Where to Draft Rob Gronkowski?

Ben Volin's recent piece for the Boston Globe shed a little light on the recovery of Patriots TE Rob Gronkowski from his first back surgery in college, thanks to his recently released book, "Growing Up Gronk" with author Jeff Schober:

After being holed up for a month and a half, Rob finally was able to do back and core exercises, which “helped minimize the setbacks and flare-ups,” Schober wrote.

One troubling aspect — Gronkowski was not fully healed to participate at the NFL Combine, which occurred at the end of February, five months after his first back surgery. Finally, on March 27, Gronk and his brother, Chris, held their own Pro Day on Arizona’s campus.

So Gronkowski was unable to participate in the NFL Combine in mid-February, which was five months after his surgery. While it's not uncommon for players to skip the Combine when they are nursing an injury, it would have been a statement had he been able to alleviate all concerns about the back by participating in February. Instead, he held his own Pro Day six months into his recovery.

Most timetables for his current recovery hover in the 3-4 month range, but that seems awfully optimistic considering how long it took him to recover from his previous back operation.

We asked our injury expert, Russell Manalastas (@russmanalastas), about how Gronkowski's recovery from his previous injury might shed some light on his current recovery timeline. Russ is a licensed Physical Therapist and Clinical Director at Professional SportsCare & Rehab in Baltimore, Maryland. He has a Doctorate in Physical Therapy from the University at Buffalo as well as his Bachelors Degree in Exercise Science. Here's what he had to say:

"With Gronk undergoing his second back surgery at a different spinal level this past June, are we being over zealous in putting his timetable at 3-4 months? A microdiscetomy is a relatively simple procedure where they just shave or cut out the portion of the disc that is causing the irritation in the spinal canal. Most patients after surgery will be in a brace ranging from 4-6 weeks to protect the spine from moving excessively in one direction and to allow the disc to heal. Unfortunately, there was no information given about if he was dealing with any pain or tingling/numbness in his legs prior to the surgery which could complicate recovery time as the nerve usually takes much longer for it to heal compared to the actual disc.

"Gronk has shown to be a slow healer in the past and is now dealing with recovery from the new back surgery in addition to the four surgeries he had from his original forearm fracture this past season.

"Every spinal surgery is different regardless if the person undergoes the same procedure they had before. I think it's looking more and more unlikely that he will return even when he's eligible to come off the reserve PUP list and it'll be a wait and see game. He is young, so he does have that to his advantage but he's still got a long way to go to be able to produce at a high level. The Patriots are very frugal with the amount of information they give out about injured players, so that'll only complicate decision-making come draft day."

Russ is being kind saying that the Patriots are "frugal" when it comes to dispensing injury information. They are the least forthcoming team in the league, which just makes it that much more difficult to get a confident read on Gronk's return. Throw in the fact that Gronk has also had multiple surgeries on his forearm and has been generally injury-prone in his career and there are a number of ways that his recovery could go sideways.

Russ also passed along this article (also written by Volin) which provides a player's perspective of the amount of recovery required for this type of surgery. Anyone considering drafting Gronkowski in the early rounds should give it a read before pulling the trigger.

Scott Peak (@scott_peak on Twitter), a neuro-oncologist and contributor to Dynasty League Football, also published a series of tweets outlining his "best guess" of Gronk's return:

"Did research on microdiscectomies for lumbar disk herniations: Return to play: 4-6 months for contact sports... 6-8 weeks for percutaneous discectomies and microdiscectomies w/non-contact sports like golf. Outcomes excellent 90%, single or multi-level [Lumbar Disc Herniation]. Most athletes return to pre-injury level performance. 3 months possible given excellent surgeon/rehab for Gronk. Best guess: If 4 months [return to practice] early October... If 3 mo, then early Sept [return to practice]. So he could miss 1-6 games most likely, if recovers as expected... Incidentally, recurrence rate of lumbar disk herniation is about 8%. Data is on recurrence after one surgery. More than one LDH is a tougher call but probably a higher risk."

Peak is a bit more optimistic regarding Gronk's recovery, saying that three months is possible given the quality of care he's receiving.

So where should Gronkowski be drafted?

This is not an easy question to answer given the information we have and the wide range of potential outcomes. I tend to be conservative in the early rounds of fantasy drafts, hopefully gaining my edge in the middle and late rounds by picking the right value plays and quality sleepers. That said, at some point in the draft, Gronk will become a quality risk/reward play.

Given his otherwise slow recovery to the first surgery, it seems like a foregone conclusion (to me) that Gronkowski ends up on the Physically Unable to Perform (PUP) list, and will miss at least the first six games of the season. A four-month recovery would put him back Week 7. A five-month recovery would put his return in Week 12, and a six-month recovery means a return in Week 16. Perhaps Gronk's quality medical care will be able to shave a month off his previous six-month recovery, but four months (the Week 7 theory) seems quite optimistic.

The Patriots have a Week 10 bye, so they may decide to keep him out until Week 11 and give him an extra two weeks (almost five months) to recover. In that case, he would play in six fantasy-relevant games from Week 11 to Week 16. We currently have him projected to play in eight games (as TE5), and that includes Week 17, so it assumes a return in Week 9.

Given the wide spectrum of possibilities, I'd feel comfortable taking Gronkowski in the 5th round, once the WR talent starts to even out and the 5th round players look pretty similar to those wideouts available in the 8th round. For example, I'd probably prefer Gronkowski and Anquan Boldin to Torrey Smith and Greg Olsen or Kyle Rudolph. If I do take Gronk, I'll be looking to target an "upside" TE like Jordan Cameron, Fred Davis and/or Rob Housler in the later rounds to provide decent TE production in the first half of the season.

8/19 Update: Patriots TE Zach Sudfeld has emerged as a viable handcuff option for Gronkowski owners.

The problem with this strategy is that Gronk will probably be gone by the end of the 4th round, but I think I'm okay with letting someone else assume the risk this year. I'd rather take Jimmy Graham in the 2nd round or perhaps someone like Vernon Davis (who has Gronk-like upside when he gets the requisite targets) in the 5th round. Keep in mind that fantasy owners who draft Gronk will have little to no margin of error elsewhere on the roster. If they start the season 1-5, it won't matter that they have Gronk returning in Week 7 because they would basically have to run the table to make the postseason.

So, barring new information, that's my recommendation at this point -- wait until the 5th (of 12-team leagues) and if Vernon Davis is gone (or perhaps Jason Witten and Tony Gonzalez in PPR formats), then consider the Gronk.