Fantasy Football: Is being 'injury prone' even a thing, and how to draft injured players in 2023

Injuries in the NFL are a part of the price tag for playing, but it doesn’t mean that for teams, fans and even the most seasoned fantasy managers, they don't arrive like anything but an unexpected gut punch, one completely deflating to an entire season.

At the risk of rehashing bitter memories, who had a fantasy season wrecked by Jonathan Taylor’s high-ankle sprain when the Colts’ running back was the consensus 1.01 in 2022 fantasy drafts? How about the double-barreled ACL tears by promising young running backs Breece Hall and Javonte Williams? Those were just last year.

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Those types of injuries dim what had been previously glowing reputations for players who have had thousands of words written and videos made singing their praises to the fantasy community. Sometimes it leads NFL fans and fantasy managers to wonder if these or other players might actually be injury prone. That brings down ADP and often leads to fantasy managers casting their eyes on the next hot thing.

But are they right in doing so?

Recently, I sat down with Dr. Edwin Porras on my Familia FFB podcast. In his day job, Porras is a physical therapist for the Minnesota Twins in their minor league system and is the medical analyst for Fantasy Points. He’s also the host of the Injury Prone is a Lie podcast, where Porras does great work to debunk this label that so many fantasy managers drop on players coming off injuries. Porras is also writing a book titled The Injury Prone Draft Guide and Season Long Playbook where he tackles the idea of whether there are NFL players who deserve that unfortunate moniker.

“A lot of people think that I'm saying nobody gets injured when it's the exact opposite,” Porras said. “We have data and studies to suggest that 98% of NFL players in an NFL season will be injured. Bottom line, period, everybody gets hurt. So if everybody gets hurt, how do we know anybody's injury prone? The issue with those studies is we don't see it play out that way.

You can look at guys who've had a cluster of injuries. Think about someone in the past like Keenan Allen: A ruptured spleen … an AC joint sprain. An ACL tear. All those things happened within … two years of his (early) career, and he went on and he's been fine. That's because those injuries can sometimes cluster to one individual and they can be random.”

The important message to keep in mind is that football players are playing hurt practically from the first snap of every NFL season. Are those players injury prone? That label cannot be assigned to 98% of NFL players, as Porras pointed out. It takes peeling back layers of the onion to find information that is vital to keep in mind.

Instead of thinking of a player being "injury prone," focus on injury history.

How to understand injury history

The Allen example paints quite the picture. After playing only nine total games in the 2015 and 2016 seasons because of those injuries, fantasy managers were starting to feel their confidence in a player who put up 1,046 receiving yards in his rookie season shaken. What was important about Allen’s injuries is that the shoulder, spleen and knee were in no way interrelated.

When a player’s injuries are not a recurrence of or somehow connected to a past injury — Allen’s name will come up later in this article on this topic — then they can be looked upon as isolated incidents that happen in the course of the NFL season.

“If we can identify outliers,” Porras said. “If we can know, ‘Hey, these injuries are random.’ Or, ‘Hey these injuries probably are not random.’ And we learn who to fade and we learn who not to fade and take above ADP, that is literally textbook 101 how you gain an advantage. That's why it's so important, I think, that people sort of devalue histories and they're either all in or they make some excuse like 'it doesn't matter, they are going to get so much volume' … Or it's, ‘Oh this guy's burned me so many times, I'm not really excited about their ADP.’ But it's always somewhere in the middle and it's always so specific.

“What I'm saying is, everybody gets injured. It's our job to wade through and find out who is actually going to be injured more frequently based on their history, and who kind of just has had really bad luck. It's not easy to do.”

Christian McCaffrey's 2022 season

McCaffrey tried the patience of fantasy managers during 2020 and 2021 seasons that were lost to injury. It hurt even more after his Herculean 2019 season when McCaffrey put up 1,387 rushing yards, 116 receptions for 1,005 receiving yards and 19 total touchdowns for 471.2 PPR fantasy points.

