Injury Profile: Saquon Barkley
How many times have you been burned by injuries to your star fantasy football players? How many times have you invested immensely high draft capital, only to watch that value waste away on injured reserve while you try to scavenge the waiver wires for a solution to your contending team?
This is precisely what happened to those of you who invested in Saquon Barkley in 2020, whether it was in the first round of your dynasty start-up, acquiring via trade, or holding high hopes for the addition of Jason Garrett as the new offensive coordinator.
One of the more complex discussions of the off-season involves how to view Barkley moving forward. How does his recent injury affect his future?
2020 Week One-Two
BREAKING: Per @ProFootballDoc Saquon Barkley has a torn ACL is is out for the season.
Let's hope he's wrong but it doesn't sound likely. pic.twitter.com/rWj6Vv71Hh
— Giants 366 (@Giants366) September 20, 2020
Barkley was off to a hot start, catching six of nine targets the previous week for 60 yards and starting week two with 4-28 rushing. His day was unfortunately cut short after suffering a torn ACL, MCL, and meniscus in his right knee – the “terrible triad” as we call it. Barkley suffered the injury on 9/20/20 and had surgery on 10/30/20. Why did Barkley wait five weeks and five days to have surgery to repair his knee?
In these cases, it is often customary to allow a torn MCL to heal on its own, particularly if it is a partial tear. The MCL has a large blood supply and the majority of the time, the tissue can scar over and heal on its own. We have seen a recent example of a player suffering a complete MCL tear that did require surgical repair due to severity: Joe Burrow. However, Barkley’s MCL was not addressed in surgery, thus we can speculate that his tear was not as severe. This explains why they waited to perform surgery, in order to improve range of motion and reduce swelling in his knee prior to surgery for better outcomes.
Terrible Triad Return to Play
According to this systematic review on ACL reconstructions (ACLR), the average rate of return to play (RTP) following ACLR for football players is roughly 67.2%, however, it is known that RTP differs per position. The review revealed that, across 15 studies, the average running back RTP was between 46.4% to 81.2%. The average RTP also revealed a higher RTP rate for players with higher draft capital and preinjury performance level, both variables that favor Barkley’s possibility of returning to prior form. However, this study only incorporated ACLR and not concomitant variables such as an included MCL or meniscus tear.
As for the ACL tear, Barkley’s was a typical repair. So why is there a heightened concern? When these injuries also incorporate a meniscus tear, the risk in return to play heightens. Meniscus tears can be addressed with multiple techniques. Most commonly, the torn piece of meniscus causes a mechanical fault, limiting function and causing pain, and a meniscectomy is performed to cut out or remove the torn piece. The downside to these procedures is that removing a portion of the meniscus can lead to increased chondral (cartilage) defects, diminishing an NFL player’s playing career.
The good news? Barkley did not have a meniscectomy performed. Rather, he had his torn meniscus repaired, which involves suturing the torn pieces of the meniscus back together and allowing the tissue to heal on its own. Typically these procedures are only performed if the tear occurs in a highly vascularized (large blood supply) portion of the meniscus in the outer portion, so that is more good news.
In fact, patients often have a 91% success rate with a concomitant ACLR and meniscus repair (click that link if you want more information on meniscus repairs). The meniscus serves a very important function for load-bearing and shock absorption through the knee, so it is key that Barkley’s was repaired and not partially removed, particularly for long term outcomes.
While not many studies exist involving return to the NFL following a combined ACLR and meniscal repair, studies show that both meniscectomies and meniscal repairs have good outcomes for return to pre-operative level of competition, and that players’ career lengths are often not reduced after having a meniscus repair, compared to the meniscectomies. This is great news for Barkley long term.
All in all, I believe we can have confidence that Barkley returns to the field in 2021. An updated video on March 22 revealed certain exercises that he has been performing. Based on the typical timeline for recovery and a typical “protocol” if you will, I believe Barkley was around one month behind schedule in his rehabilitation. This could be an indication that the meniscal repair was larger than expected and required more extensive time to heal prior to progressing into various single leg balance exercises and lunge training. However, this is simply speculation on my end.
.@Saquon on his comeback grind 😤
(via nicshimonek/IG) pic.twitter.com/jDYFNhW8T5
— B/R Gridiron (@brgridiron) March 22, 2021
On April 16, Barkley posted a video of much more aggressive exercises, working on deceleration, agility, single-leg explosiveness, and reactive training, all primarily focused on his right lower extremity. This was much more optimistic to see at this stage in his rehabilitation program, especially given he still has roughly five months to continue training prior to the 2021 season. This is further evidence to be optimistic for a Saquon Barkley return to form in this coming season, and more importantly I expect him to be ready to play in week one.
Saquon Barkley Crushes Workout 6 Months After ACL Surgery, Jumps Off Injured Knee! https://t.co/Ypsd8Q3Elr
— TMZ (@TMZ) April 16, 2021
Fantasy Production
While I believe he will be ready to play in week one, what should we expect from him in terms of fantasy production right out of the gate? Let’s take a look at a few prior running backs who have suffered ACL tears and returned to play. Note: None of these players had all three ACL/MCL/meniscal tears with an ACLR and meniscal repair surgical procedure, so a comparison cannot be truly one for one but it can at least give us an indication of early expectations.
