Medical, NFL Draft Prognoses for Brandon Thomas Following His Torn ACL

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Medical, NFL Draft Prognoses for Brandon Thomas Following His Torn ACL
Michael Conroy

Devastating news made its way through the NFL draft community on Monday when ESPN's Adam Caplan reported former Clemson University guard Brandon Thomas suffered a torn ACL last week.

The injury comes as quite a shock, as many experts projected Thomas to be a potential early-round talent in the 2014 draft.

While there is not yet reason to panic—athletes routinely recover from ACL reconstruction surgery without complications—Thomas will almost certainly miss most or all of the 2014 NFL season. Additionally, the unfortunate timing of his injury—just over one month prior to the draft—casts doubt over his competitiveness in this year's field due to his presumed absence next year.

Wikimedia Commons.
This diagram shows the anatomy of the knee. The ACL—or anterior cruciate ligament—lies in the middle of the knee and connects the femur (thigh bone) to the tibia (shin bone).

After all, despite the relative frequency of ACL injuries in football, the recovery time remains long. Most of the time, an athlete will need well over six months of rehabilitation—and sometimes over a year.

Furthermore, not all ACL injuries heal without issue. For instance, if an ACL tear comes with other ligament or cartilage damage, rehab becomes much more complicated.

Luckily, at this point, no news of additional injuries exists, so it seems safe to assume Thomas suffered a non-contact ACL injury—though precise medical details are still scarce.

Often, non-contact ACL tears occur when an athlete jumps and lands awkwardly on one leg or sharply plants his or her foot in an attempt to make a cut. If the knee twists inward too far—the exact type of motion the ACL tries to prevent—the ligament can tear.

On the other hand, contact ACL tears frequently involve a hit to the outside of the knee that forces it to bend inward. The MCL or meniscus—or both—also suffers damage in a large portion of contact injuries.

Following a tear, an athlete may still be able to move forward in a straight line, but when he or she attempts to cut or change directions, the knee may buckle inward—not a good recipe for a budding offensive lineman in the NFL.

ACL tears almost always require reconstructive knee surgery. During the operation, an orthopedic surgeon will actually replace the torn ligament with a piece of the athlete's own hamstring tendon. The tendon then serves as the new ACL and, over the weeks and months that follow, the body cements it into place within the knee.

Thomas will almost certainly undergo surgery soon—if he has not already. By the time the draft rolls around, he will then likely be working through the initial stages of rehab—such as quadriceps strengthening and range-of-motion exercises—but not yet weight-bearing or agility drills.

In other words, NFL teams will be able to gauge his very early progress prior to the draft, but his ultimate outcome will remain a mystery for at least a few more months—as opposed to ACL tears from several months ago during the prior college football season, for instance.

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That degree of unknown may make teams shy away from calling him to the podium early on draft weekend.

What's more, if a team originally ranked Thomas highly because he could address an immediate need on the offensive line, this injury might cause his stock to fall significantly with that particular squad.

That said, if Thomas' injury is, indeed, a run-of-the-mill non-contact ACL tear—and if his recovery proceeds uneventfully—his prognosis is still likely excellent in the long run. With that in mind, a team with a goal of addressing long-term needs on the offensive line may still draft him in the middle rounds.

In the end, his draft stock depends—as always—on a combination of medical and football risk-versus-reward analyses by each of the 32 NFL teams, and every team and medical staff might value him differently. Some may downgrade him a round or so, and others may take him off the board entirely.

Fortunately for Thomas, however, it only takes one.

 

Dr. Dave Siebert is a resident physician at the University of Washington who plans to pursue fellowship training in Primary Care (non-operative) Sports Medicine.

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