Can Christian McCaffrey stay healthy? That's the key question for Carolina

By Dr. Matt Provencher
FOX Sports Injury & Performance Analyst

When the Carolina Panthers take the field on Sunday against the visiting New York Jets, their star Christian McCaffrey will be with them for the first time in 308 days.

It will be a welcome sight for coach Matt Rhule to have his do-it-all offensive star back in action, as his absence obviously played a huge part in their disappointing 5-11 campaign in 2020.

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McCaffrey started his career as an iron man of sorts, playing in all 48 regular-season games through his first three seasons, starting 42 of them. In 2019, his last full season, McCaffrey gained 1,387 yards on the ground and added another 1,005 receiving yards on 116 catches.

The 2020 campaign was a different story, though, as the running back missed six games with a high ankle sprain, returned to action, but then suffered a shoulder injury (AC sprain) that put him back on the sideline. He hasn’t been tackled since ­– not in a game, not in the preseason, not even in practice this fall.

As we examine McCaffrey’s return, we’re going to focus on the ankle injury and take a look at what fans can expect to see.

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Hear why Reggie Bush thinks Christian McCaffrey is the most versatile running back in the NFL.

When it comes to high ankle sprains, running backs tend to have reduced production upon their return. The data shows that rushing yards per game typically drops to about 84% of pre-injury levels, with yards-per-attempt at about 77%.

If those numbers were to hold true for McCaffrey, his stats from his last full season (2019) would reduce to about 3.7 yards per carry and 72.8 yards per game. His productivity could also be reduced if the Panthers coaching staff looks for "load management" opportunities to keep him healthy.

There are outliers, of course, and those tend to apply to elite running backs like McCaffrey.

For example, Alvin Kamara suffered a high-ankle injury in 2019 and his production actually went up the following season. Kamara’s numbers:

2019: 14 games, 4.66 yards per attempt, 57 yards per game.
2020: 15 games, 4.98 yards per attempt, 62 yards per game.

Keep in mind, however, that Kamara's New Orleans Saints were playing well and Kamara may have pushed to get out on the field more often.

Perhaps of greater concern than the reduced production is that running backs returning from high ankle injuries tend to sustain new injuries – 75%, in fact, suffer a new injury in their first season back, with 78% of those being to a lower extremity.

New York Giants star Saquon Barkley is a prime example of this. Barkley came back quite well from a high ankle injury that caused him to miss three games early in the 2019 season. But then he tore his ACL in 2020. We outlined his prospects in returning from that injury earlier this summer.

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Dr. Matt Provencher takes a look at Saquon Barkley's ankle injury and what comes next.

When it comes to McCaffrey, the good news is that he has had a lot of time to rest – 308 days, as stated above – and the Panthers have treated him carefully heading into the season.

Ankle injuries are important to watch for running backs, as it is an explosive position that requires pivoting and yards after contact – even more so when you touch the ball as frequently as McCaffrey has done in the past.

As Panthers offensive coordinator Joe Brady recently said, McCaffrey is a guy who "you can throw it to two yards behind the line of scrimmage … and he can take it 80 yards (for a touchdown). He has shown that throughout his career."

But that’s when McCaffrey is 100 percent. If there is a reason to be concerned, it’s that McCaffrey has not been tested much during his layoff, and there is potential that some other ailment to a lower extremity – hamstring tweaks, etc. – could crop up. 

A nagging ankle injury can cause issues.

McCaffrey’s status as an elite player, however, likely improves the odds for a strong return.

The Panthers – and fans who love watching the NFL’s stars shine – certainly hope so.

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