Fantasy Football Daily - 2022 Injury Update: Josh Allen's UCL Injury

Episode Date: November 9, 2022

Dr. Edwin Porras (@FBInjuryDoc) reviews the tape on Josh Allen's injury and discusses possibilities and return-to-play timeline. --- Support this podcast: https://podcasters.spotify.com/pod/show/fantasy-points-podcast/support Learn more about your ad choices. Visit megaphone.fm/adchoices

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It's time for the Fantasy Points podcast, brought to you by FantasyPoint.com. Top-level fantasy football and NFL betting analysis from every perspective and angle, from numbers to the film room, with a single goal to help you score more fantasy points. Welcome back to the Fantasy Points podcast. I am Dr. Edmport's Doctor of Physical Therapy Medical Analyst here at FantasyPoint.com, giving you a little bit of a special edition. I want to discuss Josh Allen, some of the implications in what direction things may go at this point, give you an update on where we are exactly with the news.

Here's the thing. This is being recorded around noon Eastern time on Tuesday. And so I'm going to try to keep this episode as evergreen as possible. So I'll cover as much ground as I can, understanding that the second this gets published, we could get news out of Buffalo that something is confirmed or something changes with Josh Allen. So keep that in mind. I'll try to be as quick as possible as concise as possible. Here is what happened.

So what happened with Josh Allen? On one of his last throws in week nine, Josh Allen cocked back. If you imagine your normal general football throw when the arm cocks back, that specific position puts stress and strain on the inside of the elbow. The structures involved, the structures on the inside of that elbow are the UCL, the ulnar collateral ligament, otherwise known as the Tommy John ligament in baseball, the ulnar nerve, and in some cases, the flexer tendons, the muscles that flex the hand and the fingers. Those structures are all implicated in the specific injury. So when Josh Allen

cocked back, what happened was that he, a defender took his arm, his, his, the lower portion of his forearm, and they continued to cock it back. So what Josh Allen did to try to get the pass off was, of course, throw forward. And with that resistance from the defender hitting his arm backwards and Josh Allen's force trying to get rid of the ball forward, we got a strain and a stress on the inside of that elbow. So what we're dealing with, according to Mortensen now,

this is a report that came out of, at a Chris Mortensen's Twitter account yesterday, is that Josh Allen is indeed being evaluated for an elbow injury to his owner, collateral ligament and related nerves. So that adds up. So everything's tracking right now. Everything makes sense. That injury makes sense. Yes, this is a common baseball injury. The difference between a baseball throw and a football throw, which we'll get into a little bit later, is that the football throw is not as stressful because there aren't as many rotational

forces going through the elbow. And a baseball throw actually stresses the UCL, the ligament that Josh Allen injured, much more actually. to the maximum extent that the ligament can even hold. So that is not probably close to where Josh Allen, the max at Josh Allen's ligament was stretched, but we know that it was definitely strained more than a normal throw. So this is a general baseball injury. I'm still far away from the situation.

I don't have any inside sources, anything like that. I do feel like I'm relatively qualified to talk about this injury that I treat most days. This is a really common injury among baseball players. Just because you injure the ligament doesn't mean that it's a complete rupture every single time. Even if it was a complete rupture, there are guys who can throw a baseball and pitch without a UCL. Now, I'm not saying that's what's going on with Josh Allen, but I just want to get it across, especially to Bill's Mafia. This is not the end of the world.

The sky is not falling. And as of now, based on moving on to another report here by Ian Rappapaport, Josh Allen is likely limited this week because of an elbow injury. suffered late in Sunday's lost, but now is it's considered a situation to monitor rather than an ailment that would keep him out of the game, sources say. He's still undergoing tests to be sure. So what does that tell us from Ian Rapaport? Let's read between the tea leaves. That means that on the spectrum of won't miss any time at all, this is a non-story. We're not even talking about this. To the other end of this is season ending and he's going to need a surgery that's going

to be 12 plus months of rehab. It seems like on that spectrum, Josh Allen, is closer to the this is a non-story. But of course, it's a spectrum. So we're living somewhere in the middle. My opinion, based on what we know everything about everything that's going on right now and the reports that we have from Rapsheet and Mortensen is that he's probably getting a nerve conduction velocity test. So basically they're seeing if there's any disruption, electrical disruption in the nerve itself, the owner nerve of that elbow. and they're probably getting a second opinion from specialists down in Alabama who specialize in baseball players. Or it could be anywhere across the country.

They're probably just getting a second opinion. It is very common. Second opinions are extremely common because they want to make sure that they're covering their bases and getting the most input is possible for their star player, especially somebody like Josh Allen. So have the injury. We have an implicated structures. We have a confirmation from Mortensen. we have the reports from Rapsheet and Mortensen.

So, I just covered is this season ending? It doesn't seem like it. It doesn't seem like this is season ending. Another frequently asked question, especially on my tweet, if you go over on my Twitter, I tweeted this, and this is sort of the genesis for all these questions that I'm getting, is could he have made the elbow worse? Technically, yes.

Once Josh Allen had the ball forced out of his hand, and he initially injured the inside of the elbow. Could he have made it worse by throwing that 70-yard dime to Gabe Davis? I mean, the answer is technically yes. Here's what I'll say. In the heat of the moment, when you're in the middle of a game, when the adrenaline is pumping, and the adrenaline is rushing,

Josh Allen isn't thinking about, oh, is the integrity of my UCL good enough to uphold this next bomb that I'm about to throw? Josh Allen doesn't even know if he's going to throw a bomb before the next play. So it's generally unreasonable for Josh Allen to pull himself out of the game in that specific instance. Is it the right answer? No. Can I blame Josh Allen? Absolutely not.

