NFL Training Camp 2015: Arian Foster's Injury is the first of many to come

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By WILL CARROLL
FanDuel

Before we get to the issue of early-season injuries in the NFL, let's focus on Arian Foster. Foster has a significant groin strain and early reports have him heading for surgery. Despite this, we still don't know enough about the injury in order to put a solid timeline on there. There are some guesses:

Any muscle strain is bad, but one in this location is even more difficult. First, it's painful and uncomfortable, but the size of the muscle and tendon make it difficult to reconstruct. The best-case scenario (or really, best of the bad scenarios) is Foster pulled the tendon away from the bone. The tendon could be re-anchored and the muscle itself would be essentially intact.

There's also the chance this is more like a sports hernia, as noted by Dr. Chao. In this scenario, the muscle sheath is damaged rather than the muscle itself. Surgery to repair these is very successful and players tend to come back quickly, though there isn't a big history with this. The best comp would be Adrian Peterson, who played through a sports hernia during his huge 2012 season.

If it is the muscle itself that is damaged and has to be sutured back together, that's tougher from a technical standpoint. It's like taking a steak, cutting it, and then stitching it back together. The healing itself is actually the same process, but because it is held in place, the scarring necessary to re-join the fibers should be cleaner and simpler. It doesn't always work that way.

Whichever path this takes, we have to consider this a career-threatening injury for Foster and a season-altering one for the Houston Texans. Foster has had a history of leg injuries, including groin and hamstring strains, which could contribute to this. He's always come back well and on a normal timeline, so we have to anticipate he can do so again. However, a late-season return will depend on many factors, including how the Texans are playing and how Alfred Blue and any other RBs the Texans use produce up to that point.

We should know more about the specifics of the injury after further testing. Watch to see who Foster chooses to do the surgery for some indication of severity. Sports hernias have turned into a surgical subspecialty, so if Foster heads to Dr. William Meyers, that will be a clear indication. (Update: NFL's Ian Rapaport reports that Foster will see Dr. Meyers.) We'll also get a very good look at this on Hard Knocks, but that's not until Aug 11.

Another interesting thing to watch will be how the Texans deal with this from a roster standpoint. There's no current incentive for them to make a quick IR/DFR (designated for return) move. While it would be nice to bring in more RBs to take up the load, it's not a big deal to play a "man down" when the rosters are at 90. The DFR tag can only be used once, so the team must have a clear indication that Foster will be able to return effectively. They may not make a roster move on Foster until they cut down to 60 in a few weeks.

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Injuries happen early in the NFL. A study done by Football Outsiders a few years back showed that nearly 70 percent of all injuries that will happen in a season will occur before Week 2. There are a lot of reasons for this, including the sheer number of players that participate in the early stages of NFL training camps, but there continues to be a debate about the effect of contact.

It would appear to be simple. New rules put in after the last CBA reduced the number of injuries by a notable amount. Most of this change came in a reduction of traumatic injuries, which are almost always the result of contact. While there are non-contact injuries that happen, often with traumatic leg injuries, any reduction is a positive.

The "next man up" culture of the NFL is actually self-defeating. Any player lost reduces the overall talent level. Remember, an RB1 is not in fact replaced on the roster by an RB2; he's usually replaced by an RB5 or 6, a "street guy" who has usually been cut by multiple teams. While an RB2 can step up – think Justin Forsett or Rashad Jennings last season – and make a valuable contribution to his team (or your FanDuel lineup), NFL teams are doing far too little to prevent injuries.

Take this simple fact: Less than half of NFL teams currently have an active ACL prevention program. While this is an unofficial number, compare this to English soccer, where every team in the Premier League has a defined program to prevent knee injuries. We can also go all the way down to the fifth and sixth levels of English soccer and see each team having a program. Cost isn't the issue, culture is. It's time for the NFL to get with the program, literally.

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On the RotoExperts show Wednesday morning on the Sirius Fantasy Channel, Adam Ronis asked me to define "injury-prone." Those of you that have read me for years know I disdain the term, but occasionally, I'll use it. It slips. I don't think there is a true definition and the term is vastly overused, largely as a pejorative, but there are two ways where the term can be instructive.

