The Dynasty Doctor: Brian Quick’s Shoulder

Scott Peak Posted On July 5, 2015

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Editor’s Note: Injuries are a huge part of winning and losing each year in fantasy leagues. Staying abreast of the injury situations is key as knowing what to expect from your players health-wise in the short term can help you make educated decisions in managing your team. Lucky for us, we have a Doctor in the house. Dr. Scott Peak is an ABPN board certified neurologist and neuro-oncologist. He is also a dynasty football addict and huge friend 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.

The Dynasty Doc has been paged by “David” to discuss the shoulder injury sustained by St Louis Rams wide receiver Brian Quick, asking how likely he could fully recover from it. I’ll add some comments on Eddie Lacy and Victor Cruz as a bonus.

Brian Quick, WR STL

Quick suffered a dislocated shoulder and torn rotator cuff week eight last season after landing on his left shoulder. The injury has been described as torn ligaments, and was worse than initially feared (per Rams head coach Jeff Fisher). Quick underwent surgery in November 2014 and (per Fisher again) had an extensive injury, with the rotator cuff, labrum and biceps tendon involved. Various media outlets have also reported Fisher expecting Quick to have a full recovery, but more recently he expressed uncertainty whether Quick would be ready for training camp. The picture is cloudy right now for Quick, but hopefully we can clear it up a bit.

The shoulder joint is a compilation of three joints (glenohumeral, acromioclavicular and sternoclavicular), but the glenohumeral joint is the main one. The shoulder joint is held together by soft tissues such as ligaments, tendons, muscles and a joint capsule. Dislocations can occur anteriorly (most common) or posteriorly (less common). Dislocated shoulders are typically reduced, or put back into place, but residual damage to the shoulder joint can lead to recurrent dislocations, instability that can be painful and reduced range of motion.

High-level athletes will typically get surgery to repair damage done from a shoulder dislocation, as risk of shoulder instability and recurrence of dislocations are much higher in those treated conservatively with rehabilitation and not surgery. That Quick had surgery to repair his injured shoulder is not a surprise, and will increased his chances of having a successful outcome. Most studies report the risk of shoulder instability and recurrent dislocation is 10-15% following surgery, typically two years after the initial injury.

[inlinead]Quick had not only a shoulder dislocation but rotator cuff tear and injury to the left biceps tendon. There are published reports describing this injury and good results have been reported. One study reported on a group of six rugby players who sustained rotator cuff tears in combination with shoulder dislocations, some of which also had biceps tendon injuries. All six had good outcomes. Five returned to sport at or better than their previous performance. One player retired given prior history of injuries but his shoulder was functioning well post-operatively.

Rehabilitation is an arduous process and return to play takes 6-to-9 months after surgery. Success rates are fairly good, with 88% having good outcomes. Given Quick’s surgery was November 2014, it is understandable Fisher isn’t sure if he will be ready for training camp.

Whether or not to invest in Quick for dynasty formats may depend less on his shoulder injury and more on whether his six game run in 2014 is a true reflection of his future production. I think the hype on Quick got a bit overdone, as after the first six games he was the WR27 in PPR and WR28 in standard leagues (per profootballfocus.com). When healthy, Quick was a high-end WR3, behind Malcom Floyd, Eddie Royal and Terrance Williams. Despite all the accolades and hype, Quick finished 2014 with only 375 yards receiving and three touchdowns.

Based on present literature, it seems reasonable to conclude Quick stands a fairly good chance of returning to his previous performance level with an acceptable risk of re-injury (10-15%). I’m still not a buyer, though. If Quick can be acquired cheaply, I would give it some consideration, but expectations should be tempered on his future production. I think his overly optimistic ceiling is a WR3, but realistically he’s probably more of a flex play or spot starter.

Eddie Lacy, RB GB

I’ve been mulling over ownership of Lacy shares on my dynasty teams. Back in June 2013, I was a big fan of Lacy and wrote an article on why I thought his draft stock dropped from misguided obsession over his toe injury and bizarre media reports questioning his mental toughness to succeed in the NFL. I remember posting a twitter message imploring Draft Twitter to ignore the hysteria, take the discount and grab Lacy mid-to-late 1st in rookie drafts. Now, however, I think I’m changing my tune on him. Lacy has had concussions in back-to-back NFL seasons and those are red flags. Prior history of concussions increases risk of subsequent concussions. Lacy has a reckless style to his game, runs upright and isn’t afraid to stick his neck out to would-be tacklers. If Lacy gets concussed again, the media reaction will be extreme, and we all know how much that influences trade value in fantasy football, especially in dynasty formats. Lacy’s value, unlike in 2013, is at its peak. Lacy is the RB2 overall, with an ADP of 13. I recently traded Lacy in a deal to get Jeremy Hill plus picks and I’m happy about it. I think dynasty owners should give some consideration to trading Lacy, pocket his high valuation and let someone else assume the risk of another head injury.

Victor Cruz, WR NYG

I’m as pessimistic as anyone on patellar tendon ruptures. I wrote an article on Ryan Williams back in June 2013. Published studies at that time were not as bad as one might think. Return to play was still high and even some suggested return to previous level of performance was better than expected. It’s hard to interpret this data, given patellar tendon ruptures are not that common. The best examples on offense are Ryan Williams, Cadillac Williams and Correll Buckhalter. Williams and Buckhalter managed to have productive seasons after their injuries. Still, there aren’t very many big-name players with this injury. NFL teams haven’t had motivation to spend time, money and a roster spot rehabilitating players like Greg Childs, as draft capital hasn’t been substantial. As heartless as that sounds, I do think it makes a huge difference in interpreting the true outcomes of patellar tendon ruptures for NFL athletes. Victor Cruz is an NFL star player, a leader for the Giants, plays an important role in their offense and the Giants have a lot of money invested in him. I believe Cruz will be a true test of how NFL players can recover from patellar tendon ruptures. Based on current media portrayal, the valuation of Cruz has been beaten to a pulp. I could easily see Cruz being sold for a super cheap price, like a rookie third round pick. The Giants offense should be a solid contributor for fantasy teams, Cruz is super cheap right now and it may be worth trading a small amount to see if he can rise above the historical ashes of this injury. The Giants certainly will give Cruz ample opportunity to play again, and it may be worth the small risk to acquire him in dynasty formats.

References

LeClere LE, Asnis PD, Griffith, MH et al. Shoulder Instability in Professional Football Players, Sports Health 2013: Sep 5(5): 455-457
Goldberg JA, Chan KY, Best JP et al. Surgical Management of large rotator cuff tears combined with instability in elite rugby football players. Br J Sports Med 2003; 37: 179-181.
Curtis RJ. Shoulder Injuries in the Young Athlete. DeLee and Drez’s Orthopaedic Sports Medicine; 131: 1576-1596.

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