The entries on this list are considered among the top injury concerns for fantasy football owners as the 2016 NFL season approaches. The players are on this list because a) they are of significant interest to fantasy owners, b) their injuries are among the most severe or c) both. It should be noted that these entries are based on player status at the time of the launch of the fantasy football draft kit. In the event of major developments, this list will be updated accordingly.
Numerous players and their associated injuries did not make this list, but their status is relevant for fantasy owners. Those players will be added and updated from the start of training camp until the first game of the season kicks off, so check back frequently.
Quarterbacks
Tony Romo, Dallas Cowboys: Maybe the third time's the charm. Romo has now dealt with fractures in his non-throwing clavicle (collarbone) on three occasions: twice in 2015 and once back in 2010. When he was injured in 2010, he never returned to play in that season, which effectively gave him multiple months to heal before facing contact. In 2015, Romo was injured in Week 2. Once again, he sustained a break of his left collarbone when he was driven to the ground. After the Cowboys utilized the short-term IR designation for his recovery, Romo returned to action in Week 10. A week later, he was taken to the ground again, and once again, his collarbone was broken. His season ended on that sour note, and questions remained about what to expect for the Cowboys quarterback's future.
In March, Romo underwent a Mumford procedure, a surgery to remove a small portion of the distal (far) end of the clavicle that is often done when there is pain at the junction of the collarbone and the point of the shoulder. After his multiple injuries to the same shoulder, there was undoubtedly residual stiffness and joint discomfort in the area that warranted the procedure. In Romo's favor all along has been the fact that the series of injuries has been to his non-throwing shoulder. As long as he can handle the ball adequately for receiving snaps, setting the ball to throw and making handoffs, there should be no concern about his ability to perform at the position. Is he at risk for further injury? Well, any time a quarterback gets taken to the ground, the worries are concussion, shoulder separation (AC sprain) and clavicle fracture. The risk is lowered simply by staying off the ground, so the better Romo's protection, the less risk of re-injury. A solid offensive line goes a long way toward keeping Romo healthy.
At the age of 36, Romo has shown some signs of the wear and tear of the NFL in recent years. In addition to the multiple clavicle injuries, he has had two spine surgical procedures (a cyst removal in 2013 and a microdiscectomy to address a herniated disc prior to the 2014 season), and he fractured two transverse processes in his low back during the 2014 season. He can still throw the ball effectively (based on the limited amount we saw of him last season), but his mobility, as expected, is not what it once was. That alone can be a risk factor, as a quarterback's greatest self-preservation tactic is evading pressure. Thankfully for Romo, he has good protection up front and a rookie running back in Ezekiel Elliott who presents a threat worthy of a defense's attention. The key to Romo's staying on the field in 2016-17 will be his ability to stay upright as much as possible.
Joe Flacco, Baltimore Ravens: Every year, it seems, there is at least one quarterback returning from ACL reconstruction. Last year, Sam Bradford (Eagles) and Carson Palmer (Cardinals) were coming off their second ACL surgeries. This year, it's Flacco's turn. The low-key signal-caller is not one who typically generates headlines in the offseason, and even as he recovers from his first major NFL injury, that is still the case. Heck, Flacco didn't attract attention even when the injury occurred; he stayed in the game for two additional handoff plays before spiking the ball to set up a field goal, then came to the sideline to have his knee examined.
The truth is his injury was more than an isolated ACL tear; Flacco also tore the MCL in his left knee against the Rams in November. Since undergoing surgery in early December, he has steadily progressed, and the Ravens expect him to be ready for Week 1. Whether he sees much action during training camp remains to be seen, as the team will no doubt ease him into football activity. Flacco has never been a running quarterback, but he still has to regain enough agility to make plays on his feet and escape pass rushes. He also needs to regain the confidence to stand in the pocket as the space around him shrinks -- something quarterbacks who suffer contact injuries, as Flacco did when backup left tackle James Hurst accidentally rolled into his knee, often acknowledge as being more difficult than expected. Part of regaining confidence is repetition, so Flacco's presence in camp is important, but it will be equally important that his offensive weapons are healthy enough to remove some of the pressure he will face. With Justin Forsett, Steve Smith, Breshad Perriman and Crockett Gillmore all coming off injuries of their own, there are a number of variables in play beyond Flacco's health when it comes to assessing his 2016 value.