Now, if something was obviously, obviously wrong, you know, he still could have gotten by on pure adrenaline. That happens. There are guys who can continue to pitch after, like I said, without a ligament. They can still pitch. There are some guys who are doing it right now. They have no UCL. They're still pitching. So it's kind of a moot point to really argue should he have thrown it, should

you have not thrown that last pass? There's no way to know if he would have made it worse. It seems like at this point it's not season ending. So it doesn't really matter. It's just incredible to me, the amount of people who were applied to a tweet, not impressed by the 70-yard bomb Josh Allen through, whether it's adrenaline, whether it's pure grit and toughness, I guarantee. guarantee you that was a harder throw for Josh Allen to put off than any thrown, one of,

you know, one of the hardest throw that he's ever put out there. And to do it through pain and an injury is not something to bat your eye at. Yeah, we get it. You played high school, you know, basketball, you rolled your ankle and then you shot a three-pointer and it went in and, you know, you got sixth place at your tournament of champions. We get it. The fact that he threw this bomb should not be discounted. It's pretty cool. It's pretty amazing. It's kind of a tangent. But does the bomb mean that he's going to be fine? No, not necessarily. Sort of goes back to the point bringing it full circle here. Guys can throw without a UCL. It doesn't mean that they're going to be fine, that he won't miss any time. So that's sort of the point that I'm trying to make

there. So will he miss time? That is a good, fair question. Right now, last time I checked, the books still have Buffalo as a six and a half point favorite, depending on where you you look. And that's, it's possible. It's possible that Josh Allen doesn't miss any time. If we go back to Rap Sheets tweet, rap sheets suggests he might not miss any time at all. And they might just be crossing their T's, dotting their eyes, making sure that they have everything in place so that they don't put their star quarterback at more risk. Here's the thing about Josh Allen. He's had this injury before. He missed, it was about four or five weeks in 2018 as a rookie. They weren't in a rush to bring him back. So they really took their

time and at that point they probably said to themselves we do not want our future quarterback our franchise guy to be dealing with the ucel issue the rest of his career we're going to do this a right way we're going to rehab and arrest him and he's going to he's not going to come back until four or five weeks after the injury and that's generally the right answer what i can tell you now that they are obviously super bowl contenders and josh allen is obviously an MVP candidate they might not be as conservative and that tends to happen that's normal whether it's right or wrong is a totally different argument. But I think in a worst case scenario world, Josh Allen misses somewhere between two to four weeks and they bring it along relatively slowly. They allow him to heal

before getting to the playoff run. Now, Rapsh said he won't miss any time. So again, I think this is sort of the worst case scenario. Missing somewhere between two to four weeks. I think four to six weeks would be ultra conservative for something like this. Of course, unless there is actual nerve damage, then I think four to six weeks is also on the table. But if I had to, if you told me Josh Allen is going to miss time, which again, we haven't confirmed, I would say he's going to miss somewhere between two to four weeks. That's what I would guess. Or until he's asymptomatic. That's how these guys, that's how you can typically start a rehab is you give a time frame and or you say when they are asymptomatic on a physical exam. So if he misses time, this is going to be a

two to four week thing. Now, if he doesn't miss time, which is very possible, it's very possible. it's very possible that he misses no time or just one game. He's going to be playing through some pain. It's very possible that the bills lean a little more run heavy and that those Gabe Davis palms are by design, not even just by symptoms, right? By design, they simply might just not ask a lot out of Josh Allen for the next several weeks.

That's very possible. So you're going to see a limited Josh Allen this week. and rap she says he won't miss any time. I think the worst case scenario is he misses roughly two to four weeks. But again, this doesn't seem like this is season ending. It doesn't seem like this is something that's going to end his season. And based on all the data that we have, which is not a lot, to be honest with you, the average amount of mistime, according to Dodson and colleagues,

is about 24 days, which lines up with that two to four weeks roughly. So if he does miss time, it'll be two to four weeks. If it's a grade one, he'll miss one week or not miss any time at all. I think those are, I think that's the way to look at it. I think that in a worst case, near a world, he misses a month of time. So if Josh Allen is active, should you play him? Yes, you should play him. There's no quarterback on the planet that's going to give you the potential on the upside,

even with a rushing that Josh Allen will. So, that's the summary on Josh Allen. UCL and ulnar nerve issue, very similar to a baseball injury, but not as aggressive, meaning you can come back a little bit quicker than a baseball injury. Doesn't seem to be season ending. And if he misses any time, the worst case scenario, in my opinion, I think right now, is that he's going to miss about a month of time.

I think the mid-case scenario is he misses, you know, two to four weeks. I think that's the median outcome here is two to four weeks. And will this bother him the rest of the season? Yeah, probably. Will they continue to rehab him all season? Yeah, probably. But this is not a time to sell Josh Allen. This is not a time to unload him.

Don't get cute with your roster construction. If he's active, he's active. This might give a slight uptick to Devin Singletary, Naeem Hines. But other than that, this is a stay put. Wait for the news. And we'll see what happens on Josh Allen. Don't panic.

The sky's not falling. If you have any questions, make sure you follow me on Twitter. Ask him at FB injury doc. Thanks for tuning in to this edition of the Fantasy Points podcast. Remember to subscribe, rate, and review on your favorite platform. And come join the roster at FantasyPoint.com.