The threshold of doubt towards the Philadelphia Eagles has grown considerably higher after this weekends loss to the Minnesota Vikings, which puts them under the .500 mark, at (2-3). Adding insult to injury, news broke earlier this week of starting running back, Jay Ajayi, tearing his ACL. Ironically, the report surfaced just hours after he openly criticized head coach, Doug Pederson, for not giving him enough touches out of the backfield.
The injury serves as a huge blow for the promising back. At just 25 years old, Ajayi subjectively still has the time to play a few more years. However, the running back has had a fair share of injury concerns throughout his career. Ever since Ajayi declared for the NFL draft out of Boise State, teams stayed away from picking him early because of a chronic knee condition. Reports describe his knee condition as “bone on bone.” This terms refers to the rubbing away of cartilage that exposes the joints and bones in the knee, which induces a significant amount of pain even when walking. Another point to note is Ajayi’s size at just under 225 pounds will make his recovery slightly longer because of the great amount of force he puts on his knee. His style of running relies on him being able to bounce lightly on his feet for a split second till he can burst through an open seam; this type of play also comes with its fair share of wear and tear.
Looking ahead, the Eagles don’t have the most proven options to fall back on. The names that come to mind are Wendell Smallwood, Corey Clement, and an injured Darren Sproles. Sproles is known for his receiving skills, Smallwood tends to get the most carriers, and in short, Clement is a hybrid of the two. Sproles wont see the field this Thursday as the Eagles take on division east rival, the New York Giants, but a return from Corey Clement is confirmed.
This all being said, the New York giants come into this matchup with the 28th ranked rushing defense in the league. There may be some potential value rolling with Smallwood at the flex position; however, if one was on the fence between Smallwood and a more consistent flex option, the answer wouldn’t be an Eagles running back.
Video: Todd Gurley battling arthritis-Dr. Parekh
The Todd Gurley health questions answered
Q: Can Todd Gurley’s knee pain and arthritis be managed?
So look at this model can you get an idea of how arthritis affects the knee. On the far left is a normal healthy knee, however as the arthritis starts to take affect it gradually worsens as you get to the right of the model. There are two main types of cartilage in the knee, the meniscus which is what I like to call the ‘shocks for the knee,’ like the shocks for the car. Meniscal tear are what most athletes eventually have a knee scope to clean up, where the surgeon will go in and ‘smooth out the edges of the mensicus’ after a tear. Meniscal injuries are typically secondary to twisting mechanisms, and if you remember running back Sony Michele had one earlier in 2018 season. The other type of Cartilage in the knee is articular cartilage, shown as light blue on the model, and this is what I like to describe as the protective layer on bones. Almost like paint on wood to help to protect the surface area, the articular cartilage protects the edge of the bone. When meniscal injuries happen, the two lower leg bones start to rub against one another starting to cause articular cartilage injuries.
This is what leads to pain, recurrent swelling and these are very challenging to treat, with only about a 30 to 40% surgical success rate (see Boston Red Sox Dustin Pedroia). For Gurley, this will be more about management and prevention of worsening as opposed to true treatment. A combination of PRP/ stem cell injections, appropriate physical therapy, and possibly viscosupplementation injections can be helpful. Although given Gurley’s age avoiding, he should try to avoid anything besides PRP/stem cell and physical therapy would be in his best interest. Think about Gurley’s lower extremity/knees and the cartilage as the wear and tear of car tires. Unlike most people his age, Gurley’s knees have already seen thousands of miles, given how much he has run and his past history of injuries. At this point he is running on ‘balder tires’ than most athletes his age, along with worsening articular cartilage, which has been described as almost like driving on a flat or spare tire. Unfortunately there is no good/safe/legal fix that allows an athlete of his caliber to return to his effectiveness. This will be more about rep management and injury prevention than it will be about true treatment of his knees.
Q: How worried should he and the Rams be? Isthis to be the beginning of a rapid decline? Can treatment and rep management create the necessary balance?
See here’s the concern that all NFL teams inevitably face. We know that the half-life of an NFL running back is short, about three years, and only a few RBs to have long careers, like Adrian Peterson who is a genetic freak. Can he reverse his arthritis? No. Can he use different treatment modalities to prevent the progression of osteoarthritis? Yes. Such things as glucosamine/chondroitin, physical therapy, appropriate weight loss, PRP/stem cell injections have all been proven to be effective in this nature. Without personally examining him my answers will obviously be very generalized, but unfortunately I believe Gurley has peaked and will not be able to repeat his record breaking effectiveness. He could possibly have 1 to 2 more years of elite top-five RB talent, but he will likely “lose a step.” With the amount of talent and resources that NFL teams have they should be able to prevent a rapid decline for a Gurley-type talent, especially with as much money as they have invested in him. They will likely decrease his workload and strive for something like 150 to 200 rushing attempts, or possibly increase his route running abilities. Optimizing Gurley will require finding a happy balance between running and receiving but I do not think he will be able to repeat the volume he has been able to over the past couple of years. Top, and effective running backs are seemingly ubiquitous in the NFL. Guys like the Chiefs Damien Williams can burst onto the scene and become instantly effective because they are younger and have less wear and tear on their knees. Veteran guys like Adrian Peterson & LeSean McCoy are few and far between. The goal is to prevent Gurley’s knees from becoming what happened to Jay Ajayi, as he had reportedly severe osteoarthritis and will likely never be the same.
Patrick Chung undergoing multiple surgeries-Dr. Patel
Patrick Chung of the New England Patriots suffered a forearm fracture during the Super Bowl, and he is set to undergo surgery this week. This will involve placing plates and screws across the bones to allow them to heal in the proper position. This could be something similar to an injury that Rob Gronkowski had several years ago, but all of the details are not available.
A few weeks later he will also have surgery to address a shoulder problem that he had been dealing with throughout the season. This is most likely a partial or complete injury to the labrum in the shoulder or the rotator cuff. These tend to be injuries that athletes can play through with some pain and address in the off season.
Regardless, he is expected to miss the OTAs and be back for training camp.