Fantasy football injury mailbag: Keenan Allens hamstring issues, ranking 2022s injured running -

In this week’s injury mailbag, we answer the question “Is Keenan Allen an injury concern?” Plus, ranking returning RBs, we hit on Joe Burrow again and more.

First, here’s a quick glossary of terms commonly used by Inside Injuries:

IRC = Injury Risk Category (three designations: “Low,” “Elevated,” “High”) — the overall likelihood a player will get injured
HPF = Health Performance Factor (Peak, Above Average, Below Average, Poor) — our metric to predict player performance
ORT = Optimal Recovery Time — the amount of time a player needs to fully recover from an injury (not the same as how much time they will actually miss.

Q: Of the Running Backs who missed significant time last season due to injury, who’s best placed to make an immediate impact for their team this year? I’m thinking but not limited to the likes of Williams, Hall, Mitchell, Harris etc. – SD

Of those listed, I’d put them in this order, assuming you mean immediate impact once they’re cleared to play:

Some of these guys, notably Hall, are unlikely to be ready for Week 1, but that doesn’t mean he won’t be impactful. I wrote a shorter piece on him and what our data shows in another article earlier this week — our data predicts his Optimal Recovery Time is closer to Week 3 or 4 rather than Week 1. That said, he fits great into the Jets’ scheme and with Rodgers under center there is a lot of potential for him to reach Aaron Jones-like levels of production.

At the bottom of the list is Mitchell because I am not quite sure how he fits into the 49ers’ plans with McCaffrey and even Deebo Samuel being the main two rushing/receiving threats. Mitchell is currently listed as RB2 on San Francisco’s depth chart, but he also suffered an adductor strain that will keep him out for at least one week. He’s had similar injuries in the past (hamstring strains) so he’s in a spot right now where I’m hesitant to say he’ll make an immediate impact.

Somewhere in the middle are Harris and Williams. Both have a lot to look forward to this season. Williams is rejoining a Broncos offense that frankly can only do better than it did last year. In fact, I’d gladly be wrong about listing him at No. 3. I’m only hesitant because his knee injury was brutal and the timeline Denver has provided for his return worries us a little. That being said, Sean Payton is the type of guy to get the most out of a player like Williams.

Harris won’t be the focal point of the backfield like Williams will be. Instead, he’ll be joining a committee composed of himself, James Cook, and Latavius Murray. He also suffered a knee injury earlier this week, but there haven’t been many details or specifics on what the injury is. His Injury Risk isn’t as high as some of the other guys on this list (he’s considered Elevated), but it’s more about how much usage he’ll get, similar to Mitchell. The good news is Harris doesn’t have a 2x Pro Bowler ahead of him on the depth chart.

Q: What impact does a period of not playing have on your likelihood to luck up an injury – does it increase or decrease risk? Thinking players like Calvin Ridley and Jameson Williams. – Ed M.

Good question! The relationship between not playing and then starting again has a lot to do with preparation more than anything. Both increased and decreased risks can be associated with a hiatus, depending on various factors such as the reason for the time off, the player’s position, training regimen during the time away, and more. But at the end of the day, it almost becomes a question of work ethic. Basically, if a professional football player wants to return to the game at the same level they left it, they have all the tools required to do so (provided there isn’t a natural, age-based regression taking place or a glaring injury holding them back).

That being said, on one hand, a period of not playing can actually lead to a decrease in injury risk under the right circumstances, as it gives the body time to heal from any previous or lingering injuries. On the other hand, extended time away might also lead to a decline in physical conditioning and football-specific skills. This decline could result in an increased risk of injury upon returning, as the player might be more susceptible to strains or other injuries associated with being out of game shape.

