Written by Tom Christ, PT, DPT, OCS, FAAOMPT
@FantasyInjuryT
We are a little over a week away from the 2023 NFL Draft. What an exciting time! All 32 teams have a unique opportunity to improve their rosters. There is no shortage of mock drafts, with analysts attempting to place incoming rookies in their perceived best landing spots. One factor that often weighs heavily in the draft is injuries. There are a few 2023 draft prospects with injury concerns, and I will help interpret which players’ injuries are a cause for concern and whose aren’t.
Hendon Hooker – QB, Tennessee
The 2023 Draft Prospects with injury concerns page starts with one of the oldest players in the draft. Hooker was a top QB prospect prior to suffering an ACL injury on November 19th against South Carolina. A classic non-contact mechanism in which his foot got caught in the ground, and his left knee caved inward, a motion we call “valgus.” It appears Hooker is dealing with an isolated ACL tear, with no other tissues involved, and is on track with rehab.Â
A few weeks ago, I published an article discussing major factors playing a role in an athlete’s ability to return for week one after an ACL tear. Included are age, time from surgery to week one of the following season, the number of tissues involved in the injury, and whether or not they are a “freak athlete.” Hooker is 25 years old, which does not help or hurt his recovery. By all reports, his injury was an ACL only; no other tissues were repaired, which is favorable. His surgical date is unclear, but his injury puts him nine months and three weeks until week one. This time frame is possible to play in week one, but he is unlikely to be at 100%, especially since he is a runner. I would argue Hooker is a freak athlete, which is another factor in his favor.Â
It is unlikely any NFL team expects him to be the week one starter but may draft him to groom into their future starting QB. The long-term outlook is not affected by this injury. While historical data samples do not include many mobile QBs, overall QBs respond well to ACL surgery. There is no reason to draft Hooker in re-draft leagues, but in dynasty, this injury may allow you to draft him later, providing great draft value for a high-upside player.Â
Jaxon Smith-Njigba
The polarizing Ohio State receiver played in only three games in 2022 due to a hamstring injury initially suffered in week one against Notre Dame. Smith-Njigba exploded for 95 catches, 1,606 yards, and nine touchdowns in 2021, hammering him in as a top NFL prospect. JSN had hoped to build his draft stock in 2022; unfortunately, a hamstring injury derailed those hopes. JSN remains a day one or early day two draft prospect, and some analysts, such as ESPN’s Todd McShay, speculate that JSN could have returned for Ohio State’s playoff push but instead elected to prepare for the NFL. I am not here to speculate but will discuss any potential lingering effects of this injury.
Hamstring injuries occur when the hamstring is stretched excessively or when the muscle contracts excessively. In fact, the latter is more common. Most hamstring injuries occur when the leg is in the “terminal swing” phase, which is when the leg is all the way forward on a stride. This happens because the hamstring acts as the break, stopping the leg from continuing to fly forward. The second most common phase of running when a hamstring injury occurs is at “initial contact,” which is when the foot first hits the ground and is also due to excessive contraction of the muscle. Of course, these are not the only ways hamstring injuries occur. When the leg is forcefully bent, like in the video of JSN’s injury below, the hamstring undergoes excessive stretch, which can also cause injury.
What is also concerning is the JSN suffered a recurrence of his hamstring injury as he was unable to finish games against Toledo (week 3) and Iowa (week 8). Hamstring injuries have very high recurrence rates. Studies suggest a previous hamstring injury increases the likelihood of another by 2.7x! This is particularly noticed in wide receivers. The strain on the hamstring increases dramatically when an athlete’s speed increases from 80-100% of a maximal sprint. It takes 40-50 yards to get to full speed, a distance that only receivers cover on a routine basis, which is why they are so prone to hamstring injuries.
After an entire offseason to rehab, JSN should be 100% by now and certainly will be by training camp. JSN remains the top receiving talent in this draft class, and his injury-riddled 2022 should not compromise his fantasy draft stock.
