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Fantasy Football Injury Exam Room - Hard Truths on Todd Gurley and More

In our new weekly feature in collaboration with Inside Injuries, we take a comprehensive preseason look into major injuries and their Fantasy Football implications.

The medical team at Inside Injuries breaks down each player’s outlook from physical perspectives. RotoBaller then provides in-depth fantasy recommendations based on the impact of every injury breakdown. It’s an unrivaled combination of medical and fantasy expertise, designed to help you gain a true advantage as you prepare for your 2019 drafts.

Inside Injuries predicts the impact of injuries on player performance by using data analytics, medical expertise, and statistical modeling.

Editor's Note: All you early birds can get a full-season NFL Premium Pass for 50% off. Our Draft Kit, In-Season tools and over 150 days of Premium DFS. Sign Up Now!


Todd Gurley (RB, LAR)

Todd Gurley has been one of the league’s best running backs every season since he entered the league in 2015, but his future in the NFL is uncertain due to a mysterious knee problem. While the Rams have kept very quiet about what exactly is going on, there is a clear medical explanation for his latest knee trouble. Gurley’s issues with his left knee began in 2014 when he tore his ACL while at UGA. It takes most football players around a year to fully recover, but even after hitting that mark there are other problems that can arise.

In Gurley’s case, there was likely early cartilage loss due to the ACL tear that happened years ago. When a player undergoes a serious surgery like this, there are post-surgical changes in the knee that can lead to problems such as arthritis. The wear-and-tear that a running back puts on their joints is also more extreme than other positions, so it is no surprise that Gurley is dealing with ongoing knee problems. Will it end his career in 2019? No. But will it continue to be a red flag throughout the 2019 season and the rest of his career? Yes.

So what can we expect from Gurley in 2019? A lot of inconsistency. This cartilage loss will lead to excruciating pain at times as the knee becomes inflamed, and it is easily aggravated. The damage can be managed, but it can’t be reversed. While Gurley has missed just six games in the last four seasons, some lengthy absences are likely coming his way in 2019 and beyond. If the Rams manage his reps both at practice and in games and they give him weeks off to rest, he could make it through the season without any serious issues, but that isn’t typically how NFL teams manage chronic injuries like this. Expect some big games from Gurley as the talent is still there, but it won’t happen every week.

Engel’s Fantasy Analysis

This medical analysis confirms a lot of suspicions we already have as fantasy analysts, especially after we saw Gurley struggle to stay on the field late last season and in the playoffs. Gurley will likely not be the workhorse back and superstar we have known in previous seasons. He could share some reps and be in the field at the same time with other RBs like rookie Darrell Henderson. The Rams will monitor and manage him very carefully, and that takes him out of the fantasy RB1 picture for 2019.

High-stakes players are being more conservative on Gurley, as his current ADP in the FFPC is 17th overall. He is going as early as 9 or 10 in PPR drafts on some other sites. If you draft Gurley in the first round you are taking a risk that even aggressive high-stakes types are not willing to chance. If Gurley can be very efficient with likely reduced touches, he may serve you well often as an RB2 when available. To me, though, the possible inconsistency and health concerns just aren’t worth a second-round pick.


Emmanuel Sanders (WR, DEN)

Sanders was seen running just four months after surgery to repair a December Achilles tear and he said a Week 1 return is possible. So does that mean he will be good to go in 2019? Not exactly.

The injury occurred during a practice ahead of Week 14, and Sanders underwent surgery soon after. While Sanders will slowly ramp up his workout throughout training camp and wants to return to the field as soon as possible, it takes most players around 12 months to recover. Add in the fact that Sanders will be 32 years old and it’s even less likely he returns early in the season and is effective. The Broncos insist that they will be smart with their veteran wide receiver, but we’ve seen players rush back from serious surgeries way too many times. His Injury Risk will be incredibly High if he returns any time before December.

Not only is Sanders returning from one of the toughest injuries for an NFL player, but he also has a concerning injury history. That includes problems with his hamstring, knee, ankle and foot. The two main injuries to watch out for when a player is coming back from an Achilles tear is a problem with the opposite Achilles and a hamstring strain. Because Sanders already has a history of hamstring injuries, he will be highly susceptible to this specific compensatory injury. Don’t expect much from Sanders this season, even if reports are fairly positive coming out of training camp.

Engel’s Fantasy Analysis

Many fantasy players seem to be approaching Sanders with the required caution. In the FFPC, he is going as the 52nd WR off the board, and in the late 40s to early 50s on some other sites. He is going as early as 38th on one notable platform. For the most part, he is going behind WRs like Keke Coutee, D.K. Metcalf, and Geronimo Allison. That seems to be a conservative approach that is deserved, but after absorbing the scouting report above, I am going to completely steer away from Sanders in 2019 drafts while recommending you do the same. He could turn out to be a wasted pick. Of course, the player and the team will publicly deliver a more positive outlook than a realistic one. Meanwhile, there should be an increased emphasis on the potential upside for Courtland Sutton and Daesean Hamilton this season.


Devonta Freeman (RB, ATL)

Despite playing in just two games in 2018, Freeman racked up an extensive injury list. Freeman spent most of last spring recovering from a serious knee sprain that didn’t require surgery. He felt good heading into the season but re-injured his knee in Week 1 and went on to miss the following three games. After the Week 5 game, there were reports that he injured his foot, then he was suddenly out with a groin injury. Freeman ultimately landed on I.R. and didn't play another snap after undergoing groin surgery.

Now fully recovered from his surgery, Freeman shouldn’t have any lingering issues with his groin. Unfortunately, his knee is a big concern going forward. There is an inherent weakening of the ligaments due to multiple serious sprains. This could be the year that his MCL (or another ligament) finally tears, requiring surgery. The other real concern for Freeman is his history of concussions. He had two documented concussions very close together in 2017 and had one in 2015. Once a player suffers a head injury, they become more susceptible to future head injuries. One more big hit could lead to a lengthy absence.

Because he has had so much time off to heal and work on his strength, Freeman should look good early in the season and perform well. The concern is that his overall Injury Risk is High, and it won’t take much to aggravate his knee, pick up another concussion or suffer a compensatory injury.

Engel’s Fantasy Analysis

Freeman is the 17th RB being taken in FFPC drafts, but he is going as early as 12 to 13 in PPR drafts on some other sites. Once again, I agree with the high-stakes players to take a more conservative approach on him. There seems to be some optimism surrounding Freeman heading into 2019, but some players are simply bigger injury risks than others, and that is indeed the case with Freeman here. He is going ahead of Josh Jacobs and Kerryon Johnson. I believe Jacobs can be an instant high-end RB2 if his contract dispute does not linger, and Johnson can be within that same range this season. I will take both of them over Freeman.

At 5-8, 206, he always seemed to be a risk given his size as well. In the past, he has often performed admirably for a guy with his stature and build, but he has obviously incurred some health issues while doing so. I will likely pass on Freeman in most cases as an RB2. Plus, I will be targeting Ito Smith in the late rounds, as he will likely be needed to step up more if and when Freeman goes down. Brian Hill and rookie Qadree Ollison could also potentially figure into the mix.

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