490: Injury Proneness

00:00:02
Speaker 1: This is the Label Podcast with your host JJ zacher Retha j J Zacherson.

00:00:11
Speaker 2: What's up everyone, It's JJ Zacharyes and the editor in chief at fandel and at Number five dot com in this episode four hundred and ninety of the Late Round podcast on many shows that are part of the FanDuel podcast Network. Thanks for tuning in. Injuries play a huge role in this game about a game that we all love, but it's almost like we don't think enough about them. Like we know when a player tears his ACL he's done for the year, but we probably don't collectively think enough about the impact that hamstring polls have, our high ankle sprains have. And then there's the big label of injury proneeness that gets thrown around all the time as if it's this thing that absolutely one hundred percent exists. But we're not doctors, at least most of us aren't, So why are we creating these labels when we don't know if they should exist or not. That's where Edwin Paudos comes in. Edwin is a doctor of physical therapy and he's a medical analyst for Fantasy Points dot Com. I sat down with him to chat about whether or not injury pronus is actually a thing, and how fantasy managers can take advantage of the idea of injury proneenus. And then we dig into specific players for the twenty twenty one season, like Joe Burrow and Will Fuller. I know I learned something from talking to him, and I'm sure that you guys will too. Now, before we get into the interview here at the Late Round podcast, you know that we live and breathe football, but I think we can all agree that March belongs to basketball. And what better way to get caught up in the tournament action than with a huge new TV from best Buy. Right now, you can find great deals on big screen TVs from brands like Samsung and LG. Best Buy will even bring it to you with fast, free curbside pickup and delivery, So go visit best buy dot com today. Now let's listen to why injury proneness may not be as much of a thing as you think. So you wrote a two part series over on Fantasy points dot Com called injury proneness is a Lie? What was it that made you want to write those articles? And how big of an edge is there for fantasy managers to properly understand this concept of injury proneeness.

00:02:09
Speaker 1: Yeah. Man, So essentially I wrote this article because the bottom line is there's a two point three percent injury free rate of games in the NFL. There's a study published from twenty twelve to twenty fourteen. Literally only two point three percent of them or injury free. So everybody gets injured. So injury prone in and of itself is just, you know, not real. But the reason I wrote it for fantasy players was because I found there wasn't a lot of information out there beyond like that was an ACL tear or that was a high ankle spring. That's information that's going to be out there and Shefie's gonna tweet it within like sixteen hours, right, That doesn't really help anybody. So I wanted to take it a little further beyond that to help people sort of dissect their drafts. And another reason is fantasy managers are I think they just misuse the term and they approach it. They approach drafts sort of on levels that are extreme, so they're either super super wrongly calling players injury prone. I think of like twenty twenty Carson Wentz, even though that was a dumpster fire on its own because of his play. But Chris Carson's another one who I think he gets slapped with that injury label, injury prone label. And they were fine. I mean, generally speaking, Carson was fine. Both of the Carsons were fine, or they go the other way. And I feel like twenty nineteen Girly AJ Green, twenty twenty Julian Edelmand, David Johnson, to me, a lot of those people, a lot of those players were sort of not really worth further investment. But dudes, either dudes and ladies either are extreme. They're like, I write that player off completely, or they're trying to ride a train that isn't really riding anymore, if that makes sense. So anyway, moral of the story is that there's a lot of gray, and I wanted to give sort of a tangible understanding of what that gray is and so that it's not just injuries or random and out of my control. You know, I feel like that that's not very helpful.

00:03:54
Speaker 2: Yeah, So that's at a high level. The two point three percent number that that you threw out there, which is really really interesting, that's at a high level. But when does injury history matter for a player if at all, maybe it doesn't matter.

00:04:06
Speaker 1: Yeah, I think injury history history sort of always matters, or you know, at the same time, never matters. It just depends. And that's a really weird way to look at it, but you have to. You have to look at injuries. I think, in my opinion about recurrence and performance like they matter when they're going to recur, and they matter when the other specifically impact performance. So you think about something like an achilles injury or an older player with like an acl tear. Those are catastrophic injuries that are probably not going to lead to good performance. They're not, I mean, the data shows are not going to lead to good performance. You also think of recurrent injuries like concussions and hamstrings, like you know, Will Fuller and Cooks. We're gonna get to Fuller a little bit, but yeah, Fuller and Cooks, Like concussions and hamstrings, that's when performance is impacted and availability in general. But another common phrase that I think I've seen a lot of too when it comes to injury histories is oh, they're coming off of the surgery or they're coming off of the injury, And that sort of makes sense. But I think it's a little two blankets. Still, I think twenty seven year old Lamar Miller in twenty nineteen coming off in ACL and niscus is an appropriate time to say, oh, you know, they're coming off an injury. But I don't think. I don't think a twenty three year old Saquon Barkley, you know, literal generational talent is an appropriate time to use that phrase.

