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2018 NFL Injury Guide: Dalvin Cook

Jesse Morse M.D.

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Photographer: Stephen Lew/Icon Sportswire

Name: Dalvin Cook

Age: 22 years old (turns 23 in early August)

Team: Minnesota Vikings

2017 Stats: 74 rushes for 354 yds, 2 TD. 11 rec for 90 yds, 0 TD.

2018 Projections: 262 rushes for 1,127 yds, 7 TD. 45 receptions for 363 yds, 2 TD.

Projected 2018 Fantasy Rank (FantasyPros):  RB10

Injury:

Dalvin Cook came into the 2017 season like a bat out of hell, averaging almost 20 rushes and 89 yards per game in the Vikings’ first 4 games. He was on pace for more than 1,500 rushing yards, which would have led the league, and then in one second, his season ended. I’ll describe the events to you. It’s week 4 versus the Lions, Cook tried to make a cut to his right and his knee buckled. He immediately dropped the ball to grab at his knee, losing the fumble in the process. It was obvious that something was seriously wrong – we found out soon after that Cook had torn his ACL, and damaged a little of bit of cartilage as well. By this what is usually meant is that there is also some damage to the meniscus, as this occurs in about 60% of acute ACL injuries.

Cook had his surgery on October 9th, 8 days after he sustained the injury. That would give Cook, a rare three-down NFL running back, 11 months out from his ACL reconstruction surgery before week 1. This fits perfectly in the timeline of 9-12 months that we like to recommend for an athlete trying to return to a sport like football.

If you’ve read/heard any of the other profiles (I’ve published), there’s a good chance that you have heard the studies on revolving ACL reconstruction surgeries and how the players perform when they return. Well, just in case you haven’t, here is an overview: there is a 94% success rate after ACL reconstruction surgery, which means there is a 6% re-tear rate. There’s a 6x increased risk of a 2nd ACL injury when compared to healthy subjects. 30% of athletes suffered a 2nd ACL injury within 24 months of return to sport, and within those 21% had a contralateral ACL tear, and 9% had a graft re-tear.

About 20% of RBs and WRs never return to the NFL after an ACL tear. Two different studies demonstrated that NFL players experienced about a 33% performance drop after suffering an ACL tear. One study from 2017 demonstrated that NFL players experienced significantly shorter careers postoperatively than players in other sports (NBA, NHL), 2.1 years vs. 3.2 years. All athletes played fewer games 1 season postoperatively, and the NFL had the lowest rate of active players 2 and 3 seasons postoperatively.

There is some good news though. Taken from an article in NBC Sports from March of 2018 that reviewed ACL injuries in WRs, and the data states that high-level athletes who were around age 25 when they tore their ACL, and remember Cook was only 22 when he tore his, manage to do quite well upon return. The older you are when you tear your ACL, especially for RBs and WRs, the harder it is to return to the field, and the more their returning performance suffers. Remember, Adrian Peterson tore his ACL for this same Vikings team in week 16 of 2011 and then went on to play all 16 games the following season, finishing ONLY 8 yards shy of Eric Dickerson’s single-season rushing record of 2,105 yards, mind you AP was 27 years old at the time.

Questions

Despite his young age, is Dalvin Cook at an increased risk for performance drop? Yes. Age is on his side but unfortunately his new ACL will never be as versatile, strong and flexible as his original one.

2018 Health Outlook:

In his second-year campaign, Dalvin Cook has already reported to training camp healthy and even shed his knee brace. As we have seen in the past, many RBs and WRs who suffered ACL tears do not like to wear their knee braces, as they feel it hinders their performance. Despite a large 15-study review, there is very little confirmatory data that states these braces actually help decrease the rate of reinjury after ACL reconstruction surgery. One study did conclude that braces lowered ACL strain only 0.1% better (1.4% vs. 1.3%) in ACL reconstructed knees versus ACL intact knees. We know that movements that involve landing, cutting or pivoting pose the greatest threat to the integrity of the ACL, and that’s what Cook will have to do thousands of times in this upcoming season if he expects to be effective.

Risk of Re-Injury: 30% risk of having another ACL tear within 2 years, 6% risk of re-tear.

