Despite all the talent and resources afforded to a player, the potential of achieving an exclusive invitation to the NFL can easily be wiped away due to injury. Florida State safety Hamsah Nasirildeen appeared to be on the fast track to the NFL until a left ACL tear knocked him off course for nearly a year. 

Heading into the 2021 Draft, there are more questions than answers regarding Nasirildeen’s health and whether he can regain his 2019 form in which he racked up 100-plus tackles for a subpar Seminoles team. Below are season-by-season publicly known injuries. 

2017 season

Appeared in all 13 games, with no publicly known injuries.

2018 

Appeared in all 12 games, with no publicly known injuries. 

2019

Appeared in 12 games, suffering two injuries: an undisclosed injury that limited him against Louisville and the season-ending ACL tear against Florida.

2020

Appeared in two games against North Carolina State and Duke after missing seven games of the season recovering from his ACL tear. 

Undisclosed injury

Nasirildeen dealt with an injury prior to his ACL tear that had little to no acknowledgment other than that he was limited. Looking at the game film, Nasirildeen is spotted on the sidelines against Louisville in pads and holding his helmet, indicating that he was available to play. He didn’t have any official defensive statistics on CFB reference but the team website does acknowledge that he did play which suggests that he participated on special teams.

In searching when Nasirildeen was injured, the week prior against Virginia, he went flying out of bounds on a tackle with 10:57 left in the third quarter and then disappeared for a while, eventually returning with a compression sleeve on his right leg with 11:42 left in the fourth quarter. He didn’t play a lot against Louisville, reportedly only eight snaps, and then began ramping up his playing time as the season progressed until he played against Boston College without a sleeve on the leg over the course of 8 weeks. It’s possible that he could have ditched it sooner, but the Seminoles wore maroon-colored socks during earlier games which prevented identifying whether a sleeve was on underneath. 

The presence of a compression stocking suggests that he may have been dealing with a calf strain. When he went out against Virginia, his right leg planted hard into dorsiflexion off the turf in an attempt to regain his footing and slow down, demonstrating a similar mechanism for a calf strain. That would explain the lack of playing time against the Cardinals but slow ramp up as the season progressed. Looking at this as a whole, I do not believe his right leg injury contributed to his eventual left ACL tear.

ACL tear

Nasirildeen’s left ACL tear came during a play with 12:08 left in the second quarter, attempting to get the proper angle to tackle WR Kadarius Toney. Nasirildeen ran up the field to the left before Toney switched directions to his left, forcing Nasirildeen to plant hard on his left leg. He attempted to slow down to change directions and in the clip below, the left knee simply gives way and he falls down. 

This is the classic mechanism for an ACL tear, which ultimately ended his season. He had surgery shortly after however, the exact date is not known. Timelines are generally anywhere from 9-12 months for recovery. However, Nasirildeen was unable to return until Nov. 14 against North Carolina State, two weeks shy of the year mark for his ACL tear. To better understand the purpose and function of the ACL, read below.

Knee anatomy

The ACL is a ligament that runs lateral to medial and prevents anterior translation of the femur over the tibia. This ligament assists with rotational stability by preventing the knee from rotating at the tibia, ensuring that the knee acts as a hinge joint. The ACL contains mechanoreceptors that assist with detecting changes in direction, speed, and tension. It is the most commonly-torn ligament in the knee during sporting activities.

Causes for injury include a sudden change of direction, jumping, and poor landing, deceleration, or direct blows to the area. There is usually, but not always, associated damage to the area during an ACL tear, including damage to the meniscus, articular cartilage, and MCL. Damage to the PCL and LCL is also possible, along with nerve and vascular damage in severe knee injuries. Recoveries for an ACL tear vary between 9-12 months but can take even longer with associated damage, as mentioned above. 

Delayed return

There were reports that Nasirildeen re-aggravated his knee which led to his delay in returning to play. There are not reports that indicate specifically what he did, but he ultimately missed the first seven games of the season. Based on the schedule, the plan appeared to play the last five games of the season to get back into a normal rhythm. However, three of the next five games were canceled due to COVID-19 which led to a month missed between game appearances. 

Looking at the film when he did return against NC State, he simply does not look fluid like he did prior to the injury. He wore a hinged brace on the left knee and it appears that he doesn’t quite have confidence in planting on the leg or slowing down to tackle. A month later against Duke, he does look more fluid but to the trained eye, he still doesn’t look great. However, in those two games, he was able to rack up 13 tackles and an interception, indicating his eye for the game and skill set weren’t totally diminished.