Let’s look at the two players you mentioned:

Jameson Williams ruptured his ACL in his final year with Alabama, which forced him to miss the first 11 games of 2022. He did manage play in the final six games of the season, but wasn’t a focal point of the offense. Now, heading into 2023, he’ll miss the first six games of the season due to a suspension he received for violating the league’s gambling policy. All things considered, Williams’ absences from the game don’t concern us too much. Detroit readily admitted they were taking things slow with him last year, and while the suspension this year doesn’t help, it shouldn’t be the sort of thing that prevents him from remaining physically fit or staying sharp.
Calvin Ridley hasn’t seen NFL action since October 24, 2021. At that time, he announced he would be stepping away from the game for mental health reasons. He remained inactive for the rest of the 2021 season before receiving a year-long suspension in 2022 after the NFL determined he violated the league’s gambling policy. Atlanta traded him to Jacksonville in November. It’s worth noting that Ridley also is said to have played the entire 2020 season with a fracture in his foot. Whether that needed additional rehab or not is unknown, however the time off should have helped in some capacity.

When it comes to both of these guys, their time away has not impacted how we view their respective Injury Risks.

Q: Is it fair to call Keenan Allen an injury concern? What’s his risk level for 2023? – F D.

In short: yes, and his Injury Risk is High. That’s not a super fun answer, though, so let’s examine Keenan Allen’s injury history and what we’re seeing.

At 31 years old, he’s on the wrong side of 30 and his injury history up to this point does raise red flags. He’s missed time with various strains and sprains since entering the league in 2013, but the ACL tear in 2016 is where everything starts to be put under a magnifying glass, especially his hamstrings.

For anyone who has kept up with the mailbags, you know how much I try to emphasize the severity of hamstring issues. So this part may sound repetitive, but I have to acknowledge it.

A hamstring strain involves a tear or stretch in one or more of the muscles at the back of the thigh. These muscles include the semitendinosus, semimembranosus, and biceps femoris, which are collectively referred to as the hamstrings. They run down along the back of the thigh from the hip to just below the knee and are responsible for numerous functions including bending the knee and extending the hip.

When it comes to football (and really any sport for that matter), the hamstrings are invaluable. They’re heavily involved in running, jumping, and a majority of other explosive movements. From a mechanical standpoint, for example, when a player sprints, the hamstrings pull the leg back and extend the hip, which allows for powerful bursts of speed.

Hamstring strains are graded as such:

Grade 1: a mild stretch with discomfort, might heal within a few days to a couple of weeks
Grade 2: partial tearing with moderate pain, can take several weeks to a couple of months to heal fully
Grade 3: a complete tear of the muscle. requires several months to heal, sometimes even longer

Recovery tends to be slow because it’s not just athletic movements that the hamstrings play a role in. They are engaged in many daily activities and tend to get pulled on throughout just a normal day. This can prolong recovery time and potentially lead to chronic issues.

Circling back to Allen, he missed seven games last season due to hamstring issues, so it’s something we are keeping a very close eye on heading into 2023.

Considering his age and the cumulative effect of these injuries, Allen’s Injury Risk is classified as High. Recovery from these types of injuries can be slower as one ages, and the chances of recurrence might increase. While his track record shows that he has been able to return to play and be productive, there are just too many injuries present for us to not be concerned.

Q: When will Jalen Ramsey be on the field? – Reed S.

Recent reports have indicated that Ramsey will be out until December, which certainly is brutal news, but not that surprising given the injury. The meniscus is a tiny, C-shaped piece of cartilage in the knee joint, serving as a cushion between the thigh and shin bones. There are two in each knee, one on the outside (lateral) and one on the inside (medial). Both play an essential role in distributing weight and providing knee stability.

A full meniscus repair, which Ramsey is said to have undergone, is a surgical procedure where the torn cartilage is sewn back together instead of being trimmed or removed. The goal of this surgery is to preserve as much of the natural tissue as possible so as to maintain shock absorption and improve long-term health. The downside of this surgery is that it typically requires a longer recovery time compared to other surgeries and treatments.

