MoxBlog

This week, we push aside our dear readers so our fantasy football staff can pepper injury expert Greg Scholz with their questions. In this Very Special Injury Mailbag, we get into Kyler Murray’s timetable, the difference between Breece Hall and Javonte Williams, the MetLife Stadium turf situation, high ankle sprain recovery time and more… 

Q: When do you expect to see Kyler Murray back on the field? Will the injury nerf his rushing production when he comes back, or will it be wheels up once he plays? – Jay Felicio

Our data suggests Murray is likely to return around Week 4 or 5. Regarding his rushing performance, we don’t anticipate he’ll set the world on fire, at least initially.

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What’s interesting about Murray, as a mobile quarterback, is that we generally don’t see players like him tear their ACL. The majority of quarterbacks who suffer these kinds of injuries tend to be pocket passers who get hurt when the pocket collapses.

With players like Murray, it’s crucial to remember that ACL recovery goes beyond just the knee getting healthy. The psychological aspect of the injury often lingers long after surgery and recovery. Players may initially hesitate, consciously or subconsciously, to make sharp cuts, sudden changes in direction, or sprint at full speed. This is a completely normal period of readjustment.

If Murray exhibits such hesitancy, it’s vital that his mechanics are monitored. Poor or faulty mechanics could indicate that he hasn’t fully recovered or that the knee didn’t heal properly. Ff his mechanics are sound, then once the mental recovery period is over, he should return to his dual-threat ways.

Read more: 2023 fantasy football draft kit: Rankings, cheat sheet, player projections, mock drafts and more

Q: How are Breece Hall and Javonte Williams so different in recovery despite Hall’s injury supposed to be less serious than Williams was? And is there any chance Javonte Williams suits up in Week 1 having sustained a worse injury than Breece Hall, who has yet to take the field himself? – John L. & Jake Ciely

I lumped these two questions together because they both touch on the injuries suffered by Javonte Williams and Breece Hall.

Hall and Williams are both entering the final phases of their rehab and are ramping up for a return to the NFL following significant knee injuries. At the time of writing, Williams is about 10.5 months removed from experiencing a more severe overall injury, with the anterior cruciate ligament (ACL), posterolateral (PCL) corner, and the lateral collateral ligament (LCL) being ruptured. Such a wicked combo of injuries doesn’t only affect knee stability but also its side-to-side movement. Additionally, the nature of Williams’ injuries typically necessitates a more extended and complex rehabilitation process, but all things considered, that doesn’t appear to be the case with him.

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On the other hand, Hall is recovering from a ruptured ACL in his left knee, which should have a more straightforward recovery. That being said, it’s important to remember that the frequency of ACL injuries in the NFL has somewhat desensitized a lot of fans to the true severity of it and the challenges that come with recovery.

Looking at both of their injuries, one would typically expect Hall to be further along in his recovery, considering he suffered a less complicated injury and has had roughly the same amount of rehab time. However, recovery goes much further beyond the initial timeline, so let’s look at a few factors:

• Severity of Rupture: Not all ruptures are created equal. While Williams had three ligaments affected, recovery times can be shortened somewhat if one or more were partial ruptures.
• Rehab Plan and Adherence: It’s possible that Williams might have followed a more aggressive rehabilitation regimen or may have strictly adhered to all medical advice, accelerating his recovery. That’s not to insinuate Hall hasn’t been smart or strict about his rehab, rather Williams might be on a faster track than most expected thanks to this.
• Biological Factors: Often overlooked, but genetics really do play a role. Everyone’s body responds differently to injuries, surgeries, and the recovery process that follows. Williams’ body might have just responded really well to everything so far.
• Mental Preparedness: Even more overlooked than biological factors, recovery isn’t just physical. The mental aspect of rehab is highly taxing and players often meet with sports psychologists to gain a better understanding of the injury and the trauma surrounding it.
• Team Strategy: Finally, the people who make the decision. This kind of goes hand-in-hand with the rehab plan and adherence. If the team wants to fast track rehab and the player’s body responds well to it, great. If the player’s imaging and performance looks good, even better.