Todd Gurley
Gurley tore his left ACL on 11/15/14, and did not play in an NFL game until week three of the 2015 season, on 9/27/15. Along with the left ACL, he reportedly suffered a torn meniscus that required a meniscectomy. How did Gurley perform upon return to play (his first season in the NFL)?
- 2015 RB9 (16.1 FPPG): 229 rush, 26 targets, 250 total touches in 13 games
- 2016 RB23 (12.4 FPPG): 278 rush, 58 targets, 321 total touches in 16 games
- 2017 RB1 (25.6 FPPG): 279 rush, 87 targets, 343 total touches in 15 games
In Gurley’s age 21-23 seasons, he gradually saw an increase in total touches within the offense. His first season upon return from ACLR he averaged 17.6 rush attempts per game and 1.6 receptions per game. He also benefitted from scoring ten touchdowns, while he regressed to only six in his 2016 season with 17.4 rush attempts and 2.7 receptions per game. The volume in year one was promising, with 10 months and 12 days separating injury to RTP.
Adrian Peterson
Peterson suffered a torn left ACL and MCL on 12/24/11 and returned in eight months, 16 days to play in week one on 9/9/12. As everyone knows, he returned with a vengeance at the tune of 348-2,097-12 rushing with 40 receptions, statistically his best career year. He had 388 total touches in his return post-injury, finishing as the RB1 overall in fantasy. His next year saw regression, with 279-1,266-10 rushing and 29 receptions, finishing as the RB8 with 308 total touches. Note: Peterson was 27 and 28 years old during those years, while Barkley will be 24 this season.
Terrell Davis
Davis suffered a torn right ACL and MCL in 1999, his age-27 season. His story is a cautionary tale of what could occur. He struggled to return from his injury, suffering a stress fracture in 2000 and then requiring arthroscopy surgery on both knees in 2001, ending his career.
Injury Takeaway and Expectations
I would temper expectations of the Giants using Barkley in a high-volume role right out of the gate. Among the injury variables, Dave Gettleman has stated that he signed Devontae Booker because he is viewed as a three-down back (let’s be real… No.) and Barkley has been rumored as a “hold out candidate” for this upcoming season to push for a contract extension. How much does that change his value?
From an injury standpoint, taking into consideration medical advancements and prior examples of RTP for these high-level athletes, everything points to Saquon Barkley returning to his prior level of form. He has attacked his rehabilitation wisely and aggressively, in fact with input from Adrian Peterson and his personal trainers who helped him through his own recovery in 2012.
Should we expect an Peterson-like 2021 from Barkley? Absolutely not. I caution you to temper expectations, as Peterson’s return was a one-in-a-million example that will likely never be seen again. He was the anomaly of anomalies. However, it would not surprise me at all if we saw Barkley receive anywhere from 240 to 280 total touches this year. How efficient will he be and how much will he be used as a receiver? If the Giants choose to extend Barkley, it would not surprise me if they eased him into a workload this season and then ramped his workload back up in 2022.
Summary
From a value standpoint, this is where many will differ. Is Barkley an RB1? Absolutely. Will he be THE RB1 again in fantasy value? To be honest, I am unsure, but my bet is Christian McCaffrey and Alvin Kamara begin to trend downwards. This is where I get a little controversial: It is far better to be a year early on trading a high-value asset away, than being a year late. This begs the question: Is Barkley at peak value?
Looking at the DLF Trade Finder, it is clearly apparent that Barkley is not at his peak value right now. There have been some absolutely egregious trades that would be embarrassing to even put into this article (one example was straight up for Michael Thomas, another was Barkley for Terry McLaurin/1.07, but I will save you from the rest).
At one point, I saw Barkley traded for Cam Akers, Tee Higgins, and a 2021 second-rounder. If you’re able to get that kind of haul and you need the overall roster help, I would absolutely pull the trigger. Otherwise, have zero doubts about holding Barkley for now and waiting for his value to rise again once other managers see him play at his typical elite level.
I recommend at least considering trading him away for a haul over the next one to two years, simply to get ahead of any potential regression. Outside of that strategy, enjoy having Barkley on your roster, but be patient with him at the beginning of this year if he is somewhat limited out of the gate. Do not trade him away for peanuts out of panic if he is not living up to early-season expectations.
One other note after diving into the DLF Trade Finder: even if you are in a rebuild, I would strongly consider finding out trade value to acquire Barkley in your leagues. If you can acquire him at some of these cheaper prices now, wait several weeks until his value skyrockets again, and then flip him for even more, you’ve just expedited your rebuild with one simple transaction. Play the market and take advantage. After doing this deep dive, I do believe the risk is low on Saquon Barkley and that we will likely see him return to his prior level of performance.
- 2024 Injury Breakdowns: Tight Ends Returning from Injury - April 18, 2024
- 2024 Injury Breakdowns: Wide Receivers Returning from Injury - April 11, 2024
- 2024 Injury Breakdowns: Running Backs Returning from Injury - April 1, 2024
