ACL Expert Carson Palmer Gives Advice to Carson Wentz

Carson Palmer was just 26 years old and in the first quarter of his first NFL playoff game when Kimo von Oelhoffen rolled into his knee on Jan. 8, 2006. As Chris Henry caught Palmer's deep ball down the right sideline, Palmer was left writhing in pain on the turf of Paul Brown Stadium. 

Palmer's knee was destroyed. He tore his ACL, MCL and dislocated his patella. The injury was considered by some to be career threatening. But less than eight months later, Palmer played in a preseason game and started the season opener shortly after. 

That was the first time Palmer tore his left ACL and returned to play in Week 1 the next season. He did it again a decade later, going into the 2015 season when he was 35. 

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Palmer might be the world's foremost expert on a QB returning for Week 1 after a tearing an ACL. "Unfortunately," he agreed. 

"God didn't design your knee to split it open, pull everything apart, wrap stuff with pliers, wrench stuff down, screw a ligament into a bone and then sew it all back up," Palmer said to NBC Sports Philadelphia by phone last week. "That wasn't intended for the knee."

Which brings us to Carson Wentz, who shares a first name and hopes he shares a similar knack for recovery. Wentz, who tore his ACL and LCL on Dec. 10, has said many times that his goal is to play in Week 1 against the Falcons. Based on his progress, that seems very possible. 

Every injury is different, so this isn't an apples-to-apples comparison. But it's not apples to bowling balls either. And Palmer is certainly an expert on knee injuries. 

The three factors 

Palmer had just eight months to heal from his devastating injury back in 2006 before that year's opener. The good news for Wentz is that his injury happened a month earlier, so it'll be nine months from the date of the injury to the season opener. 

Still, in order for Wentz to be on the field Week 1, absolutely everything needs to go right. There's no time for any setbacks. 

"It's a crapshoot," Palmer said. "Coming back and playing in Week 1, there's a number of factors that need to happen."

Here are the three factors Palmer laid out: 

1. A good physical therapist

Palmer said it's incredibly important to have a PT that has experience and knows when to push the player and when to back off. And the player has to trust them. That PT is going to sometimes force him into uncomfortable positions or movements, some that the player will even have doubts about; it's just a part of recovery. 

"It's a perfect storm of having somebody who is great and knows what they're doing and is great at rehab," Palmer said.  

2. Hard work

There's really no replacement for this. Coming back from a devastating injury, especially in a short window of time, is a grind. The player needs to embrace it. Palmer said most players get used to having some off time in the offseason, but there's none of that in recovery. 

"It is a bigger bear physically than an actually football season is and it's longer because it's an eight- or nine-month process," he said. 

This doesn't seem like it'll be a problem for Wentz. We've all see his work ethic. Even on his honeymoon, he found ways to get in rehab work. 

3. Luck

This is probably the hardest one to accept because it's really out of the player's control. There are so many little things that can slow down the process and avoiding them can be difficult and sometimes impossible. 

"There's a lot of guys who work really hard and have great trainers, but (Tom) Brady's knee brace rubs against his knee and it gets infected or if you just get a little bit of swelling and inflammation behind your knee cap," Palmer said. "There's so many little things that can slow you down and delay the process, so luck is definitely a part of it." 

Under pressure 

While Palmer allowed that Wentz's situation might be slightly different with Nick Foles behind him, he said, "There's always pressure." The Eagles have been very cautious with Wentz, but Palmer knows there's always pressure from the coaches and GM and owner and then from the doctors and trainers. 

Palmer said it's important to listen to doctors and trainers, but only Wentz will really know whether he's ready to play or not. That, in itself, is a ton of pressure on his shoulders. 

How did Palmer deal with all that pressure back in 2006? 

"I was dumb and young and arrogant and I didn't care what anyone else said," Palmer recalled. "I was playing Week 1. I thank God that I was ready and my knee was ready. Had I not been, I don't know if I would have had the wherewithal to wait until Week 2 or Week 3. 

"It's a dangerous thing because Carson doesn't want to let anybody down. He doesn't want to let his teammates down, his coaches, his fans. It's just a dangerous pill you have to swallow. If you're not ready, you're not ready. The public is going to have a different perception about that but you just can't worry about that. The only person that knows Carson's knee is Carson." 

Feeling good as new

Back in 2006, Palmer estimates he was about "90ish" percent when he returned. Had he been a defensive back or a running back or another position, he's not so sure he would have been ready. 

He now admits that he didn't have full confidence back in his knee when the 2006 season began. 

"It's all a feel thing," Palmer said. "That confidence comes from how it feels to step into a throw or how it feels to really push off an explode off of that leg. It takes 18 months to where your knee feels somewhat normal again. It takes two years until you can't really tell that you had surgery on it. So that first year, it just doesn't feel right." 

This is the part that might be a drag for Eagles fans. Because even if Wentz returns for Week 1, it doesn't mean he'll be the same player he was when the injury happened, at least not if his recovery goes the way Palmer's went. Palmer made the Pro Bowl for the second consecutive year in 2006, the year that ended with the injury. While Palmer threw for over 4,100 yards and 26 touchdowns in 2007, he never felt like himself that next season. 

Advice from Carson to Carson 

As an unfortunate expert, Palmer gets asked for advice quite a bit from other players who are going through ACL rehab. Relatively speaking, Palmer is a success story. We'll never know how his career would have gone if he never tore his ACL. 

Palmer retired after last season and isn't missing the grind of NFL training camps after 14 years in the NFL. He's 12th all-time in passing yards (46,247) and passing touchdowns (294). But he'll also be remembered as the guy who suffered ACL tears twice and twice made it back for the start of the following season. We'll see if another Carson can do the same. 

Here's the advice Palmer would give to Wentz or another young QB in his position:  

I think there's a really important mixture of you, the player, feeling confident and comfortable and that going in combination with the person that's doing your rehab or the doctors or the trainer, or whoever it really is that you trust, trusting in them when they tell you, you are ready. Or we need to pull back and you need to wait until October or November or December, or whenever that is. It's just a combination of you as a player knowing the thing is going to hold up. If I have a 300-pound guy coming at me, I have enough explosiveness, enough power, enough strength to explode off the leg and push up in the pocket or whatever it may be. It's just a combination of feel.

I tell guys all the time, nobody knows what's going on inside your knee better than you, off of feel and movement. The greatest doctor or the greatest surgeon in the world can tell you this or that, but at the end of the day, nobody knows your body and how you need to move or how it feels to move in order to protect yourself and protect your team, which is more important that probably anything.

At the end of the day, you have to listen to those people, but if it doesn't feel right and you don't have confidence in it, you're not going to play at your best and you're going to end up hurting your team. You really have to listen to yourself and understand that nobody knows better - no degree, no medical school, no 40 years on the job as a physical therapist - nobody knows what you need to feel like to perform at your best more than you. 

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