INDIANAPOLIS — There is finally some clarity on the condition of Todd Gurley’s left knee, and the news over the weekend painted a gloomy picture for the Rams’ star running back.
On Friday, John Breech of CBS Sports reported that the Rams might consider stem cell treatment for Gurley’s knee, which was surgically repaired in 2014 after an ACL tear during his junior year at Georgia. On Saturday, Jeff Howe of The Athletic reported that recent tests have revealed Gurley is dealing with arthritis in the knee.
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Both revelations cast doubt on the future of Gurley, who signed a four-year contract extension worth $60 million last summer that takes him through the 2023 season and guarantees him $45 million.
With head coach Sean McVay talking about putting a plan in place to manage Gurley’s workload and general manager Les Snead pondering the potential need to add another running back alongside him, a dreaded question the Rams and their fans never wanted to contemplate is now absolutely valid.
Are Gurley’s best years behind him?
Since arthritis is a common occurrence in knees that have been surgically repaired, it is possible Gurley could be suffering from the condition. An orthopedic surgeon, speaking anonymously to The Athletic, said: “When you use the words arthritis in a knee that had an ACL back in college, that’s the connection. You’ve lost the alignment, and the tires are wearing out prematurely.”
If that is indeed the case, it creates an ominous situation for Gurley based on multiple doctors consulted, including Dr. Jesse Morse of Florida Orthopedic Specialists.
“Without personally examining him, my answers will obviously be very generalized, but unfortunately I believe Gurley has peaked and will not be able to repeat his record-breaking effectiveness,” Dr. Morse said. “He could possibly have one to two more years of elite top-five running back talent, but he will likely lose a step.”
Publicly and privately, the Rams are not indicating anything more beyond the recent comments by McVay and Snead that Gurley was dealing with “wear and tear” issues late in the season.
McVay said this week at the NFL Scouting Combine that surgery is not planned for Gurley. According to the doctors consulted by The Athletic, Gurley clearly has a condition that requires management rather than an injury that needs surgery.
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As far as stem cell treatment — which some doctors insist is a radical and not-yet-proven treatment that should be approached cautiously — Rams sources said no such course of action has been discussed within the organization.
McVay and Snead have talked about putting a plan in place that will help keep Gurley fresh and effective over the course of a full season. Presumably, that means managing Gurley’s usage and touches during practice and games and investing in a capable backup running back that can capably share the workload.
If arthritis has truly started to set in, Gurley and the Rams must proceed diligently and carefully in order to maintain an effective level of play for as long as possible. That likely means the days of Gurley running the ball more than 250 times (as he did the last three years) and being targeted in the pass game more than 80 times (as he was in 2017 and 2018) might be over.
“With the amount of talent and resources that NFL teams have, they should be able to prevent a rapid decline for a Gurley-type talent, especially with as much money as they have invested in him,” Dr. Morse said. “They will likely decrease his workload and strive for something like 150 to 200 rushing attempts, or possibly increase his route-running abilities. Optimizing Gurley will require finding a happy balance between running and receiving, but I do not think he will be able to repeat the volume he has been able to (achieve) over the past couple of years.”
As far as actual treatment, there are non-surgical options that can potentially stall or decrease the advancement of arthritis. But short of knee replacement, there is no actual cure.
“Can he reverse his arthritis? No,” Dr. Morse said. “Can he use different treatment modalities to prevent the progression of osteoarthritis? Yes. Such things as glucosamine/chondroitin, physical therapy, appropriate weight loss and PRP/stem cell injections have all been proven to be effective in this nature.”
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Unfortunately for Gurley and the Rams, there are no guarantees any of this is achievable over a 16-game NFL regular season. And without the ability to cure or reverse knee arthritis, the prognosis is murky.
Keep in mind, Gurley led the NFL in rushing and touchdowns for most of the 2018 season. And he looked like his usual self against the Dallas Cowboys in the Rams’ divisional playoff win. But, despite his insistence he was perfectly fine against the New Orleans Saints in the NFC Championship Game and against the New England Patriots in Super Bowl LIII, Gurley’s subpar performances and low usage said otherwise.
We might not know the real story until next season, when questions can be answered. How much will Gurley play? In what manner will he be used?
And for how long can Todd Gurley be Todd Gurley?
Top photo of Todd Gurley: Patrick Semansky / AP Photo