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Offseason Injury Primer: Running Backs

For the purposes of this article, we will focus on fantasy relevant running backs who finished the 2018 season on injured reserve.

Derrius Guice – It was an unfortunate start to Guice’s career, as he tore the ACL in his left knee during the Redskins’ first preseason game in early August. By now, everyone has heard of the infection that caused Guice to delay his progress in rehab, but based on his workout videos, he appears to be on track. There was a recent video posted on his Twitter of him running in a straight line, which is good and all, but nowhere close to where he needs to be. Don’t expect Guice to start cutting for at least another 2-3 months. Guice should be ready for training camp in what will be his first season actually on an NFL field.

Corey Clement – Clement suffered a sprained knee in Week 14 and was sent to injured reserve shortly after. The Eagles didn’t provide many details regarding Clement’s injury, but my sense of the situation is that it’s more serious than not. According to the Philadelphia Inquirer’s Zach Berman, it’s possible that Clement misses time this offseason. That leaves a lot of questions to be answered about the specifics of the injury, but this isn’t the place for speculation. This should be treated as a wait and see type of situation, and Clement’s status for the 2019 offseason program can’t be predicted.

Jay Ajayi – Ajayi tore the ACL in his left knee in Week 5 against the Vikings and underwent surgery to reconstruct the torn ligament shortly after. Ajayi has been posting videos on his Instagram recently, and there’s one on there showing him do a box jump, which is a normal exercise to complete when rehabbing an ACL. At approximately 4.5 months out from surgery, he appears to be right on track. Don’t expect much from Ajayi during OTAs, but he should be fine for training camp and Week 1. An impending free agent, Ajayi will be better suited in a committee type of backfield given his history of knee injuries and documented arthritis.

Alex Collins – Collins was placed on injured reserve just prior to Week 13 after battling a foot injury for a few weeks prior, which may have played a role in him losing his starting job to Gus Edwards. Fortunately for Collins, he was able to avoid surgery, so this should be treated as a foot sprain. If given enough time to heal, Collins should be a full go for the offseason program of the team that he is playing for in 2019. With Collins becoming a restricted free agent, his immediate future in the NFL is in question.

Isaiah Crowell – Like Collins, Crowell’s season was also cut short due to a foot sprain. He was placed on injured reserve after Week 14 after battling foot pain off and on for several weeks. It’s possible he was placed on injured reserve as more of a formality given that there were only a few weeks left in the season. Regardless, Crowell was able to avoid surgery and should be able to make a full return in 2019.

Devonta Freeman – Freeman had a lost season in 2018 due to multiple injuries, all before being sent to injured reserve after Week 6. Freeman got banged up towards the end of 2017, injuring his right knee. He suffered a sprained MCL and PCL. Despite spending the offseason rehabbing and presumably entering the season at full strength, he got banged up in Week 1 and was never the same, dealing with knee soreness for the next few weeks. Upon returning to the field in Week 5, Freeman suffered foot and groin injuries, which subsequently sent him to injured reserve. He underwent surgery to repair a core muscle injury, and this recovery typically takes about 2 months. If the Falcons were in the playoffs, it’s possible Freeman would have returned, but with Atlanta out of playoff contention, it made sense to leave him on I.R. He will be participating in full during the offseason program, but he comes with some risk in fantasy in 2019, primarily because of his knee injury, which is likely to linger off and on during his remaining time in the NFL.

Frank Gore – The IronMan himself, Frank Gore, finally went down with injury after playing in all 16 games every season dating back to 2011. He played 14 games in 2018, going to injured reserve late in the year with a sprained foot. Gore’s foot should heal up nicely over the course of the offseason, but his effectiveness upon return at this phase of his career is in question. Now 35 (turning 36 in May), Gore is repeatedly going to attempt to come back for a 15th season, but he will be a free agent.

Kerryon Johnson – Johnson was impressive during his rookie year, but a sprained knee ended his season early. He went down in Week 11 against the Panthers and didn’t play for the remainder of the year. There was initial worry that Johnson had potentially injured his ACL, but an MRI confirmed this was not the case and also confirmed that he would not need surgery. Historically, the Lions don’t provide many details when it comes to their players injuries, and Johnson’s injury is no different with the team, only calling it a sprain. Technically, this isn’t wrong, but it’d be nice to know the specifics to be able to predict the long term risk associated with Johnson’s knee. Regardless, Johnson should be a full participant in the team’s offseason program and will certainly be ready to go full speed at training camp.

Aaron Jones – Jones suffered a sprained MCL in his right knee in Week 15, ending his season. If the Packers were in playoff contention or if this injury had happened earlier in the season, Jones would have been just fine to come back from this injury in about 2-4 weeks. With that being said, owners can feel confident about Jones throughout the entire offseason. He’s already at 100%.

Phillip Lindsay – The impressive rookie from Denver took the NFL by storm, but his season was cut short when he broke a bone and suffered ligament damage in his wrist in Week 16. Lindsay fractured the scaphoid bone in his wrist and also likely injured the scapholunate ligament, which helps to create stability when gripping objects, like carrying a football. He underwent surgery to stabilize the bone and repair the torn ligament in late December. Given that this rehab typically requires about 3-4 months, Lindsay will be ready well ahead of training camp without limitations.

Jerick McKinnon – McKinnon tore the ACL in his right knee just before the start of the 2018 season and underwent surgery to reconstruct the ligament in early September. Reports to this point have all been positive, and it appears as though McKinnon is right on track with where he should be now about 5 months out from surgery. McKinnon probably won’t start any cutting movements for at least another 2-3 months, but that’s completely normal for the ACL recovery. He’ll be ready to go when training camp rolls around.

Ito Smith – Smith flashed for the Falcons in 2018 as the backup to Tevin Coleman once Devonta Freeman went down with injury. However, Smith’s season ended after Week 15 when he suffered a torn meniscus in his left knee, which did require surgery. Based off a recent report that Smith is close to finishing his rehab about 7 weeks after his surgery, I suspect he had the type of surgery where they go into the joint and remove the torn portion of the meniscus and don’t repair it. Typically, a repair will require about 4-6 months of rehab, so he’s well ahead of that timeline, making the former type of surgery more likely. In addition, Smith posted a photo on his Instagram of him standing without crutches or a brace on January 1, just 13 days after surgery. If the meniscus was repaired, this would not have been the case. Regardless, Smith will be 100% by the time training camp rolls around and could have a bigger role in the Atlanta offense in 2019 with Tevin Coleman likely to test free agency

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About Matthew Betz

I'm a sports and orthopedic physical therapist currently working in Burlington, VT. I've been a sports fan my entire life and when I became a PT, I decided to combine my two passions into one awesome hobby. My goal is to provide injury analysis and information so that you can win your next dynasty title. Follow me on twitter: @TheFantasyPT