Post-NFL Draft Rookie Injury Breakdowns

The NFL Draft always brings some surprises with it, and we certainly saw some players slip, whether by character concerns or injury/medical concerns. Who do we need to be aware of or concerned about as they transition from college into the NFL with some potential long-term injury or medical risks? I’ll touch on a few key prospects as you enter rookie draft season.

Will Levis, QB TEN

Levis slipped to the top of the second round, going pick 33 to Tennessee. Rumors swirled that he slipped due to a turf toe injury that some scouts are concerned about, particularly if it requires surgery at some point if symptoms continue to linger or if it gives him problems during camp. I’m not buying these rumors, because he was medically cleared and he has already stated that he does not require surgery on the toe. He has been adamant about being able to step right onto the field and be fully ready to go for camp.

Other reasons were likely why he slipped, although notably Tennessee and several other teams were trying to trade into the end of round 1 to have the fifth-year option on Levis. I’m not worried about the low long-term concern of his prior turf toe injury and he should be safe to draft from an injury perspective in superflex leagues (not sure I care about him in 1QB leagues). Even if he does eventually require turf toe surgery if his plantar plate has not fully healed, the surgery provides good long-term outcomes for returning to prior form and has low long-term reinjury risk.

Kendre Miller, RB NO

Miller had some injury concerns, coming off of the MCL injury and surgery that prevented him from performing during the NFL Combine, unable to test in key areas such as the 40-yard dash and vertical jump. His draft capital tells us it’s of very little concern moving forward, obtaining top-75 DC on a team that loves to run the ball and may be without Alvin Kamara for some time this season if/when he winds up being suspended for a projected six or more games (and who is also a cut candidate into 2024).

Miller may wind up being the third option and low producer for year one behind Kamara and newly signed Jamaal Williams, but I’m not concerned about his injury long term for dynasty. He should be able to return to form by July and ramp up to full reps in time to be a day-one producer, if the team elects to throw him right into that role. If you want to put Miller in there as your RB3 of this draft class, I do not think his injury history causes any concern there.

Tyjae Spears, RB TEN

Spears reportedly “has no ACL” in his knee after having two surgeries to address the issue (2015 and 2020). While it is technically possible to play without an ACL (Hines Ward reportedly played his entire career without an ACL in his left knee) if you have enough dynamic stability from your muscles, it is very rare and will likely lead to a very short career in the NFL. It’s such a rare occurrence, granted the ACL provides proprioception in the knee as well as key static stability, but if his quadriceps and hamstrings are strong enough it could be allowing him to cut and sprint without issue.

A recent post by Dr. David Chao discussed how playing without an ACL is possible in his situation, considering he has grade four full-thickness cartilage loss (click on the link to see a picture describing this). This essentially means that he has no cartilage left in his knee, exposing subchondral bone and leaving him at significant risk for early-onset osteoarthritis. Typically, when we see these scenarios, the best way to describe it is that his knee is on trajectory to being a candidate for a total knee replacement by age 40-45 (which is more common around age 65-70). The risk is very high for him having a “Todd Gurley knee” scenario play out, and the likelihood is high that he only lasts two-three years in the league.

The only way I see Spears paying off at cost is if you get him mid- to late-second, Derrick Henry is traded away, Spears starts, and you capitalize on a trade. I’m personally not playing that game with Spears and would rather draft a player who is more likely to play longer plus have equal if not more upside for fantasy. I strongly recommend not to draft Spears in the late first, or early second round of rookie drafts like some people are recommending.

Darnell Washington, TE PIT

Washington is an extremely athletic tight end who slipped into round three because of concerns regarding his knee, having required surgery to address a “cartilage issue”. By all accounts and reports that I have seen, the cartilage defect was minor, which if true would tell me that the surgery was a very basic “clean-up” similar to if a player had a small meniscus tear that needed to be trimmed. While slightly concerning, it is unlikely to impact his next 3-4 years in the NFL, even as one of the larger players on the field (bigger size equals more loading through his joints).

The downside here is that he will be behind Pat Freiermuth, who has injury concerns of his own specifically regarding concussions, and it typically takes tight ends two-three years to turn into fantasy producers. I am personally fading him in rookie drafts unless it’s a 1.5-2.0 TEP league, but if he is on your radar, I do not believe his injury history gives us any reason to fade him over his next three-four NFL seasons.

Sean Tucker, RB TB

Tucker notably went undrafted after it was revealed that he had medical concerns surrounding a mysterious heart condition and was not allowed to participate in the NFL combine. He was medically cleared to participate at his pro day, but teams were obviously still pessimistic about his long-term health considering he went undrafted while other less talented running backs obtained day three draft capital.

The Buccaneers signed him as a UDFA, which is honestly a great landing spot for him to contend with Rachaad White for touches, considering from a talent perspective that he should be able to beat out Ke’Shawn Vaughn for a role on the team (Chase Edmonds likely wins the change of pace and receiving role behind White). Tucker is worth a late third or fourth-round rookie pick dart throw, banking on him staying healthy and if he can perform at the NFL level even for two-three years.

I would strongly recommend against drafting him in round two like some of those Justyn Ross truthers did last season. While very talented, it is telling that teams would rather have spent draft capital on other players and locking those players into a four-year cheap deal, while signing Tucker to a one-year UDFA deal and taking it one year at a time to monitor his health. Hopefully this mysterious cardiac issue is not a long-term problem (but again, good sign that he was at least cleared in the short term to perform at his pro day).

Kayshon Boutte, WR NE

Talk about your rocket ship going straight up towards the moon, taking a sharp 180 turn, and nosediving straight into the ground. Boutte had extremely high hopes and expectations before fracturing his foot last season, and he was never quite the same after returning this past year for 2022. The one notable positive here is that several accounts of avid film enthusiasts, including one of my favorites in Angelo Analysis, stated that Boutte did appear to gain a step and improve in athleticism such as cutting, agility movements, route running, and acceleration/deceleration towards the last half of the 2022 season.

The positives stop there, because by the time the NFL combine came around, he put up a gigantic dud. He tested out with a 4.80u RAS (relative athletic score) with a poor explosion grade (poor vertical jump and poor broad jump), decent 40-yard dash with 4.50, and a decent shuttle time of 4.25. He tested poorly, and he looked sluggish in his receiving drills during the combine. There were also some questions about his work ethic and character concerns, and it seemed at times that he did not really care about his testing. Maybe that is why he fell to the sixth round, or maybe teams have lingering questions and concerns about his lackluster production in his last college season coming off of his foot fracture.

We curiously did not hear any negative reports from the combine about poor medicals, so it is safe to assume that he passed his medical screening without big question marks. He simply did not test as athletically as we thought he would. There is a chance that two years out from his foot fracture provide him with more explosiveness and ability to produce, so he is certainly worth taking a dart on in the third or fourth round of your rookie drafts. At that point of the draft, you might as well take the highest potential player, and Boutte once showed his potential upside in his freshman year of college, even if that was three years ago.