NFL Draft Injury Impact: Virginia Tech CB Caleb Farley

04/12/2021
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Possibly the top cornerback prospect in the 2021 NFL Draft, Virginia Tech CB Caleb Farley brings not only elite talent to the position but several significant injuries in his short career that could derail his chances at a high draft slot. On top of the injuries, Farley didn’t play in 2020 due to opting out due to the pandemic, leading to more concerns about what he can really do at the position as he’s only played it for two full seasons. Could Farley be a top-10 prospect regardless of the injuries, or does he fall as so many have before him?

Caleb Farley’s injury history

High school

Hip flexor strain during track, noted as Farley mentioned that this was the first injury he had ever had before. 

Virginia Tech

2017

Suffered a torn ACL, side not specified but potentially the right side based on pictures available below. He suffered the injury during pre-season practices, lining up at wide receiver, his original position entering college. Used his first year to recover and rehab.

https://www.instagram.com/p/CHV4XTknZEf/

2018 

Burst out onto the scene with two interceptions, two tackles, and a sack against Florida State in his redshirt freshman season. He parlayed this strong start in 2019 to All-ACC honors with 36 total tackles, seven pass deflections, two interceptions, and a sack. In addition, he did not have any publicly reported injuries. 

2019

Continued his stellar play with 20 total tackles, 12 pass deflections, four interceptions and an interception returned for a touchdown, though dealt with several injuries later in the season. Suffered a head injury against North Carolina, exiting the game, but did not miss any games from that injury. There also are not any reports stating that he suffered a concussion. 

Farley later suffered back spasms, forcing him to miss the last two games of the season, eventually requiring a procedure. At the time it was not detailed that he required a microdiscectomy, but reports later indicated that he indeed did have the specific procedure. 

2020

Sat out due to COVID opt-out, reportedly stated that he did not feel comfortable with Virginia Tech’s COVID protocols.

2021 Offseason

Suffered another back injury while training, injuring S1 this time and requiring another microdiscectomy to the area. This comes after he required the same procedure in 2019 at the L5 level as Farley noted in an interview. He states the original injury occurred while deadlifting in August of 2019 which resulted in a herniation at L5 and bulge at S1. He had the procedure performed prior to Virginia Tech’s pro day on March 23, missing further testing and letting his game film do the talking. 

To understand the implications of the above-mentioned injuries, anatomy on both the knee and lumbar vertebrae must be understood.

Knee anatomy

Normal knee anatomy and torn ACL. Credit: Aquaphysicaltherapy.com

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.

Knee injury risks

Despite Farley having a previous ACL tear, he continues to be at risk to suffer another tear in the future, though I would downgrade his risk to re-tear as he is outside the two-year window to either tear the same side or opposite side. He is not immune from ever suffering another ACL tear, but the highest risk window appears to be behind Farley at this point. 

However, he is 22 years old, which puts him under the age threshold to suffer another tear. Furthermore, as a defensive player, he always has to react to what the offense is doing, putting him at a disadvantage in that he can’t control the movements. In that instance, a wrong step or shift to one side could lead to further injury, though this is far from certain. Most of the time, this would be a bigger injury concern, but this is the low on the list of concerns assessing Farley.

Back anatomy

In the spine are a series of vertebrae that house the spinal cord, which connects to the brain and allows control for all aspects of function, including muscle movement, sensation, vital organ use, and all other systems of the body. The vertebrae are comprised of cervical, thoracic and lumbar vertebrae. Between each vertebra lies an intervertebral disc, which allows the vertebra to move while providing stability. Without these discs, movements such as bending over would not be possible without serious injury to the spinal cord. 

Lumbar anatomy. Credit: Orthoinfo.aaos.org

Within the discs are three portions: the annulus fibrosis, the nucleus pulposus, and the endplate. The annulus is the firm outer portion of the disc, which connects to the endplate that attaches to the vertebral body. The nucleus pulposus sits inside of the disc, which is a jelly-like substance comprised of water and collagen fibers. 

A bulging disc occurs when there is a force through the spine either through compression, sudden flexion, or rotation. This could force the annulus fibrosis to partially tear and cause the nucleus pulposus to herniate out and push against either the spinal cord or nerve root of a specific nerve. In a bulging disc, the annulus is partially torn, putting pressure on the structures but not outright herniating into the spinal cord or nerve root.

