Alabama football is synonymous with winning national championships and producing elite NFL talent. That’s a fact just as sure as death, taxes and Buffalo having snow. Edge defender Anfernee Jennings is no exception to this rule heading into the 2020 NFL Draft. However, Jennings comes with injury concerns which could affect what round he gets drafted at and his career longevity.
Jennings is a redshirt senior that was incredibly productive during his time in Tuscaloosa. He appeared in 54 games, racking up 99 solo tackles and a total of 194 tackles. In addition, he had 34.5 tackles for loss for 146 yards and 15.5 sacks. Rounding out his stats, he also had two interceptions, 20 pass deflections, three forced fumbles and two fumble recoveries.
He did all this despite dealing with a right high ankle sprain requiring surgery early in 2018. In addition to the surgery, later that season, Jennings suffered a rather gruesome-looking left knee injury in the semifinal game, damaging his PCL similar to Willis McGahee along with sustaining artery damage with resulting blood clot which nearly led to an amputation.
— Leonardo (@leonardo_RGV) January 2, 2018
High Ankle Sprain
Outside of these injuries, Jennings seemed to be fairly healthy, appearing in every other game during his Alabama career. Going in chronological order, he suffered a right high ankle sprain in the season opener against Florida State, nearly derailing his season. Reviewing the anatomy, the ankle is made up of the talus, medial malleolus of the distal tibia and lateral malleolus of the distal fibula.
A high ankle sprain occurs when the foot is in dorsiflexion and the foot is forcefully everted, or turned outward, injuring the connecting tissue known as the syndesmosis in between the fibula and tibia. This occurs when a player falls on the heel of another player and forces the foot outward. A fall onto the heel doesn’t always have to occur. It’s the act of forceful turning of the ankle outward due to a foot planted and the body rotating inward.
This is what occurred to Jennings’ right ankle in the season opener. He was running with his assignment and appeared to get his foot caught in the turf trying to change directions by not hitting a defenseless receiver that caught the ball over the middle. He immediately began hopping on his left leg, unable to bear weight on the right side.
Initial presentation of the injury includes some swelling, delayed bruising, difficulty with plantar flexion and difficulty weight bearing. Difficulty rising up on the toes is another telltale sign of a high ankle sprain, but the inability to do that isn’t isolated to high ankles.
Normally, a moderate to severe high ankle sprain takes four to six weeks just to regain normal movement before returning to play. Severe sprains can require timelines upwards of 10 weeks. Had Alabama stuck to traditional methods, Jennings could have missed the season and put his NFL Draft stock into question. Fortunately, Jennings plays for Alabama and the team of orthopedic doctors has developed the tightrope procedure for a high ankle that has considerably cut the healing time down. The tightrope procedure is where a hole is drilled into the tibia and fibula and a suture is inserted with buttons on the outside to pull the bones together to heal in a maximal position. As a result, he only missed two games before returning.
Posterior Cruciate Ligament Injury
While Jennings continued to have solid production in his junior year, his injuries were not over as he suffered a PCL injury in the Sugar Bowl National Semifinal. His injury occurred late in the fourth quarter when a fellow teammate leg-whipped Jennings, forcing his left knee to buckle backward in a rather gruesome angle — similar to that of a chicken.
When knees are hyperextended to that degree, multi-ligament damage is usually expected with lengthy recovery time. However, despite the gore factor in the video, Jennings only suffered a PCL tear. This occurs when the tibia is forced back due to a blow to the front of the knee — like in Jennings’ case — or falling directly onto a bent knee and causing hyperflexion. Other mechanisms include landing poorly from a jump, sudden change of direction or misstepping.
Jennings fortunately managed to avoid further serious ligament damage which shortened his recovery timeline. Unfortunately, a knee getting bent back that far can compromise other structures in the area, including the popliteal artery. At the time, it was known that he had suffered a PCL injury but the arterial injury was not apparent.
