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NFL's Biggest Injury Risks For Returning Players in 2023

The NFL's biggest injury risks in 2023 feature some of the biggest names in the league, including Jimmy Garoppolo and Kyler Murray.

Whether they're playing for your favorite team or you're considering them for fantasy football, there are a handful of players that carry significant injury risks heading into the 2023 season.

Risk should not be a bad word. Every player on every play is a risk, some more than others. The wrong step, the big hit, the turf monster bites, and a season is done. However, modern sports medicine can get most players back on the field. Once they are, things change. Certain injuries to certain players are tougher to come back from. I detailed five guys I think will come back healthy earlier this week. This time, I'm putting a little dark cloud over five guys who might not, and I hope I'm wrong with each of them. The NFL is better when the best players are on the field, so let's take a look.

Jimmy Garoppolo, Las Vegas Raiders (fractured foot)

HENDERSON, NEVADA - JULY 26: Quarterback Jimmy Garoppolo #10 of the Las Vegas Raiders throws during the first practice of the team's training camp at the Las Vegas Raiders Headquarters/Intermountain Healthcare Performance Center on July 26, 2023 in Henderson, Nevada.

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Jimmy Garoppolo has a new team and a healed foot, but add that to his long list of injuries that has fans wondering if he'll have a real chance to shine in Las Vegas. Garoppolo had surgery after the season and while it likely happened in March, there's still some question. There was a lot of worry that there was a clause in his contract that would give the Raiders an out if the foot remained a problem, but that's a standard clause and why teams take the entrance physicals so seriously.

Garoppolo did not have a Lisfranc fracture, but the surgery to fixate the fracture in his foot was much the same as would have been done. Pins and plates and a small screw are holding things together and the return rate from that is very high and quick. Garoppolo's not the most mobile guy to begin with, so it shouldn't be as big an issue for him as one of the more run-focused QBs, like say the next guy we're going to discuss.

With history of foot, knee, shoulder, and ankle injuries, Garoppolo has always been good (and good looking) when he returns. Playing on grass should help some, but then again, he injured the foot on grass as well. The risk is more in his history than in the foot, but Garoppolo is the very definition of risk.

Kyler Murray, Arizona Cardinals (sprained knee)

ACL injuries are pretty routine. Harvest the tendon, loop it in place of the ligament, anchor it in, and boom, good as new. Some new techniques are getting athletes back on the field in as little as six months, but those haven't made it to the NFL yet. Instead, they're doing roughly the same surgery that Dr. James Andrews and others developed using arthroscopes in the 1980s. It was a game changer then, but we're doing the same techniques and rehabs from 40 years ago. That means Kyler Murray had only a slight variation of the surgery that Dr. Riccardo Galleazi first described in 1936.

Murray had an isolated ACL sprain. That means that only the ACL suffered damage, with no issue in other ligaments or the meniscus and cartilage of the knee. It usually recovers better than multi-structure reconstructions, but it's still significant. While the return rate from this surgery is high, there are still some consequences. Studies have shown that numbers are down overall for QBs in their first year back, especially in rushing numbers, but recent players like Joe Burrow show that might be changing (or might just be an exception.)

For Murray, the complications of return are multiplied by the timing. He'll have to come in mid-season, depending on when he's ready. The mid-December surgery would put his timeline behind some who have come back from playoff injuries to be ready in Week 1, like Wes Welker and Adrian Peterson, but Murray is a unique athlete with unique quickness. Protecting any QB is tough, but harder with a one-of-a kind talent. If he's not running and practicing in full by Week 4, I'll be worried.

Tua Tagovailoa, Miami Dolphins (concussions)

MIAMI GARDENS, FLORIDA - AUGUST 09: Tua Tagovailoa #1 of the Miami Dolphins is seen drinking water during training camp practice with the Atlanta Falcons at Baptist Health Training Complex on August 09, 2023 in Miami Gardens, Florida.

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For all the talk about concussions in the NFL, there's not much that can be done if a quarterback's brain sloshes around inside his skull, bounces off the FieldTurf, or takes a direct hit from an oncoming giant. The game is not designed to protect brains; in fact, it's largely the opposite, despite the best intentions of rule changes, helmet improvements, and medical technology.

Let's be clear: things are better. Not that long ago Archie Manning looked like this and announcers said "he got his bell rung." Some of Archie's teammates and contemporaries haven't been as lucky, suffering long term effects of those hits. We still don't understand concussions well, though it's far better than it was in the past.

That doesn't help Tua Tagovailoa. Two nasty concussions in succession got tongues wagging in the media, some calling for Tagovailoa to retire. The thing is, what we know now is that most concussions heal if given time. Tagovailoa had plenty of time and should be fine now, but he or any other quarterback is likely to take some hits, some sacks, and if one comes from the wrong spot or lands the right/wrong way, he's going to have another one. He's no more or less likely to have it happen, but his history is going to make it tougher in perception.

Jamal Adams, Seattle Seahawks (strained quad/rehab)

The Legion of Boom is long gone, but Jamal Adams remains. Kind of. Adams missed almost all of last season after tearing his quadriceps tendon in Week 1. Let's be clear about this - it was Adams' quad tendon, not quad muscle, as I've seen regularly reported during camp. It was a very significant tear that had to be repaired and it's a difficult operation. Go cut a piece of osso buco and try to stitch it back together.

The toughest part is that Adams is a player that is known for his quick burst. Guess what you need for that? Strong quads and hamstrings. Doing what he does best is going to put the most stress on the repair, which is always a worry. Strengthening and balancing should be easy for an NFL S&C staff, but you can see that Adams' thighs are not the same size yet. This is very common at this stage, but being noticeable means he's not back to normal.

Adams is still on the PUP as he continues his rehabilitation and at 11 months post, many are starting to get concerned. It's normally a 9 to 12 month rehab, but it's also pretty linear. There are milestones along the way that let a team know that a player is on track. Adams seems to be slightly behind at each of them, so I have questions about not only when he'll be back, but how long it will take for him to be full go.

Shaquille Leonard, Indianapolis Colts (inflamed lower back)

WESTFIELD, INDIANA - JULY 31: Shaquille Leonard #53 of the Indianapolis Colts participates in a training camp at Grand Park Sports Campus on July 31, 2023 in Westfield, Indiana.

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Most of the attention in Colts camp has been focused on Jonathan Taylor's contract situation and young QB Anthony Richardson's progress. However, the return of Shaquille Leonard after two seasons of injury issues might have more impact on a team in search of an identity. Leonard's manic defense and penchant for punching out turnovers has been sorely missed and if back, the defense could keep the team in games.

Leonard had ankle surgery, then back surgery, for the same problem. (Yes, it's confusing and no, the Colts haven't explained it well.) Not only that, he had a second back surgery. He did pass his physical, but he's not full go either and again, the Colts haven't felt the need to explain much. The hope is that the second surgery, done by Dr. Robert Watkins, fixes things, because much like Peyton Manning, the next step is likely a spinal fusion, which can be career threatening.

Reports from camp are that Leonard is moving well, but hitting is key here. Linear compression down the spine is going to test the injured area and could cause additional inflammation or even damage. He's certainly limited now and we'll have to wait to see how much he plays, if at all, in preseason. The big test is going to be how he responds to the big hits he makes. I'll be looking to see if he makes Tuesday practices after Sunday games for any indication that he's not recovering well.

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