Tony Romo is reported to have an L-1 compression fracture and likely to be out for the next six to 10 weeks. I predicted and abbreviated season for Romo, but I did not expect the blow to come this early. The bigger question for me now is “will this be the end of Tony Romo?”

A compression fracture is a little different from most fractures as the mechanism of injury is compression rather than trauma like most fractures. In this case the compression was caused by trauma, but I have many elderly patients with compression fractures that are caused by poor posture. L-1 refers to the first lumbar vertebrae which represent the beginning of the lower back region. As we saw when Romo went down, it is the flexed or bent position that puts the vertebrae at risk for this compression injury.

For the most part, this injury is just about time. Romo will have to avoid forward bending for six to eight weeks and may be given some type of brace to aid with this. Romo will be limited in regard to training, as trunk bending is a part of just about everything we do. Generally if someone with this injury adheres to the movement restrictions they are given, the vertebrae will heal on its own. Upon return, Romo would likely need to work on his core after having his trunk mobility restricted for six to eight weeks. The 10 week return mark is realistic on the injury healing, but Romo would once again be in a position where his conditioning and feel for the game is lacking while other players are in mid-season form. This injury is not the end of the world by any means, but I think there is a larger point when it comes to Tony Romo.

This is Romo’s fourth bone fracture in two years! I don’t believe that any other player can match this fracture rate. Furthermore, when you consider that Romo plays the safest position on the field and has the best offensive line in the league, there is no reason he should get injured this often, or have his injuries be this severe.

I often compare the bones in the human body to being like a high value target; like a boss of a mafia family or even the President of the United States, as most of our bones have many layers of protection. When someone fractures a bone, you can assume that all the structures that are supposed to protect the bone have been overpowered. History tells us that “The boss” and the President can be harmed, but it also tells us that this is very uncommon. There are typically only two ways you can get to these high value targets. The first way is by having a greater force, that simply overpowers the security of the high value target. The second way is when the high value target has some level of dysfunction among his security that gives a lesser force a way to get to the target.

In the case of the human body, the bone is the high value target and when you see someone get “jacked up” (have an overpowering force overcome their protection) and come out with a broken bone, you can understand why this happens. On the other hand when you see a player take hits that are routine, end up with broken bones, you must consider whether this player has some bodily dysfunction that is allowing this to happen. In the case of Tony Romo, I have definitely come to the conclusion that he suffers from the latter scenario. I can’t put my finger on it, but I believe Tony Romo has something more going on. I am in no position to speak on his bone density or any other condition he could have, but I will not be surprised if somewhere down the line we find out Romo has some type of chronic issue that causes his body to be more susceptible to injury.

There are already reports that Romo plans to return, but I think he should listen to his body and wrap up a decent career. We will see what happens with Romo’s real career, but I think it is safe to say that his fantasy football career is basically over.


How Injury Science can give you an edge in your fantasy football draft

With fantasy drafts quickly approaching, many of us are looking at various types of data to decide who to draft and when to draft them. In my opinion, Injury Science is one of the most underrated angles that can be used pre-draft to help decide the value of a player. Being able to decipher which injuries to stay away from vs. which injuries to ignore could be the difference between winning and losing. Some people will fade players that will return to the field playing at a high level; and some will draft players who have little chance of playing to their full potential due to the lingering effects of an injury from last season. Here are some players recovering from injury that you might be interested in:

Steve Smith Sr. (ruptured Achilles)- This is in no specific order, but I will admit that Steve Smith Sr. is easily my favorite player in the league. With that said, I don’t expect him to be nearly as productive as his normal self and I think we may get a Kobe like farewell tour out of the Allen Iverson of the NFL. I fear that Smith will have very little explosion from what was termed a “double rupture” of his Achilles, and the only way I am playing Smith Sr. is in daily fantasy and on a week where his motivation has been heightened. I believe Smith Sr. has one or two good games left in him. Otherwise, fantasy owners should completely fade him as this injury is a career closer for an explosive position such as wide receiver.

