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Matthew Betz
FaniumMD: Time to buy low on Guice?

Injury expect Matthew Betz thinks expectations should be tempered for Guice’s 2019 stats.

Mar 14th

Editors Note: Adrian Peterson signed a new 2 year contract with the Redskins after this post was written and video was filmed. Peterson’s return should cut into potential Guice’s workload.


On August 9, 2018, the Washington Redskins faced off against the New England Patriots in each team’s first preseason game, and dynasty owners everywhere couldn’t wait to see their newest addition to their team, Derrius Guice, in an NFL uniform. Largely the consensus 1.02 in rookie drafts, owners were counting on Guice to be an immediate every-week starter in their fantasy lineups, but things changed quickly on that August night. Guice started the game off strong, showing his skill set that made him the 59th overall selection in the NFL Draft just a few months prior. However, on his sixth carry of the night, Guice’s 2018 season was over before it even began, tearing the ACL in his left knee. Now six months removed from ACL reconstruction surgery, what can we expect from Guice in 2019? Will he be back to full strength despite getting an infection in his surgically reconstructed knee? And what will Guice be doing during the Redskins’ offseason program?

The Injury and Surgery

Initial reports indicated that the fear immediately after the injury was a medial collateral ligament (MCL) injury rather than an ACL injury, but that’s what MRIs are for. Imaging the next day confirmed that Guice suffered a torn ACL in his left knee. His season was over. He then underwent surgery to reconstruct the ligament on August 20 and has been rehabbing ever since. From the day of the injury to playing in the first NFL game after surgery, the average time it takes for a player to return from an ACL tear is about 55 weeks. As a result, if a player is going to tear their ACL, it is much better for it to happen sooner in the season rather than later, simply because it buys the athlete more time to be able to make it back for the start of the following season. Time is your friend when rehabbing an ACL, primarily because as time goes by, the interface between the new ACL graft and the bone becomes more mature, making the ligament “strong” once again. This phenomenon is known as “ligamentization.”

This concept is so important for Derrius Guice specifically because of the fact that his knee became infected after his surgery. Unfortunately, that’s always the risk with any surgery – infections do happen, just not that often. However, when they do, especially in professional sports, it’s big news. News broke in November that Guice had been dealing with infection and that he had undergone a series of procedures to address fluid accumulation in the knee from the infection. When I first heard the term, “procedure,” I was concerned because when a reconstructed ACL gets infected, it can cause the new ACL graft to fail, basically making the initial surgery unsuccessful. The graft is never able to undergo the ligamentization process I discussed earlier. If this had happened, there’s a chance Guice wouldn’t have been able to play at all in 2019 because the medical staff would have had to clear the infection first, then operate again with a new ACL graft months later. Fortunately this was not the case for Guice, and his procedures done were described as “flushes” in his own words. Basically, small needles are used to drain fluid from the knee joint. This in conjunction with the course of intravenous antibiotics, has allowed Guice to clear his infection and progress his rehab accordingly. “Once that was finished I was back to rehabbing. Everything kind of got back on schedule, but my timeline was off because I wasn’t working out for two months. I had to play catch-up so I had to work a lot harder and spend a lot more hours here, getting rehab in the weight room, catching up on my running and stuff. It was tough, when I already started over in August, and then I had to start over again in December.”

Guice’s Rehab and Timeline

A couple of weeks ago, Guice posted a video on his Twitter of him running in a straight line. Rightfully so, Redskins fans and fantasy owners alike were excited about this update, but Guice is far from 100%. Even if Guice’s knee hadn’t got infected, he would be nowhere close to 100%. Now about 6 months removed from surgery, Guice is pretty much right on track with where he should be in his rehab timeline. In a recent article on the Redskins’ website, Guice provided some insight on his rehab. “We’re not doing full speed lateral stuff yet, but we’re doing full speed straight ahead and we’re doing a lot of bounds and jumping and single leg stability, and a lot of glute, hamstrings, hips, just focusing on all the small things now trying to build everything back up slowly.”

Running in a straight line after an ACL surgery typically starts at about 4-6 months, so if anything, he’s on the later end of this timeline. This is likely due to the complications of the infection shortly after his surgery, but with that in the past, he will continue to progress nicely this offseason. Don’t be surprised to see Guice limited throughout all of OTAs and mini camp this summer, as he will most likely be limited to non-contact work and individual drills during these team practices. During training camp when he is about a year out from surgery, Guice will likely start sharp cutting and start participating in 7 on 7 drills, giving him a realistic shot to be ready for Week 1.

What to expect in 2019 and Beyond

If Guice is indeed ready for Week 1, the Redskins will be smart to limit his workload during the first month of the season in order to allow him to get acclimated into being the workhorse they drafted him to be. Coming back from four total surgeries makes Guice more likely to deal with intermittent knee soreness and swelling as he ramps up his activity and workload, so don’t be surprised to see the Redskins employ a committee type of backfield in September, especially if Adrian Peterson resigns with the team. As the calendar turns to October and November, Guice will start to look more like himself and the player he was at LSU when he rushed for 2,638 yards and 26 TDs in his final two years. If Guice does indeed start slowly in 2019, don’t be alarmed. Rather, go buy low on him in dynasty with confidence that he will return to form later in the year. It’s possible we won’t see Guice’s true potential until the 2020 season. Over the course of the next few seasons, owners will want to be mindful of Guice’s injury and the complication after surgery as it could have implications on his long-term joint health. Infection after an ACL surgery can cause cartilage damage, joint stiffness, and intermittent pain. I’m not saying this will happen for Guice, just warning owners that it’s a possibility.

Insight by
Matthew Betz