to procure him from those who may have already panicked. The only caution is that he may be more susceptible to another similar injury in this leg. The medical staff is likely to protect the area with some kind of shell or extra padding but when a running back's legs get hit and tangled in a pile, there are no guarantees. Then again, no running back's legs are really guaranteed when it comes to this game. If later tests confirm Brown's initial impressions of his injury, his return to action could come soon enough to still yield plenty of value.
Le'Veon Bell, Pittsburgh Steelers: The rookie running back has been unable to stay on the field consistently this preseason. First it was soreness in his left knee, which caused him to miss the Steelers' preseason opener. Days later he aggravated the knee in practice. He returned quickly enough to make an appearance in the Steelers' second preseason game, but that outing was also cut short due to injury. This time it was not his knee; Bell sprained his right foot after playing in just one series.
The big question now is how long this latest injury, called a midfoot sprain by coach Mike Tomlin (originally referred to as a Lisfranc sprain in ESPN reports), will keep Bell on the sidelines. At this point, there is no timetable being offered by the Steelers, but on the positive side, Bell's injury will not require surgery.
So what is a realistic expectation for fantasy owners? And why does panic ensue when we hear the term "Lisfranc" associated with a foot injury?
As for what fantasy owners can expect, the only sure thing is that this will be a multi-week injury. Bell has already been ruled out of the Steelers' third preseason game, and while the Steelers are not saying when they expect him back -- in their defense, it's too early to make that projection with any degree of certainty -- early reports suggest a recovery time of 6-8 weeks. That timeframe is fairly typical for non-surgical Lisfranc sprains, but it should be noted that depending on the actual degree of injury, the athlete's ability to heal and whether any setbacks occur along the way, that time estimate could fluctuate in either direction. Ray Fittipaldo of the Pittsburgh Post-Gazette reported Thursday that Bell said he was walking without discomfort and feeling positive about his progress. While that's great news, the big tests will come when he has to push off with running and pivot, twist and cut on that foot. Although the details of the injury aren't available, if it's indeed a Lisfranc sprain, it's difficult to imagine Bell returning to football before late September. It's critical to the long-term foot health of any player who suffers this type of injury that complete healing occurs prior to return to play, hence the slow progression, even when the player says he feels fine.
Jonathan Stewart, Carolina Panthers: Foot and ankle problems have been a sore spot for Stewart since he entered the league, but prior to 2012, Stewart had played in all 16 games in three of his four professional seasons. In fact, he had missed only two games in 2010. That changed in 2012 when Stewart was sidelined for seven games with a finicky high-ankle sprain, which ultimately required January surgery. The good news for Stewart is that Dr. Bob Anderson, his surgeon, is also a Panthers team physician and knows him and his history well, so he can be carefully monitored. His activity will be controlled throughout the summer, but the expectation is that Stewart will gradually increase his participation during camp. In Stewart's case, he largely has been able to stay on the field in his career, which bodes well, but the bigger question may be how the Panthers will view his role this season.
Addendum: Stewart was placed on the physically unable to perform (PUP) list, which means he will miss at least the first six games of the season.
Arian Foster, Houston Texans: It might not be a preseason without an Arian Foster soft tissue injury. We all remember the infamous hamstring MRI image Foster tweeted two years ago, which sent fantasy owners into a panic. No MRI images this time, but the sight of Foster on crutches in May might have had the same effect. The crutches help offload the calf so he is not forced to push off through the leg while walking, allowing the muscle to recover with the goal of minimizing any risk of worsening the situation. No panic is necessary this time, but it does remind us that Foster's body is a finely tuned machine. The same physical qualities that make him such a talented back may also make him susceptible to intermittent soft tissue strains. Still, despite a heavy workload as a starter, he has played in all 16 games two out of three seasons. Foster should be ready for the season, even if the team opts to lessen his workload during training camp, and the one place it won't shy away from using him is in the red zone. As long as he stays healthy, he will be highly productive, but a bit of risk comes with the territory.
Addendum: It's Aug. 19, and Foster, still on the PUP list, has yet to participate in a team practice. Now should fantasy owners be worried? They wouldn't be unjustified in being a little apprehensive, but it might be a mistake to panic. While Foster's situation bears monitoring, it's not yet clear whether the back ailment currently sidelining him (yes, his back, not his calf, is keeping him out of practice at the moment) will present a problem for him once the regular season arrives.