In 2020 he suffered a high-ankle sprain, rehabbed then injured the AC joint in his shoulder. In training to return, McCaffrey strained his quadriceps. Season over, with only three games played and all the fantasy managers mimicking horse-racing betters tearing up losing ticket stubs.

In 2021, the running back was limited to seven games after suffering two separate hamstring injuries, which have a 30% recurrence rate within the same season, according to Porras.

Looking beyond the number of injuries, it was the types of injuries on different body parts that stood out. McCaffrey also didn’t require surgery for any of his ailments. His durability in college and the NFL — he played all 48 games his first three seasons — also played a part in Porras recommending McCaffrey highly.

“You look at a guy who's had two contact injuries to totally different regions of the body and two soft tissue injuries in different parts of the same body part, that's just bad luck,” Porras said. “You have to realize that's just bad luck for a guy who missed like two games when he played in college.”

McCaffrey totaled 1,860 combined yards and 13 touchdowns to finish as the RB2 overall in 2022; a perfect example of injury history being more important than if a player is injury prone. If a player has injuries to different body parts that are not correlated, that’s a good sign. Lack of surgical procedures is also a positive. A history of durability is important.

Who is at risk of repeated injury?

Looking at previous injuries helps determine if there can be future recurrences too. Porras’ extensive research covered some of the most common injuries, and what the re-injury rate is in-season for these injuries:

• High-Ankle Sprains: 32% in-season, with 5% the following year

• Chest/Shoulder Injury: 21% year-to-year

• Hamstring: 30% recurrence in-season; 34% year-to-year

Injury history may not be an exact predictor, but it can be the difference between drafting a couple of players. With training camps about to open and the fantasy redraft season fast approaching, I asked Porras about several players who may have questionable injury histories. That could add some context for fantasy managers weighing quick decisions before drafting these players next month.

D’Andre Swift & Rashaad Penny, RBs, Philadelphia Eagles

These players are grouped because they’re expected to be co-leaders of the Philadelphia backfield. And they have extensive injury histories. Swift has had multiple shoulder injuries, which is cause for concern because this could be an “internal shoulder issue that doesn't necessarily go away even with rehab.” That said, Swift has played through injury, appearing in either 13 or 14 games his first three NFL seasons.

Penny is a player Porras pointed out has an extensive injury history, but to different body parts, similar to McCaffrey. Penny has a 2019 torn ACL in his background, as well as a hand fracture in 2018 and had his last season ended by a broken tibia on Oct. 9, 2022. Penny was a first-round pick in 2018, is age 27 and was brilliant in the closing weeks of the 2021 season to help people win fantasy championships. “Is he some injury pariah, an injury-prone guy? I'm not sold on that yet.”

Swift has a Yahoo ADP of 74.4, while Penny’s is 92.1. Penny may be a solid value as an RB3 and contribute quite a bit.

Keenan Allen, WR, Los Angeles Chargers

While Porras does use Allen’s recovery as stated above as a prime example of why a player is not injury prone, there is some cause for concern after consecutive seasons with hamstring injuries. His being only 31 adds to it.

“At this point, and as we recognize that he has a history of hamstring strains two years in a row, it's really tough to see that not being an issue moving forward,” Porras said, adding that Julio Jones’ repeated leg injuries are comparable. Allen did close the 2022 season averaging 18.9 PPR points in the final eight games, so his production can still be significant if he can avoid re-injury. His ADP is 49.4 overall, so not much of a draft-day discount.

Mike Williams, WR, Los Angeles Chargers

The 2017 seventh-overall pick has an extensive injury history with back, shoulder, knee, hamstring, ankle and neck injuries all on his chart. Porras pointed out that the injuries are multiple, but to look at games played. Last year’s 13 games were preceded by playing either 15 or 16 games every season from 2018 to 2021. At an ADP of 78.9, Williams may, in fact, be a bargain come draft day.

