A preseason injury outlook on fantasy-noteworthy quarterbacks. This column will be updated throughout the summer, and the latest information will appear toward the top:
Arian Foster, Houston Texans: It's reasonable to have concerns about how well an athlete will perform coming off back surgery, particularly when that athlete is expected to pound the ground, demonstrate agility and explosiveness and absorb contact week in and week out. But those concerns should be put at ease when the athlete is Foster, whose fitness level, work ethic and health history support the notion that he could actually have a better season this year than the one he was having prior to his injury in 2013.
Microdiscectomies in the lumbar spine (low back), performed to remove the offending portion of the disc that is causing pain and weakness in the spine and lower extremity, have become more routine, as is the return to sport of the athletes who have the procedure. Patriots tight end Rob Gronkowski returned to play last year after undergoing the procedure in June and performed well until suffering an unrelated injury. Cowboys quarterback Tony Romo has been participating in offseason workouts without incident after a December microdiscectomy. Foster, who had surgery back in November, has had even more time to recover and was cleared for full activity in March.
But what about a running back having this procedure and returning to play at an elite level? Well, there is the example of Steven Jackson, who had a microdiscectomy in April 2010. Jackson, also known for his fitness level and work ethic, returned the following season to the tune of more than 1,200 rushing yards and six touchdowns.
But Foster has a history of hamstring problems. Isn't that a concern? Yes, but perhaps not as much. Of course, when an athlete who is a power runner has chronic hamstring issues as Foster does, there is concern as to whether that tissue can be more easily aggravated going forward. It is also true, however, that lower back pain can be associated with repeat hamstring injuries. The complex relationship between the nerves that travel from the back to the posterior thigh and leg can result in increased pain, cramping and even more susceptibility to localized injury when those nerves are irritated, as they can be with disc problems. Addressing the root cause of the problem at the spine can result in fewer hamstring-related injuries. It is quite possible that Foster's earlier hamstring injuries were related, at least in part, to an underlying spine condition that ultimately grew to be a primary problem.
Addendum (8/8): Foster has missed several practices over the past week with an undisclosed issue, which head coach Bill O'Brien would describe only as "kind of a day-to-day thing. Nothing serious." It does not appear to have the Texans concerned, and perhaps they are simply taking the proactive approach with Foster, given his offseason back surgery.
Steven Jackson, Atlanta Falcons: No one can question Jackson's commitment, his work ethic, his focus or his fitness. But his ability to stay healthy is another matter. To be fair, in the four years preceding last season, Jackson played in either 15 or 16 games each season. Still, there were times when he played through ailments, typically of the soft-tissue variety, that limited him. In 2007 and 2008, Jackson played in only 12 games, and that was the pattern again last year. A hamstring injury sidelined Jackson for four full games and the bulk of a fifth, reminding us that recovery at the age of 30, after a decade playing in the NFL, is not as swift as it once was. Jackson retains all of the above qualities that make him valuable to the Falcons, but his fantasy value, particularly because of that injury risk, isn't quite what it used to be.
Addendum (8/8): It's not the way Jackson or the Falcons imagined camp starting, yet it is all too familiar. Jackson sustained a left hamstring injury early in camp, one that is expected to sideline him for a couple of weeks. The team is hopeful he will still be ready to play by the season opener, but this doesn't ease concerns about his injury risk.
David Wilson, New York Giants: In a strange bit of irony, Wilson ended up requiring surgery similar to that of the former Giants running back whose role he had assumed. Ahmad Bradshaw sustained a neck injury while with the Giants; when he went to the Colts he had a recurrence of symptoms and later underwent a cervical fusion. Wilson was diagnosed with spinal stenosis, a narrowing of the spinal canal which houses the spinal cord; the condition was responsible for symptoms Wilson developed in conjunction with an October injury. He ultimately underwent a fusion surgery in January. Wilson has not yet received clearance for contact, but both he and (more importantly) team physician Dr. Russell Warren anticipate he will be cleared in advance of training camp. Bone healing with a fusion tends to be better established by six months, and Wilson will be approaching that mark when camp begins. The bigger concern might be whether Wilson will be football-ready or rusty after being sidelined since Week 5 of last season and after having significant activity restrictions in place until this spring.
Addendum (8/8): After consultation with his surgeon and New York Giants team physicians, Wilson has elected to retire from the NFL. After suffering a burner early in camp where he experienced temporary loss of feeling in his extremities, Wilson went through extensive evaluation. Although he will not need any additional surgical intervention at this time, the conclusion of the medical team was that he would be at considerable risk if he were to continue to play.
Adrian Peterson, Minnesota Vikings: After Peterson put together a season for the ages following ACL reconstruction, are we really going to be concerned about him after a core muscle (groin) repair surgery? Didn't think so. While no surgical procedure should be dismissed, Peterson has had ample time to recover from this operation, which was performed in January to address an issue that had bothered him intermittently during the season. Also working in his favor is he has been through this rehab process before following a similar procedure just a year ago. Expect Peterson to continue to prove that he can run "All Day" -- and maybe even catch a few more passes this year, too.
Doug Martin, Tampa Bay Buccaneers: Last year, Martin was struggling to live up to the preseason hype generated by his rookie performance in 2012, and that was before he suffered what would ultimately be a season-ending injury. Martin landed hard on his left shoulder in Week 7, tearing the labrum, the cartilaginous ring that lines the rim of the shoulder socket and adds depth and stability to the joint. Despite his efforts to rehab the shoulder for several weeks, it became apparent he would need surgery to repair the torn labrum, and his season came to an official close in November.
The good news for Martin is he has ample time to cushion the normal recovery timetable for this injury, which should help ensure he is at full strength to start the season. As of April, Martin was cleared to return to all activity. He is not an overhead thrower, so the functional demands of his shoulder should not be hampered. The primary element to watch for in the preseason is how Martin responds to contact, both direct (to the shoulder) and indirect (with an outstretched arm). Those looking for a silver lining can appreciate the freshness of Martin's legs after being limited to just six games in 2013. With a repaired shoulder and fresh legs, the only remaining variable to consider is just how many carries the Buccaneers' new coaching regime will plan for him.
Out for the season
The following players have already been ruled out for the 2014 season due to injury:
Kendall Hunter, San Francisco 49ers: Hunter tore his right ACL in practice on July 24 and has been placed on IR.
Vick Ballard, Indianapolis Colts: Ballard, who was just returning from a right ACL reconstruction, tore his left Achilles in practice on July 24 and will be sidelined for the season.
Tyler Gaffney, New England Patriots: Gaffney tore the lateral meniscus in his left knee in Carolina Panthers' practice on July 24, ending his season. In a surprise move, the Patriots claimed him off waivers and Gaffney will be with New England going forward.