Here's the information we have. On Aug. 18, head coach Gary Kubiak acknowledged that Foster's back soreness -- which cropped up during the preseason -- is still present. Kubiak said Foster has been receiving injections as a measure of treatment for the back soreness but noted, "It's causing some discomfort and it's something that's going to take some time for him to get through." Kubiak said that Foster has more recently experienced some soreness into his legs, a byproduct of his injection treatment. When asked if there was concern about nerve damage with Foster, Kubiak said, "No, they've done numerous MRIs and everything looks fine. They're just trying to make sure that he's comfortable with how he is feeling and where we're at before we say 'go.'"
Although he said he believes players need to get practice reps to be ready to play, Kubiak conceded that doing whatever it takes to get Foster back healthy for the season is the priority. "We've got to do the smart thing here," said Kubiak, adding, "… when he's ready to go, I know Arian can make up a lot of time very quickly."
There are a couple of takeaways from Kubiak's comments that should be considered positives. The first and most obvious is that all the imaging studies done on Foster's back look "fine." The interpretation then is that there is no large herniated disk impinging on a nerve, no significant bone spur or any other obvious structural finding that would pose a bigger cause for concern. Also, it is not uncommon for individuals to experience soreness both locally (in the area of the initial problem) and referred (in another area related to but removed from the original site of the symptoms) following spinal injections. The expectation, if all progresses well, is that those symptoms will resolve in time for the start of the season, as long as no activity provokes them in the interim. This may be the reason the medical staff wishes to grant Foster some additional downtime. While it would be nice for Foster to get some reps and work at game speed before Week 1, especially to provide peace of mind for all interested parties that he is indeed healthy, he has shown in the past that he can ramp up his activity quickly and be successful.
It would seem the biggest potential concern with Foster would be for him to return to action too quickly, not only because his back soreness could spike but also because it could translate to a problem for his hamstrings. Low back pain and hamstring strains can be interrelated; one consequence of back pain can be guarding or protective spasm in the hamstring muscles which, in turn, can make the hamstrings more susceptible to injury. Even if Foster could forcibly push through discomfort in practice, the Texans would not want him to return only to leave with a more serious hamstring strain that could sideline him for multiple weeks.
The Texans plan to re-evaluate Foster on Tuesday, at which point the outlook for his health should become a bit clearer. If he is indeed able to return to practice within a few days and ease his way back into action, there would be little doubt about his availability for Week 1. This back injury might then translate to a slightly increased risk for Foster going forward, but it wouldn't significantly affect his value. If, however, Foster is not cleared to return to practice for the remainder of the preseason, the questions about his health -- and the apprehension -- should justifiably increase.
Information from ESPN.com's Tania Ganguli was used in this report.
Maurice Jones-Drew, Jacksonville Jaguars: When Jones-Drew injured his left foot last year, no one knew it would be season-ending. In fact, the team went from one week to the next expressing hope Jones-Drew could return. Unfortunately, some midfoot injuries are tricky, in that they are not serious enough to warrant immediate surgery yet ultimately fail to respond to conservative treatment. Such was the case for Jones-Drew and after he was unable to progress during the season, he underwent surgical stabilization in December. After several months of being in a boot, Jones-Drew is on the rehab train and making progress. Although he is not participating in June minicamps, the expectation is that he will be on the field when the Jaguars' training camp begins in late July. While the increase in his activity will be gradual, if there are no setbacks he should open the season on time. The relatively uncomplicated repair of Jones-Drew's injury bodes well for him going forward, and it's worth keeping in mind he is still only 28 years old. To date, he has one of the best track records as far as health for a running back, playing all 16 games in four of his seven seasons. Last year was the first season in which he played fewer than 14 games. While this injury takes him down a notch in terms of percentage of games played in a year, it shouldn't lessen his overall draft stock significantly, especially given that his knees benefited from some additional rest last year. As long as his football conditioning improves along with his foot, there is little reason for concern with Jones-Drew.
Addendum (Aug. 2): Jones-Drew was on the field with his teammates when training camp opened, albeit on a limited snap count. Still, he has been participating in both running and passing plays and introducing his foot to cutting maneuvers. The Jaguars maintain they will ease him back into action, but so far, so good for a target of Week 1.
Ahmad Bradshaw, Indianapolis Colts: It took a while for Bradshaw to find a home, but by the second week of June he had landed in the Midwest. The Colts obviously felt his talent outweighed the risk of resurgence of foot problems which have plagued Bradshaw for several years. Should fantasy owners feel the same way? In a word, yes. Bradshaw underwent another surgical procedure on his foot to address a chronic non-union in his fifth metatarsal (it had been surgically repaired with a screw once in 2010, then addressed with a paste when he began having troubles due to a stress injury, but ultimately required a second surgery to replace the screw). Now that Bradshaw has had a more extensive stabilization combined with adequate time to recover, the stress fracture should no longer be an issue. He expects to be ready to participate in training camp in late July. His feet and ankles may not be perfect, but even last year Bradshaw showed his willingness to play through pain. He also sustained a neck injury in 2012 which kept him out for a game and does raise a concern of potential recurrence. With only a one-year contract, however, Bradshaw needs to make the most of his time and should see his fair share of action in Indianapolis.
