The Dynasty Doctor: Injury Updates

Scott Peak Posted On August 7, 2013

Editor’s Note: Dr. Scott Peak is an ABPN board certified neurologist and neuro-oncologist. He is also a dynasty football addict and huge fan of Dynasty League Football. He’s excited to lend his expertise in medicine with hopes he may help the DLF Team and its followers better understand medical conditions and injuries that may impact NFL players and dynasty football owners. If you have a question for The Dynasty Doctor, just click here. Please remember The Dynasty Doctor is geared towards questions regarding medical science, injuries to players and their collective impact in fantasy football.

We asked him to make a special house call to describe the recent injuries and here’s what he had to say.

Jordy Nelson, WR GB

Nelson recently had knee surgery to repair a nerve problem that dates back to his college days at Kansas State. Nelson had been having pain that was bothersome and decided to have surgery now rather than risk missing games or practice sessions during the season.

Delving a bit deeper, Nelson may have an unusual but reported overuse syndrome in athletes called peroneal nerve entrapment syndrome. It usually occurs in athletes when enlarged muscles in the lower leg place pressure on the peroneal nerve as it exits around the fibula, through the peroneus longus muscle before dividing into the superficial and deep peroneal nerves. Cysts, tumors or scar tissue can put pressure on the nerve as well. It is associated with treatment for compartment syndrome, ACL tears and knee dislocations, but Nelson doesn’t have a history of these injuries. Contusions and/or trauma can be causative. Conservative measures can be tried for 3-4 months, but I’m sure they wanted to get it resolved before the season started. The main risk is pain, but if the peroneal nerve is damaged, weakness in the foot or ankle could be debilitating.

The surgery involves making a small incision on the side of the knee, tracking along the path of the peroneal nerve. The surgeon will then free up space around the nerve in the peroneal tunnel, which is the exit point of the nerve around the fibula and through the peroneus longus muscle. It usually works fairly well. If a cyst, tumor or scar tissue are pushing on the nerve, the surgeon will remove it. Literature on this injury is scant but 80% will have improvement in pain, and nearly all return to play sports. I think the 4-6 week time frame is reasonable, as it is minor surgery. I do not anticipate this injury being a long-term issue for Nelson’s dynasty value.

Danario Alexander, WR SD

Alexander unfortunately tore the ACL in his right knee and will miss the 2013 season. The left knee has undergone five surgeries, including two ACL repairs, so this is a big blow to have a torn ACL in the right knee. We’ve seen players like Chris Givens and Ryan Broyles return from ACL injuries to both knees, but one has to wonder whether this is the end of the road for Alexander. Still only 25 years old, Alexander just cannot stay healthy. There are studies showing certain athletes are at higher risk for ACL injuries whose body types use valgus landings (knee bent inward, like being knock-kneed), and this places maximum stress on the ACL leading to rupture. Whether or not this has anything to do with Alexander is hard to say, but it does support the notion that certain athletes may be at greater risk for ACL injuries. Surgery and rehabilitation have both come a long way in helping athletes return from ACL ruptures much faster and stronger than ever before. Still, dynasty owners should factor in the tendency for certain players to sustain ACL ruptures, like Broyles and Alexander, when acquiring or selling talent for their teams. As for Alexander, I think his value has evaporated in dynasty and I have doubts about his ability to be a productive asset for dynasty teams in the future. I would not hesitate to cut him from dynasty rosters now. I am excited about Keenan Allen’s potential and Vincent Brown could have a clearer path to be the top option at wide receiver for the Chargers. I still would not rush to the waiver wire for Eddie Royal or Robert Meachem, both of whom have proven to be disappointments in their fantasy production. Malcom Floyd has a long history of injuries, so buyer beware.

Arrelious Benn, WR PHI

So much for Benn resurrecting his dynasty value. After Jeremy Maclin ruptured an ACL, Benn was a hot player to grab off waiver wires. Dynasty owners eager to capitalize on Maclin’s injury plucked Benn off waivers, but his entire career has been derailed from injuries. Interestingly, this is the second time Benn has ruptured the ACL in his left knee, further reinforcing the notion that certain athletes may be at risk for these injuries (see Chris Givens, Ryan Broyles and Danario Alexander discussion above). Russell Shepard has been getting some recent buzz from training camp. I don’t see Riley Cooper as worth rostering in dynasty. The Eagles depth at WR is incredibly thin. This might give a bump to the Eagles running backs, and I’d give some thought to adding Chris Polk if he is available on waivers. Polk was a prolific running back at University of Washington and Kelly saw his talents first-hand when Oregon played the Huskies. Kelly hates turnovers and silly mistakes, so Bryce Brown might be on notice. Given the Eagles receivers are dropping like flies, Kelly may have no choice but to rely more on his rushing attack. This might also help James Casey and Zach Ertz gain value. I would not hesitate to cut Benn. He can’t stay healthy and is not worth rostering in dynasty.