Welcome to the 2024 edition of the “entrance physicals,” beginning with LB Payton Wilson. We will evaluate each new player drafted by the Pittsburgh Steelers or added via free agency as indicated based on their history with a focus on current health and past injuries. As always, these reports are based on publicly available information, including player interviews, injury reports, game film and reliable news sources. I have no access to the players’ medical records and have not examined them or discussed this with them unless otherwise noted. But I will try to cut through the rumors and present the facts.
First up is the player selected with the 98th overall pick, Payton Wilson, who may be the best off-ball linebacker in this year’s draft class. Due to concerns about his injury history, he slid far past the early- to mid-second round range where many analysts had mocked him.
At the time the pick was announced, NFL Network insider Ian Rapoport shared the concerns, reporting that Wilson doesn’t have an ACL in one knee and that his shoulder surgery didn’t go well, as well as the likelihood that Wilson would only make it through his one contract.
It’s possible that Rapoport had access to the medical records and testing made available to teams via the NFL Scouting Combine. It’s more likely that he was echoing a report from the NFL Draft Confidential article in The Athletic that included that information almost word for word from an anonymous NFL defensive coaching assistant who may not have direct access to Wilson’s records.
Vitals
Age: 24 (4/21/2000)
Height: 6037
Weight: 233 pounds
BMI: 28.4
Season/Injury
2015 (high school sophomore year)
Surgery. I don’t know what the procedure was and believe me, I searched. It could have been anything from a hernia repair to an appendectomy to a repair of a laceration or draining of a cyst. But on Aug. 13, 2015, Wilson tweeted that surgery went well. It’s likely he was talking about himself because his close friend and teammate Noah Rogers retweeted it. Whatever the procedure, he did not miss time from any of the sports he was participating in.
2017 (high school senior year)
On Oct. 28, 2017, he tore the anterior cruciate ligament in his right knee on the opening kickoff of Orange High School’s ninth game of the season. He underwent surgery on Nov. 7 at North Carolina Specialty Hospital.
He was seen in multiple photos as early as three weeks post-op without crutches or a brace. He graduated from high school early and began his college career in January 2018 in order to continue his rehab at NC State. He did not participate in spring practice but was fully cleared by the summer.
2018
While participating in team training in July, he reaggravated his right knee injury. One local newspaper reported that he sustained a recurrent ACL tear, while two others reported that he had a setback in his recovery. According to his NC State player biography, Wilson underwent surgery on his right knee. It is not documented anywhere if he had a second repair of his ACL or just some type of clean-up surgery. He took a redshirt year to focus on his rehab.
2019
By February 2019, Wolfpack head coach Dave Doeren confirmed that Wilson was cleared to participate in practice and was already “killing it” in the weight room and running well.
Wilson played in 11 games in the 2019 season. He missed the Week 12 game with a left collarbone injury sustained the week prior but returned to play the following week. He wore a brace on his right knee the entire season, but it certainly did not seem to slow him down at all.
2020
Wilson played 10 regular-season games, missing the second game due to an undisclosed injury sustained in the season opener. In the season finale, Wilson sustained both left and right shoulder dislocations, popping them both back in place and finishing the game. Here is the play in the first quarter where he dislocated his left shoulder.
In the second quarter, he dislocated his right shoulder:
After a brief trip to the locker room, he returned to play with a brace on his left shoulder.
Payton Wilson underwent repair of his right and left shoulder labral tears in the spring of 2021 and was ready to go for the upcoming season.
2021
On Sept. 11 in the second game of the season, Wilson sustained a more significant left shoulder injury.
This required season-ending surgery. Wilson had a Bristow procedure, a modified version of Latarjet surgery, on Sept. 21, 2021, with Dr. James Andrews, who has performed orthopedic surgery on many NFL players. This surgical procedure involves transferring a portion of bone to the socket of the shoulder joint to act as a bumper and prevent the “ball,” or the head of the humerus, from dislocating. His recovery was complicated by an infection, which resolved after a few weeks of treatment. He was cleared to begin rehab a couple of weeks after surgery but was not ready to participate in spring practice.
2022
Wilson returned from his shoulder injury without a brace ready for the season opener, playing in 10 regular-season games and NC State’s bowl game. He was held out of the second game of the season as a precaution due to a stinger sustained the week prior.
2023
Wilson returned for a final year and made the most of it, playing in all 12 regular-season games before opting out the bowl game. He wore a knee brace in one game after tweaking his right knee but didn’t miss any time and shed the brace the following week.
Summary
Clean bill of health at this time. Yes, Payton Wilson has had significant injuries and multiple surgeries. He has also been healthy for the last two years and dominated his opponents. More importantly, his risk of reinjury is not significant based on the procedures that he has had.
As far as Ian Rapoport’s comment that the shoulder surgery was a “bad surgery,” there is no evidence to support that. Wilson had a complication with regard to the post-operative infection, but he does not seem to have suffered any long-term issues. The procedure that he had on his left shoulder has been shown to result in a full return to sport in a majority of professional athletes in high-impact sports with only a five to eight percent recurrence risk of shoulder dislocation, depending on which study is considered.
Although the comment regarding the lack of an ACL from a single anonymous coach went viral after Rapoport reported it during the draft, there is no way to determine the accuracy of the statement. If Wilson is “missing an ACL” (which is not a medical term), it’s acquired rather than congenital. “Missing an ACL” certainly didn’t limit Steelers WR Hines Ward, who played 14 seasons and earned four Pro Bowls, two Super Bowl rings and a Super Bowl MVP. It’s safe to assume that if Wilson is missing the right ACL, knee stability is not a factor.
Here is Payton Wilson in action last season, and his shoulders and knees look just fine.
Status: Full participant for rookie minicamp and OTAs.
Level of Fitness: Excellent