Andrew Luck, Indianapolis Colts: 2015 will probably go down as a season Luck would rather forget. After he played in all 16 games his first three seasons in the league, Luck appeared in just seven last season. Despite his 6-foot-4, 240-pound frame, the constant barrage of physical contact and takedowns resulted in significant and unusual injuries for the quarterback. Week 3 began the downhill slide, as Luck suffered what the team classified as a shoulder injury. Coach Chuck Pagano downplayed the severity of the injury in the early days and said he had "supreme confidence" that Luck would take the field the following week. He did not. In fact, he sat out another two weeks.
When Luck did return in Week 6, he had no interceptions for the first time all season, but he threw for limited distance, and his continued accuracy challenges did not inspire confidence that he was truly past his injury. Reports of rib injuries and ankle issues surfaced as Luck continued to grind out practices. There were persistent struggles in his subsequent two games, and in Week 9, Luck sustained the injury that terminated his season: a lacerated kidney and a partial abdominal tear.
Internal organs benefit more from rest than any fancy rehabilitation measures. The downtime Luck had in the second half of the season and in the early months of the postseason allowed him to finally get healthy from his general medical and orthopedic ailments. He has participated in OTAs and minicamp, with Pagano noting Luck looks good despite his extended time away from football. Although Luck acknowledged he was still working himself back into football shape, there is little reason to believe he will be anything less than fully ready to go when the season begins.
Why the concern? If one subscribes to the theory that past history is perhaps the best predictor of future results -- often the case when it comes to injury -- the concern meter is now elevated when it comes to Luck's ability to stay on the field. Although severe kidney injuries are relatively uncommon in NFL players, orthopedic injuries, especially to a quarterback's throwing shoulder, are not. The wear and tear process has been accelerated by the events of the past season, and the key to Luck's staying on the field this year is his not being on the receiving end of as much physical abuse. Certainly, solid protection for him up front is critical, and Luck should benefit from consistency at the center position with rookie first-round draft pick Ryan Kelly. But Luck has to be willing to slide more often or throw the ball away and avoid unnecessary physical contact while not turning the ball over. It will be a revamped offense for him entering the season with offensive coordinator Rob Chudzinski, so he will be learning as he tries to adopt an "avoiding injury by contact" philosophy. Luck is unquestionably intelligent enough to appreciate the need to modify his approach, and he has been practicing his sliding technique, but will he resort to old habits when in the heat of competition? That is the uncertainty factor as his fifth NFL season approaches.
Running backs
Le'Veon Bell, Pittsburgh Steelers: Were it not for a significant knee injury abruptly ending Bell's 2015 season, he would once again enter the fall as the top running back prospect for fantasy football owners everywhere. To many, he still is the top running back on the draft board, but the uncertainty surrounding whether he will come out of the gate in September looking like his pre-injury self has others concerned.
The concern is justified when taking into consideration the nature of Bell's injury. In Week 8, Bell was tackled by Bengals linebacker Vontaze Burfict, and both of his legs got tangled underneath Burfict. The right knee absorbed the bulk of the trauma, and that resulted in a tear of both the medial collateral (MCL) and posterior cruciate (PCL) ligaments. While an injury to one of the four primary stabilizing ligaments of the knee is never desirable, a multi-ligament injury is an entirely different dimension of concern. The medial collateral ligament reinforces the medial (inner) side of the knee and, when compromised, makes it difficult for an athlete to cut sharply. An injury to the PCL or posterior cruciate, the ligament that travels behind the ACL, affects stability in the forward/backward direction and can impact rotation. Following surgery, the most critical element in the early phases is allowing the repairs to heal and not disrupting that process by doing too much too soon.
To that end, Bell has been in extremely capable hands. After undergoing surgery with Dr. James Bradley, the Steelers' team orthopedic surgeon, Bell went through his early rehab with the Steelers' rehabilitation staff, a long-tenured and much respected group. There were positive reports from team personnel and Bell regarding his progress.