In turn, this could cause a common complaint known as sciatic pain, named for the nerve that runs down the leg. This could cause pain and weakness down the leg, limiting the ability to run, jump and perform at the position. This could also cause the back spasms that he dealt with before and generally inhibit his abilities to effectively play. If you’ve ever had back pain, it affects nearly every function in day-to-day life and makes physical activity very difficult.

Herniated disc and microdiscectomy. Credit: Mayoclinic.com

In the case of Farley, he required a microdiscectomy is when a portion of the disc that bulges out is trimmed away, along with possibly bone, in order to take the pressure off the surrounding areas. Typically, the incisions are small and the surgery is not invasive with relatively excellent outcomes.

Lumbar injury risks

Farley is 22 years old and has already had two microdiscectomies. He does play an incredibly physically demanding sport at one of the highest competition levels that is not the NFL. Injuries are bound to occur, but back injuries can be problematic, especially if there is a recurrence. It’s very interesting how forthcoming he was with the back surgeries, noting when the original injury occurred, the levels injured, and even went so far as to state that the original level that required the surgical procedure at L5 was still intact. There are concerns this year about the lack of medical information available; this may have been a way to get out ahead of any concerns teams may have who have not assessed him yet.

However, there is promising data that suggests that this may not be as big of a concern as it could be. According to research, 75-to-80% of NFL players who require a microdiscectomy return to play following the procedure. Fifteen percent of that 80% require a revision procedure, but Farley does not technically fit that due to requiring procedures on two separate levels. 

The average career length following a microdiscectomy is 4.1 years or 36 games for an offensive position, however, there are similar numbers for defensive players. There is no discernible performance decline compared to controls, but the career length is shortened slightly. This does not imply that Farley’s career will only be four years, but that is on average how long players play following the procedure of those already in the NFL.

The two levels that he injured, L5 and S1, are the most commonly injured areas within the back when it comes to disc herniations so it’s of no surprise that he required surgical intervention at these levels. My strong assumption is that they attempted to manage these complaints conservatively, at least the second instance, but did not have immediate, positive results. Looking long term, it benefitted Farley to receive the surgery as career lengths are longer as compared to those managing the complaints conservatively. 

Despite the overall positive outcomes, there is a concern for further herniation of the discs as mentioned above or further injuries that lead to degeneration of the surrounding structures such as the vertebrae leading to spondylosis. A recurrence of disc herniations is anywhere from 5% to 18%, which is a distinct possibility considering his occupation. The thinning of the discs could lead to further pressure on the spinal nerves, leading to pain and weakness, potentially going down the leg, noted as radiculopathy. This isn’t guaranteed, but a concern. 

There is also the possibility of eventually requiring a lumbar fusion to stabilize the area from further pain. While contact sports are typically not recommended following a lumbar fusion, there are instances where players in the NFL have had a fusion and returned to play for many years, even at a Pro Bowl level. However, for those surgeons that do allow for a return to sport, 91% of those required a fusion return after one year or less.

NFL Draft impact 

Farley was considered a top-10 pick at one point. He has had only one healthy season of college production, hasn’t played in over a year, and has had several notable injuries. His transparency with the back injuries may help his case but I’d find it hard to believe that some teams wouldn’t be hesitant to use a high draft pick on him. 

At some point, Farley’s talent will outweigh the injury concerns. Will he stay put draft-wise like Tua Tagovaiola did despite his hip injury, or fall precipitously as DK Metcalf did following his neck surgery. My educated assessment states that he will have a fall similar to Metcalf. The talent is there to be a first-round draft pick, but at what pick? I could see him going as a late first-round draft pick or early day two pick, no later than the second round. If he falls below the second round, then there are concerns more serious than what is publicly known. He will likely go to a team that has some needs but would benefit from an impact player that helps take them over the top. 

While the microdiscectomy timeline of four years after a procedure is noted, it doesn’t mean that it is an expiration date. This is merely an average and also means that Farley could play much longer than the standard NFL career. Some team will take the risk on Farley and grab the talent, hoping it gets them over the top. The benefit to picking him in the first round is that extra option year, depressing his costs in case he performs well and the team has a decision whether to pay him. I’m not certain that he is a cornerstone of the defense for years to come, but he’s certainly worth a pick. 

My hope is that he defies what the research states and have a long, productive career. But the research is there to help guide the decision-making process and to look into the future as a draft pick in any round is a significant investment. Farley will give an NFL team first-round talent at a potentially discounted rate early in the 2021 NFL Draft.

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