Running backs are often considered the workhorses of a football team, bearing the brunt of physical contact as they navigate through defenses. This demanding role subjects them to a high risk of injuries. Here, we explore some of the worst injuries running backs can suffer, their impact on careers, and recovery prospects.

1. ACL Tears

Anatomy and Function

The anterior cruciate ligament (ACL) is one of the key ligaments that stabilize the knee joint. It connects the thigh bone (femur) to the shin bone (tibia) and is crucial for movements involving sudden stops, starts, and changes in direction.

Mechanism of Injury

ACL tears commonly occur when a running back makes a rapid change in direction, stops suddenly, or lands awkwardly from a jump. The intense physical contact in football also increases the risk.

Impact on Career

An ACL tear is one of the most dreaded injuries for running backs. It typically requires surgical repair and a lengthy rehabilitation process, often sidelining players for nine to twelve months. While advancements in medical technology have improved recovery outcomes, the injury can still significantly affect a player’s performance and career longevity.

Examples from 2022-2023: Breece Hall, Javonte Williams, Nick Chubb, Keaton Mitchell, Gus Edwards

2. Achilles Tendon Ruptures

Anatomy and Function

The Achilles tendon connects the calf muscles to the heel bone, facilitating walking, running, and jumping.

Mechanism of Injury

Ruptures often occur during activities that involve sudden acceleration or deceleration. For running backs, this can happen during explosive sprints or abrupt stops.

Impact on Career

Achilles tendon ruptures are severe and can be career-threatening. The recovery process is extensive, often requiring surgery followed by a year of rehabilitation. Even with successful recovery, players might not regain their pre-injury level of explosiveness and agility, which are critical for running backs.

Examples from 2022-2023: Cam Akers, J.K. Dobbins, Marlon Mack

3. Meniscus Tears

Anatomy and Function

The menisci are two crescent-shaped cartilage discs that cushion and stabilize the knee joint, allowing for smooth movement and weight distribution.

Mechanism of Injury

Meniscus tears can occur due to twisting motions, direct impacts, or degenerative changes. Running backs are susceptible due to the high-impact nature of their position.

Impact on Career

Meniscus tears vary in severity. Minor tears might heal with conservative treatment, but severe tears often require surgery. Recovery can range from a few weeks to several months. Chronic meniscus issues can lead to long-term knee problems, affecting a running back’s performance and durability.

Examples from 2022-2023: De’ Von Achane, Evan Hull, James Conner, Keaton Mitchell

4. High-Ankle Sprains

Anatomy and Function

A high-ankle sprain involves the ligaments that connect the tibia and fibula above the ankle joint. These ligaments stabilize the lower leg and ankle during movement.

Mechanism of Injury

High-ankle sprains typically occur when the foot is twisted outward, often during tackles or sudden direction changes.

Impact on Career

High-ankle sprains are particularly troublesome for running backs. They can be more painful and take longer to heal than regular ankle sprains. Recovery time ranges from several weeks to a few months, sometimes requiring surgery, and lingering instability or pain can hamper a player’s agility and speed.

Examples from 2022-2023: Saquon Barkley, Jonathan Taylor, Alvin Kamara, Kyren Williams, Rhamondre Stevenson, David Montgomery, Jerome Ford, Khalil Herbert, Tony Pollard, Dameon Pierce

5. Concussions

Anatomy and Function

A concussion is a type of traumatic brain injury caused by a blow to the head or body that causes the brain to move rapidly within the skull.

Mechanism of Injury

Running backs are at high risk for concussions due to frequent collisions with defenders. Helmet-to-helmet hits and violent tackles are common causes.

Impact on Career

Concussions are increasingly recognized for their long-term impact on players’ health. Symptoms can include headaches, dizziness, memory issues, and cognitive impairments. Multiple concussions can lead to chronic traumatic encephalopathy (CTE), a degenerative brain disease. Managing concussions often involves strict protocols and can lead to extended absences from play. The long-term health risks make concussions a particularly serious concern.