Jordy Nelson (ACL tear)– Many of these ACL cases will sound like a regurgitation of my feelings. I don’t want any skilled players with ACL tears that are less than two years removed from surgery on my fantasy team. That is my rule and Jordy Nelson is no different. The latest news has him suffering from a left knee injury, which is not surprising considering he is not at his one year mark for the ACL tear he suffered last pre-season. I don’t fear the ACL repair failing with these guys, but I fear the delayed return of their normal body mechanics and the compensations that occur when the mind does not trust the body. Nelson is likely to play most of the season; but I am betting that the combination of being 31 years old and being one year removed from ACL repair means that we see the pre-2013 Jordy Nelson who you do not want on your fantasy team.

Kelvin Benjamin (ACL tear)– Kelvin Benjamin has the benefit of being younger than Jordy Nelson as he enters his 3rd season in the NFL, but my rule remains the same. I expect him to struggle to get back into game form and likely show his normal skill set late in the year. Benjamin may be a consideration for daily fantasy during the latter part of the season, but I wouldn’t draft him in season long leagues as he is another player that is hovering around that one year mark. Just in case you missed it earlier–No ACL repairs that are less than two years removed from surgery on my fantasy team!

Keenan Allen (lacerated kidney)– Keenan Allen is on this list because he missed half the season, but in truth I would completely ignore the lacerated kidney that finished off his season last year. The chances of him having a recurrence of this type of injury is very slim and as a fantasy owner, my hope is that others are deterred them from picking him. Allen is someone I would keep my eye on, especially in PPR leagues as I believe he picks up exactly where he left off with a high volume of catches and the potential for some huge games. At the age of 24 years old and with very little injury history prior to last year, Keenan Allen may one of the best values on this list.

Kevin White (lower leg stress fracture)-Kevin White is a perfect example of why I use caution when investing in “Freaky Talented” athletes. When you are 6-foot-3 inches, 216 lbs, and run a 4.35 40-yard dash; there are consequences. The stress fracture to White’s tibia is a sign that his body is not likely to keep up with his level of talent for long durations. This injury basically says that White’s muscles are creating so much force and speed that his bones simply can’t withstand it. Ruling White in or out based on his injury alone would be very difficult. However, when I consider that his coach wants balance, he is a clear number two option to Alshon Jeffery, and that his quarterback is Jay Cutler, the risk/reward equation definitely tips in the risk direction. I would fade White this season unless the injury prone Alshon Jeffery goes down and White becomes the top option for the Bears at receiver. White definitely has the talent to be a fantasy superstar, but I don’t think his body will hold up for him to realize his full potential.

LeVeon Bell (MCL tear)-I have made my feeling about LeVeon Bell very clear on a few occasions. I believe he will enter the season at 100% and if he keeps his weight down, I consider him no lower than the second best fantasy players earth. As a fantasy owner, I am far more worried about Bell’s pending suspension and his weight than I am about his injury status.

Jamaal Charles (ACL tear)– I read an article earlier this summer that made the case that Charles may be the most under-valued back in fantasy this season. I would like to tell that writer that YOU ARE WRONG! By the time Charles recovers from this ACL injury he will be staring 30 years old dead in the face; and for a running back I translate these facts to mean it’s over. I believe the Jamaal Charles that was a fantasy beast for so many years is officially gone, and at best we get a player who is a solid contributor to a running back by committee duo or trio. Those who use a high pick on Charles will definitely regret it. The injury wrap sheet for Jamaal Charles is too long for me to rattle off here, but trust me, it’s over!

Tony Romo (collarbone fracture) – I’m not really sure Romo is worth talking about. He has the best offensive line in the business and somehow manages to fracture bones on a yearly basis. With the Dallas Cowboys being a running team and Tony Romo’s injury floor being pretty high, I’m not sure why anyone would take Romo as more than a situational fantasy start. Tony Romo doesn’t strike me as being a gym guy beyond what is required of him, but he might benefit from adding a bit more muscle to absorb these hits that are causing him fractures. I doubt much will change with Romo’s body and I think we can expect another abbreviated season from him.