Addendum (Aug. 2): Bradshaw opened the preseason on the Colts' PUP list and remains in a walking boot on his surgically repaired right foot. This is not overly alarming, though, given that the goal is to have a healthy Bradshaw for the regular season, not the preseason. There is no need to subject his foot to excess work out of the gate, and the Colts had previously indicated they planned to ease him into the mix in camp. The expectation is still that Bradshaw will be ready by Week 1.
Adrian Peterson, Minnesota Vikings: Peterson put any and all critics to rest with his dominating performance in 2012 fresh off ACL/MCL surgery on his left knee. He was so fresh off the injury, in fact, that the Vikings did not confirm his Week 1 playing status until hours before kickoff, torturing fantasy owners far and wide. But the pain of the uncertainty heading into the season wore off quickly, as Peterson delivered week in and week out in a way no one could have predicted. Unfortunately, he has set the bar for performance following ACL surgery at a virtually unattainable level for all those who come after him; his recovery was the exception, not the rule. While no one is concerned about his knee heading into this season, Peterson did undergo a different offseason procedure this year, specifically a core muscle surgery (formerly known as a sports hernia repair). Somehow, Peterson continued to perform well despite the presence of the injury late last season and once the Vikings were finished, he took care of the issue via an operation. After going through intensive rehab last year, Peterson has indicated this recovery is like a walk in the park. Any doubters out there in fantasy land? Didn't think so.
Marshawn Lynch, Seattle Seahawks: Unlike in 2011, Lynch was not scratched from a game during warmups in 2012, but his back did continue to bother him occasionally. Despite appearing on the injury report for multiple weeks last season, Lynch played in all 16 games for the first time in his professional career. The back troubles are not likely going away, but neither are Lynch's touches.
Trent Richardson, Cleveland Browns: One thing you have to acknowledge about Richardson: He knows how to play through pain. Richardson played in 15 games in his rookie year, despite entering the season fresh off of arthroscopic knee surgery and suffering a significant rib injury in Week 6 (the only game he did not play was in Week 17 due to a high-ankle sprain). Alarm bells sounded during OTAs when the Browns announced Richardson was dealing with a shin injury which would sideline him until training camp. The shutdown here is proactive, as the concern would be progression toward a tibial stress fracture, which could ultimately sideline him for multiple weeks. Early rest should allow him the opportunity to heal before the season begins. According to the Cleveland Plain Dealer, the Browns do expect him to be ready for camp in July. His workload in his final college season at Alabama, along with his rookie year in Cleveland, have some worried -- especially given his injury history -- that he will not hold up for long. They might be right in terms of all-out NFL longevity, especially if he remains an every-down back. But, if his toughness is any indication, it will take something substantial to sideline Richardson on any given Sunday.
Jamaal Charles, Kansas City Chiefs: Last year, there was some uncertainty about what to expect from Charles heading into the 2012 season, as he was coming off of ACL reconstruction in his left knee. Fortunately for Charles, his injury happened so early in the 2011 season (Week 2) that he was itching to play by Week 1 of 2012. Despite playing in a mediocre offense, Charles had seven games in which he totaled more than 100 yards and ended up with more than 1,500 rushing yards on the season. Given that most football players have better statistics in their second year following ACL surgery, Charles should be primed for a big season. And with new head coach Andy Reid at the helm and quarterback Alex Smith under center, Charles may have even more reason to smile. He seems to be aware of the opportunity, telling the Kansas City Star in June, "This offense might be the best thing that ever happened to me." Charles did have his toe stepped on in OTAs in late May, but X-rays revealed no fracture and he resumed practice within three days. Fantasy owners have much to like here.
Addendum (Aug. 16): On Aug. 12, Charles went down with a foot injury in practice, and the social media world went into a panic. Now that the term "Lisfranc" is familiar to fantasy football audiences - it's often associated with ending seasons prematurely, as was the case with Santonio Holmes and Maurice Jones-Drew -- the worst was immediately assumed in Charles's case. It turns out that was a bit premature. Not only did Charles sustain a relatively minor injury, his pain wasn't even in the same area of the foot Lisfranc-type damage occurs. Charles experienced pain on the outside of his foot. As Chiefs' athletic trainer Rick Burkholder told reporters, "There's a tendon that attaches right at that spot and that's what is sore. … That's why they call it a strain and [now] he is sore up his leg, which is natural and we expected to see that."
