Dr. Toby Kobach, M.D.: Owners Should Panic Over Luck’s Injury

As you’re sifting through pre-season NFL games and injury reports ahead of the 2019 fantasy football season, just know the GMRRFFA owners are doing the same. While training camps enter their third (or fourth) weeks, Riff Raff Football is following every tweet or video of potentially crippling injuries, and the impact they have on NFL teams and fantasy football rosters. By your Commish’s esteemed accounting, owners on GMRRFFA’s Boy Chat (code name for our league WhatsApp chat) have sent 398 messages per day about player injuries in particular, and how they impact our league draft next week.

We squeeze Twitter for every inkling of new details on those injuries, but everyone knows a guy who offers instant takes on how serious those injuries are, and GMRRFFA is no different.

Exhibit A: Toby Kobach’s near-instantaneous update on Cooper Kupp’s injury last fall:

Toby has become the closest thing to a medical expert in our league following a spat of injuries and illnesses that would make a Traumatophobe blush. Based on his own ankle injury, Toby PEGGED the AJG injury earlier this summer. And while Toby is no medical expert, he’s nothing short of a quasi-expert on thousands of medical maladies (to the point that GMRRFFA made a list below).

Given his vast knowledge of injury and illness (Toby literally attended your Commish’s bachelor party with whooping cough), GMRRFFA felt no one was better suited than to take a look at some of the lingering NFL injuries impacting the upcoming fantasy football season, starting with Colts quarterback Andrew Luck, who two weeks ago was a bonafide top-five quarterback but already dropped to 25 spots as of this week in FantasyPros rankings.

Let’s be clear: the WARNING SIGNS for Luck’s injury are available, but it takes a real (fake) expert to parse through the 140-character tweets and sound bites to really understand how the injury impacts Luck. Without further ado, let’s introduce our very own Toby Kobach, MD to offer his expert (ed: he’s not an expert) opinion:

Dr. Toby's Medical Opinion

Time is the great equalizer. Everyone loses eventually to time, including pro athletes, and time exacerbates acquired weakness more than anything else. When your body is weaker in certain areas it overcompensates for it in other areas. I just had a Brostrom procedure (Don’t click if images of surgery make you queasy) on my ankle (ed: “vagankle”), where they reattach two ligaments that get torn or detached by a low ankle sprain, and during the healing process pain flared up in my right knee, which I injured as a teenager skiing, and my right hip, which is attached to that previously injured knee (ed: who says he’s not a medical expert??). The main reason this happened is because more pressure was forced onto that previously but now weaker injured knee, and it is not keeping up with it.

How does this apply to Indianapolis quarterback Andrew Luck? Luck has a weaker throwing shoulder, but what many forget is he also has a weaker set of abdominal muscles. Luck’s history of injuries to his throwing shoulder, and the Colts deceptive handling of it, is well known, but few people remember he had his kidney lacerated back in November, 2015. Even fewer recall the more important part of that injury report, which indicated Luck had a “partial tear of an abdominal muscle.” Luck was only supposed to be out two to six weeks, but instead missed the rest of the regular season, and his shoulder problems spiraled out of control during the next season.

When quarterbacks throw the ball, they use their arm, shoulder, and then twist their body, using their core, to build as much velocity as possible, and push off with their throwing arm leg. Right now, Luck has two weaker parts in that equation, but because of the previous abdominal injury, he has a more difficult time with the rotation portion. The last part of the body that absorbs or adds to that rotation is the non-throwing arm foot, which in Luck’s case is his left foot.

As reported, Luck has an injury to either his calf, or his Achilles’ tendon, or “A small little bone,” or his “High Anklish,” or the “Little area below his calf,” all descriptions offered from either the Colts’ general manager or owner. The vagueness and different explanations are eerily reminiscent of how the Colts handled Luck’s 2015-17 shoulder injury, which on its own should give folks pause when they consider Luck as a fantasy option, but what might be worse than that, is the fact they are likely describing either a high ankle sprain or an injury to Luck’s Achilles tendon, both of which would be terrible for Luck as a quarterback.

I am going to make a guess that this is a high ankle sprain, which is where rotation of the leg tears the ligaments and membrane between the Tibia and Fibula bones. If it is an Achilles’ injury, then the reference to “a small little bone” might make sense if Luck has bone spurs irritating the Achilles, which could eventually result in an Achilles rupture or tear.

But I am willing to bet it’s actually a high ankle sprain for a few reasons. First, the Colts have described it as affecting his left leg, which is the last part of the body impacted by rotation when Luck is throwing a ball, and we went over his extensive injury history above which might put more rotational force on this part of his body. Second, reporters filmed Luck going through a pre-game drill on August 18th where the Colts’ medical staff seemingly had him test lateral stability and then end the drill with a rotation and plant and throw. This tells me they are more worried about stability and rotation in the left leg, and if that is the case it is less likely to be an Achilles issue.

The good news for Luck if it is a high ankle sprain, is a newer surgical procedure can speed up recovery times. The Tightrope procedure runs sutures or threads through the Tibia and Fibula bones, places an implant between the ligaments and membrane to provide extra padding, and then tightens it together. Alabama Quarterback Tua Tagovailoa was able to get back to practice within 10 days in 2018 after having the procedure.

Why Luck hasn’t had this procedure yet seems to be the next question, and that might lend credence to the idea this is actually an Achilles injury, but I am willing to bet strongly that the Colts have an incompetent medical staff (see Luck’s previous shoulder issues), so maybe they don’t even know about the Tightrope procedure? With this being the Colts, and considering their past history, it could also be something even worse, so my assessment is PANIC if you are a Luck owner or own T.Y. Hilton, which I do in Riff Raff Football. I am going to bed each night saying a silent prayer for Luck’s ankle, and praying the medical staff knows what a Tightrope is, because if it gets worse expect Luck’s and Hilton’s ADP to drop precipitously.

Ok, that was a lot more than anyone was expecting, but Toby Kobach, MD is right to panic, and not just about Luck. T.Y. Hilton’s ADP hasn’t dropped too much yet (currently #30 overall and 12th WR), but a word of warning for his value without Luck… In 2017, with Luck missing the season, Hilton caught just 57 passes for 966 yards, ranking 27th overall in a PPR league among all receivers. In 2018, Hilton took a huge leap with 76 catches for 1,270 yards (in just 14 games), finishing 14th overall.

It might not be a perfect fit, but also consider Eric Ebron’s stats with and without Luck. In his first four seasons (in Detroit), he averaged just 46.5 catches for 517 yards. In 2018 with Luck, he leapt to 66 catches for 750 yards.

It’s no surprise that with Andrew Luck, the Colts offense is sooooo much better than without, and given Dr. Toby’s quasi-expert (but more-than-likely-correct) advice, the Luck injury should cause an exodus from nabbing Indy’s skill position players with serious draft capital.

Thanks to Dr. Toby, just know you’ve been warned. If you’re leaning on Jacoby Brisset to fling passes to TY Hilton for a late-September victory, remember you could’ve avoided this fiasco...

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