James Conner, RB, Arizona Cardinals

Porras made note of how Conner has been on the injury report with an ankle issue four out of the last five years, and connective tissue injuries six of the last seven years. Conner also played 13 games last season, missing time with a rib injury, and averaged 11.9 PPR points, right behind Travis Etienne Jr. With not much competition for touches in the Arizona backfield and at a rank of RB22 and ADP of 65.1, Conner may be worth the risk. “Chalk him up to miss two to three games per year, but if you need a floor guy, and he's there, he's probably a decent floor guy,” Porras said.

Deebo Samuel, WR, San Francisco 49ers

The electric 49ers wide receiver is being drafted at 42.4 overall, and some might have worries about hamstring and Jones fracture injuries in his past. Both can be worrisome, particularly the hamstring, though Porras pointed out that there is another red flag that has nothing to do with injuries. The San Francisco offense also features McCaffrey, George Kittle and Brandon Aiyuk with a projected starting quarterback in Brock Purdy who is returning from elbow surgery. “The offensive situation scares me a little bit more than his [Samuel's] injury history, but the injury history doesn't help,” Porras said.

Dalvin Cook, RB, free agent

The Vikings made a salary cap move to cut Cook after he put up four consecutive seasons with at least 1,100 rushing yards. He’s played through shoulder injuries, missing eight games over that span. Cook did have shoulder surgery this offseason, and as of this writing is still a free agent. His landing spot may be more troubling for his fantasy value — RB26 and 56.3 overall. “He's always at risk to have that issue again, but he's not a guy that I'm necessarily too concerned with moving forward. I'll say he's fine,” Porras said.

Kadarius Toney, WR, Kansas City Chiefs

The multiple leg injuries for the Chiefs’ dynamic wide receiver stick out, but for Porras, it’s the hamstring injury in the past that is at the forefront. Kansas City managed Toney’s snaps, as he was on the field for just 18, four and five offensive snaps, respectively, during the playoffs. Is he ready for a full workload as a WR1?

“You get nervous with the hamstring, but we don't really have a precedent for a player like him,” Porras said. “We know that he needs that burst, and we know that he needs that quick twitch. In order to do that, to decelerate and accelerate really quickly, you need your hamstrings. So you don't love the fact that he's having his hamstring issues so early on. That is a consideration to point out, but I do think that he could provide some sort of value there. It's just a matter of how long he'll hold up. And we need to see him do it right. That's one of the things that I subjectively incorporate into my analysis. I like when a guy has shown us in the past that they can do it, and we just haven't seen Kadarius Toney do it.”

Toney was already reportedly set to miss some time during training camp after an offseason knee clean-up procedure, but now his status for the start of the 2023 regular season is now up in the air after a second surgery to repair a torn meniscus.

Raheem Mostert, RB, Miami Dolphins

In his age-31 season, Mostert is an elder statesman in the current running back landscape. Before playing 16 games and totaling more than 1,000 total yards last season, Mostert played just nine combined games the previous two seasons. The Miami running back has meniscus and cartilage issues in his injury history, which should not be ignored. The age factor for a position where youth is embraced, as well as a shared backfield with Devon Achane and Jeff Wilson Jr., only add to Mostert’s ADP dropping to 129.9.

Injury knowledge is the edge

Keeping in mind the injuries to be truly worried about is the added advantage that fantasy managers need to be looking for. Don’t just make blanket statements or believe a narrative about fading a player coming off an injury or surgery without knowing the true context of the situation.

Are the injuries a recurrence or completely non-related? Age, draft capital, athleticism and complexity of injury are important to note.

“The sharper the market has gotten I think the harder it is to find any edges,” Porras said. “I think injuries, because they're so niche, so specific and yet still play such a crucial role in an individual and a team's performance, I think that we still have not fully realized how much of an edge we can actually gain from being informed and up to date.”