Injury Expert: Percy Harvin, Ivory, Rice, Stewart, Edelman

By Russell Manalastas (Injury Expert) on Aug 5, 2013

Russell Manalastas's picture

Russ is a licensed Physical Therapist and Clinical Director at Lattimore Physical Therapy in Rochester, NY. He has a Doctorate in Physical Therapy from the University at Buffalo as well as his Bachelors Degree in Exercise Science. Russ provides a unique perspective on NFL injuries as they relate to fantasy football. Follow Russell on Twitter: @russmanalastas.

Training camp is underway, and the Hall of Fame Game is behind us. We’ve already seen a number of injuries occur to some prominent players that have organizations scrambling for a backup plan. Injuries are a regular occurrence in the NFL and every year there are major injuries that change the landscape for teams and affect how they approach the season. For fantasy managers, it's important to stay updated on injury situations and how they should impact your thinking as draft day approaches. The theme of this column is opportunity, either for the injured player trying to take it to the next level, or for the players competing with them for playing time.

 

Percy Harvin

Hip Labral Surgery - Your hip is a ball (top portion of the femur) and socket (acetabulum) joint which allows for freedom of movement in multiple directions. Your labrum is a thick fibrous tissue that blends with ligaments to encapsulate the ball and socket to give it more stability. With continuous running, cutting, and twisting motions it can cause portions of the labrum to wear down which leads to a tear. Depending on location and size of the tear it can lead to pain and a pinch/catching sensation that causes changes to the surrounding tissues, including the ball and socket. That pinching sensation is usually diagnosed as Femoracetabular Impingement (FAI).

Reports are that Harvin is recovering well from surgery. The details of his surgery are unknown, but it seems like it was just a clean-up to remove the portion of the labrum that was causing the irritation. No work was done on the actual bone which is a good sign. If they had to reshape the bone that means they would've had to do more extensive work not only to the bones but also to the labrum which could've lead to a complete reconstruction and a longer recovery time.

Bottom Line - When dealing with any labral issues and FAI in the hip, surgery is usually the only option to fix the cause. The research to manage it conservatively with injections and rehab isn’t very strong so he opted to have the surgery ASAP. Havin's return to play timetable is 3-4 months with no setbacks. Again, no details were reported as to what type of surgery was done but it sounds like just a clean up which would fall in the 3-4 month range. The optimistic end of this range would have Harvin back on the field for Week 9 against the Bucs, while the other end of the spectrum could see him back for a Monday Night matchup with the Saints in Week 13. There’s reason for optimism that Harvin could potentially make a big impact down the stretch for the Seahawks if he recovers well from surgery. Keep a close eye on how he progresses through his rehab. If he's able to perform activities with minimal pain early on it'll be an encouraging sign toward his long term outlook for this season.

 

Chris Ivory

Hamstring strain – The hamstring is the main muscle in the back of the thigh that originates from the pelvic bone and attaches behind the knee. It’s responsible for bending the knee, extending the hip, and for proper acceleration/deceleration when running/cutting.

Ivory has been dealing with some tightness and soreness in his hamstring over the past two weeks and has been limited in training camp as to not exacerbate the issue. He doesn’t have the cleanest bill of health dating back to when he was with the Saints so this is a concern because we’re not even at pre-season yet.

Bottom Line – Make sure that Ivory is participating again fully in training camp and in pre-season games before feeling confident in drafting him. Even if he is healthy, hamstring strains are always in the back of my mind when it comes to players just because the slightest tweak or irritation to it could lead to more severe strains which require more time out. He’s got a great opportunity with the Jets to be the lead back and show his talents on the big stage in New York, he just has to stay healthy in order to tap into that potential.
 

Sidney Rice

Knee pain - Rice recently returned from Switzerland to undergo a procedure to help with his knee pain. The procedure he received is similar to Platelet Rich Plasma (PRP) injections which is where they took some of his blood, put it in a centrifuge to separate the platelets from the rest of the blood, and then re-inject the platelets into the affected area. Platelets have healing and regenerative properties that help accelerate recovery and PRP has been used more frequently in professional sports to give trainers/doctors more options for rehab.

Rice has been dealing with this knee pain since he was spotted on crutches after the divisional round last year. We’ve seen other athletes in other sports go overseas to receive treatment and have good results (Kobe Bryant, Alex Rodriguez, Brian Urlacher), so Rice decided to see if it could help with his bothersome knee.

Bottom Line - Rice needs to step up since his injured counterpart Percy Harvin will be out for a while. His knee will only continue to bug him as he grinds through the regular season, so it could be a problem moving forward. Coach Carroll called it preventative; I call it more of a reactive treatment which could require additional attention as it seems like the issue never resolved after last season. There still isn't great evidence for PRP injections long term so if the procedure he received is similar, I'm not sold that it's going to get him through the season. If you plan on drafting him, make sure you have a backup plan, or set your eyes on Golden Tate who offers more upside.
 

Jonathan Stewart

Right and Left ankle surgeries – your ankles have many ligaments that help stabilize the bones of the lower leg as they attach into the foot. When dealing with multiple ankle sprains, those ligaments become less able to stabilize the ankle which leads to more wear on the bones. Bone spur formation can lead to limited mobility in the ankle which then leads to increased irritation back on the ligaments.

Stewart was just put on the active PUP list as he recovers from arthroscopic surgery on both ankles. Details as to what type of surgery he had are unknown, but he either had cleanup to remove any damaged tissue around the ankles or a more extensive surgery known as a Bromstrom procedure where they clean up and possibly shorten the lateral ligaments of the ankle to give it more stability. A bromstrom procedure is often used when someone has dealt with chronic ankle sprains and does not have the stability due to the laxity in the ligaments. Regardless of the surgery, Stewart is almost 7 months removed from surgery and he states that his right ankle continues to be bothersome during football activities.

Bottom Line – When you have surgery on both ankles the recovery is never easy, as the ability to rely on the “healthy” side is not an option. At this point I expected Stewart to be further along, but when you deal with areas that have a lot of ligamentous attachments, the healing is always delayed due to the lack of bloodflow to those ligaments. Stewart has shown in the past to be a slow healer, so his status heading into drafts is up in the air at this point. Definitely keep a close eye on his recovery; if he starts the season on the PUP list, DeAngelo Williams is the clear choice out of this backfield. When Stewart does return healthy, he might not have a starting job to come back to.

 

Julian Edelman

Broken foot – When direct trauma or excessive force is applied to the foot, a fracture of one or multiple bones may occur. Fractures are more prevalent especially when trying to cut or twist and the bone is not able to withstand the amount of force being applied to it. Unfortunately we don't know the specifics of Edelman's foot fracture. 

Edelman was just activated off the PUP list and has been participating in limited capacity during training camp. He suffered a setback with his foot back in May but apparently is over that issue. He did undergo a surgical procedure to clean up around the area that was fractured last year which possibly could mean he was dealing with some tissue build-up in that area that was causing irritation.

Bottom line – Opportunity knocks for Edelman, as the Patriots are looking for any playmakers that can help Tom Brady. He has a good opportunity to be the #2 wideout behind Danny Ammendola, and Brady would probably feel better with a familiar face on the offensive side of the ball. Edelman definitely has a red flag when it comes to his injury history, but if he can stay healthy he should be productive in the Patriots’ offense. The one thing I worry about is if he does re-injure his foot again, the likelihood of it being more severe is high with a lisfranc injury always being a possibility. He’ll be worth a late round pick if he gets through camp and pre-season healthy. The Patriots need him.

Filed Under: Preseason, 2013