Recommendations: Dalvin Cook has the potential to be a top 5 RB in the NFL. The problem is the Minnesota Vikings’ offensive line ranks in the bottom third at nearly all 5 positions, last year ranking 28th in run blocking and 24th in pass blocking, and despite trying they didn’t get any better. I really like Cook; he runs really hard and is a three down back. The offense has tons of talent with Kirk Cousins leading the way, Kyle Rudolph, Adam Theilen and Stefon Diggs among those being targeted. The ACL injury scares me, but I would still draft him in late round 1 or early round 2. He is in the RB6-10 range for me. He’ll find his one on at least a couple of my teams.

Links:

http://www.nfl.com/news/story/0ap3000000942480/article/vikings-rb-dalvin-cook-sheds-knee-brace-before-camp

https://www.readbyqxmd.com/read/28510477/performance-based-outcomes-after-anterior-cruciate-ligament-reconstruction-in-professional-athletes-differ-between-sports   https://www.theguardian.com/sport/2017/may/11/acl-injuries-sports-athletes-careers

https://247sports.com/nfl/tennessee-titans/Bolt/51-NFL-Players-tore-ACL-during-2017-season-114750922/

https://www.nbcsports.com/chicago/bears/how-do-acl-tears-affect-wide-receivers-numbers-are-promising-allen-robinson-cameron-meredith

https://www.ncbi.nlm.nih.gov/pubmed/28195986

https://www.ncbi.nlm.nih.gov/pubmed/29188333

Jesse A. Morse, MD is a Sports and Family Medicine Physician originally from Worcester, Massachusetts, and currently living in Stuart, Florida. Dr. Morse specializes in fractures, sports-related injuries, joint injections, musculoskeletal ultrasound, regenerative medicine (stem cell, PRP) and concussion management as a non-surgical orthopedist. He grew up watching Wade Boggs, Pedro Martinez, and Larry Bird dominate the Boston sports scene before Tom Brady and David Ortiz came to town. In 2017-18 served Dr. Morse served on the medical staffs of the Philadelphia Phillies/Threshers, the Toronto/Dunedin Blue Jays, and the University of South Florida. Now he currently consults for the Miami Marlins and also serves as a MMA ringside fight physician. Dr. Morse enjoys staying up-to-date on all the latest injuries in sports, playing fantasy baseball and football, as well as DFS.

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NFL Week 7 start em’ sit em’

Drew Lannin

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Welcome to week 7 of start em’ sit em’.  Hopefully you were able to make it here without being flagged for illegal use of hands to the face.  Sorry Lions fans.  Maybe some positive changes will come from this, but I’ll believe it when I see it.  We’ll unfortunately have to make due without some of the top players this week, so let’s see what we can do.

Byes this week: Browns, Bucs, Panther, Steelers

QUARTERBACK

Start of the Week:  Kyler Murray at Giants: As noted in last week’s article, Kyler was sitting at one of the league’s lowest touchdown rates at 2%, making him a prime candidate for positive regression.  With 3 touchdowns against the Falcons, he made a big step forward.  Now sitting at QB7 on the year, Kyler looks to continue his streak with a great matchup against the lowly Giants secondary.

Starts

Josh Allen vs Miami: A consideration for the start of the week, Josh Allen gets the best matchup in all of football, the Miami Dolphins.  Playing against the Dolphins is enough reason to start anyone, but Josh Allen has had a great start to the year, outside of his 3 interceptions and apparent deathwish running up the middle vs the Patriots.  This game has plenty of potential to be his best of the season.

Daniel Jones vs Arizona:  I have to admit, Danny Dimes was a lot better overall vs the Patriots than I expected from a fantasy perspective.  Obviously for the actual game, things were terrible for him, but considering he was missing almost his entire supporting cast, scoring a touchdown and ending the night in double digits is a pretty incredible feat.  Danny gets the relief of a much better matchup vs the Cardinals, making him a much easier choice this week.

Sits

Sam Darnold vs Patriots:  I know we all love what we saw from Darnold in his first game back from mono, but unfortunately he has the worst matchup possible this week vs the Patriots.  If he’s available though, he is a great stash as his schedule is incredibly favorable after this week.