Once players depart the facility, however, it's a bit more challenging to supervise their physical activity. Bell posted video to demonstrate the healing of his knee ... in a pickup basketball game. While some interpreted the video as a sign Bell was making good progress, the Steelers' medical staff was likely less than thrilled. Pickup hoops isn't exactly on the checklist for running backs.
The evidence of readiness for return to football won't come until Bell's activity in training camp is on display. As with other significant knee injuries, the progression from individual drills to team drills to contact to scrimmaging to game action is deliberate, with each move predicated on how the athlete responds to the prior one. Until there is an opportunity to see Bell nearing a return to competition, it is difficult to say with certainty that he will be ready for the start of the season. Bell is clear that his goal is to be 100 percent by the season opener, but will he have regained all his quad strength, the power and explosiveness for which he is known, his confidence in pushing through piles, and his quickness and agility? Perhaps, but he wouldn't be the first running back coming off major knee surgery to need some playing time before he shows signs of his former self.
Bell's unique talent and positive attitude are enticing to fantasy football owners, and he might prove to be capable of doing exactly the same things he did before surgery. After all, Bell told ESPN.com's Jeremy Fowler that he takes his inspiration from Adrian Peterson. But consider his acknowledgment that he wants to wait until his knee is "good" before proceeding with contract discussions. There is still something for him to prove with regard to his knee, and until that proof presents itself on the football field, there is no ability to fully measure Bell's recovery.
Carlos Hyde, San Francisco 49ers: It might not be fair to judge Hyde's statistics in the last few games he managed to play last season. Although he never took the field after Week 7 because of a foot injury, he appeared on injury reports because of the foot prior to the Week 5 contest. Even after Hyde acknowledged that he was playing with a stress fracture, it took two more months before the 49ers placed him on injured reserve. It wasn't until January 2016 that the team acknowledged Hyde had undergone surgery to address the fracture prior to the end of the season. For his part, Hyde told reporters in April that he wished he had had the surgery sooner but was hoping the fracture would heal on its own. In high-level athletes, these injuries typically get managed surgically, as was the case with Hyde, with a screw inserted to stabilize the fracture.
As of April, Hyde was projecting a positive outlook for his recovery and said he already felt game-ready. Given the risk of re-injury for athletes who do too much too soon following this type of procedure, the calendar works in Hyde's favor. He won't have to test the foot in new head coach Chip Kelly's offensive scheme for several more months, but he has made it clear he believes it to be a good fit.
Jamaal Charles, Kansas City Chiefs: If there's any silver lining to be found in suffering a second ACL tear in five years, it's the familiarity of the surgery and rehab process. Charles tore the ACL in his left knee in Week 2 of 2011, then returned the following season to play in all 16 games and rush for more than 1,500 yards. In 2015, he tore the ACL in the opposite knee in Week 5. It was unquestionably a huge disappointment, as he appeared on pace to deliver his fourth straight 1,000-plus rushing yard season since the first ACL reconstruction. Now fantasy owners are wondering whether they can expect a similar bounce-back this time.
Working in Charles' favor is the fact that this is like déjà vu. He knew what to expect upon waking up from surgery, when the quadriceps muscle has all but disappeared. He knew to expect the pain of regaining his range of motion, the awkwardness of teaching the leg how to walk without a limp, the challenge of rebuilding his quad. As of June minicamp, he was back to participating in individual drills. Charles also knows what his progression will look like as training camp approaches, including preseason action and an eventual return to on-field competition. All reports have been good thus far, and it appears there is every expectation that he will be ready when the season begins.
But it has indeed been five years since Charles' previous ACL reconstruction. The rest of his body has absorbed an additional three-and-one-third seasons of football wear and tear. He will turn 30 in December. Last season saw the emergence of a pair of running backs in his absence, Charcandrick West and Spencer Ware. It only makes sense that they would continue to be utilized this fall in a way that serves to complement Charles and perhaps extend his career longevity. Although there has been no indication from the team that there is any plan to scale back Charles' workload, the more he's on the field, the more exposure to potential injury; the presence of two other capable backs can serve to mitigate risk. No one should write Charles off heading into 2016, but there are reasons to temper expectations compared to past years. It's also worth noting that in the season immediately following his previous ACL injury, Charles' average fantasy points per game (standard scoring league) was lower than it was in each of the following seasons, which reinforces the notion that players often perform better statistically two years removed from ACL surgery.
