Trey Lance Vs Brock Purdy | The Dilemma
The 49ers had a season that ran on determination. Injury after injury took its toll, but the next-man-up mentality carried the team to the NFC Championship. With major injuries on both sides of the ball, none hit harder than those at the Quarterback position.
Trey Lance, Jimmy Garoppolo, and Brock Purdy all suffered season-ending injuries. With Jimmy G headed out to the desert, it’s Trey Lance Vs Brock Purdy – two young QBs who are on different recovery timelines for 2023.
Trey Lance’s Injury
Trey Lance was the first Niners QB injured on September 18th (week 2) and had surgery the next day. According to the 49er’s official announcement, Trey had a fractured right Fibula (the bone on the outside of the lower leg), and a torn deltoid ligament. He did not have a fractured tibia (the big shin bone).
To highlight the difference let’s explore the anatomy. There are two bones in the lower leg. The tibia is the larger bone on the inside which is responsible for about 85% of weight bearing. The fibula is the smaller bone on the outside. The bottoms of these two bones are called malleoli (or malleolus for singular). They are the nubs of bone that make up the ankle.
Just below the inside malleolus (the medial malleolus) is a series of 4 strong, flat ligaments (the Deltoid ligament complex) that hold the foot and ankle bones in place. This might technically be a sprain (a tear to a ligament), but it is treated as a fracture due to its strong nature and how it works. Damage to this deltoid ligament is rare and the research on best surgical practices still seems split.
Trey’s First Surgery
This injury is commonly treated with Open Reduction Internal Fixation (ORIF) surgery. This is where they put in a plate, rod, or screws to align the bones. This is how the fibula was fixed and it soon becomes important. There does not appear to be public confirmation that directly states he had the deltoid ligament repaired.
But, the press release states that the areas repaired include the “ligament disruption.” This leads me to believe that he had the surgery which slightly improves his outcomes and timeline.
With this reconstruction, his recovery timeline is at least 4 months until performing some light football-related activity.
However, it is usually closer to 6 months to achieve higher level athletics. This would time out to January for activity and Mid-March for actual football practice.
Trey’s Second Surgery
On December 28th, Trey underwent a second surgery to remove hardware from his ankle. It was reported that something felt too close to a tendon which was causing rubbing and discomfort. At this point, Trey would have been in the progressive strengthening phase.
He would have been using the ankle muscles a lot in isolation, running in a pool or transitioning to land, and starting change-of-direction-type activities.
If a specific movement caused a muscle to rub against the hardware, then it wouldn’t get better on its own. Removing it was the best option for high-level performance.
This second surgery reinforces the idea that Trey had an ORIF surgery. Unfortunately, this second surgery does set back the clock. Depending on what was removed, the recovery timeline could add 3-6 more weeks of healing before restarting rehab.
The new timeline would place Trey returning to team activities around April 29th. It just so happens that the 49er’s Instagram shows him throwing on May 5th which suggests he is on track for all pre-season work.
Comparison and Recovery Timeline
Trey’s situation compares well to Dak Prescott’s. Dak’s recovery timeline started October 11th – 3 weeks later into the season compared to Trey’s. The difference is that Dak suffered both a fractured tibia and fibula.
Two months later in mid-December, Dak had a second surgery to repair his deltoid ligament from an older injury. In February Dak was walking without major issues and he was throwing by March and officially practicing by July 22nd.
In the first four years of his career, Dak averaged 60.25 carries and 305.25 yards per season. After the injury, he has averaged 46.5 carries and 164 yards per season.
That’s a 23% drop in carries and a 54% drop in yards. It’s clear he isn’t pushing quite as hard on the ground. It could also be a sign that the injury forced him to avoid scrambling in favor of self-preservation.
Expectations
Based on the example Dak has laid out, Trey is looking on track in terms of his recovery timeline. He should be 100% involved in team camp and battling for playing time.
I would expect him to get most of the work in the preseason due to the totality of his recovery. This will likely make a case for him as the starter – or will at least drive the preseason drama headlines.
Trey’s Projection
Just for fun let’s extrapolate what Trey might do in a full season as a starter. To get a sense of possible outcomes, I extrapolated Lance’s 2021 NFL season and then averaged it with his 2019 college season. Those are the best, and frankly, only real numbers with which we have to work.
