Expect Gronkowski to be ready to play when team activities start, and anticipate a full return to his prior level of performance in the short-term. However, given his injury history - particularly related to his concussions, knee, and spine - we have very high level of concern regarding his durability.
2009: herniated disc (L5-S1) w/nerve impingement, treated with surgery
2012: high ankle sprain, treated with surgery
2012 (Nov): broken forearm, complicated by infection; (6 games missed)
2013 (Jan): re-fractured forearm
2013 (May): herniated disc (L4-5) w/nerve impingement, treated with surgery; (6 games missed)
2013 (Dec): tore right ACL/MCL (knee), treated with surgery Jan 2014; also had “minor” concussion (9 games missed)
2015 (Nov): right knee bone bruise (1 game missed)
2016 (Aug): hamstring strain (2 games missed)
2016 (Nov): chest/lung contusion (1 game missed)
2016 (Nov): herniated disc w/nerve impingement (reportedly different disc), treated with surgery; (8 games missed)
2017 (Oct): thigh contusion (1 game missed)
2018 (Jan): concussion (1 game missed)
2018 (Oct): back strain, then returned and re-aggravated back (3 games missed)
Regular Season Games Played:
Return to Play:
Gronkowski reportedly passed his physical and will be expected to be ready to play at the start of team activities.
With a full year to have healed from the back strains he sustained and re-aggravated in October of 2018, we anticipate a full return to his prior performance level. Of Gronkowski’s prior injuries, only his 2013 knee injury (in which he tore his ACL and MCL) is directly associated with sustained decrease in performance in the medical literature, but this is expected to be have been stable for multiple years now. Therefore, we do not anticipate a further decline.
Gronkowski’s extensive injury history is worth breaking down one-by-one. His forearm fracture, though complicated by infection and re-fracture that required multiple surgeries at the time, is unlikely to cause further issues now. Regarding his concussion history, having one concussion makes him more likely to sustain another, and each is known to contribute to cumulative damage to the brain. Gronkowski has now had at least 2 minor concussions. The effect of his 2013 knee injury - which we know involved a torn ACL and MCL - depends on what other structures (cartilage and meniscus, which both help protect the joint) were injured at the time. While these details were not released, the involvement of multiple ligaments increases the likelihood that these additional structures also were injured. If this is the case, his career length and games played are both expected to be decreased compared to his uninjured peers, especially over the long-term. Finally, and perhaps most importantly, Gronkowski’s history of 3 disc herniations - when the cushion in between the bones of the spine moves out of place, exerts pressure on the adjacent nerve, and causes (potentially very severe) back and leg pain - raises significant red flags. Each time that he has had surgery, treatment involved removal of some portion of the affected disc. Reports indicate that his 2009 surgery was done on a different disc (the one in between lower back vertebrae L5 and S1) than his 2013 one (disc in between vertebrae L4 and L5). Although descriptions of his symptoms leading to his 2016 surgery suggest that one of these two discs was most likely involved, but his agent stated that it was done for a different disc. Because it is rare, we don’t have much data on NFL players who have undergone this surgery 3 times, but the cumulative effect of removing pieces of the discs 3 times is to increase the stress placed on the remaining ones, thereby increasing his risk of further injury to the lower spine area. If Gronkowski sustains another disc injury, he may need a surgery to fuse the bones in the lower spine, and likely would have to end his career. Taken altogether, this injury history leads to a very high level of durability concern for Gronkowski.
Image Source: Jeffrey Beall, CC BY 4.0