However, at the Senior Bowl, video footage of the practices indicate that he was beginning to find his groove in keeping with man coverage and changing directions easily. There appears to be universal praise from his performance down in Mobile which could significantly improve his draft stock. It’s also important to note that he ditched the knee brace and was far more aggressive in the limited film.

As mentioned above, the ACL contains mechanoreceptors that assist with detecting changes in direction, speed, and tension, collectively known as proprioception. When the ACL is torn, the native ligament is removed and a graft is put in place to adapt as the new ligament. The body no longer has that feedback coming from the ligament as efficiently as it once did. 

There is research to support leaving a remnant of the ACL to assist with regaining proprioception during rehab, but this lack of prior feedback during activity likely leads to diminished production the year following ACL reconstruction. This could explain why Nasrildeen initially lacked the fluidity seen in the film prior to his injury in 2019.

ACL complications

But the question is, why did he take so long to come back? There are a few factors that could contribute to this:

• He could have had additional damage not publicly known such as meniscus tear, MCL sprain, articular cartilage damage, among other structures. To tear the MCL and meniscus during an ACL tear is common.
• Recurrent swelling and pain within the knee during activity while increasing levels of activity in returning to the field.
• Functional outcome testing not appropriate such as drop hop test or vertical single leg jump. 
• Deficits in strength compared to the uninvolved knee with isokinetic testing.

There are no details available as to the struggles or limitations that he experienced during his rehab process. There are several interviews of Nasirildeen discussing his rehab during spring practices in 2020 seen here and here, but he does not go into great detail regarding the specifics. In the two interviews available, it appears to state that he is ahead of schedule and that he did not have a target date in mind. 

The timelines for ACL rehab, at least the expectations, continue to shrink, placing greater pressure or unrealistic realities for players to return on their self projected timelines. It’s very possible that he continued to push his rehab, even at times attempting to rush through some of the later steps. He may have simply required more time to be fully healthy in order to return. 

Had he returned for the regular-season opener, he would have been a little past nine months since his surgery. Research indicates that the chances to re-injure the operated knee or contralateral knee is seven-fold attempting to return prior to 9 months following surgery, putting him right on the edge of that timeframe. It’s possible that he could have been rehabbing up until that time and simply wasn’t football ready. Stepping back to look at the big picture, Nasirildeen followed the general timelines for recovery, but lost in the noise was the fact that he wasn’t ready for the first game of the season. 

While he is not out of the woods yet regarding re-injury, there are significantly higher chances to suffer future injury to not only the same knee but to the opposite side for upwards of two years following the procedure. Several risk factors weigh against him in regard to re-tearing the knee once he gets to the NFL. Still being under 25 years old (22), he is at risk to suffer a future ACL tear for up to two years, and still at risk to tear the other ACL due to the original injury with about a 20-30% increased risk. Specifically, the MOON study showed that roughly 10-percent of football players re-tear within two years. 

Players entering the NFL from 2006-2012 were analyzed retrospectively, and those that had an ACL tear prior to entering the NFL were at greater risk to re-tear. Their rates when re-tearing either side was 25%, compared to 9-percent in the control group. These injuries also occurred within the two-year window mentioned above.

By the time Week 1 of the 2021 NFL season kicks off, he will be approximately 21 months out from his surgery and will have had an entire offseason to train for football-specific activities. 

NFL Draft impact

Nasirildeen’s game film following the ACL injury isn’t great which leads to questions about his talents translating to the next level. His Senior Bowl work showed an improvement in his game, but that is a small sample size. He certainly has the talent to play in the NFL, but where will he land? 

He does show potential to play a hybrid position at safety/linebacker similar to what Clemson’s Isaiah Simmons entered in the NFL as or he could make a permanent switch to linebacker such as now Buffalo Bills linebacker Matt Milano. The team that drafts him I believe would expect him to contribute on special teams and act as a depth option during his rookie year regardless of position. 

He certainly has the potential to move up into a starting spot, but he would be best suited to let his body further acclimate to the NFL, especially as he comes back from the ACL injury. Overall, I am not concerned about his long-term prospects due to the previous injury once he gets outside the 2-year re-tear window. If he doesn’t pan out, it will be due to his talent and lack of opportunities. 

Even with a strong pro day, I don’t anticipate that he moves up into the first round. His talents are notable, but the ACL injury drops him to a Round 2, maybe early Round 3 selection. Nasirildeen could be a player that a team could go up to get if he begins to free-fall. As long as the knee checks out with the medicals, which it should, I would expect him to contribute and hopefully have a productive NFL career. 

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