To answer the question about Williams being ready for Week 1, it appears to be a very real possibility given everything going on. Our data tends to lean on a more conservative approach and predicts an Optimal Recovery Time closer to Week 5, however Denver is going to make the final decision and they appear to be full-steam ahead.

Q: It’s really uncomfortable and stretches beyond fantasy football but can we confidently rely on a full season from Tua Tagovailoa? – John L.

The short and simple answer is no, we can not rely on a full season from Tua, but that’s just the simple answer. I know it sounds grim, especially considering the seriousness and severity of his injury history, but it’s not as bad as it looks on the surface.

First, the elephant in the room. Concussions are highly serious injuries that — despite a growing understanding — continue to be overlooked and chalked up as a byproduct of the game. Yes, the sport is physical. Yes, most of the contact that causes concussions tends to be incidental. However, that doesn’t mean the NFL, medical staffs across the league, and players themselves shouldn’t start employing ways to mitigate risk.

That’s where Tua comes in. His concussions last year brought a spotlight onto the league and its concussion policy, so much so that they amended it mid-season. Additionally, the Dolphins medical staff was put under a microscope. Because of this heightened awareness surrounding Tua and his overall health, we anticipate a much more rapid response to any injury of his that occurs throughout the season, especially to the head. It’s never something we look forward to, but yes, we anticipate he will suffer another concussion scare at some point this season, putting his status for all 17 games in question.

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Beyond that, once someone suffers a concussion, there is a period of heightened susceptibility to another concussion. Generally, this period lasts a few weeks or months, however it can grow exponentially if the person suffers a second concussion within the original heightened susceptibility period. This was the case with Tua last season, meaning we still consider his Injury Risk to be High.

Q: It seems like the high ankle sprain has gone from a crazy six week absence and then four weeks of the player not being himself to about a week off and then a couple weeks over the next month or so of some kind of after-effect. Has the treatment gotten better? Are players just being tougher? Are we imagining this? – Nando Di Fino

You’re definitely not imagining it, and there are a few reasons for why that may be. But first, I’d also like to point out that you are 100% correct in saying the high-ankle sprain is capable of forcing a player to miss multiple weeks. Last year, players like Sam Darnold, Jonathan Taylor, Mac Jones, N’Keal Harry, Cooper Kupp, and Aaron Donald all missed 3+ weeks with high-ankle sprains.

From a treatment perspective, there have been some advancements in medical procedures that result in shorter recovery times. The most noteworthy is the development of what’s known as “tightrope surgery.” This is a procedure designed to stabilize the ankle joint by placing a sturdy, yet flexible suture between the tibia and fibula. The goal of tightrope surgery is to allow for more efficient healing of the syndesmotic ligaments without fully immobilizing the ankle joint. Before this, surgery involved placing two metal screws into the ankle to stabilize it. This meant the joint had reduced mobility — leading to side effects like muscle loss — and a second surgery was required to remove the screws, delaying recovery.

While not all players opt for tightrope surgery, especially if the ankle responds well to non-surgical treatments or if the injury isn’t as severe as initially believed, this brings us to your question about perceived shorter recovery times.

It’s not so much about shorter recovery times as it is about overestimating the initial injury’s severity. Specifically, with high-ankle sprains, there can be confusion distinguishing them from the more common lateral ankle sprains, especially if imaging is not done right away. Despite the best efforts of medical staff, a lateral ankle sprain can sometimes be misdiagnosed as a high-ankle sprain early on.

Since lateral ankle sprains heal quicker, we might think to ourselves: “Wow, that guy only missed one game with a high-ankle sprain, how’d he do that?” — when in fact, there wasn’t a high-ankle sprain to begin with. Additionally, there may only be minor damage to the syndesmotic ligaments, which is where the injury grade scale comes into play.

So between tightrope surgery, misdiagnoses, or an injury simply not being as severe as originally thought, the perception of quicker recovery times can be influenced by a lot. Simply put, it’s a blend of actual medical progress and the presentation of injury information.

