The trajectory of the 2018 season hinges in part on the left knee of Philadelphia Eagles quarterback Carson Wentz.
A front-runner for league MVP before he tore his ACL and LCL in December against the Los Angeles Rams, the North Dakota State product developed into one of the most impactful players in the game in just his second pro season. While the Eagles went on to win the Super Bowl without him, a return to form would significantly increase the chances of a Philly repeat.
What are reasonable expectations for Wentz as he works toward a comeback? We consulted ESPN injury analyst Stephania Bell and Dr. Brian Sennett, associate professor of orthopaedic surgery at University of Pennsylvania Hospital.
How realistic is a Week 1 return?
Wentz set his sights on Week 1 for his return early in the rehab process and has not moved off it.
“My goal is to not miss a game,” he said in a recent sit-down with ESPN’s Sal Paolantonio. “I feel I missed plenty last year. I want to be out there with the guys. It’s a fluid process, we’ll see what happens, but I’m confident I’ll be back Week 1 and ready to play against Atlanta Thursday night.”
It typically takes nine-to-12 months to come back from an ACL tear. The opener against the Falcons on Sept. 6 is just shy of nine months from the date of injury (Dec. 10), which would put Wentz on the early side of that return window. What makes that goal more ambitious is the fact that Wentz is dealing with not just an isolated ACL tear but an LCL tear as well.
“Anytime you have more than one ligament on its own, it’s a different story when it comes to healing and rehab,” said Bell, who is also a physical therapist. “Multiligament knee injuries are more problematic, and they are less common, so you are a little bit comparing apples to oranges versus a straight ACL repair.”
Even so, the consensus is that the regular-season opener is a reasonable target return date but not a slam dunk.
“It’s not unrealistic for him to think he can be back Week 1 right now, but it’s a fluid process, and that could change anywhere along the way,” Bell said, noting that swelling in the knee, for example, could force Wentz to back off at any point. “I certainly don’t think he’s a lock to be back Week 1. … Anyone who says that they know for a fact that he will or will not be ready is not correct.”
Should we expect Wentz to be his high-flying self upon return?
Wentz did not concede the point when it was suggested that his mobility would be limited early on and that he’d have to alter his game accordingly.
“I guess we’ll see when the time comes. I believe I’ll be fine,” he said.
Despite that optimism, it could take some time before Wentz is the sharp-cutting escape artist fans grew accustomed to seeing last season.
“It will take a little while to get back up to full speed,” Sennett said. “Most athletes are typically missing the ‘quickness’ with acceleration and cutting. Coaches will also probably change their design to match his recovery.”
Bell agrees that a ramp-up period should be accounted for, especially if Wentz does not participate in the preseason, which is a distinct possibility.
“There’s usually an acclimation to playing in traffic that happens after an injury like this,” she said. “And so even if he’s ready to take the field from a stability standpoint, a conditioning standpoint, mentally he appears ready, you cannot simulate game conditions until you are in a game. And sometimes what we see on the rehab side is until the player gets exposure in that situation — repeated exposure — they’re not quite themselves. That’s normal, and it takes a while to get that back. How long it takes varies greatly from one player to the next. Him being ready to play Week 1, let’s say that does come to pass, doesn’t necessarily mean he looks like Carson Wentz pre-injury Week 1.”
Adjusting to those limitations, if they do in fact exist, will be key as Wentz retakes the controls of coach Doug Pederson’s high-octane offense.
How will this injury affect him over the long term?
Wentz has said time and again that he will not change his style of play and will maintain his aggressive mentality despite this setback, but he has acknowledged that he’ll have to pick his spots better in the name of staying upright.
The studies pertaining to ACL reinjuries have produced varying results, but Bell notes that as a common rule, “Once you’ve torn your original ACL, the risk of another injury always goes up, even if only slightly.”
Sennett expects Wentz to wear a knee brace on his lead leg this season as a protective measure.
“While braces can’t prevent every injury, they do provide some reinforcement for the knee, especially lateral stability,” Bell said. “Having the brace on does provide some mental confidence as well because it’s an additional measure of support.”
The opposite leg, though, is arguably the greater concern.
Bell pointed to a review published by the department of orthopaedics and rehabilitation at Vanderbilt University School of Medicine that aggregated results from various studies and concluded that the risk of an ACL tear in the opposite knee (11.8 percent) is double the risk of an ACL rupture in the same knee (5.8 percent).
The other factor that needs to be accounted for, even if it’s more difficult to quantify, relates to that confidence Bell referenced. Most commonly, a player is better in his second season back from an ACL injury than in his first.
“There’s a physical component, and then there’s kind of getting the feel of your leg underneath you again, and when does it start feeling like your own?” Bell said. “The third part is the mental part, not thinking about your knee, just thinking about football and not having any thoughts about your knee.
“Some people are really good at it — it’s almost like it doesn’t faze them — and some people get stuck there.”
In this respect, and others, only time will tell with Wentz.
Source : ESPN
