Updated Injury Analysis for Washington Redskins' Robert Griffin III

Will Carroll@injuryexpertSports Injuries Lead WriterJune 12, 2013

Jun 12, 2013; Landover, MD, USA; Washington Redskins quarterback Robert Griffin III (10) warms up prior to mini camp at Redskins Park. Mandatory Credit: Evan Habeeb-USA TODAY Sports
Evan Habeeb-USA TODAY Sports

Robert Griffin III hadn't walked 10 steps before I got the first text. "You seeing this?" one fellow writer asked me from his spot along the red carpet at the NFL Honors award ceremony on Feb. 2. "It's tape delayed," I responded, but it gave me a clue what was coming. Griffin was walking, just a few months after his knee surgery; red carpet or not, that is big news.


It was more clear later, when Griffin won the Offensive Rookie of the Year Award. He stood, twisted as he hugged his mother, walked without a limp and climbed stairs without hesitation. While it was clear he had a brace, this was impressive less than one month after his surgery. 

It was much the same when Griffin showed up at Washington's OTAs on May 30th. He looked ripped, with muscles bulging underneath his shirt. While there was clear evidence that there had been a leg problem from the muscular imbalance in his calves, he also showed how far he'd come. Griffin had no issues with straight-line running and showed the ability to twist on the knee in drills. 


You can pretty much tell which leg had surgery and has atrophied the last few months. twitter.com/MikeWiseguy/st…

— Mike Wise (@MikeWiseguy) May 31, 2013

Griffin has recently begun sprinting and, according to ESPN, is trying to figure out how to get his rehab work in during his upcoming honeymoon. It's not romantic, but it does show Griffin's commitment and work ethic, two key points to why his rehab has been so positive to this point. 


Guarded Optimism

Even so, it is important that Redskins fans temper their enthusiasm slightly. While this was a very good sign and the first solid information about how his rehab is progressing, it is not enough to change any expectations. Griffin still faces at least five more months of rehab before he is allowed to do any sort of football activities.

Griffin had knee surgery on Jan. 9, a reconstruction of his ACL and LCL, performed by Dr. James Andrews. Reports just after surgery stated six to eight months for the recovery, making his return right around the start of the 2013 season. Even after Adrian Peterson's recovery and great season, this seemed a little optimistic to many.

It's even more interesting considering the ligaments involved. The LCL complicates things due to the goals of the rehab. One of the first goals of rehabbing an ACL injury is to get to full extension of the leg. This normally occurs by Week 4, according to the currently used protocols by top physical therapists. With the LCL, the lateral collateral ligament, the therapists have to be careful to avoid full extension until the repair is strong. 

Griffin's gait back in February was interesting for two reasons. First, he was walking without discernible pain or support. Second, he was having no issues with either leg. Since this was his second ACL reconstruction, Griffin had the patellar tendon of his "good" leg harvested for the graft. 

He also showed no hesitation in doing some rotation on the leg, as he did in this video showing off his socks. The brace that Griffin had on his knee is more clearly seen, but as is also clear, it is not so bulky or restrictive that he could not get his suit pants over it.


Is Griffin the next Peterson?

I spoke with Mike Reinold, one of the top physical therapists in sports and the author of one of the most widely used rehab protocols for knee surgery. While Reinold has not worked on Griffin, he has worked on hundreds of cases, including after surgery with Dr. Andrews. 

Reinold was not surprised that Griffin was at this point. "I've worked with enough athletes that anything they do doesn't surprise me any more," he said with a laugh. "The thing that you have to remember is that no two surgeries are alike. A lot comes down to how hard the athlete is willing to work before and after the surgery."

Walking without a limp early in the process told Reinold something as well. "He's got his quad turned back on," he explained. At this stage of the rehab, the therapist is going to want to have quadriceps strength at or above the 60 percent level. "The better someone goes in, the better someone comes out."

While all comparisons will lead back to Adrian Peterson, it is important to remember that Peterson's injury is not that same and he is an extreme "best-case," where nothing set back his rehab. Peterson had a pristine knee, according to Dr. Andrews, aside from the torn ACL and MCL that is. Griffin is of course having his second such surgery in addition to the LCL sprain.

Physically, it is impossible to compare Griffin and Peterson, but it is fair to say both are in top physical condition. It is also fair to say that both have excellent work ethics. Neither would be in the position they are in without those two basic skills and both are key to a good rehab outcome.


Perception and Reality

Our view of knee rehabs is still colored by the legends and myths of the past. Joe Namath's long scar, hobbled gait and medieval-appearing brace may be from only a few decades ago, but just as computers have come a long way from the room-sized monsters of the '60s, sports medicine has taken bigger leaps. 

The giant scar that Namath has as a reminder of his problem may affect many fans' view of knee injuries, but the current truth is that most players come back from this surgery and play at a similar level. (There's more questions about defensive backs, which becomes a major question for Darrelle Revis and the Buccaneers.) 

At the same time, we have reports that Griffin will open the season on the PUP list. This is a procedural move and not very instructive. With Griffin on the list, the Redskins get an extra roster slot they can use on a quarterback, likely to be a "project QB" that could compete for the third-string slot. Griffin could come off that list at any time, will participate in practices and meetings, and, let's face it, the minute he can, he'll be the starting QB. 

If there's anything that's clear, it's that we'll have endless looks at Robert Griffin III this offseason, but we're still a long ways off from knowing anything solid about his return or his mobility. Redskins fans will still take the positives they have so far, especially from Griffin himself. 

"I'll be ready," he keeps saying. It looks like he's right. 

All quotes were obtained first-hand unless otherwise noted.

Will Carroll has been writing about sports injuries for 12 years. His work has appeared at SI.com, ESPN.com and Football Outsiders.