The key to Sam Bradford's knee

THE EAGLES were upfront from the day they traded for him in March, that Sam Bradford was still in midrecovery from his second ACL surgery in as many years. Still, it was a bit of a shock to confront the reality last week, when reporters were allowed to watch OTA work for the first time.

The guy who's going to be paid $13 million to quarterback the team this year can't quarterback yet, and doesn't seem all that close to being full-go. He might do some seven-on-seven work today - Chip Kelly said Thursday that Bradford was scheduled to start that this week, though he didn't specify today, the only time reporters will watch workouts during that time span.

The offense is going to be installed this spring pretty much without the guy who is supposed to run it, which isn't a crisis, with the season opener in Atlanta still 105 days away, but it underscores the gamble Kelly took when he sent Nick Foles and a 2016 second-round pick to St. Louis for Bradford.

Asked about the need for Bradford to get some work in a new, unfamiliar offense on Thursday, Kelly said he didn't think it would be a problem.

"No, not the way Sam approaches things," Kelly said. "I don't think it sets him back. Everybody's got to deal with whatever they're dealt. We have full confidence that he will be back, though."

It isn't that unusual anymore for a player to return from a second tear of the same ACL - Jeremy Maclin put up career numbers last season and earned a 5-year, $55 million contract in free agency from Kansas City, in the year following his second right ACL tear. But Maclin played 4 years between tears. Is there anything different about tearing the same ACL 2 years in a row?

Here again, there are precedents. Carolina outside linebacker Thomas Davis is the most famous, Davis tearing his right ACL three times in 3 years. Davis has played three seasons since his last ACL tear, and he has played effectively. Last month, New Orleans selected University of Washington 3-4 outside linebacker Hau'oli Kikaha in the second round, 44th overall, despite his 2011 and 2012 left ACL tears; Kikaha has played 2 years since his most recent tear, and he led the NCAA with 19 sacks last season.

Bradford spoke Thursday of taking it a little slower the second time around, and Dr. Art Bartolozzi, former team orthopedist for the Eagles and the Flyers, said yesterday that is to be expected. Bartolozzi noted that Bradford's left leg has spent much of the last 2 years at considerably less than a full activity level.

"What happens when you do it twice is that the muscles take a hit; they don't always recover their full function after a year," Bartolozzi said. "They have another major whammy, there could be some residual muscle weakness or laziness. That's why it does take more time the second time.

"You spend time in rehab, but that's not the same as full-speed action."

Bartolozzi said tearing an ACL twice, in and of itself, is not that big a deal; replacing the ligament isn't all that traumatic. The bigger factor these days with most knee injuries is the status of the cartilage. If you have plenty of cartilage, you should recover well. If you don't have cartilage, you're going to have swelling and pain.

"To orthopedic sports medicine, in my patients, in NFL patients, any high-level athletes, cartilage is the holy grail," Bartolozzi said. "The ligament is a static structure. The cartilage is a live structure; it's very complex. It endures tremendous compression and twisting."

The details of the extent of Bradford's injuries, suffered when he played for the Rams, are a little fuzzy. Both were contact-related - he was bent awkwardly by a tackler the first time, had a tackler fall into the knee the second time. We aren't sure how much cartilage damage he has sustained. We do know he has not had microfracture surgery, the procedure that attempts to grow a sort of knee scar tissue to replace cartilage. Reporters in St. Louis were told there was no cartilage damage arising from Bradford's first injury.

"That would really be the bottom line, what the cartilage looks like," Bartolozzi said.

Will Bradford be able to take the reins when training camp starts at the end of July? Kelly wouldn't answer that question last week; he said he wouldn't look past the scheduled seven-on-seven throwing. Bradford said: "We're just kind of taking it on a day-to-day, week-to-week kind of basis. Continuing to push the knee, doing more things every week. As long as it keeps continuing to respond well, we'll keep adding more to that."

Kelly was asked where Bradford is in his recovery.

"We all think there's three phases: There's medical rehab, there is performance rehab, and then there's prepared to play. He's probably right at the tail end of medical rehab," Kelly said, before alluding to the pending seven-on-seven work. "I think he's right on schedule in terms of where he is."

Bradford is wearing a brace, but then, he had the knee braced in last year's third preseason game and tore the ACL again anyway. Bartolozzi noted that knee braces are most effective on hits from the side, but most ACL injuries involve twisting, and no one has figured out how to brace for that yet.

Bradford was asked Thursday about people who doubt he will make it through the season.

"[Bleep], there's a reason for it," he said, before asserting that all he could really control is getting himself ready. "I think things will play out."

Blog: ph.ly/Eagletarian