Can Christian McCaffrey Squash the Injury Bug to be the RB1 Again in 2025?
At this point in his eight-year career, we all know who and what Christian McCaffrey is. When he stays healthy, he's the best running back in fantasy football. But when he doesn't — like in three of the last five seasons — CMC is a major disappointment and a waste of an early draft pick.
So, what's it going to be in 2025? Do we buy back in on the promise of greatness? Or do we slap a "Do Not Draft" tag on the All-Pro back and move on? Let's break it down.
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A Step Above Elite
Since his 2018 breakout season, Christian McCaffrey has played 16+ games four times. In those seasons, he finished as the RB3 overall (2019), the RB1 overall (2020), the RB2 overall (2022, on two different teams), and the RB1 overall (2023). It's a stretch of dominance that would be earth-shattering if it hadn't itself been shattered by several lost seasons. His half-PPR points per game over the last seven seasons sit at 20.9 ... not just best at the position, but best by more than three points per game and best by any non-QB.
| Player | Half-PPR PPG |
|---|---|
| Christian McCaffrey | 20.9 |
| Derrick Henry | 17.5 |
| Jahmyr Gibbs | 17.3 |
| Alvin Kamara | 17 |
The only running backs to top McCaffrey's 20.9 PPG in any one of the last three seasons were McCaffrey himself (22.4 in 2023) and Saquon Barkley last year (21.2). Four of the top 14 RB fantasy seasons since 2018 were recorded by McCaffrey, including both of the top two (413.2 points in 2019 and 357.8 in 2023). If you took all of McCaffrey's numbers from the last seven years and calculated his 17-game pace, you'd get 1,281 rushing yards, 11 rushing touchdowns, 96 receptions, 820 receiving yards, and five receiving touchdowns. That's better than Bucky 2024 Irving as a rusher, and 2024 DK Metcalf as a receiver.
Since 2018, despite missing more than 30 games, McCaffrey's 43 games with 20+ fantasy points are the most at the position, five more than Derrick Henry in second, and 14 more than Saquon Barkley in third. Only Josh Allen, Patrick Mahomes, and Lamar Jackson have more 20-point games over that span in the entire NFL.
Whatever elite is, McCaffrey is a step above ... when he's healthy. But therein lies the rub.
The Medical Records
The laundry list of injuries CMC has dealt with over the last five years is unquestionably concerning (data below is from DraftSharks.com).
- September 2020: High-ankle sprain, missed six games
- November 2020: Shoulder sprain, missed four games
- December 2020: Thigh/glute strain, missed four games
- September 2021: Hamstring sprain, missed four games
- November 2021: Ankle sprain, missed five games
- December 2023: Calf strain, missed one game
- August 2024: Achilles sprain, missed eight games (Achilles tendinitis)
- December 2024: PCL sprain, missed five games
If there were a database for most strains and sprains by a single player in a five-year span, McCaffrey might hold some sort of record. And it's odd that despite all the time he's missed, none of the injuries have been of the massive, season-ending, year-long-recovery variety. Moreover, he's typically been productive and efficient coming off these injuries — you don't maintain the overall fantasy production he has with slow starts.
Still, the litany of issues across his entire lower body (specifically his right leg) and the appearance of multiple soft-tissue issues on that list cannot be ignored. Unlike Derrick Henry, who's seen massive volume but only missed significant time once in his career, McCaffrey carries legitimate injury red flags into 2025. The (poorly reported) Achilles tendinitis from last year is obviously concerning, and he's also 29 years old now, which is a major difference from his bounce-back 2022 season, when he was freshly 26. To say there are zero worries regarding McCaffrey's health in 2025 would be disingenuous or foolish (or both).
All that being said. It's also important to remember that outside of the three single-digit-game seasons, McCaffrey has played 16 or 17 games in each of his other five seasons. As opposed to someone like James Conner, who's missed a few games just about every year of his career, if McCaffrey doesn't lose the vast majority of the season, he plays all of it. And, even despite the history, I'm typically unwilling to bet on player injury in an upcoming season. Everyone has a high chance of getting hurt in this league, and we are drafting to win, not to finish comfortably in sixth.
So, if we assume health from McCaffrey in 2025, what can we expect for fantasy?
Expectations in San Francisco
After finding a superb fill-in (and potential successor) for McCaffrey in Jordan Mason last season, the 49ers quickly shipped him off to Minnesota, leaving Isaac Guerendo as the primary backup once again ... and arguably signaling confidence in their veteran to return as strong as ever this year and beyond. As a result, McCaffrey will once again be the clear-cut bell-cow and probably rank near the very top of the league in percentage of team touches. Moreover, with Deebo Samuel's departure and the currently murky situations surrounding Jauan Jennings's status (contract, calf) and Brandon Aiyuk's recovery (knee), McCaffrey may be called upon to carry an even bigger portion of the team's receiving work.
In 31 games with the team, he's seen 167 targets and caught 134 balls, a seasonal pace of 91 targets and 73 catches. But if Brock Purdy is a little more desperate for trustworthy receivers early in 2025, it wouldn't be surprising to see McCaffrey threaten the triple-digit reception range he used to hit back in Carolina. And with the Niners defense potentially a little softer than it has been in recent years, we may see the team forced to ratchet up their passing game a touch.
If McCaffrey plays 17 games, it's hard to imagine him falling short of 300 touches (with 75-100 catches), 2,000 yards, or double-digit touchdowns. Which is wild to say. Those numbers are reserved for All-Pro seasons by the league's very best ... or in other words, for Christian McCaffrey. And if he hits those marks, it's even harder to imagine him finishing anywhere short of RB1 or RB2 overall. Considering he's currently priced as the RB4 at 1.07 overall in our multi-site ADP, that would make him a steal. The only question is whether drafters are willing to take the inflated risks with McCaffrey's medical history, for the potential reward of the game's best fantasy star.
The Bottom Line
- When healthy, Christian McCaffrey is the best running back in fantasy, arguably the best fantasy asset at any position, and potentially the best to ever grace our fantasy lineups.
- Health is a legitimate concern, with a substantial history of multi-game absences, lower-body and soft-tissue injuries, and Achilles tendinitis from last season. We can't ignore the risks, but we should also weigh them appropriately with McCaffrey's five healthy seasons and the upside he brings when active.
- At a current ADP of RB4 (1.07 overall), the investment to get McCaffrey is massive. You're spending your first-round pick, and if he misses half the season, it could kill your chances at the championship. But, if he plays 17 games of vintage CMC football, you'll be getting the number one player in fantasy six picks later than he should have gone. I, for one, have put a lot of eggs in the McCaffrey basket because I believe in playing to win. Simply put, he is high risk, highest reward.