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Q: Darren Waller has sustained numerous injuries over the past few seasons. Are they related, and is there concern for his injury risk this season? – Jay Felicio

It’s impossible to say with 100% certainty if the injuries are all related, however we can make some inferences based on the location of the injuries and previous recovery times. To summarize our analysis, we believe the injuries are related and he is entering this season with a High Injury Risk.

Since 2015, we’ve cataloged nine lower body injuries for Waller. Not all of these have forced him to miss time, however a lot of them have. Beyond that, it paints a concerning picture for his health moving forward.

The big focus should be on his hamstrings. I plan on answering another question in this mailbag about Cooper Kupp where I’ll discuss the hamstrings further, however the key takeaway is these strains take a lot of time to heal. If you aren’t resting adequately, a mild hamstring strain can take months to heal, and each time a player tries to return too early they’re only making it worse.

Waller is heading in that direction. If he suffers another hamstring strain this season, he could end up missing a lot of time. 

Q: Can you explain the MetLife turf situation? They changed it from slit to monofilament this winter because everyone was getting hurt on it in previous seasons. Is this significantly better for players not getting injured? And is there some kind of downside (lack of speed burst, mobility, etc) with the new surface? – Nando Di Fino

The relationship between turf fields versus grass fields is still ongoing, but most players tend to believe grass is the ideal playing surface for health. When grass isn’t an option, monofilament turf is considered better than slit-film for a few reasons that I’ll touch on shortly. But first, what is slit-film turf? Slit-film turf is made up of thin sheets of plastic that are slit into narrow strands and woven together. The result is a dense, rigid, durable surface. It provides increased traction and is known for a sort of “sticky” feeling when playing on it.

Monofilament turf, on the other hand, uses individualized and more grass-like fibers. Generally, this makes the surface softer and less “sticky,” though it is less durable and needs to be replaced more often.

MetLife switched its turf due to complaints and concerns from players. Because slit-film is harder and there is less natural movement (little “give” in the ground), there is believed to be an increased risk for lower body injuries.

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Let’s look at the pros and cons of the switch:

Pros:

• Injury Risk: Like I mentioned, there’s still an ongoing debate about turf versus natural grass and injury rates. That being said, there is enough concern surrounding certain turf compositions, like slit-film, that a switch was made with the hope of reducing injuries. Though tests are still in their infancy, reports suggest that monofilament turf might indeed be safer in terms of traction-related, lower body injuries.

Cons:

• Performance: That “sticky” feeling on slit-film turf can make players feel more in control of certain agility moves, like juking or launching off the line. But the transition from slit-film to monofilament is not typically associated with any significant performance decline. The feeling of the surface might be different, but this doesn’t necessarily translate to a blatant decrease in speed or mobility. It often comes down to individual preference.

The relationship between playing surface and injuries, especially to the lower body, is still going to be a topic of conversation. Players are going to continue to plead for natural grass fields, but until then, this is a step in the right direction.

Q: How worried should we be about Cooper Kupp re-aggravating his hamstring injury? – John L.

Our data says his Injury Risk is High, and this is likely to remain the case for at least the first few weeks of the season.

Hamstring strains are notorious for recurring, especially if not addressed correctly. While they might seem minor, understanding the anatomy of the hamstrings and their function sheds some light on why they can be such difficult and significant injuries.

The hamstrings are made up of three muscles at the back of your thigh: the biceps femoris, semimembranosus, and semitendinosus. TThese muscles facilitate the extension of your hip (moving the leg backward) and the bending of your knee. Picture the motions of things like running, jumping, cutting, or really any other athletic lower body movement, the importance and strain on the hamstrings become evident.

Their function is also what can make them slow to heal. Because they’re involved in so much, it can be challenging to fully rest them and avoid re-injury. Additionally, the blood supply to the hamstring is relatively limited, which can slow the healing process.

(Top photo: Mike Stobe/Getty Images)

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