ADRIAN PETERSON OUT 2-4 WEEKS? (Update: Peterson out 3-4 months)

(Update: after publishing this, reports confirmed that Adrian Peterson would miss 3-4 months. It is clear that Peterson must have suffered injury to the portion of the meniscus that has little blood supply and needs surgery to repair. I had already suggested that this may be the beginning of the end, but with this news it may just be THE END!)

Adrian Peterson is reported to have a right knee meniscus tear and the timetable for his return seems to be unclear. Many of the injuries we see in the NFL have little tells and clues that allow me to make a very educated guess on how it will play out, but a meniscus tear may be one of the trickiest injuries to forecast without explicit details.

There are two menisci in the knee, the medial meniscus (inner part of the knee) and the lateral meniscus (outer part of the knee). These structures are fibrocartilage that basically serve as the pillows for the knee-joint and act as joint stabilizers. When the knee is straight, the menisci are typically at little to no risk as they are safely tucked into the knee-joint space. As the knee transitions to a bent position (usually for a squatting or lunging like motion) while the foot is in contact with a surface (usually the ground), the menisci assume a position in which they seem to peek out of the joint. During this peek is when most meniscus injuries occur. Adrian Peterson demonstrated this well if you watch the position of his right knee as his injury occurred.

this image shows a tear to the medial meniscus
Medial meniscus tear

The problem with speaking about a meniscus injury that you do not have intimate knowledge of is that the variables are countless. The details of the tear is important with a meniscus, as the inner 2/3 of the meniscus is avascular, meaning it has no blood supply. The outer 1/3 has blood supply and therefore typically has a better healing prognosis.  Aside from the site of the tear, the size of the tear and the subsequent position of the torn tissue are other factors that play a big part in giving a prognosis for recovery.

I can see how some may believe that Mike Zimmer is just playing injury report games by not ruling Peterson out for next weeks game vs. the Carolina Panthers, but meniscus injuries have a broad enough range that Peterson could play next week or this could effectively end his career. The answer is likely somewhere between.

The fact that surgery has not been mentioned suggest that this is likely an injury to the vascular outer third of the meniscus, which means there is a chance that Peterson will only need conservative interventions such as Physical Therapy and modalities to heal. On the other hand the optics of Peterson being carried out, being unable to even touch the ground with his right foot leads me to believe the tear may be more significant. I have treated patients who are in and out in a matter of weeks for meniscus injuries, patients who take months to get back on track, and the worst are the ones who you think are healed and months later they’re back. When a meniscus is torn it may have significant symptoms such as pain and clicking which is usually the torn tissue getting caught in the knee-joint as the joint bends and straightens, but for some the torn tissue is in a good spot and doesn’t cause any interference with joint movement. The most annoying part about a meniscus is sometimes you get both sets of symptoms. One day there is no clicking and no pain, and one squat or bend later, the torn tissue is caught between the femur and tibia and the patient can’t stand to bend their knee.

The meniscus has an annoying quality of re-injury and symptom fluctuation. Based on the position of the cartilage and its peekaboo type movements during bending, many people who have to return to repetitive bending activities will eventually catch the meniscus peeking too long and suffer some level of setback.

If I had to give a ball park guess, I would guess Adrian Peterson will be out for two to four weeks. The problem is that an NFL running back won’t be able to avoid forceful bending, which means that upon his return, the chances of re-injury are higher than most.

When you consider the elephant in the room that he is a 31-year-old running back, and that productive running back play after 30-years old is rare; my advice is find a strong plan B for Adrian Peterson as this may very well be the beginning of the end. 

Carson Wentz WILL BE READY FOR WEEK ONE!

The Teddy Bridgewater domino effect has finally produced some actionable fantasy football strategy. I know that knee jerkers everywhere will believe that Adrian Peterson’s value went up because he lost his quarterback, but I believe at best his value stays exactly the same. I downgraded Stefon Diggs a bit and decreased my investment in him with daily fantasy, but overall there really was no big shift that would affect anything I planned to do in week one.

That was until the news broke that if healthy, Carson Wentz would start for the Philadelphia Eagles in week one. I don’t expect many to target Wentz as a season long quarterback, but with the daily game being my fantasy setting of choice, this  news is big. I won’t go too deep into strategy, as injuries are more what I am here to talk about, but take a look at the Cleveland Browns defense and then at the salary for Wentz and you be the judge.

If you come to the same conclusion as me, the only thing stopping you from locking Wentz into a bunch of lineups is the hairline rib fracture that he suffered on August 13th. I am here to tell you that you have nothing to worry about on the injury front, as Injury Science virtually guarantees that Carson Wentz will be ready for week one.

Here are a few reasons that I am so sure:

  1. Wentz was injured on August 13th. A CT scan on August 29th suggested he was 60 percent healed. At this rate of healing, his rib would mathematically be 108 percent healed by opening day.
  2. Rib injuries are mostly about pain tolerance. Because the ribs are not weight-bearing bones, the risk for re-injury is less than other bones which must bear weight. The issue with rib injuries is that pain during movement may disrupt rhythm or the chance that a direct hit may cause intolerable pain. There is always a chance to suffer a more severe fracture if the player returns too soon, but in the case of Carson Wentz this will not be a concern after 4 weeks of healing time.
  3. If you pay attention to Carson Wentz’s personality, there is no way that he will choose to sit out in week one with the chance to take the starting job. I fully expect the medical team to clear him and the only remaining variable will be his willingness to play through any lingering pain symptoms.

I often talk about using the injury angle to your advantage and this will prove to be a perfect example. Those who play daily should build line-ups around Wentz, and those who don’t have a good quarterback or a good matchup in week one for season long should consider starting Wentz. I can almost guarantee that the obscurity of Carson Wentz combined with the questionable tag will make Wentz one of the lowest owned quarterbacks in week one.

I am not promising that Wentz will outscore the likes of Ben Roethlisberger and Cam Newton type players, but considering the low price he will cost across the board, and the defense he will face, I am sure he will prove to be a great investment.