Instant Analysis: Julio Jones Injured

Scott Peak Posted On October 9, 2013

jjones

Fantasy football owners received shocking news today that Julio Jones may be gone for the year. Reports are that Jones sustained a foot fracture. It is unclear which bone in Jones’ foot has been fractured, and that is important in determining treatment, return to sport and long-term recovery. For dynasty owners, this is particularly painful, as owners now must now be concerned about his value not only in 2013, but 2014 and beyond.

The foot has about thirty small bones that fit together like a puzzle, and ligaments help hold it all together. Tremendous force is applied to these bones, as much as 210 tons of force per foot per mile when running.¹ Fatigued athletes can suffer micro-trauma resulting leading to stress fractures. Symptoms include tenderness, bruising and swelling over the injured bone. X-rays can sometimes show signs of a fracture, but nuclear medicine bones scans and magnetic resonance imaging are the tests of choice to confirm the diagnosis.

Treatment starts with rest and immobilization. Rest is important as repeated stress on the foot, especially by athletes, can worsen the injury. Notably, there are reports suggesting Julio may have been playing with the injury, and if true, that seems risky. Nevertheless, fantasy football owners must face the reality that Julio has a very significant injury. Not all stress fractures in the foot require surgery, but fractures like certain types of Jones’ fractures (5^th metatarsal), tarsal navicular fractures, distal tibial fractures or vertical stress fractures typically require surgery to facilitate bone union.¹Ahmad Bradshaw has been dealing with a Jones’ fracture, and I suspect non-union of bone could be an issue for him. That’s not to say that Jones will follow the same path as Bradshaw. In fact, 94% of Jones’ fractures treated surgically heal with bone union, and that number drops to 70-80% with non-operative management, and thus Jones’ fractures are often treated surgically.²

Return to sports activity varies based on the fracture location, but can be as little as two months for metatarsal fractures, three to four months for Jones’ (5^th metatarsal) fractures, and six months for navicular fractures.¹ Care must be taken not to return to play too soon, as recurrent fracture is a concern. Stress fractures treated non-surgically typically involve immobilization and rest for six to eight weeks. It typically takes three months for radiographic confirmation of bone union, so return to sport can still be delayed. Athletes will usually return to play once evidence of bone union is noted and pain is resolved with gradual advancement of sports-specific activities.

Recurrence rate depends on the type and severity of fracture, but it is not trivial. It is hard to call a specific re-injury risk, as it depends on the type and severity of fracture. Depending on whose data is reviewed, the type and severity of fracture, re-injury rates can be 0 to 40%. I would be careful about assigning a specific re-injury risk for Jones until more information is known about his specific fracture. Notably, Jones did have a history of a left foot fracture in 2011, and spent eight weeks in rehabilitation for it. Even if Jones is able to return in two or three months, and that seems like the most optimistic scenario, the likelihood he will be productive for fantasy owners this year seems quite low. For re-draft owners, I would still wait and see if Atlanta places him on injured reserve, and officially ends his season before cutting him. He is simply too vital of a player to cut right now, until we have confirmation his season is over.

The dynasty value of Jones certainly takes a hit, but the extent of his value depreciation depends on how this situation unfolds. I would advise not selling him at a substantial discount until more information is known. I am concerned, however, that given he has sustained a second foot fracture, this could become a chronic issue long-term. If you can get something close to his pre-injury value, I would definitely trade him, but I doubt any dynasty owner will give up near value for a player with a foot injury who is likely out for the year. I am concerned that dynasty owners are left to wait it out and hope that Jones has a complete recovery, and that is still certainly possible. Only time will tell.

References:

Haskell A and Mann RA. Foot and Ankle Chapter 25. DeLee: DeLee and Drez’s Orthopaedic Sports Medicine (3^rd Ed); pages 1865-2205.
Thevendran, G, Deol R, Calder J. Fifth Metatarsal Fractures in the Athlete. Foot Ankle Clin N Am 2013; 18: 237-254.