When will Giants see the old Saquon Barkley? NFL 2021 injury analysis

By Dr Rajpal Brar

Published: 17:30, 19 September 2021 | Updated: 21:15, 23 September 2021

Just 20 touches into New York Giants running back Saquon Barkley’s second season, he twisted his right knee vs the Chicago Bears at Soldier field and was carted off the field.

Hands-on examination and follow-up MRI imaging revealed a ruptured anterior cruciate ligament (ACL) and partially torn meniscus (these often go hand in hand).

The days following the injury were as Barkley himself calls the “weakest moment of my life” but then he got himself mentally ready for the road to recovery and underwent reconstructive ACL surgery.

All off-season the Giants have been intentional about not putting pressure on their young star rookie running back, not providing any firm timelines for his return and being reticent on how involved he would be in the offense to start the season.

Barkley didn’t play in any pre-season games but did participate in all warm-ups with Giants head coach Joe Judging stating the staff was more so focused on assessing how he was doing with his reaction speed and explosiveness rather than in-game situations.

His first in-game situation came during week 1 when he played but only had 13 touches total in the game. Considering there was a chance he wouldn’t even play and hadn’t faced any contact for most of the pre-season, that was actually a good, gradual step up for him.

In Week 2, that took a slight increase to 16 touches and Saquon had his best play of the season with an explosive 41 yard run – although he only had 16 yards on his other 12 runs, a paltry 1.33 yards per carry. Some of that could be blamed on the lower leg injury to offensive lineman Nick Gates.

The question for Giants fans – and fantasy owners – becomes when might Barkley be back to the explosive, confident Saquon we saw prior to his high ankle sprain (syndesmotic tear) during his rookie season?

ACL research on return to play

The research has some good news and bad news when it comes to elite athletes returning from ACL reconstruction. Let’s start with the bad news.

It can take up to 18-24 months for a player to fully recover all symmetry side to side following an ACL rupture and the research increasingly shows that the last step is overcoming the nebulous “confidence in movement”, meaning is the player over their fear of reinjury and fully confident in their body.

That being said, although the research overall does show some decline in running backs coming off ACL surgery, there are multiple high level running backs who have torn their ACL and come back as good if not better the following year including Adrian Peterson, Jamal Charles, Frank Gore, Willis McGahee, Jamal Lewis, Todd Gurley in the first four years following his ACL tear at Georgia, and Nick Chubb.

Further, a key positive is that nine months looks to be the key inflection point for athletes younger than 25 years old to reduce reinjury risk when returning after an ACL injury. Recent research shows there’s nearly a 7x increase in reinjury when returning prior to nine months.

Moving forward

The key for Barkley is reintegrating gradually and the process the Giants have shown has been superb in my opinion, not sacrificing the long-term for the short-term (which is very un-NFL like)

That graded exposure is even more important considering Barkley missed significant time his rookie season with the high ankle sprain and then essentially all of last season with the ACL injury. This naturally leads to fitness deficits – even though Barkley is in extremely good shape overall which does bode well for recovery – because in-game fitness cannot be replicated off the field and a loss of rhythm and feel for the game.

If everything goes smoothly, I’d look at week 5 as a target for him to become the primary lead back again.

Closing thoughts

Overally, the operative word here is patience.

The limited touches may look concerning in a vacuum but when you consider the full context, the Giants are handling him responsibly by allowing him to reacclimate gradually. When he suffered that high ankle sprain two seasons ago and came back quickly, he struggled for the remainder of the season.

It looks like the Giants have learned a vital lesson and are now setting him up for success in the middle and latter stages of this season as well as long-term with his career.

Dr. Rajpal Brar, DPT, (@3cbperformance) is a physiotherapist, movement expert, fitness trainer, sports scientist and mindfulness coach. He runs the LA and online based wellness and athletic performance clinic 3CB Performance, and you can subscribe to his Youtube channel (which posts a variety of sports injury, performance, & skills content).