Pinpointing Tre’Davious White’s return to play

Intense focus has been placed on All-Pro cornerback Tre’Davious White as he races to be ready for a potential Week 1 return for the Buffalo Bills. His return would be nine months after his ACL injury on Thanksgiving in Week 12.

All offseason, the team has stated that White is “on schedule” but the video and reports are available to support their statements.

From The Athletic’s Joe Buscaglia

The star cornerback did change-of-direction drills, including several reps of backpedaling, stopping on a dime and then exploding off his back foot either to his left or right side, depending on the rep. He also mixed in sprints across the length of the field, which he had also done in previous practices. But the significant development, especially given the nature of a torn ACL, is that he began doing those change-of-direction drills and exploding off the back leg following a backpedal. While they don’t make his return imminent, these drills were a definite step forward from what we’ve seen.

To recap, over the last week, the public has observed Tre’Davious White performing various agility drills. This includes: sprinting with and without resistance, decelerating after sprinting, single leg jump, knees to chest, and lateral jumping. Reports also state he has backpedaled with change of direction to both sides.

Current Deficits

It’s important to note that this is not the first time that White is performing these drills, but he continually requires refinement of these skills. Right now, the movements on the left side are not as natural as they once were. He still likely has to think about what he has to do or how the knee feels. Coming back from an injury, the person is frequently hyperaware of how that body part feels as they perform particular activities that are explosive and multidirectional in nature.

The big limitations that I see in White within the videos are that he still has to put effort into deceleration during sprinting. When slowing down, it’s not expected that he stops immediately, but to slow down using the quadriceps indicates that he still relies on his right side more, which is not uncommon at this stage.

He also possibly appears less explosive or has to concentrate more on the left side when single-leg jumping, though there appears to be minimal differences.

I bring these asymmetries up as there is some expectation that he exhibits them as he continues to rehab. Fortunately, there are many tools at the Buffalo Bills' disposal to determine when he is cleared to resume practice.

Return to Sport Criteria

Listed here is a detailed Return To Sports rehab protocol, but many of the measurements require additional equipment or an individual has to personally take the athlete through the specific activities to score.

Some of the key metrics that the team is looking for White to achieve when returning to sport:

• Quadriceps strength (90% or greater) compared to non-injured leg
• Hamstring strength (100%-110%) compared to non-injured leg
• Hamstring-Quadriceps Ratio Strength (80% or greater)
• Limb Symmetry Index (LSI) of 95% on hop tests
• SL Hop tests 100% compared to non-injured leg

While attempting to keep things brief, the team is looking to ensure that the strength and control in the surgical leg are equal to or greater than the uninvolved leg. This can be measured with an isokinetic dynamometer or by performing a one-rep max of specific exercises to determine strength differences between the two sides.

The hamstring-quadricep ratio is best understood as how strong each of the muscle groups is to each other within the involved limb. The hamstrings and quadriceps allow for sprinting and stopping respectively, and dynamic stability during running. Having one group stronger than the other may lead to imbalances and further injury.

The limb symmetry index is a series of tests to determine how close each leg is in relation to each other regarding movement with specific dynamic activities. The closer they are, the less likely injury is to occur.

They also must understand how White is feeling mentally, and whether he feels he is ready to return. White appears itching to get out there, which indicates that he is not fearful of the injury happening again.

Re-Injury Risks

Research indicates that re-tear rates do vary but according to the NFL research specifically, 12.7% re-tear the same side compared to 7.3% in the opposite leg for up to two years. However, the rates of re-tear in the general population are upwards of 20-30% depending on the study.

An athlete’s risk of re-tear decreases by 51% each month that return to sport was delayed up to nine months. The risk to fail any of the objective measures above was also significantly greater prior to the nine-month mark than after.

White also has to react to what he is seeing; he doesn’t dictate the action. So to backpedal, pivot, and turn to stay with the receiver may be a step slower. The ability to push off the left leg to jump the route may not be as crisp. Going up for jump balls, there may not be as much height initially as he once had.

Depending on the side of the field he lines up on, he may be susceptible to certain routes beating him. He will combat this through strong technique, but do not be surprised if he gets burned early in the season.

These things take time to recover as there is a neurological component to these injuries; it is far more than the structural integrity of the joint. Eventually, he won’t have to think about these movements, but for now—that feedback that his knee gives his brain—it takes a while for those connections to re-establish.

Dates To Consider

Nine months from the surgery for White will be technically August 25 when counting the weeks on a calendar.

Exactly two weeks prior to kickoff for Week 1 on September 8.

A deadline to watch out for is August 23, the cut-down date to 80 players. At that point, they can designate a player for reserve/PUP and he won’t count against the 80-man roster, but still count against the 90-man limit.

Basically, they won’t need to cut an additional player to keep the injured player on the roster. If that date passes without White moving to reserve/PUP, then that’s a good sign.

However, the team has until August 30 to make the decision to move a player to the Active roster or move him to reserve/PUP.

If he waits on regular season PUP, then he delays his time with the defense until at least Week 5, looking at October as the earliest to practice. During that time, he could only participate in team meetings and work to the side.

Instead, he could be activated off PUP prior to roster cutdowns, getting into a controlled setting to work in with the defense to continue his rehab among in-game scenarios.

Originally, I had stated that Week 1 would be a tight timeframe for White to return. I had also stated that going to injured reserve to buy more time was a possibility, but that has since been disproven as once you pass a physical, it wouldn’t make sense to be immediately on injured reserve for the regular season. The rules for PUP have also changed from missing six games to four games back in May and now are the same length.

Based on video and written reports along with the change in PUP/IR rules significantly change my outlook for him to return. Considering the fact that he had minimal associated damage to the knee; it was reported that he suffered an ACL tear along with a meniscus tear. These findings have increased my confidence that Week 1 is possible.

Return Date

I believe Tre’Davious White will return to play Week 2 against the Tennessee Titans on Monday night in Buffalo.

Boiling it down, White could be activated prior to August 30 to make the 53-man roster. Depending on how they are feeling about his game readiness, he could be inactive for the Los Angeles Rams game as he ramps up with three weeks of practice available.

He could then return in limited snaps in Week 2 at home against the Tennessee Titans on Monday night on September 19. I would then expect his snap count to increase as the season progresses though remains limited until at least the bye.

He realistically could platoon the cornerback position as he begins to take the lion’s share of snaps. However, if the team activates him sooner from PUP, then it’s reasonable that he could be active in Week 1, but the snap count would still be limited.

This decision will not be made without the agreement of the player, the medical staff, and the front office.

There may be several variables that may not be known that could affect their decision-making. Understanding the type of player that Tre’Davious White is, the injury, the timeline, and the positional demands, this appears to be the most realistic outcome.

One final thought: Don’t expect elite play from White until later in the season, so temper your expectations.