Burkholder went on to say that Charles had also seen two orthopedic surgeons, noting, "We agree that he has a mild foot strain, and he is day-to-day." (Strain refers to a muscle or tendon injury, sprain refers to a ligamentous injury.) Charles will not play in the Chiefs' second preseason game as a precaution, but this should not threaten his status for Week 1.
DeMarco Murray, Dallas Cowboys: Murray insists he isn't injury-prone. His history thus far in his young career suggests otherwise. In 2011, Murray played in 13 games before his season ended prematurely as the result of a fractured right ankle and high-ankle sprain. Last year, the number of games played dropped to 10 after a left foot sprain sidelined him for Weeks 7-12. When Murray returned to play, he never looked back and was able to run without issue the remainder of the season. Still, there are questions as to how he will hold up in this his third professional season. Given that he was largely held out of spring OTAs due to a hamstring strain, the worries remain, particularly since hamstring injuries have plagued him at various times since his college years at Oklahoma. For his part, Murray waved off the early preseason concerns, telling the Dallas Morning News, "I am going to play all 16 this year." I like the confidence and the talent but need the proof.
Ryan Mathews, San Diego Chargers: There is so much talent there that you want to believe in his potential. But there is also so much apparent fragility it's impossible to overlook the risk. When the number of broken clavicles in a season (two) outnumbers the touchdowns scored (one) for a running back, there is no denying the injury concerns. After a rookie year that was marred by a high-ankle sprain which seemed to linger, perhaps the result of attempting to return too quickly, subsequent soft tissue ailments in 2011 were significant enough to result in continued missed time for Mathews, even in the form of early exits if not entire games. The hope was that 2012 would be different, as the team looked to be leaning toward him for primary-back production. Then, on the first carry of the first preseason game, Mathews' first injury of the year happened; seemingly routine contact resulted in a broken right collarbone. The second clavicle fracture came in Week 15 against the Panthers and resulted in Mathews being placed on injured reserve. In between the two fractures, Mathews dealt with a minor ankle issue and neck stiffness, although neither kept him from playing, along with fumble challenges. Mathews is healthy as of this preseason writing, but given his history the question in everyone's mind is not so much can he stay healthy, but how long until the first injury crops up. Until he shows he can endure an entire season in the NFL, or even the majority of one, the risk appears to outweigh the reward.
Darren McFadden, Oakland Raiders: The 12 games McFadden played in 2012 were a big improvement over the seven he played the prior season, but he still has yet to post a full slate of games in the NFL. In 2011, a foot sprain turned from a week-to-week injury to a season-ender and it's hard to blame McFadden for something that should have been acknowledged sooner by the team. To his credit, he returned strong in 2012 and looked in the preseason as if it could be a banner year. The regular season disappointed, however, and a high-ankle sprain midway through did not help. Leg injuries have been McFadden's nemesis and are too numerous to ignore heading into this season. It's hard to believe he'll be only 26 years old when the season gets underway, but it suggests he's still got potential. That said, the injury frequency remains a worry for fantasy owners.
Fred Jackson, Buffalo Bills: Jackson was as unlucky as any running back in 2012. After ending his 2011 season on injured reserve due to a fractured right fibula, Jackson worked hard to ensure he'd stay healthy the following year. Unfortunately, an awkward play in Week 1 resulted in a lateral collateral ligament (LCL) sprain in his right knee, which, he later told the Bills' official website, never fully recovered in-season. Jackson went on to sustain a concussion in Week 10, which caused him to miss a game, then sustained a Grade 2 medial collateral ligament (MCL) sprain (also to his right knee) in Week 14, ending his season. Although he's 32 years old, his route to the NFL actually resulted in less mileage during his earlier years and Jackson could still post a strong season in 2013, although that may depend on how much the Bills lean on C.J. Spiller.
Mikel Leshoure, Detroit Lions: After serving a two-game suspension, Leshoure participated in the remaining 14 games of the 2012 season, despite entering the season coming off Achilles surgery and dealing with a variety of other ailments throughout the fall. Hamstring, groin and calf strains were all part of his in-season injury list and may have been associated, at least in part, with his return from serious injury. Power and explosiveness are usually lacking the first year following Achilles tendon repair and Leshoure's running should be improved heading into this season. For what it's worth, a hamstring ailment kept Leshoure out of early OTAs this spring, leading one to wonder whether that's a signal of more soft tissue injuries on the horizon. Now that Reggie Bush is in the mix in Detroit, Leshoure will have to show he can stay healthy enough to command more carries.
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