Here’s how it generally breaks down:

Immediate Post-Surgery (Weeks 1-2): Very limited movement. The main focus is to reduce/minimize swelling, pain, and discomfort.
Early Recovery (Weeks 3-6): Weight-bearing and range of motion exercises/activities gradually increase.
Mid-Recovery (Weeks 7-12): Light physical activity still aimed at reducing impact on the knee (anti-gravity treadmill, exercises in a pool, etc.)
Late Recovery and Full Return (Months 4-9): Ramping up sport specific activities in preparation for a return to the game.

The timeline provided by the Dolphins indicates they’re optimistic Ramsey can return on the earlier side of things. Provided he doesn’t suffer any setbacks, it is a possibility but there is still a long road ahead for him.

From an Injury Risk standpoint, Ramsey will be considered High if he does return in December. There is potential for him to drop into the Elevated category if his return is pushed back to January, but realistically it will probably remain High for the entire 2023 season.

Q: How much control over the quality of team medical staff and facilities does a GM have vs the ownership, and are certain teams plagued by injury in real meaningful ways, or really only in fluky ones? Asking as a nervous Giants fan with a shiny new glass cannon tight end – Fred S.

It’s certainly true that fluky injuries are part of the game, but you touch on an important aspect of the game off the field. If you haven’t read my piece from last week regarding the role team medical staff plays in injuries, I’d strongly recommend it. Otherwise, let’s talk a bit more about the relationship between GMs, ownership, medical staff, and player health.

Generally, the GM’s role is to build and manage the team, which does include some oversight of the medical staff and facilities. However, they are typically more focused on the aspects that impact the team as a unit. Think things like scouting, player transactions, and other team-building responsibilities. GMs may have a say in the hiring and evaluation of medical staff, but they more than likely redistribute that responsibility to someone like the Head Team Physician. Additionally, their control over facilities and other related resources tends to be limited.

Meanwhile, the ownership usually has more direct control over the budget and allocation of resources, which includes the quality of medical staff and facilities. In the NFL, good things rarely come cheap. State-of-the-art facilities, top-tier medical professionals, ensuring each staff member is supported in their role, hiring enough staff, etc. all cost money. Additionally, if someone higher up (like a Head Team Physician) is not meeting expectations, the GM may not have authority to fire them. Therefore, while GMs have influence, ownership ultimately has more control over these aspects.

Regarding injuries, some teams might appear to be plagued by them more than others. It can be tempting to attribute this to poor medical staff or subpar facilities, however, football is still football. Guys are getting hit, and other guys are doing the hitting. Someone is always going to get banged up.

There’s no doubt it’s essential to have a competent medical team and well-maintained facilities to help players recover, but these factors alone are rarely — if ever — the sole reason for one team suffering injuries at a higher rate.

Q: What is the expected timeframe for recovery on Joe Burrow? I have heard that his injury could linger and make it hard for him to plant his leg to throw even after he is cleared to play…your thoughts? – Greg G.

I provided a more in-depth answer to a similar question in my previous mailbag, but here’s the short version of what we’re seeing.

First, a calf strain is an injury to one, or both, of the calf muscles: the gastrocnemius and the soleus. Regardless of which muscle is strained, both are crucial for lower body movement and stability. Like you mentioned, this goes beyond Burrow’s ability to scramble or move around the pocket, it can also impact his throwing motion.

The good news is that calf strains tend to heal well with relatively minor treatment, even when the strain is considered moderate, like in Burrow’s case. Basically, he needs to rest and progressively work his way back into mobility and athletic exercises. If that goes well without any setbacks, there isn’t much concern for him and his mechanics long term.

Cincinnati should certainly be wary of clearing him too early, again circling back to your point. He might feel good moving around and the discomfort might be gone, but monitoring his mechanics is crucial to determining if the strain is fully healed or not. If they’re seeing something that doesn’t look right, he shouldn’t be cleared — simple as that. We’ll be monitoring his mechanics on our end, and it’s something we’ll use to calculate his Optimal Recovery Time, but for now we predict he will be ready for Week 1.

(Top photo: Kirby Lee-USA TODAY Sports; in-line photo of Keenan Allen: Kevork Djansezian/Getty Images)

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