Baltimore Ravens

Will Ravens' Joe Flacco bounce back from his knee injury? Two things point in his favor

An important hurdle seemed to be cleared last month.

In the Ravens' third preseason game, against the Detroit Lions at M&T Bank Stadium, Joe Flacco returned 279 days after tearing two ligaments in his left knee.


Not only did the 31-year-old quarterback look fairly sharp throwing the ball, but Flacco also fell to avoid getting sacked, felt pressure around his feet while throwing and moved out of the pocket a couple of times, seemingly as unfazed as he was before last season's Week 11 injury.

Now Flacco's comeback officially begins.


When the Ravens open the regular season today against the Buffalo Bills, Flacco will be starting the process of trying to add his name to a rather impressive list of current NFL quarterbacks who have successfully come back from major knee surgery.

As is his nature, Flacco was low-key during training camp about his comeback. While he said early on that there were times he forgot about the fact that he was wearing a large brace to protect the knee, he conceded recently that the knee didn't feel "100 percent."

Still, Flacco seems to be well aware of those who have made successful comebacks the season after major knee surgery, including an elite class of quarterbacks led by Philip Rivers, Tom Brady and Carson Palmer, who did it twice over a nine-year span in Cincinnati and Arizona.

"I mostly go off how I feel, but I've thought about" others who have made comebacks, Flacco said. "Plenty of guys have dealt with this. It's not a new thing. I think the biggest thing with that is it taught me not to be scared by the whole process.

"As long as I do the work, I'm going to be able to get back out there and do what I've always been able to do. It was a big confidence thing going through the rehab and that whole process. Guys have done it. I'm not the first guy to do it, obviously."

According to a former NFL quarterback who did it himself more than a decade ago, there is a lot tending to prove that Flacco can play at a high level after suffering what was considered — and in some cases still is thought to be — a significant, career-threatening injury.

It starts with which knee is injured and the playing style of the quarterback who is injured.

"When I was going through it, I was looking at how my situation compared to someone else and what can I do, and I kind noticed that the guys that it was their lead leg, they had a greater rate of return and also a mobile guy versus a pocket guy," said Trent Green, now an analyst for CBS.


Green said the quarterbacks who have made it back faster, and for the most part played better, were those whose lead leg was injured as well as those who did not rely on their legs as much as their arms. That would bode well for Flacco on both accounts.

Two quarterbacks who struggled after injuring their plant leg both also relied on their ability to run.

After breaking the NFL record for total yardage by a quarterback in 2004 while with the Minnesota Vikings, Daunte Culpepper started poorly in 2005, with no touchdowns and eight interceptions in the first two games, then tore three ligaments in his right knee seven games into the season. Culpepper finished his career as a journeyman backup.

"He was never the same guy [as before the surgery] because it was his plant leg," Green said.

The same could be true for Robert Griffin III, now trying to revive his career with the Cleveland Browns.

Despite many other problems being raised during Griffin's tumultuous four seasons in Washington, Griffin's troubles seemed to start when he was first injured late in the 2012 season after his right knee was twisted by former Ravens defensive tackle Haloti Ngata.


A few weeks later, in a playoff loss to the Seattle Seahawks, Griffin tore two ligaments in the knee. He returned by the opening game of the 2013 season, but never played as well and suffered a dislocated ankle in 2014 that further complicated his comeback.

"You're really not generating very much power at all from your lead leg, it's your plant leg," Green said. "Not only is he a runner, but it's his plant leg. You've got to be able to drive, plant that foot, and that's really where everything comes from."

Rivers represents a success story after suffering an ACL injury in his plant leg, but he's also a pocket passer who relies more on accuracy than athleticism.

Rivers actually played in an AFC championship game against the New England Patriots at the end of the 2007 season with no ACL. In the week before the game, he had arthroscopic surgery to remove the ACL and knew he wouldn't have been able to play if he had had it repaired.

A few weeks after the game, Rivers had major reconstructive surgery to properly repair the knee and was back on the field six months later.

Rivers didn't miss a game in 2008, setting then-career highs for passing yards, completion percentage and touchdown passes. His 34 touchdown throws led the NFL, and he had the highest passer rating of any quarterback in the league.


"It's a tough road," Rivers said recently. "I was told by my doctor that it was an 18-month recovery, from surgery to where you can actually say, 'I don't know which knee I hurt.' I felt ready to go by training camp, but you had those days when it's sore.

"You had some sore days throughout that [2008] season, but I never felt I wasn't strong, like it was hindering me in any way. But probably not until that next year did it feel great, feel fully that I had no symptoms whatsoever."

Dr. Luga Podesta, director of sports medicine at St. Charles Hospital in Port Jefferson, N.Y., and a former team doctor for both the Los Angeles Dodgers and Angels, said most athletes coming back from major knee surgery are ready "functionally" after six months.

"Psychologically it takes a little longer," Podesta said. "An ACL injury is a huge injury for an athlete. The rehabilitation is very intense and demanding at times. It's difficult to get through it. A lot of these guys have never been hurt before, always in the back of their minds, it's 'Can I come back from this?' It's really trying to prove that they can come back and play."

Green, who was injured in a preseason game in 1999 after signing a big free-agent contract with the then-St. Louis Rams, said the mental part was his biggest hurdle and knows that Flacco, whether or not he admits to it, will go through that himself.

"You're thinking, 'I want to show that I'm as good a player than I was before the injury,'" said Green, who wound up having more problems with concussions in his career than any aftereffect of the knee surgery. "That's just human nature, I think."


Flacco acknowledges that even during the rehab process, "you clear some mental hurdles here and there. If you show up and just do your work, it is not the biggest deal in the world. I feel like that is what I was able to do and keep a good mind about the whole thing."

Having seen teammates endure rehabilitation processes over his first eight years in the NFL, Flacco said he "heard some horror stories." Once, he had gone though it, Flacco said, "It was probably better than I expected it to be."

In Flacco's mind, there are still moments to overcome — including getting hit where the knee takes the brunt of the contact.

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While much was made after he went down trying to avoid being sacked by Ngata, a former teammate, in the preseasson game against the Lions — with many inside M&T Bank Stadium holding their breath until he got up — Flacco said that the sack didn't amount to much.

"I was moving around, and I just dove into a hole because the play was over at that point," he said after the game. "So I really didn't get touched today, the way I view it. I went back there, and it was a pretty clean 20-some plays."

As much as Flacco and the Ravens hope to keep it that way, a big hit is bound to happen. While rookie left tackle Ronnie Stanley has been impressive in protecting Flacco's blind side during training camp, NFL quarterbacks rarely go through a game, let alone a season, without being hit.


The short memory that has enabled Flacco to overcome poor games and less-than-successful seasons, including one last year even before he was injured, should help again as he deals with trying to facilitate the recovery the Ravens plan to make in 2016.

"I feel great," Flacco said. "I don't think it's going to affect me at all with my play. I just have to — knock on wood — stay healthy for the rest of it."