00:05:17
Speaker 2: Yeah, okay, that makes sense and then does so. Right now, we're sitting in a time where we're doing a lot of prospecting and looking at college athletes that are entering the NFL, and obviously I'm looking at my prospect models at running back and wide receiver, and one of the big topics, one of the topics that I talked about actually last week on the Late Round podcast was about wide receiver BMI. So I'm curious, does the size of a player like his BMI does that matter when you're looking at these injuries.

00:05:46
Speaker 1: You crush that episode, by the way, I listened to that. That was good. Thank you. Yeah, that was really good. So you sort of nailed it. I think when you were talking about like you just have to worry about performance first, there's a big a big study of five hundred and fifty NFL players, literally NFL wide receivers who another PT shout out at the real Adam underscore h Adam Hutchinson put this this out and he basically showed that regardless of BMI, there's no statistical significance in injuries for wide receivers. So there's no BMI basically doesn't matter, Like if they're not at a high BMI or at the threshold that they need to perform, you need to worry about performance before you even worry about, you know, injuries, And even when you go back and calculate for injuries, there's no difference in games missed for BMI in any wide receiver bucket. And then you think of running backs. There's another study done on two hundred and seventy five NFL running backs over a ten year period. If those running backs were between twenty nine and thirty two kilograms per meter square, that's just the BMI between twenty nine and thirty two. There was also no difference in games missed. So when it comes to BMI, I think it's just overstated. It can matter in certain instances, but if you look at it one way, I mean, I think higher BMIs get sort of a bad rap. But when you're at a higher BMI, technically you have more bone density, which means you might get injured less. But other than that, I think you should look at positional demands instead. You should look at pass catchers and how they have more ACL tears, hamstring strains, concussions. Running backs have high ankles and shoulders. So BMI is more of a question of you know, are they at the threshold you and performing? I think you nailed that one, Okay, I got you.

00:07:14
Speaker 2: So are there then specific injuries? You just mentioned some injuries that fantasy managers seem to overstate or understate when they happen. You know, someone tears an ACL, everyone freaks out. Someone has an achilles injury. That's always been one that fantasy managers like myself or fantasy analysts are always worried about. Are there specific injuries though that we do end up overstating or understating when they occur?

00:07:40
Speaker 1: Yeah? I think that I really like this question because it allows me to address sort of like the Carson Wentz syndrome. People hypically overstate random collections of injuries that really don't matter. So Clark Carson wentz right, he had the ACL, the concussion to back the wrist. Those are all sort of and that wasn't even the timeline that it came in. But like none of that really mattered, It didn't really correlate. You also think of a random collection. You think of Matthew Stafford, Keenan Allen who had like a lacerated kidney and ACL and ac joint. None of those things early on in their career tend to matter. I think we're going to look back on Onz if he sort of sticks it out there, I mean, and moves forward as actually, you know productive, we're going to be like, oh that was funny. We call them injury prone. But in terms of like generally understated, I think concussions are taken seriously, but I still think they're understated. Just because you have, you know, one, a history of being okay with you know, one concussion doesn't mean you're actually at an increased risk. You're at double the risk to get another concussion. So and that's the thing is that the concussion protocol isn't as sensitive as we like it to be. It's not perfect. So even if players aren't reporting symptoms or they passed through the protocol. That doesn't mean that they didn't have you know, technically have a concussion. And then in terms of like in season management, high ankle sprains are definitely understated. The first week back, I did a study on sixty It's pretty small study, but it's sixty players, and essentially the first game back, they had about a fifteen percent drop in Fantasy points. So that matters for like cash players, especially high stakes players. You definitely don't I don't think that a high ankle sprain. Playing a player through a high ankle sprain when you're trying to go for ceiling is a smart thing to do. And then hamstring strains. Hamstring strains in season, there's about a fifteen percent recurrence rate in the season. So there are some of the some of the injuries that I think aren't necessarily appropriately framed. I think people just forget about them or they want to overlook them.

00:09:21
Speaker 2: Yeah, I almost think that people look at that stuff in too much of a binary way. You know, in this in like in a high ankle sprain, for instance, we see this injury happen. You know, someone's out for four weeks or whatever, and then they come back, and we assume that when a player comes back he's one hundred percent. What didn't Alvin Kamara have that a couple of years ago whenever? He Yeah, yeah, Like that was a good example of like clearly you could just watch the guy and you could see that he was hindered in some way. But I think that we just look at games played and we say, oh, he was on the field, therefore he must have been healthy. But it just seems like we we don't take that into consideration enough. I don't know if you've seen that or not.