Kayshon Boutte
Once thought to be the next great LSU wide receiver Boutte fractured his ankle in 2021 against Kentucky, requiring season-ending surgery. Unfortunately, complications with healing led to a second procedure. Sometimes healing fractures have a “non-union” in which the broken ends do not fully aline, allowing proper healing. Another possibility would be that Boutte was not regaining full range of motion (ROM) and may have required an arthroscopic procedure to clean out scar tissue, restoring ROM. Either way, he is now at 100% and has been for almost a year.Â
Being deemed 100% healthy does not always mean the athlete has returned to their prior level of production. This appeared to be the case for Boutte last season. Boutte flashed an impressive 16.3 yards per catch in 2020 and 13.4 in 2021 before the injury. In 2022 this dropped to 11.2, and fans grew concerned that he was not back to full capacity. It is possible that he was not at 100%. With two surgeries in one year, Boutte missed a lot of game time, practice time, and training time. More important is the impact of ankle surgery on mechanics. Sometimes athletes will never regain the full range of motion after ankle surgery, which has the potential to influence mechanics that impact running, cutting, jumping, and other athletic moves. The foot and ankle are very complex, with numerous joints that must work harmoniously to allow normal function. When one or more of these joints are stiff, everything is thrown off.Â
If stiffness were a factor in Boutte’s drop in production, he would have his work cut out to regain normal ROM. However, youth is on his side. At only 20 years old, his body is in prime age to regain full ROM and strength and overall heal properly. Boutte’s injury history certainly provides more caution than many others on this list, but his upside is as high as any. Fantasy players must determine their acceptable level of risk when drafting this season. For those who choose to be cautious, Boutte may not be the one for you. For the gamblers, Boutte’s upside is fantastic if he can return to his pre-injury form.
Dalton Kincaid
Many regard Kincaid as the top tight end in the draft after going for 70 catches, 890 yards, and eight touchdowns in 2022. Kincaid did not participate in the combine after suffering a lumbar fracture in the season finale.
This should be seen as a non-issue for fantasy players as Kincaid heads into the NFL Draft. Fractures heal in 4-6 weeks, and this sounds like it was minor, to begin with. Occasionally, a history of a fracture can alter the local muscle integrity and performance, which could alter mechanics in a way that could lead to future injury, but we don’t see this as much in the back. He has the entire off-season to rehab to reduce the likelihood of mechanical changes from the injury and much of the off-season to train at full capacity to prepare for the NFL. Fantasy players should see Kincaid’s massive upside and understand that this injury will have little to no impact on his career trajectory.
Kendre Miller
The TCU running back sat out of the National Championship butt-whooping due to an MCL injury suffered in the prior game. Miller did not participate in his pro-day workout but did post a video of him squatting, in which he looked great.
While this is nice to see, it is worth educating readers that an MCL injury is less likely to impact this type of motion. Sure, an MCL injury leads to pain and swelling that, while acute, would cause stiffness that would make a squat like this very challenging, but the MCL is more implicated during lateral agility and cutting, making it hard to judge his progress from this video. That said, his MCL will be more than fully healed from training camp, and he should be 100% ready to go by week one. I do not see this injury as typically predictive of future injury, and fantasy players should not allow this to impact their stock in Miller’s career outlook.Â
Sean Tucker
The Syracuse running back could not participate in the combine due to a “medical exclusion.” We still have no clarity on what the medical issue was, but as of Monday, April 17th, Tucker was cleared. Tucker ran well during his time in Syracuse, amassing 1,000 yards and double-digit touchdowns in both 2021 and 2022.Â
Luke Musgrave
Musgrave suffered an MCL injury in week two against Fresno State that required surgery and never returned in 2022. Musgrave has since received full medical clearance and participated in the senior bowl. Musgrave is regarded as one of the top tight-end prospects, a position that is scarce for difference-makers in the fantasy landscape. The scarcity of talent routinely leads to tremendous intrigue towards the incoming rookies in the fantasy community. Fortunately for Musgrave, his injury appears behind him. This type of injury typically does not impact future production, which can help fantasy players’ confidence in the Oregon State product. Re-injury is always a risk; a history of injuries and surgeries can contribute to future injuries. Still, Musgrave is only 22 years old, and every player will deal with some injury in their career. Relatively speaking, Musgrave’s injury concern is not much higher than any other incoming rookie.Â
Tom has been passionately playing fantasy football since he was 7 years old. Originally from Philadelphia, PA, Tom graduated from Coastal Carolina University with a B.S. in Exercise and Sports Science in 2014 and worked as a personal trainer for two years while earning his M.S. in Exercise and Sports Physiology at West Chester University of Pennsylvania in 2016. Next, he moved to Atlanta, GA, for physical therapy, earning his Doctorate of Physical Therapy at Mercer University in 2019. Over the past three years, Tom completed a physical therapy residency in orthopedics and passed his specialty examination to become a Board-Certified Orthopedic Clinical Specialist (OCS). He followed that up by enrolling in a two-year fellowship training in manual therapy which will conclude on July 1st, 2022. Tom works with a variety of patients with orthopedic conditions, including athletes from middle school to professional, of all sports, including football.