Joe Flacco (ACL tear)– Joe Flacco comes closest to making me break my ACL rules, but not quite. Flacco plans to wear a brace to protect his plant leg and despite his big arm, I believe this will have a negative effect on his performance this year. With the Baltimore Ravens offense being inconsistent at best, I see no reason to trust Joe Flacco who will only be about 10 months out of surgery when opening day comes around. I expect Flacco’s production to decline some and his fantasy value to stay in the basement.

Andrew Luck (shoulder sprain/strain)– I have already detailed why I may be targeting Andrew Luck as my top quarterback and this has not changed. I think Andrew Luck enters the season at 100% and despite last years issues, he continues to present as one of the least risky players in fantasy football. By nature the quarterback has a low injury risk, but add in the fact that Luck is 6-foot 4 inches and over 230 lbs, and no quarterback outside of Cam Newton has a better body to body ratio when it comes to taking on defenders. As Luck continues to mature, I think we will see a quarterback who will be difficult to injure. All of the injuries from last year are of little concern with the exception of the right should subluxation, which I consider to be a low risk to recur. I am hopeful that many will sleep on Andre Luck and allow him to fall in drafts as I expect him to be the top fantasy quarterback of the 2016 season.

Who is the most reliable Quarterback in the NFL?

July 24, 2015

As a Doctor of Physical Therapy, my career has been centered around evidence.  Physical Therapy is an evidence based practice which relies on real proof that something works.  Along with evidence, I use the objectivity of science and the input of performance to make sure my clients and patients receive the best care possible.  

I used this same approach to create The SEP Reliability Rating system.  SEP stands for Science, Evidence, and Performance; and this is a new and effective way to determine which players you can count on.  I have ranked the top players at every position and will give you their rating along with a few factors that helped to calculate that rating.  

I used weight, speed, experience, football IQ, injury history, position norms, and other factors to create a rating system that predicts which players are the most reliable.  Trust that each rating is calculated with injury science, evidence, and player performance history.  I put just a pinch of subjective into these ratings as I believe there are simply some things that you have to assess with your eyes and not through data.  

For the Quarterbacks I ranked 33 players.  The most reliable Quarterback earned a rating of 124 while the least reliable earned a rating of 73.  I rated the players that I expect to be starting caliber and I included the 2 first round draft picks.  Here we go!  Click here to see quarterback rankings 33 through 23. Click here to see rankings 22 through 16.

“The best ability is availability”-Herm Edwards


15. Phillip Rivers: SEP Rating – 93

phillip rivers

144 and 2006 are the numbers to know with Phillip Rivers.  The veteran has started 144 straight games and has not missed a game since 2006.  When it comes to reliability based on history, there is only one other active quarterback that can contend with Phillip Rivers.  Despite this stellar history, Rivers is in the top third of the league for pass attempts as well as in the top third of the league for taking sacks.  As he continues into his mid 30’s, we will have to see if he can continue his good fortune.  For those who do have something riding on Phillip Rivers, keep in mind that he did have what reporters called “a significant back injury” last year, but at this point it seems that he has avoided surgery.  The bulging disc injury that he is reported to have should be manageable with some good Physical Therapy and maybe some extra back support during games.  Furthermore the offer of an extension by the San Diego Chargers leads me to believe that their medical staff is not that concerned with his back.  I wouldn’t worry much about this injury specifically, but it may be a preview of what is to come for an aging QB that tends to be a bit more reckless than the Brady’s and Manning’s of the world.