First, injury-prone can be used for a recurrent or chronic injury to one body part. A player with one muscle or joint that continually breaks down, perhaps in part due to the continued damage, such as Dwyane Wade and his knee, could be correctly termed injury prone.

On the second, it's more a systemic use. Some players break down with no discernible pattern, but are continually injured in some form or fashion. Their body just can't hold up under the workload of their sport and while one area can be strengthened, another weak link seems to find a way to break. Perhaps someday there will be a genetic test to let us know about the strength of bones, muscles and connective tissue, but until then, this is the type most often called injury prone.

For fantasy players, I don't believe the term itself is that instructive. What we have to do is assess the overall risk of a player. Prior to his injury, the proper way to value Arian Foster on a season-long basis is to take his per-game averages and project them out to 10 games. Given his previous seasons, that's a reasonable and low estimate of availability. However, as we now know, it's also too high, but it would have at least limited the downside loss of expected value based on previous production.

Foster reminds us that traumatic injuries, even with precursors and patterns, are impossible to predict. It's easy to call Foster injury-prone or to expect him to miss time, but it's impossible for anyone, even the Athletic Trainers who have worked with Foster day-in and day-out on his various injuries to have said when and how this would happen.

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While traumatic injuries may be impossible to predict, it's relatively easy to predict who will make successful comebacks. Even significant injuries like ACL reconstructions have predictable timelines and extensive histories. We know what to look for from players coming back from them, which allow us to create external checklists for a return to play. Here's five guys I'm watching in camp that I think will have successful comebacks:

1. Victor Cruz – Cruz has perhaps the least predictable timeline, coming off a patellar tendon rupture. This injury was once a career ender, but over the past five years, significant changes have been made in surgical technique and in the rehab protocol. Cruz will need to show he hasn't lost speed or quickness, but the early signs are promising. Observers say the Giants WR is cutting and stopping while also showing good burst. He hasn't truly tested the knee, but with all positive signs so far, I'm watching to see when the medical and coaching staff let him get perturbed. "Perturbed" simply means being bumped off routes the way he would in games.

2. Carson Palmer – Palmer is coming back from ACL reconstruction for the second time. He knows he can come back from this, so we should take that as a solid plus. Palmer isn't a mobile QB to begin with, so as long as he has a solid base, he should get back to level quickly. Pass-blocking will be a big key for him early, adding to his confidence. It wouldn't surprise me to see John Brown get more quick looks to prevent a rush, as well as some draws and dumps for Andre Ellington, assuming he's healthy, as well.

3. C.J. Spiller – Spiller is not only coming off a series of injuries that held him back, but now he gets an offense designed to his strengths. Assuming he lost no speed in the interim – and there's no early signs of this – he'll take up the old Darren Sproles role in the Saints' offense. He'll get more touches than Sproles did, but Sean Payton likes rotating backs for roles. Spiller shouldn't be overtaxed, though his injuries have been traumatic, not overuse. He has a chance to be a Top-10 RB even in a role split with Drew Brees in front of him.

4. Sam Bradford – Yes, Bradford has had two ACL reconstructions and has had a lot of time off. No, these haven't taken away his talent. The Eagles are a team obsessed with measurements and conditioning, so their willingness to make this deal alone gives us a big positive indication. Bradford won't be asked to do too much. He's not a terribly mobile QB, but he's mobile enough. If the pass-blocking can keep defenders from hitting him in the knees, he will at least have a chance to show how talented he is.

5. Eric Berry – Berry's comeback from cancer (lymphoma) is another inspiring story in the battle against this dreaded disease, but he's young, strong, and in great physical condition. He had a lot of advantages. While some will be surprised he's returning this quickly, the only real question was conditioning. Some people can keep up with cardio and muscle mass during treatment and it appears Berry did not lose much during his. We can only hope he can stay cancer-free and injury-free as he gets back on the field, but don't be surprised if he's quickly back to level for the Chiefs.