Bottom line: Expect Tua to be ready to play at the start of NFL team activities. His performance is unlikely to be significantly impacted by his injury history, particularly in the short-term, and he can be seen moving at a high functional level in public video footage of his virtual Pro Day. He is at increased risk for long-term complications related to his hip injury, but his risk factor profile is relatively favorable. Therefore, our level of concern for his durability is low to moderate, particularly in the short-term. There is little public information about his wrist injuries (reportedly broke his wrist, had it fixed, and re-broke it at some point at Alabama), but we do know that he has recovered from these, as we have seen him play well since the injury. Recent reports of 1-3 failed physicals from NFL teams are difficult to interpret, as they may be related to the number of injuries that he has sustained or may simply be from NFL executives attempting to drive down his draft stock. Regardless, we know that his most recent in-person medical evaluation on April 2 was done by a prominent hip and sports specialist, and reportedly went very well. Overall, we believe that his health concerns are not likely to tremendously impact his playing career.
-Mar 2018 - broken left index finger, treated with surgery (throwing hand; no games missed)
-Oct 2018 - sprained right knee, treated non-operatively (no games missed)
-Dec 2018 - left high ankle sprain, treated with surgery (no games missed, returned in ~4 weeks)
-Oct 2019 - right high ankle sprain, treated with surgery (1 game missed)
-Nov 2019 - dislocated right hip with posterior acetabular wall fracture, treated with surgery (missed 3.5 games)
-Reportedly broke wrist, treated with surgery, and re-broke (time unknown, no games missed)
Return to play:
Expect Tua to be ready to play at the start of team activities. We can see him moving well in his April Pro Day footage, and his medical evaluation by Dr. Thomas Byrd (extremely well-respected hip and sports medicine specialist) was reportedly “overwhelmingly positive”. Due to the coronavirus pandemic, it is fairly safe to say that this was his most recent medical evaluation on behalf of NFL teams. The other prominent case of an NFL player with Tua’s injury - Dennis Pitta, former tight end for the Baltimore Ravens - resulted in return to the field after 5 months. Thus, all signs point towards Tua being ready to play when team activities begin.
We don’t have a tremendous amount of data to use for comparison or projection because Tua’s injury is rare in athletics. However, all signs so far point to full return to his pre-injury performance trajectory.
Tua has an extensive injury history, so let’s break down the impact of each. First, his index finger fracture in 2018 is not something that is expected to recur. He hit his hand on an offensive lineman while throwing and this injury is likely not a sign of things to come. His knee sprain that year didn’t force him to miss any games (he did aggravate the sprain on a non-contact scrambling play and sat out the end of a blowout victory), and knee sprains treated without surgery generally heal on their own. Therefore, we don’t expect much impact from this either. Both of his high ankle sprains were treated with surgery, and while we don’t have much data on NFL players with this injury, we do know that missing a relatively short amount of time (Tua returned in 4 weeks and missed no games in 2018, and missed only 1 game in 2019) is associated with a lower severity sprain and less damage to the cartilage that protects the ankle joint. Furthermore, we saw him moving well in games since the injuries and they have had plenty of time to heal by now. There is no evidence to indicate that they will significantly impact his durability long-term. Regarding the hip injury, there is an associated risk of necrosis, which is a highly impactful consequence of injury to the blood supply during dislocation that causes the bone in the hip to die. However, Tua’s risk is low because Dr. Lyle Cain (Alabama team physician) recognized and reduced the joint (put it back in place) very promptly after it was dislocated. He does have increased long-term risk of developing hip arthritis, but his operating surgeon Dr. Chip Routt (renowned hip fracture surgeon) has publicly stated his satisfaction with the appearance of the joint after repair, which also bodes well for Tua. Furthermore, his short-medium term outlook is not highly likely to be impacted. Finally, we don’t know the details regarding the specific structures involved in his prior wrist injuries, but we do know that he has returned from these and played at a high level, so we can infer that they have healed fully by now. If they are wrist fractures, as the reports imply, this is not necessarily an injury expected to recur. Therefore, we consider Tua’s overall durability risk level as low to moderate.
Image Source: The University of Alabama, CC BY 3.0