Examples from 2022-2023: Isaiah Pacheco, Joe Mixon, Gus Edwards 

6. Shoulder Dislocations

Anatomy and Function

The shoulder joint is a ball-and-socket joint that allows for a wide range of motion but is prone to instability and dislocations.

Mechanism of Injury

Running backs can suffer shoulder dislocations from direct impacts, falls, or awkward tackles that force the arm into an unnatural position.

Impact on Career

A dislocated shoulder can cause significant pain and require immobilization. Repeated dislocations may necessitate surgical intervention to stabilize the joint. Recovery can take several months, and the risk of re-injury is high. Shoulder stability is crucial for ball security and absorbing tackles, making this injury particularly detrimental.

Examples from 2022-2023: Isaiah Pacheco, Dalvin Cook 

7. Hamstring Strains

Anatomy and Function

The hamstrings are a group of muscles at the back of the thigh responsible for bending the knee and extending the hip.

Mechanism of Injury

Hamstring strains occur due to overstretching or overloading the muscles, often during high-speed running or sudden acceleration.

Impact on Career

Hamstring strains vary in severity. Mild strains might heal in a few weeks, while severe strains can take months. Recurrence is common, and chronic hamstring issues can severely limit a running back’s speed and explosive power, essential attributes for the position.

Examples from 2022-2023: Aaron Jones, Chuba Hubbard, Gus Edwards, Jerome Ford, Isaiah Pacheco, Kendre Miller, Brian Robinson Jr., Jaylen Warren, Jahymr Gibbs, Breece Hall 

8. Turf Toe

Anatomy and Function

Turf toe is a sprain of the ligaments around the big toe joint, commonly caused by hyperextension.

Mechanism of Injury

Running backs often get turf toe when pushing off forcefully from a planted foot, especially on artificial turf surfaces.

Impact on Career

Turf toe can be deceptively debilitating. It causes significant pain and limits the ability to push off and change direction, critical movements for running backs. Recovery time can vary, with severe cases requiring several months and potentially leading to chronic issues.

Examples from 2022-2023: Derrick Henry, Jonathan Taylor, Antonio Gibson, Gus Edwards

9. MCL Injuries

Anatomy and Function

The medial collateral ligament (MCL) is located on the inside of the knee and works with the medial meniscus and the ACL to stabilize the joint.

Mechanism of Injury

MCL injuries typically result from direct blows to the outside of the knee, usually during a tackle. 

Impact on Career

MCL injuries are more common than ACL injuries but can still be severe. Treatment may involve bracing, physical therapy, or surgery. Recovery can take several weeks to several months, and long-term knee stability might be compromised, affecting a running back’s performance.

Examples from 2022-2023: Nick Chubb, De’Von Achane, Aaron Jones, Ezekiel Elliott, James Conner, Antonio Gibson, Kendre Miller,

10. Fractured Bones

Common Fractures

Running backs are at risk of fracturing various bones, including the forearm, fibula, tibia, and metatarsals.

 

Mechanism of Injury

Fractures often result from high-impact collisions, falls, or awkward landings.

 

Impact on Career

Bone fractures usually require immobilization and sometimes surgical intervention. Recovery time varies depending on the bone and severity of the fracture but generally takes several months. The rehabilitation process is crucial to regain strength and mobility, and premature return can lead to re-injury.

Examples from 2022-2023: Isaiah Pacheco, Kyren Williams, Zack Moss, Alvin Kamara, David Montgomery, Raheem Mostert



The role of a running back in football is physically demanding and exposes players to numerous injury risks. The worst injuries, such as ACL tears and Achilles tendon ruptures, not only impact their immediate ability to play but can also have long-term consequences for their careers and overall health. Advances in medical treatment and rehabilitation have improved recovery outcomes, but the physical toll on running backs remains high. Preventative measures, proper training, and timely medical intervention are essential to mitigate these risks and help running backs maintain their performance and longevity in the game. 

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