00:09:59
Speaker 1: Yeah, no, I definitely I agree, dude, because there is actually a study done. It was twenty thirteen. I wish I could over the day by the authors. It was on NFL high ankle springs and all thirty two. Like, first of all, think about the last time you heard anybody agree on something consensus more than like two people, right, So all thirty two NFL team physicians in the study agreed even though players come back in about fifteen days from high ankle springs, that they all consensus said that it takes four to six weeks for it to completely resolve. And so think about all the players that came back even just last year, you know, Josh Jacobs rhem Mostert before the five six week mark and they're still sort of struggling through those injuries. So I think you nailed it all right.

00:10:33
Speaker 2: So, with all this being said, how do you think fantasy managers can sort of best take advantage of this injury proneness argument?

00:10:40
Speaker 1: Dude? I love that you asked this because I feel like it's just the same as any other inefficiency you've identified inefficiency. You're like the master of identifying inefficiencies. It's like what you that's like your entire your stick, right, you identify inefficiencies and you exploit them. So just think about seasonal examples like hamstring data. Right, there's a twenty percent recurrens in the calendar year, fifteen percent like I mentioned in season and rate like that's going to matter the wide receiver's first first game back, right, You're probably not. You probably shouldn't play or start a wide receiver, use a wide receiver in a lineup that's that you're trying to go for seiling after the coming off their first week with a hamstring strain. I already talked about the fifteen percent dip for high ankles springs. You find the same thing with hamstrings, but the difference is that with hamstring injuries, players tend to come back too soon or they'll try to play through it. So I mean the classic example is twenty nineteen Adam Thielen. He was out for like five or six weeks after that Keenan Allen when he played that Thursday night game, he was definitely not gonna. I told the Fantasy Points subscribers in the chat, like, don't play Keenan Allen because of the hamstring strain week one and twenty twenty Mike Evans he did the same thing. So basically, I know that it's it's really difficult to not start your studs. But when you look at the big picture, the best place to exploit these market efficiencies is really like in DFS, when you are you know, the start your studs argument. I totally get it. In DFS, this works, you can exploit it and d if you're in cash game small pools. But to start your studs, I think that this is the one argument for season long where I would argue you might you might actually not be hitting your ceiling if you start your studs coming off a hamstring or a high inquismin Yeah.

00:12:13
Speaker 2: Really really interesting stuff. So let's look at a few players now as we enter the twenty twenty one season who have some injury concerns. You know, we can't get to all of these guys, but I tried to highlight some that a lot of listeners might have questions about. So let's start with Joe Burrow because obviously quarterback effects the rest of his offense tremendously. Should we be concerned about Joe Burrow and his mobility because he's someone who I'm just generally interested in because of a situation, the fact that he can be mobile when he's healthy. He had a low touchdown rate last year, so there's some positive aggression coming. Is he going to be healthy to start the season though?

00:12:48
Speaker 1: Good question? So the rea you're talking to, the rehab expertation, no, the answer, right. So here's the thing these This injury was nasty, it was bad, and that typical player comes back from an isolated aco in ten months. A good example is Preston Williams. He came back in like nine and a half ten months, and it was still borderline whether he was going to play in Week one or not. Just in twenty twenty. So Burrow's going to deal with the same thing. His positional demands are lower, but his injury was a lot more catastrophic, and so forty five percent of these players never even come back. So the primary the first thing we have to worry about is will Joe Burrow actually start the season on the pup. That's still a concern. And then when he comes back, there's actually a lot of studies published on the psychology of players, and yeah, even if he's back one hundred percent physically, there's a psychological aspect that's probably going to make him skittish in the pocket the same way Alex Smith was. So I would definitely be at least concerned or aware of the mobility issues if you're trying to decipher between Joe Burrow and another player.

00:13:43
Speaker 2: So frustrating, so frustrating, so on the same team. Though, What about Joe Mixon who dealt with that injury. He was seemingly going to come back every single week about the second half of the season. Never came back. What is the deal with Joe Mixon?

00:13:55
Speaker 1: Is he?

00:13:55
Speaker 2: Is he fine? Is Joe Mixon?

00:13:57
Speaker 1: Okay? I think Joe Mixon's fine, man, So just a round up that with with Mixon because I don't I don't, I don't want to belabor the point here. He's played, he played ninety three percent of his games in college before twenty twenty, ninety three percent of games in his career. He has a small concussion history, and what we know about the foot is that it was stable. He hasn't had surgery, He didn't have surgery, he didn't have any procedures. It was a stable fracture. And there are systematic reviews, high level systematic reviews looking at athletes with these foot issues, and if it's a stable either fracture or sprain, they can rehabit conservatively and be just fine, like there's no impact. I think, I think from a health perspective. Mix and another dude that gets lumped in with oh he's injury prone, but he's definitely going to be somebody that I'm gonna have on a lot of my rosters.

00:14:38
Speaker 2: Okay, well, that's good to hear. At least there's some some positive positivity out of Cincinnati. What about a guy who has not been able to stay healthy to start his career, who seems to have up I mean, we saw a glimpse of it to start last year. But that's Paris Campbell. What can you say about him?