14. Cam Newton: SEP Rating – 95

I like to put athletes into categories; and although the best athletes will blur the lines of either being “Freaky Talented” or “Supremely Skilled”, Cam Newton is one that I would put near the top of the “Freaky Talented” list.  Aside from Lebron James, I do not believe there is an athlete today that can compete with Cam Newton’s measurable assets.  At 6′ 5″ and 245lbs, running a 4.58 40 yard dash; Cam is surely the best athlete at the quarterback position today.  Unlike most of the players I put in the “Freaky Talented” group, Cam does not have to max out his physical talents on a regular basis as the quarterback position does not call for this often.  For this reason, I feel that Cam Newton is a quarterback guru away from being near the top of this list.  He has all the tools to be immune to injury like his closest counterpart Lebron James, BUT I have 458 problems with Cam’s game.  WIth 341 rush attempts over the past 3 years, Cam leads this group of QBs by over 30 attempts; and with 117 sacks Cam is the 3rd highest in this group.  Appropriately, to go with these statistics I gave Cam Newton a 2 out of 5 for his decision-making and quick release score.  Some of these issues are with the team that is put around him as well as a coaching staff that doesn’t seem to be getting the best out of Cam; while some goes back to that “Freaky Talented” mentality.  Cam has made a habit of using his talent over his skill and mental preparation and that has led him to too many injuries in a short career.  Despite an abundance of small injuries, I do not see any injuries that should linger with Cam this upcoming season.  If we can see even a bit of progression from Cam that will bring his sacks and rush attempts down, I expect to see Cam Newton climb this list quickly and become one of the most Teflon quarterbacks this league has today.

13. Tony Romo: SEP Rating – 97

For those who are not aware, I am an Eagles fan.  So if you hear a little bias in this analysis……oh well!  Tony Romo is a veteran quarterback at this point and over the past 3 years has managed to take the fewest rush attempts among the quarterbacks who were active for the entire 3 years.  WIth only 76 rush attempts in this time period, Romo is obviously benefitting from the Dallas Cowboys investing heavily in a top-notch offensive line and running game.  Romo has had a decrease in pass attempts of greater than 100 attempts as compared to the previous year over the past 2 years.  The Dallas Cowboys are literally extending his career by transitioning Tony Romo from a gun slinger who threw 648 passes in 2012, to a game manager who threw 435 passes in 2014.  I bet DeMarco Murray wished the Cowboys cared about him as much!  In any case, Romo has become a reliable quarterback due to the recent changes and I expect this to continue despite DeMarco Murray’s departure to a much better situation.  I look at him as a low risk/low reward option as his reliability is based on his lesser usage and not necessarily a product of him being more durable or more mature to avoid injuries.  Romo backers will want to watch out if that running game can not produce like it has in the past, as I believe the gun slinger is still alive and waiting to throw some big interceptions to Malcolm Jenkins and Byron Maxwell.

12. Jameis Winston: SEP Rating – 98

I feel kind of weird ranking a rookie this high on a reliability rating, but as the number 1 overall pick Jameis Winston will be held to high expectations.  Winston is a big body quarterback that should be able to take a few hits.  But the key is “a few” hits.  If the scouts and experts are correct, we should see Winston adjust well to the NFL and continue his trend of getting the ball out quickly.  Furthermore, the Tampa Bay Buccaneers should be in full-out Fort Knox mode when it comes to protecting their franchise QB.  This will likely have to be done through play calling and Jameis making good decisions as their offensive line continues to be poor.  I think you can rely on Winston to finish the season but his numbers may reflect the limitations of the Bucs offense.

11. Ben Roethlisberger: SEP Rating – 98

Big Ben Roethlisberger is exactly that ….BIG!  At a listed 241lbs that may be a little light, Ben continues to evade defenders and play at a high level.  Ben is only averaging 1 missed game per year over the past 3 years and despite being sacked 7th most over that time period, he has only suffered a few minor injuries.  I consider Ben’s size and strength to ward off defenders to be his greatest attribute during most of his career, but I think he may have a new secret weapon to prevent injury.  That weapon is Le’Veon Bell.  Not only is Bell allowing Ben to have more of the offensive responsibility to be off of his shoulders, Bell is allowing Ben to pile up impressive stats from short dump passes that carry little to no risk for Ben.  As we near my top ten most reliable quarterbacks, I would definitely list Ben Roethlisberger as a low risk/high reward quarterback as long as he doesn’t lose too much of that “Big Ben” mass or Le’Veon Bell.

Stay tuned for the top ten as you get ready to set your fantasy rosters.

Dr. Petty