Tom Brady at Jets:  If feels as though my entire life has been Tom Brady performing at a high level on a football field.  This year has been no exception, aside from a terrible performance against the Bills in Buffalo.  Tom did his best to make my recommendation of playing him last week look bad, until he took matters into his own hands and ran for 2 touchdowns.  (Fun fact:  Those 2 rushing touchdowns put him ahead of Mack, Gore, Montgomery, Conner, McCoy, Fournette, Carson, Kamara, David Johnson, and Adrian Peterson for rushing touchdowns on the year with a total of 3)  While the Jets D isn’t as good as the Bills, they should be able to limit Brady enough on the road to make him a lesser option this week.

Sleeper

Jared Goff at Falcons: I’ve made my feelings about on Goff known, especially when he’s played on the road.  I’ve seen him referred to as “Mitchell Trubisky in a good situation”, which is quite an apt description.  Saying he’s struggled this year would be an understatement, especially after he threw for only 78 yards vs the 49ers.  Luckily for Goff and those who have him, he draws the Falcons this week.  As the great Steve Smith said, the Falcons are the “get right team” for opposing quarterbacks.  Look for Goff to get back on track this week.

RUNNING BACK

Start of the Week: Philip Lindsay vs Chiefs:  Normally I wouldn’t want to recommend players in Thursday night games.  Everything about these games leads to more bad than good, but there’s no denying that the Chiefs’ run D is almost non-existent.  They were ranked last among non-Dolphins teams against the run before losing both starting Dlineman to injury, the game is in Denver, and the Chiefs are coming off of back to back losses.  After the Colts showed the rest of the league the blueprint to beat the Chiefs by running all game, expect teams to continue to exploit that weakness.

Starts

Frank Gore/Devin Singletary vs Miami : At this point in the season, we start to get a better idea of who teams are and developing trends.  One of those being to start almost anyone possible against the Dolphins.  The immortal Gore meets the incompetent Dolphins in what should be a great day for any Bills player that touches the ball.  As of writing this, I’m not sure of Singletar’s availability.  If he is able to go, Gore should be considered an RB2/flex, with Singletary a solid flex with upside.

Josh Jacobs at Green Bay:  Well, here’s a guy I was wrong about coming into the season.  I got too caught up in what I thought his surrounding cast would be, while not taking opportunity into account as much as I should have.  Jacobs is part of a dying breed of workhorse RBs, which in and of itself makes a RB highly likely to be valuable.  The fact that the Raiders Oline has performed much better than most expected and we have ourselves at best a weekly starter, but at worst a very high upside, matchup-dependant starter.  Although the Packers D seemed to have improved their defensive woes vs RBs against the Lions, Jacobs is likely to find success against them.  If he plays as well against the Packers as he did against the Bears, maybe he can crown himself the King of the (NFC) North.

Sits

Alvin Kamara/Latavius Murray at Bears:  I should start with the obvious, that if you have Kamara, you’re almost certainly playing him.  The problem though is, he is clearly injured right now with both his ankle and knee giving him problems.  If you’re lucky enough to have a very deep running back group, especially if you have others with incredible matchups this week, I wouldn’t blame you for looking towards one of them this week.  Add to it that this is an awful matchup and things aren’t looking great for Kamara or Murray this week.  Regardless of if Kamara is able to play or not, I would definitely not play Murray this week unless you have no other option.

David Montgomery vs New Orleans:  This one hurts me, as I traded for Montgomery before the Raiders game, hoping we would finally see him live up to expectations.  He did get a touchdown, but other than that, he’s not looking great.  While he has gotten 67, 69(nice), and 52% of the snaps the past three weeks, he hasn’t been able to get it going yet.  He should hopefully have better days ahead, this likely isn’t one of them against an underrated Saints rush D.  For now, he’s just a volume-based flex option.    

Sleeper

Carlos Hyde at Colts:  A repeat sleeper recommendation from last week that I still hate just as much as before, I can run, but I can’t Hyde (you’re welcome for the very unoriginal team name).  For whatever reason, Bill O’ Brien is determined to make Carlos Hyde a thing, despite him being the epitome of the “just a guy” moniker.  I guess I can’t entirely fault Bill when it seems to be working well enough for them.  The Colts are nowhere near as poor against the run as the Chiefs are, but Hyde is seeing plenty of volume with 21 and 26 rushes the last two weeks respectively.  If volume is king in fantasy, then Carlos Hyde will be the king of volume based RB2s this week.

