Washington offensive tackle Trey Adams is a boulder. He’s a large human who provides protection to the backfield and helps create plays. Adams at times is an immovable object, much to the chagrin of the defensive tackles and ends he terrorizes. He is also like a rock in regards to their ability to float. Simple physics tells you that rocks sink, just like Adams’ draft stock over the past couple of years. Due to a combination of injuries, inconsistent play, and sub-par Combine testing, Adams may be fighting to swim away from the idea that he won’t be able to play at the next level. Talent aside, below are Adams’ medicals from his time in Washington and how this may impact his position in the 2020 NFL Draft.

Freshman Year 

• Adams played in 10 of 13 games during the regular season, accruing several starts along the way as he progressed through the season. He began to play well toward the end until he missed the Apple Cup and the following bowl game with an injury. It was reported that he missed the last two games of the season due to a stinger in his neck/shoulder area.
• A stinger occurs when the head or shoulder suffers a blow to the area, suddenly stretching or compressing the nerves coming off of the spinal cord. These injuries occur often in football, and symptoms can last seconds to days, depending on severity. This injury is the result of when an arm is pulled down one way and the head is pushed the other. This can also occur with a direct blow to the shoulder or if the head is hyper-extended and side-bent towards the same side of trauma, causing compression. 

• These occur during routine plays, including tackling and blocking. As a result of the trauma, the pain goes down the arm, causing numbness, weakness, and pain that can last for several moments. They can last longer in severe cases, and recurrence of stingers could signify neurological damage later on. 

Sophomore Year 

• Adams played in all 14 games without any known injuries while garnering first-team All Pac-12 and second-team All-American accolades. This appears to be the time that Adams began showing up on draft pundits’ radars as a potential first-round pick in the next year’s draft. 

Junior Year

• Adams continued his stellar play without injury until a right ACL tear derailed his season, forcing him out of the last six contests. To quickly review the purpose of the ACL, the mechanism of injury, and return to play research:
• 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. 

Redshirt Junior Year

• Due to the season-ending ACL injury, Adams was granted another year of eligibility but missed most of that season due to a back injury, which forced him to miss 10 games. It was revealed in an article in The Athletic that he was dealing with back pain during all of training camp. Unfortunately, it became severe enough that he required surgery that forced him to miss 10 games. 
• In later articles, it was revealed that he was dealing with two bulging discs. There do not appear to be any specifics in regards to how he suffered the injury originally, but according to Adams, it became debilitating. To understand why a bulging disc could cause so much pain, the anatomy must be reviewed. 

• 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. 
• 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. 
• Physical therapy, epidural injections, and temporary cessation of the offending activities are typically recommended as first lines of treatment, but in severe or non-responsive cases, surgery may be required. In the case of Adams, it was not reported, but he likely had a discectomy. This 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. 

• Recovery timelines for a discectomy are typically 8-12 weeks, though some activities may take longer to return to full. The spine must be slowly loaded and motion limited in order to maximize healing in the area and prevent any further disc bulging or herniation. Even after the surgery and proper rehab, there is still a possibility that the disc could suffer recurrent disc herniations, which could cause further back pain and limitations.
• Adams was eventually able to return after 10 games and play in the remaining four. It was noted that he was in a lot of discomfort even after the appropriate time off. Fortunately, despite playing in four games, he was able to preserve his final year of NCAA eligibility due to recent rule changes that allowed a player to play in up to four games without using an entire year.

