Carolina Panthers quarterback Cam Newton continues to deal with two offseason and preseason medical issues—first, surgery for a lingering ankle injury and later a broken rib—leaving fantasy drafters and owners with a few unanswered questions.
Will he start the season? Will he play at a lower level due to the injuries? What about the rest of the year?
Two health concerns surfacing before the regular season even starts certainly does not represent an ideal scenario. However, as of now, neither merits benching the quarterback for a backup during the first week of fantasy football action—though owners are also not entirely out of the woods.
Let's take a closer look.
UPDATE: Sunday, Sept. 7, 11:30 am
A week of progressively more pessimistic-sounding reports culminated Sunday morning when NFL Network's Ian Rapoport tweeted the Panthers are expected to sit Newton Week 1.
Fantasy owners need to exercise extreme caution.
Problem No. 1: The Ankle
Newton underwent ligament-tightening ankle surgery in March. He completed his rehab, but as recently as August, he continued to feel—according to The Charlotte Observer's Jonathan Jones and Joseph Person—an intermittent "thump" of pain in his ankle:
It’s like a thump from your mom when you said something that you weren’t supposed to, she’ll thump you dead in your ear or on your head. It’ll hurt for that little second but it’ll go away after 2-3 minutes. It’s a reminder that, hey, you better check yourself.
The significance of these painful episodes is not entirely clear. They may represent some sort of intermittent impingement within his ankle brought about by certain movements, but such a conclusion represents educated speculation, at best. It's also not clear if he even continues to experience the episodes.
However, after receiving full medical clearance, one can assume his ankle joint is stable and not significantly swollen.
Yet, will it affect him on the field?
Though Newton did not rush much during the preseason—he totaled only three attempts for 12 yards during the Panthers' third preseason game, according to NFL.com's statistics—he exhibited mobility in the pocket on several instances. He also demonstrated a solid plant on his left foot in the process.
Nevertheless, for Week 1—and, perhaps, a bit longer—he may run less than in previous seasons. An entire game's worth of planting his left foot to cut to the right—the motion, if any, that could stress his ankle—could take its toll. As such, owners need to temporarily slightly limit expectations when it comes to rushing yards and touchdowns and instead hope for a pleasant surprise.
Furthermore, his ankle merits monitoring during the layoff between Week 1 and Week 2, specifically for worsening pain or the development of swelling following his first full game since his surgery in March.
Problem No. 2: The Rib
Breaking: Cam Newton has hairline fracture in his ribs. Won't play this week. Rivera thinks Newton will play in the season opener.— Steve Reed (@SteveReedAP) August 24, 2014
A hairline fracture implies minimal to no rib displacement at the fracture site, and players play through such an injury on a fairly regular basis.
It all comes down to protection and pain control.
Assuming the Panthers medical staff can provide both—a safe assumption—Newton's ribs have a chance to remain nothing more than an afterthought.
However, the fracture will almost certainly not heal in time for Week 1. Even though Person tweeted that the Panthers signal-caller looks set to start the season, a full game of twisting, bending and taking hits could lead to significant soreness late in the second half.
Cam: "No doubt in my mind" he'll play vs Bucs.— Joe Person (@josephperson) August 27, 2014
With that in mind, fantasy owners should enter Week 1 with—similar to Newton's rushing game—ever-so-slightly tempered passing-game expectations. They must also be aware that one blindside hit to the back could end his day—though the Tampa Bay Buccaneers, the Panthers' Week 1 opponent, ranked only 23rd in the league in sacks last season.
All told, from a health standpoint, owners can reasonably expect Newton's Week 1 fantasy production to come in at about 80 to 90 percent or better if all goes well.
If Cam Newton is your No. 1 quarterback, will you start him Week 1 against the Tampa Bay Buccaneers?
Additionally, most fantasy owners with Newton on their squad likely drafted the former Auburn Tiger as a No. 1 quarterback. As of now, neither health condition comes close to worrisome enough to bench him for a potentially far inferior backup.
That said, a manager with an equivalent option or slightly inferior option at quarterback can justifiably choose to wait and see how Newton performs during Week 1 before inserting him back into his or her lineup.
In the same vein, his rib fracture certainly will not help him shake off the rust of a long offseason. As mentioned, his ankle pain also remains of unclear significance. Therefore, if an owner finds himself or herself going back and forth between the Heisman Trophy winner and another quarterback on fantasy draft day, it is understandable to go with the other option purely based on the element of the unknown.
Dr. Dave Siebert is a second-year resident physician at the University of Washington and a member of both the Professional Football Writers of America and the American Medical Society for Sports Medicine. He plans to pursue fellowship training in Primary Care (non-operative) Sports Medicine.