00:14:55
Speaker 1: Yeah, dude, so Paris Campbell. Right, we have to back up and think about just what are predictors for future health and the best predictor for future health according to another systematic review that I'm talking about here is how many games did they play in college? What injuries did they have in college? And after his freshman year, Paris Campbell played twelve games, thirteen games, and fourteen games. He's got a track record of staying healthy. He's had a hotchpodge of injuries. The Carson Wentz syndrome I mentioned earlier, a foot fracture, those tend to heal, Those happen in players that are around his age. The groinstrain. People come back, Players come back from groinstrain surgery really really really well. They bounce back perfectly fine. And then he had the PCL. The only thing I would worry about with Paris Campbell is the workload issue. If his body isn't yet adjusted to be doing the full time grind of an NFL season after coming off of rehab, then he might have some soft tissue issues. But moving forward. Man, I really think that I'm going to have a lot of Paris Campbell on my rosters.

00:15:49
Speaker 2: That sounds like a good By Low situation from a dynasty perspective too, because I feel like he's one of those guys that a lot of people are just generally not on because of the quote injury history. But that's good new for him. Another player who and I only have a couple more to go through, but another player who this past season, you know, just just got a lot of criticism in general because he would start games and everyone was, you know, using him a DFS and season long, and then he just didn't finish them and he would get hurt early, which gave you that goose egg. But that's Deontay Johnson. Is there anything to worry about with Deontay Johnson?

00:16:22
Speaker 1: Man? I just created an entire new syndrome here on the podcast with you, and it's the Carson Wentz syndrome, apparently, because that's what he has hamstring. Back to me, none of those are correlated. Ankle He in college played eleven games, fourteen games, thirteen games, the same thing as Paris Campbell. I won't belabor the point. I won't, you know, drag this out. Deontay Johnson's He's gonna be fine, and I'm also gonna have a lot of Deonta Johnson on my roster.

00:16:46
Speaker 2: The last guy I got to talk about who probably is at the top of the list in terms of injury proneeness in the way that people view injury prone. Noess will Fuller is will Fuller injury prone.

00:16:57
Speaker 1: Here's where I'm gonna hedge, I don't know, okay, but but I feel like me saying I don't know is a lot less extreme than the people who are ready to jump on the will Fuller's injury prone train. Here's the thing, will Fuller, the same thing we just talked about Deconta and Paris Campbell. He played literally every game when he was at Notre Dame. He had no hamstring issues. I don't see any injury history from his high school. I have no idea why all of a sudden he got the NFL. Things changed, he started having hamstring strains. So he's got a good history. Like history is actually on his side, and this year I think he's hear me out right, I know the ped stuff, but when it comes to like a physiological perspective, there's no data or any real evidence, empirical evidence that shows any of the band substance lists that he was taking will actually help them, specifically with hamstring strains. Like if you was, I don't know, trying to gain muscle mass or something like, yeah, and he took PDS whatever, but I don't know how anything on that substance list band substances would have kept him healthy. You also hear reports that he was changing his running mechanics. He changed strength and conditioning you routine, he changes diet like basically that comes coming back to my answer. I don't know because there were so many confounders there, like you. You can't point to the PDS and be like that's why, because he did so many other things, do you know what I mean? Yeah, I'm willing to give will Fuller another chance because last time I checked this was last week, he was like wide receiver forty one or something. I'll take that all day. I'll take that all day. So I here's that's my answer, that's my hedge. I don't know, so who then I'll end on this.

00:18:24
Speaker 2: Who's one player that you're gonna draft a lot this year based mostly on the fact that you'll get an injury discount on him when there shouldn't be a discount.

00:18:31
Speaker 1: I think Evan Ingram at this point, he's another dude that you really looked at early in his career as concussions, MCL's foot. He's coming off the list sprank, but it's gonna be a second year back. We know there's a twenty percent drop in production and offensive players when they have a list frank injury. He the second year, they bounce back that he's going to be in a second year from that, he low key even though he had a lot of drop seas and he didn't do very You know that offense is that offense is what it is obviously, but he his production drops like forty percent compared to his career. ABD she have her six point eight points per game, and at least some of that had to have been because of the foot and hit not being fully healthy. I think in given his price tag at this point and the way people view him and how they view him his injury prone, I think he's a steal. I think he's an absolute steal.

00:19:14
Speaker 2: Awesome stuff. Edwin really appreciate you hopping on and dropping some knowledge for everyone today. For those of you who aren't connected with Edwin, you should go follow him on Twitter at fbinjury Doc. He's always tweeting really helpful information and you can follow me on there as well at Late Round QB. And make sure you're subscribe to the Late Round podcast so you never miss a show. Thanks for listening everyone, I'll talk to you later in the week.