Wide receivers
Dez Bryant, Cowboys: Bryant suffered the foot injury that sidelined him for seven weeks in Week 1 of 2015. The Jones fracture he sustained in his right foot -- a fracture of the fifth metatarsal -- is an injury increasingly common among wide receivers. Bryant returned in Week 8 but struggled in the later weeks, with discomfort not only in his foot but also in his right ankle. Bryant required a second surgery on his foot with bone grafting, as well as a separate procedure to remove debris from his ankle. At minicamp, Bryant was reportedly making progress, and he was cleared to begin some light football drills, but Cowboys head coach Jason Garrett made it clear the team planned to take things slowly with its star receiver. Bryant is expected to steadily increase his activity when training camp begins in late July. If all goes well, he should be on the field when the regular season begins.
After missing time and landing on injured reserve because of an ankle fracture in his rookie season (2010), Bryant remained largely healthy the next four seasons and missed only one game during that span; his seven missed games in 2015 were the most of his career. Even Bryant acknowledged that his lack of activity heading into the past season (he missed a portion of camp due to a contract holdout, then missed time with a hamstring strain) might have contributed to his susceptibility to injury. Bryant is still a playmaker, but last year's struggles raise a question as to whether he can post another 16-game season at the level to which we have become accustomed.
Jordy Nelson, Green Bay Packers: Nelson never had the chance to set foot on the playing field during the 2015 regular season. A torn right ACL suffered in August (in a preseason game against the Steelers) sidelined him and placed him on the return from injury list again this year. If there is a positive aspect of ACL tears in the preseason, it's the additional recovery time prior to the subsequent season. Although the Packers are guarded when it comes to projecting timelines for players returning from injury, both coach Mike McCarthy and Nelson have maintained that he is "on track" for the start of the 2016 season. In fact, Nelson told ESPN NFL Nation reporter Rob Demovsky during June minicamp that he felt he could have played in a game that week.
Nelson's activity is still in the controlled stage, and he was not yet participating in 11-on-11 drills in minicamp. He is expected to gradually increase his activity during training camp and might not see extensive action in preseason games, simply as a means of protection. Last year, Nelson returned from offseason hip surgery, only to suffer his knee injury in a preseason game. Although it is impossible to definitively say there was any connection between the two, it stands to reason that everyone in the Packers' organization will want to be cautious in the early going this year. Despite not playing in any games in 2015, Nelson's overall career durability is decent; he didn't miss a game in five of his eight seasons in the league, and he played in all 16 games in the two seasons prior to tearing his ACL. Given how much of an impact his absence had on the Packers last year, they certainly hope he returns to a perfect attendance record.
The fact that Nelson sustained an isolated ACL tear (no other ligaments involved) improves his outlook for this season as well -- as does his uneventful rehab thus far. He is another year removed from hip surgery and has had ample time to work on regaining his core and lower extremity strength. Add to that his favored-target status with quarterback Aaron Rodgers, and Nelson should be a top fantasy producer in the wide receiver department once again.
Sammy Watkins, Buffalo Bills: Somehow it seems there is always concern about Watkins' health, whether during the buildup of the preseason or throughout the course of the 16 regular-season games. There is no debate as to his talent; the question surrounds his fantasy value when it comes to weighing that talent against his ability to display it on a consistent basis. The concerns are justified, given that Watkins entered the league just two years ago and, in that time, he has dealt with a variety of ailments ranging from cracked ribs to a hip labral tear to ankle and calf injuries, along with his latest challenge: a fracture in his foot that required surgery in April to implant a screw.
Watkins has roughly three months' recovery time between surgery and the start of training camp. It's worth noting, however, that the foot is an area with a relatively poor blood supply, which can make it slow to heal and put it at risk for secondary injury if an athlete does too much too soon. All the more reason for the team to keep Watkins' return slow and deliberate so as not to expose the foot to undue stress before it is prepared to handle it.
