Five Under-the-Radar Injury Risk Players for 2020

Before diving into five players to be concerned about, allow me to share three basic rules of injury analysis.

Rule No. 1: Watch for patterns. Will Fuller demonstrated a significant pattern of muscular strains, specifically hamstrings, early in his career. Even “minor” injuries, such as repeated muscular strains, are not a coincidence. Conversely, if a player has a lacerated kidney, a torn ACL, and a fractured clavicle, rest assured that pattern is not medically related and he’s next-level unlucky (looking at you, Keenan Allen).

Rule No. 2: Watch the practice report. Odell Beckham was listed on the practice report with a “hip” injury from Week One until the Browns’ bye. Then, the injury changed to “groin” (aka “sports hernia”) which should have tripped an alarm in your head to sell- fast. Following Rule No. 1 led us directly to Rule No. 2 and away from boatloads of disappointment.

Rule No. 3: Follow an injury analyst. Inevitably, situations become murky and nobody has time to take an anatomy and physiology course (except me).

Dishonorable Mentions 

The following players are on my injury radar, but they’ve either performed well on a consistent basis or there’s simply not enough information about their circumstances to make an educated analysis: Mike Evans, James Conner, Todd Gurley,  Kerryon Johnson, Derrius Guice, Austin Hooper, and Odell Beckham. 

The following analysis is for players who either have a relevant injury pattern that has directly caused them to miss time or have an injury history that affects their on-field performance in the long run.

Matthew Stafford

Matthew Stafford‘s redraft ADP is a crime. That’s because he’s the first player who falls squarely into “under-the-radar” injury risk category, at least from my perspective, due to his age and injury history. The 32-year old Stafford has missed 27 games since 2009, eight coming last year.

Matthew Stafford Medical Report 2009-2019

Stafford has suffered vertebral fractures two years in a row now. This predisposes him to a recurrence even before considering his age and other injuries. Vertebral fractures are extremely problematic for players since backbones give the spine stability. When that back stability is compromised, the brain tells the back muscles to contract (spasm) to substitute for that stability and the cycle continues. If he does have a recurrence, the average return to play time is around 34 days (about five regular-season games). Successful fantasy football players take into consideration every player’s entire range of potential outcomes. The reality is that more missed time for Stafford is not unreasonable. 

Saquon Barkley

Saquon Barkley has missed only five total games as a starter since college. The concerns come from the ankle injuries. The games he has missed in his career are from two confirmed high ankle sprains and a third that is unconfirmed. With a six-percent recurrence rate that rises with each additional high ankle sprain, he isn’t a slam dunk to stay healthy in 2020.

From a physical performance standpoint, tape grinders gush at Barkley’s elusive footwork and unmatched ability to stop on a dime and spin away from defenders. Although this is what makes him great, dare I say generational, it’s also what bolsters the argument for potential re-injury. Every time he plants and spins, he’s forcibly cork-screwing his lower leg down into the turf, which is half of the recipe for a high ankle sprain. Add in the entire weight of an NFL defender compressing his foot further into the ground while making a tackle and three to five games are lost in the blink of an eye. Even if the third unconfirmed sprain is in the “low” category, those suckers carry a 73-percent recurrence rate on their own.

Let me be crystal clear: I am not predicting a re-injury in 2020. I’m walking you through the data and the clinical picture to once again explore (say it with me, kids), the potential range of outcomes. Ultimately, this is a “splitting hairs” analysis for redraft players deciding between Barkley and Christian McCaffrey. 

Dalvin Cook

For visualization of exactly how good Dalvin Cook is, consider the graph below. The orange shaded box is Cook’s Fantasy Points Per Game over his last ten games. Statistically, it represents his mean, median, ceiling, and floor. The blue shaded box represents the same for Ezekiel Elliott, Derrick Henry and Aaron Jones combined. The three players’ combined median score was 16 and Cook’s median was 25-percent higher at 20 points per game. That’s crazy good.

Dalvin-Cook-Recurrence-Rates

Dalvin Cook Recurrence Rates

Conversely, most recognize Cook comes with an injury history, but let’s try and quantify it with the medical literature. Every rose has its thorn, and Cook’s thorn sure is large with him suffering four (No. 2 among qualified running backs) Big Hits. What’s worse, his injury trouble started with a shoulder dislocation in high school. Since then, he’s had three more shoulder dislocations, an ACL tear, recurrent/related hamstring strains, and a subluxation/sprain of his sternoclavicular joint. That was a rat-a-tat-tat of medical jargon all to say his cartilage/ligaments/joints are at legitimate risk for further damage, which is listed in the table below:

Injury Recurrence Rates

I’m confident in fading Cook as a top-five running back due to his inability to stay healthy through three years. These injuries tend to recur and match a pattern of connective tissue dysfunction. They aren’t a fluke. Now, if you can also snag Alexander Mattison, then giddy on up. 

Evan Engram

It’s no shock that Evan Engram is another player I’m fading on the injury front. However, his specific situation also warrants quantifying. In three seasons, Engram has already missed 14 games. That’s almost an entire season due to concussions, MCL sprains, and most recently a Lisfranc injury that he’s still in a boot recovering from. Not only is there a 10-percent recurrence rate for MCL sprains, but there is research showing that a previous concussion places individuals at three to six times higher risk for another. The dagger in the heart when it comes to his on-field performance and longevity is this most recent Lisfranc injury for which he had surgery.

Preliminary data shows that despite an 83-percent return to play rate, Lisfranc injuries reduce offensive players’ on-field performance. Even if he doesn’t miss another one to two games with a concussion or another three to four games with yet another MCL sprain, there’s a chance he simply won’t return to full form when he’s on the field. The flip side to this messy situation is that he’s only twenty-five years old, which equates to 12-years old in tight-end years, right? Greg Olsen has a pretty lengthy injury history too and is close to ten years older. Nevertheless, Engram is not a player I’m actively acquiring. Which is a real bummer considering he finished 2019 with a 23.8-percent (No. 5) Dominator Rating. 

Julian Edelman

Let’s start with the comprehensive list of NFL receivers older than Julian Edelman:

Danny Amendola, Ted Ginn, Larry Fitzgerald.

That’s it.

Now (in dramatic sports documentary series narration voice): What If I told you there was a 34-year old NFL wide-receiver still in the league who recently underwent shoulder surgery? That he’s now reportedly scheduled for knee surgery, his second in less than three years. What if I told you that since entering the league, this player has four concussions, several foot/ankle fractures and surgeries, and an ACL tear in 2017? What if I told you that the only quarterback he’s ever had success with is, for the time being, unlikely to return to his team?

Check out Julian Edelman on PlayerProfiler’s Updated Dynasty Rankings and Projections:

To his credit, I don’t know how Edelman has done it for this long. He’s a tough SOB. However, given his age, crazy-long list of interrelated injuries, and recent surgeries, I shouldn’t have to explain too hard why I’m not actively acquiring him. The reason he’s on this list is that many aren’t aware that he’s near 35-years old or recognize his extensive injury history. This isn’t a surprise with the Patriots being the tightest-lip organization in the NFL when it comes to injuries. The long and the short is that I’m willing to miss out on another year of production from Edelman because he will have to overcome tremendous odds. He’s no more than a flex-type player with a high ceiling due to his declining health and age.

Conclusion

Remember that this isn’t an injury prediction. This is educated assimilation of data from the medical literature and clinical expertise to project the potential range of medical outcomes. That’s the name of the game.