WIDE RECEIVER

Start of the Week: John Brown vs Dolphins:    Just in case you forgot over the past few minutes, don’t forget to start anyone you can vs the Dolphins.  John Brown is currently the Kyler Murray of wide receivers.  For the amount of production he’s had, he should have more touchdowns than what he’s currently scored.  With an average of almost 7 targets per game, he is the clear number 1 WR for Buffalo, making him an easy start in this matchup.

Starts

Larry Fitzgerald at Giants:  This may be the oldest list of recommended players of all time. Between Brady, Hyde, Fitz, and Gore we could have a retirement home all-star team in a few years.  Fitz is another candidate for positive touchdown regression, having only scored two on the season despite his production in a very pass heavy offense.  The Giants couldn’t cover *checks notes* Gunner Olszewski last week, so there’s no chance they can cover Fitz and the rest of the Arizona receivers.

Golden Tate vs Cardinals:  In his first game back from “accidentally” consuming a banned substance, Golden Tate showed his big-play ability when he scored a 64-yard touchdown against the vaunted Patriots D.  While he was helped by almost the entire Giants offense inactive due to injuries, he still put on an impressive performance, especially considering it was his first game back against arguably the league’s best D.  This week, he gets a much better matchup vs the Cardinals D that makes sure to be on the field as little as possible as opponents fly by them.  Patrick Peterson does make his debut in this game, but Tate should avoid him by playing in the slot.

Sits

Terry McLaurin vs 49ers:  Remember how Goff only threw for 78 yards vs the 49ers?  While I have been very critical of Goff and rightfully so, the bigger story here is it’s time to take the 49ers D seriously.  After they completely shut down the Rams offense in LA, they have shown that they rival the Patriots and Bears for the title of best defense in the league.  I love scary Terry, but the only thing scarier than the future of the Redskins future is Terry’s matchup in this game.  Terry has gone above and beyond anyone’s expectations.  He’ll see better days, but it’s best to avoid him in this game.

Allen Robinson vs Saints:  Amari Cooper.  D.J. Chark.  Mike Evans.  These are all names I recall, but I couldn’t seem to find them the past 3 weeks after Marshon Lattimore erased them all.  These are their stats vs Lattimore: Coooper: 5 catches for 48 yards, Evans: 0 catches, Chark: 3 catches for 43 yards.  The fact that Lattimore is doing this vs such great receivers, leads me to believe that until proven otherwise, we can’t hope to play any receivers against him, no matter how good they are.  Robinson is having a great year, reminding us all who he was before his ACL tear, but unfortunately this won’t be the game for him to showcase much.  

Sleeper

Michael Gallup vs Eagles:  If the falcons are the get right team for QBs, then the Eagles are the same for receivers.  Gallup has more than lived up to preseason hype about his abilities and offseason progression so far.  One problem with Gallup though, is he’s produced when serving as the WR2, with Cooper taking on the opponent’s top CB.  When Cooper left with a quad contusion last week, Gallup ended with his worst game of the year.  Reports show Cooper is unlikely to play, meaning Gallup will have to show he is capable of taking on the WR1 role.  While he has struggled at doing so, the Eagles should serve as an easy way for him to make it happen.

TIGHT END

Start

Hunter Henry at Titans:  Whatever Hunter Henry’s injury actually was, he came back faster than most expected and seemed to have not missed a beat 8 catch, 100 yard, 2 TD performance against the Steelers.  While the Chargers offense is reeling currently and not doing much of anything, Henry seemed to be the lone bright spot.  The Titans D is great overall, but susceptible to tight ends, making Henry a great start this week.  

Sit

Jared Cook at Bears: Cook finally came back to life the past 2 weeks with his first double digit efforts of the year.  Unfortunately, he draws the Bears D in Chicago, which makes him unlikely to repeat the production of the past 2 weeks, and fall back into his single digit scoring from early in the season.  I know the tight end position is especially brutal, so if possible I would look to see if lesser-owned tight ends such as Knox or Fant are available to stream in his place this week.

D/St  

Starts

Bills at Dolphins

49ers at Washington

Packers vs Raiders

Titans vs Chargers

Sits

Jets vs Patriots

Vikings at Lions

Texans at Colts

Ravens at Seahawks

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Fantasy Impact: Amari Cooper (quad)

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Fantasy Impact: James Conner (quad)

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