In the event Trey Lance becomes the full-time starter, completes the season, and follows Dak’s model for scrambles, then we’re looking at 128 rushes for 675 yards. That’s not bad. In fact, that’s nearly Daniel Jones’s level on the ground.
If we also consider the increased focus on passing, then he shakes out to 2,414.3 yards passing. This is around Kenny Pickett levels. All-in-all it suggests Trey should be decent as a multi-dimensional QB able to manage the 49ers offense.
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Brock Purdy Injury
Mr. Irrelevant showed the world how to overcome a moniker. He was the first rookie to take over starting mid-season and win seven straight games. But on January 29th, during the NFC Conference Championship, Brock was hit while throwing which resulted in an elbow ligament tear.
The Ulnar Collateral Ligament (UCL) is a broad flat ligament that lies on the inside of the elbow near the funny bone. Its job is to keep the elbow aligned. If you hold your arm out straight in front of you with palm up, then this ligament keeps your forearm from moving out to the side. When cocked back in a throwing posture, then the ligament helps keep the elbow from bending back too far.
If you saw the hit, then you should remember Brock was cocked back and starting to throw when the defender applied extra force on this forearm. In this position, the UCL is exposed. It is a mechanically weak posture and relies heavily on that ligament to keep the elbow together.
That extra pressure is where the injury occurred. While this is pretty common among baseball pitchers, only a handful of QBs have suffered this injury in their throwing elbow.
Brock’s Surgery
Most NFL players have surgery within 24-48 hours after an injury. But in this case, they waited 40 days for the swelling to go down. This was most likely to get the clearest MRI results to help decide which type of surgery should be done.
With a UCL sprain there are two main surgical methods. There is Tommy John Surgery or the Internal Brace Technique. Tommy John Surgery is where they take a tendon from somewhere in your body and attach it through the bones of the elbow to mimic the UCL. This is considered the gold standard and has been performed for almost 50 years.
The other option is the Internal Brace Technique where the surgeon repairs the ligament and reinforces it with a collagen-coated tape. It’s much less invasive and recovery tends to be quicker but there is no clear evidence that it is superior. It seems to be a case-by-case situation that was surely debated intensely among the 49er’s organization.
Brock’s Recovery Timeline
Brock’s recovery timeline started when he finally had surgery on March 10th. A return to throwing program starts about 4 months post-surgery which lands us at about June 30th mark.
In a recent interview, Brock stated that he is set to start throwing during the week of 5/29 – 6/3. This indicates he may be ahead of schedule.
The big thing here that the general media does not understand is that the throwing program takes 6 weeks or longer to get into game-like throws. There is still quite a way to go and it may run into the start of team camp.
Comparison and Recovery Timeline
Most people will want to compare this situation to Ben Roethlisberger. While it’s not the best comparison based on injury, Ben did play 2 full seasons post-injury. His stats may give us a look at what the future may hold.
Ben had a Tommy John surgery and reconstruction of several flexor muscles. He had a larger and more involved surgery. But in his two seasons post-injury, his completion percentage hovered around career average while his yards per attempt dipped.
It was unclear if this was attributed to age and decline, but it was statistically significant. It makes sense that this injury would lead someone to make more comfortable check-down throws.
To find a more accurate injury comparison we need to look at Nick Mullens. Nick was another 49er who had a UCL injury and repair in 2020. His injury occurred at the end of his contract and the 49ers decided to move on.
He bounced around to other teams but never had the opportunity to play a significant amount post-injury. In very limited action, Mullen’s completion percentage rose but yards per attempt fell. It looks like a slight trend in making check down throws, but we’ll need more observations to be sure.
Expectation
Purdy is estimated to return to live competition near the beginning of camp assuming he has no setbacks. He’ll need to show a willingness to push the ball downfield to avoid the check down trend. Brock’s 2022 stat of 8.1 passing yards per attempt tied him with Mahomes.
A 10% regression ties him with Heinicke. That’s quite the fall-off from elite to decent. We’ll have to keep an eye on his progression through team camps to see how he’ll fair this year.
If Purdy does not make the deadline to participate fully in preseason, we could be looking at rough start for the 49ers. A strong Steeler defense, a healthy Rams team, and a determined Giants team could apply a lot of pressure on the young QBs who might still be working into a rhythm.
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