The end of 'fast-guy injuries': inside the Packers' plan to keep Christian Watson and others on the field

The Packers have taken a new, scientifically backed approach to treating soft-tissue injuries. If it proves effective, the future of football will look very different.

It’s not exotic pressure packages or a dual-threat quarterback on the opposing sidelines. It’s not an unstoppable receiver or virtuoso pass rusher. Teams can control those variables with scheme and personnel.

No, the one thing that beguiles football teams more than almost anything else? Soft-tissue injuries.

Hamstrings, calves, and groin muscles. They pull and tweak, “bite” and tighten, and it can be unclear why. Darnell Savage once called them “fast-guy injuries.” NFL teams need fast guys, but players who can fly can also get their wings clipped when their bodies betray them.

The Green Bay Packers know this well having witnessed several of their most superlative athletes like Eric Stokes and Christian Watson sidelined by soft-tissue injuries. However, the Packers’ approach to these players hints at a future where teams can control for the previously uncontrollable, where certain types of injuries can be mitigated before they happen using state-of-the-art technology and sports medicine.

Is this science fiction? No, it’s just science.

Rooting out the problem

Dr. Bryan Heiderscheit had seen cases like these before. Stokes and Watson, each of whom battled significant hamstring issues during the 2023 season, were sent by the Packers to the University of Wisconsin-Madison’s Badger Athletic Performance where Dr. Heiderscheit serves as the director. He is also a part of the NFL and NFLPA’s Lower Extremity Soft Tissue Injury Task Force, and his team has previously used grants from the NFL to research these types of mysterious injuries.

“It’s mysterious in the sense that so many of us experienced it in our other lives and then recovered from it and been like, ‘Hey, I’m back. Why are these guys out so much?’” Dr. Heiderscheit tells The Leap. “It has to do with that high level of demand of the sport.

“Any sport that involves high-speed running automatically brings an element of risk for hamstring-strain injuries.”

In other words, it is a “fast-guy injury,” and NFL athletes are outliers. They’re the top 1%. Even with sophisticated testing, it’s hard to determine if their muscles are working “normally” because normal for them isn’t normal for most people.

According to Dr. Heiderscheit, the contributing risk factors are myriad, from not training enough to training too much or too quickly without a proper warmup. Added risk could even stem from biomechanics, the way someone naturally runs. Complicating matters, an athlete might not have any outward signs of a problem until it’s too late.

“We might say if the athlete’s pain-free and moving well, they’re good, but that’s all fine until you get them at a little higher intensity, and then that weak link snaps,” Dr. Heiderscheit says. “That weak link is the thing we have to be able to detect earlier and address.”

Previous injury also creates risk, a common thread shared by Watson and Stokes. According to the NFLPA’s educational material for its players, a hamstring injury is the No. 1 predictor of future hamstring injuries. But it doesn’t have to be a hamstring injury; any injury that requires recovery with or without surgery can cause complications for the systems in the body that underpin movement.

Before his rookie season, Watson had a cleanup surgery on his knee and his hamstring issues started shortly after, precisely the kind of issue fixing an old injury with surgery was designed to prevent. And that’s the dilemma: If there’s another underlying issue, tending to one problem may unknowingly fail to address another, or worse, create a new one. And once the hamstring injuries start, they’re more likely to reoccur, kickstarting this vicious and frustrating cycle.

This is where Dr. Heiderschiet comes in. Just because a player can feel back to full strength doesn’t mean he truly is, and returning too quickly increases the risk of re-aggravation. If an injury causes asymmetry, that also has to be addressed through targeted rehabilitation.

“Obviously, the issues I've had in the past with hamstrings, not fully recovering from those strength-wise, I've been attacking the strength side of it, trying to get that symmetry back and it's been huge for me,” Watson said during the Packers’ offseason program in May.

“The thing with hamstring injuries is that symptoms are deceiving,” Heidersheit says, adding, “You can feel fine and normal. That doesn’t mean the muscle has recovered fully to be able to get back to that high level of sport that you did before. Many times, you’ve developed some level of compensation or you move differently to accommodate it.”

When Watson went through his battery of tests in Madison, they found significant asymmetry, meaning the muscles were not working with matching strength. His gap, about 20%, was well above what would be considered normal. Watson said his goal was around 6% and that during spring practices he was in a normal range between 8-10%.

“One, it puts strain on the left side, and the left is going through a lot more,” Watson said in May. “And then two, obviously when you're trying to be equal in power, it obviously puts a lot more stress on the one that's not as strong.

“So, that's been the No. 1 thing for me because that leads to fatigue as well. It's a bad place to be, so obviously that's been my No. 1 goal to just kind of eliminate that.”

When one side of the body lacks the same strength as the other, it fatigues faster, elevating the risk of an injury. Asymmetry creates even more strain on the muscle. That doubles the problem because when an injury happens, a player like Watson has to attack re-strengthening a muscle that was hindered to begin with.

Mapping out the solution