General manager Doug Whaley said he expects Watkins to be ready for Week 1. The difficult task becomes ramping Watkins up adequately, in terms of football readiness and overall conditioning, prior to the start of the regular season. Last year, Watkins was returning from offseason hip surgery and was kept to limited work in practice and minimal exposure in preseason games. He sustained a hamstring strain in the preseason (not totally uncommon in this scenario), but it was enough to set him back in terms of his overall activity, and he came out of the gate slowly. He went on to suffer a calf strain that cost him two subsequent games, followed by an ankle injury that initially put him in a walking boot and on crutches. Watkins' second half of the season told a different story (five 100-yard games in the last nine weeks), partially due to the fact that he remained healthly, and perhaps also due to an improved rapport with quarterback Tyrod Taylor.
The reward with Watkins is obvious; the risk will once again be a question of health. Although there is good reason to expect him to be available by Week 1, the unknown will be how long he can sustain his presence on the field.
Kelvin Benjamin, Carolina Panthers: It didn't look like much when Benjamin went to the ground clutching his left knee in practice during training camp last year. Then again, ACL injuries are often unremarkable in appearance and usually the result of a deceleration-rotation maneuver involving zero contact. As Benjamin pivoted on a pass route, he went down in pain, and it immediately had the feeling of a potentially lost season. Confirmation that Benjamin would miss the season after undergoing ACL surgery lowered everyone's expectations for the Panthers. Everyone's, that is, except the Panthers', and they went to the Super Bowl with a largely unknown receiving corps.
If that was the result last year, imagine the possibilities for Benjamin and the Panthers as he returns for what will essentially be his second NFL season. The early injury afforded Benjamin plenty of recovery time, and he expects to be a full participant in training camp. Benjamin took part in individual drills during OTAs and minicamp, a proactive measure by the Panthers to gradually bring him back into football activities. He should continue to progress through training camp and be ready for the start of the season.
As a rookie in 2014, Benjamin exceeded 1,000 yards receiving, despite sustaining a lesser injury (hyperextension) in that year's training camp and playing for the first time with a quarterback who was returning from a significant surgery. Just being part of a Super Bowl team in 2015 had to aid Benjamin's development, and he has the summer to continue to build a pass-catching rapport with Newton. His physical size makes him a threat even in coverage, and the more confidence he gains in his surgically repaired knee, the bigger a threat he becomes.
Tight ends
Jimmy Graham, Seattle Seahawks: A ruptured patellar tendon injury makes for an incredibly challenging return to the playing field. Just ask Giants wide receiver Victor Cruz, who has yet to take the field since he tore his in 2014.
The challenge for NFL athletes is not whether they will make it back; the majority -- 79 percent -- do return to competition, according to a 2011 study published in the American Journal of Sports Medicine. The question is whether those athletes can perform at the same level. To that end, results from a June 2016 study published in the American Journal of Sports Medicine that looked at the effect of various orthopedic procedures on NFL player careers are concerning. Of the more than 550 NFL athletes whose cases were reviewed, those who underwent patellar tendon repair fared the worst when it came to the rate of return to play, career length after surgery and performance metrics (such as yards gained and touchdowns scored), particularly in the first year post-operative. Injury to this tendon can impact overall power and explosiveness, as well as the general stiffness of the large muscle on the front of the thigh (quadriceps). Even athletes who feel they've returned to form will acknowledge that it is a slow process, usually carried out across the course of the first season post-injury.
The Seahawks maintain that they expect Graham to be ready for Week 1, but general manager John Schneider has indicated he doesn't expect to see much of him in the preseason. At the close of June minicamps, head coach Pete Carroll reiterated the expectation that Graham should be ready to go by the start of the season. It is worth noting that many of the same things were said by Giants personnel about Victor Cruz prior to the start of 2015. Yes, Cruz suffered a calf injury that ended up derailing his entire season, but even he said he believed that to be the result of his compensating for the weakness on his other side, the one with the patellar tendon repair. Until Graham is participating in actual games and we have a visual measure of how much he looks like his pre-injury self, there will be uncertainty.