Redshirt Senior Year

• After playing in only 11 games over two years, Adams decided to return to school for his senior year. He was able to appear in all regular-season games but skipped the bowl game for precautionary reasons to preserve his draft stock. He appeared to return to form, receiving All-Pac 12 honors and fourth-team All-American status. 
• It appeared that Adams finally got away from the injury-plagued seasons of 2017 and 2018, but injury struck once again during the Senior Bowl. Suffering a hamstring strain, he was unable to participate in the game that Saturday, further hurting his ability to show how healthy he could be going into the 2020 NFL Draft.
• In fact, Adams’ Combine didn’t go very well, either. He didn’t get injured, but he didn’t post numbers that inspire teams to rethink their evaluations of him. Below are his results from the few drills he did perform at the NFL Scouting Combine, all dead last for the offensive tackle position. 
  • 40-Yard Dash: 5.6 seconds
  • Vertical Jump: 24.5 inches
  • Broad Jump: 92.0 inches

NFL Draft Impact

Trey Adams didn’t do himself any favors with several injury-filled years followed by a poor Combine. Looking at all the injuries, including a neck stinger, right ACL tear, two bulging discs with resulting discectomies, and a hamstring strain, there’s a real reason for concern.

It’s been more than two years since the right ACL tear. It’s possible that he could suffer another ACL tear, but his risk is certainly lower. The stinger is a slight concern, but as there weren’t any reported repeat issues in the following seasons, it leads me to believe this was an isolated event. Considering the position, he’s always at risk for more, but this shouldn’t be considered a chronic issue.

The hamstring injury is always a concern, but nearly every athlete has dealt with a hamstring strain at some point or another. I believe the injury was just poor timing. Considering he ran at the Combine, though not very well, it makes me believe the hamstring was fully healed.

The big red flag is the back injury. He did have the surgery to correct the issue and was able to play through a full season afterward, but there is a chance that he could have a further injury to the area due to the nature of his position. 

Literature indicates that the outcomes for lumbar discectomies are generally excellent, with rates as high as 95-percent in the general population. Other articles indicate that the failure rates can range anywhere from 5-18-percent, which can cause recurrent lumbar disc herniations within the first year. It is not known which levels that Adams suffered bulging discs at. However, my guess is at L4-L5 and L5-S1. These levels typically have the highest rate of injury and can cause radiculopathy down the leg, causing pain and weakness. 

Those that require a discectomy are able to return 78-percent of the time to an NFL field, compared to 59-percent of those that don’t have the surgery. Further research does show that NFL linemen that do require discectomies are able to return back to play without any change in their career length or ability to play. Similar to other sources, 80-percent are able to return and play more games. It’s possible that Adams may have his back injuries behind him, and he’ll never have another issue. He could also continue to have issues as he plays against higher levels of competition.

While there are not exact comparisons for Adams coming out of college in regards to his injury history, there have been a number of athletes that have been able to return to play following this surgery. They include but are not limited to TE Rob Gronkowski, DE JJ Watt, C John Sullivan, RB Arian Foster, QB Tony Romo, and DE Jason Pierre-Paul. However, all of these players were either drafted high or developed into key players, allowing the team to invest the surgery and rehab into their full returns.

The research supports that those that come into the league with a pre-existing back injury were less likely to be drafted and have shorter careers when compared to a control group. Interestingly, when compared to a control group, it indicated that there was no difference in performance. It must also be highlighted that those drafted later have a lesser chance to make a team. In turn, the team is less likely to place resources into keeping that player around compared to a high draft pick.

Speaking with Cover 1’s Christian Page, he sees the ceiling for Adams at a late-Day 2 pick. Zack Hicks believes that his talent could keep him on Day 2. Greg Tompsett doesn’t believe that Adams is anything better than a Day 3 pick. Considering the injury history is such a concern, I would lock him in on Day 3. The only way he goes higher is if the medicals check out and some team just absolutely loves him. I believe Adams has the talent to play in the NFL, but he could be a developmental or even practice squad player until he can get into an NFL program that allows him to truly focus on his body. This would allow him to see if his body can hold up to the daily grind of professional football, and he won’t have the added burden of going to class. 

Adams will be drafted. The talent is there enough that someone is willing to give him a shot. But don’t expect him to come in and be a difference-maker any time soon. Having worked with enough patients who have had back injuries as a physical therapist, I am reserved in understanding that there may be limitations in Adams’ ability to play effectively at the highest level for a long time.

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