Jennings had another evaluation performed the next day which revealed a decreased pulse to the area compared to the right side with further ultrasound imaging indicating that damage to the artery had occurred with a resulting blood clot. Had doctors not found the blood clot, it would have been very possible that he would have had to have his leg amputated. If there is no blood supply, then tissue death is likely to occur. Seen below in Picture A is the posterior knee dislocation, compromising the popliteal artery which led to a tear and the blood clot.
Despite all the trauma to the knee with the potential need for amputation, Jennings had excellent outcomes. While it isn’t clear, it appeared that the PCL injury was in isolation and that he didn’t require surgery for the actual ligament. He required vascular surgery to repair the damaged artery and remove the blood clot. He was able to return for the 2019 season without missing any time indicating that he was fully healthy.
Injury Impact NFL Draft
Looking at his overall collegiate injury history, 2018 was not a good year for Jennings. He was able to rebound for the 2019 season setting himself up for NFL glory. There are always concerns about how his body will hold up in the NFL, taking his game to another level and handling a greater workload. There are concerns about his right ankle and left knee that may give pause to drafting him higher than he should go.
The high ankle sprain normally wouldn’t be a concern as research has shown that about 10% of high ankle sprains are recurrent and become chronic. Considering the tightrope procedure isn’t widely used outside of Alabama, and the research I’ve found, it just isn’t there to assess improved long-term outcomes with the procedure compared to conservative treatment. This isn’t stating that the procedure isn’t acceptable; it just isn’t known whether players are at a greater risk to suffer future high ankle sprains or if the surgery won’t hold up. At best, it cuts down the return-to-play timeline, which it has done very well.
As for the PCL injury, outcomes are far better than its brother, the anterior cruciate ligament. Unlike the ACL, the PCL has an intrinsic ability to self-heal, leading to decreased surgical needs. Those that do have an isolated tear, research has shown that over 90% of athletes that sustain a PCL tear were able to return to the same or higher level of activity. In addition, the PCL is also broader and stronger, leading to decreased injury rates.
In fact, research is slim to none because of the relative lack of isolation in incidence in injury as many PCL injuries are concurrent with MCL, meniscus or ACL injuries. So if the PCL is to tear again, there is either a direct blow to the area as mentioned above or there is multi-ligament damage and the PCL is the least of the player’s worries.
The only concerns that the PCL injury can ultimately lead to is osteoarthritis in the affected knee later on and the possibility of meniscus pathology. This is due to the possible laxity of the PCL and its effect on the biomechanics of the knee, leading to quicker degenerative changes. Research has shown that arthritic changes increase five-fold as a result of a PCL injury, though that number is likely in ACL injuries as well. However, this is almost expected with playing at such a high level and may shorten his career. Obviously hard to say as it’s unknown if someone will play five or 15 years.
Taking into consideration the blood clot, arterial blood clots can and do occur following trauma such as what he dealt with. Looking at the grand scheme of things, I think this was a freak accident that could have happened to anyone. Considering that he is a high-level athlete, he didn’t have some of the other risk factors such as being overweight, struggling with a poor diet or having a history of smoking.
If he does suffer another injury, there will likely be additional precautions and assessments taken to ensure that he does not suffer any further blood clots. It will be just another part of taking the athlete into consideration as a whole.
I do not believe these injuries impact his overall draft stock. I have observed that he is slated anywhere in the first three rounds. Had these injuries occurred in 2019, I wouldn’t agree with that. But his strong 2019 season raised his stock enough for me to agree with this despite his history. Whether he plays the more traditional linebacker role requiring lateral movements or moves up to the defensive line as an edge rusher to bend around the tackle, neither injury should impact his ability to keep up with the demands of the position or scheme.
His career may be shorter or he may have issues with the knee earlier than expected due to arthritis. However, general managers are looking at what each contract can bring their team over the next few years, not decades. Jennings is an excellent player, but far from generational. He can certainly fit into any defense that maximizes his skills though longevity is the big question mark.