Photo: Kevin C. Cox (Getty)

After months of head-scratching about what might have been up with Rams running back Todd Gurley in the playoffs and the Super Bowl, there’s finally an answer: His knee is pretty messed up.

First, there was this from John Breech of CBS Sports:

The Rams currently have Gurley on an offseason regimen in hopes of getting him completely healthy for the 2019 season, but if that doesn’t work or if his knee regresses, the team may consider stem cell treatment for their star running back, according to a team source.

Yeesh. That doesn’t sound good. Then came this from Jeff Howe of The Athletic:

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Gah. That really doesn’t sound good.

Breech’s report goes on to quote Rams head coach Sean McVay, who didn’t confirm the stem cell regimen but did say the team was open to using “new methods” for Gurley’s recovery. “As far as the stem cells, that’s not something that’s been communicated to me, but there is a program,” McVay said, per Breech. McVay also said surgery would not be an option for Gurley this offseason.

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Gurley sustained an ACL tear on his left knee in 2014, during his final year of college ball, and while he’s been wildly productive throughout four NFL seasons, he was limited toward the end of 2018. After sitting out the Rams’ final two regular season games because of a knee injury, he had a monster game in a playoff win against the Cowboys before getting just five touches in the NFC title game and 11 in the Super Bowl. Afterward, both Gurley and McVay insisted Gurley was fine—which, taking them at face value, made it fair to wonder why he sat for extended stretches of the team’s two most important games.

Stem-cell treatment involves injecting bone marrow extracted from a person’s pelvis into the affected area. The stem cells in the bone marrow work as an anti-inflammatory; the thinking is that they can also accelerate healing. A few years back, Sports Illustrated’s Jenny Vrentas explored the low-key proliferation of the procedure among NFL players. Vrentas’s reporting put the number of players using stem cells as of July 2014 in the hundreds—a group that then included Peyton Manning (neck) and Prince Amukamara (foot), plus running backs Chris Johnson and Knowshon Moreno. A year later running back Jamaal Charles also sought help from stem cells. Johnson, Moreno, and Charles were, like Gurley, dealing with the effects of previous ACL injuries.

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For comparison’s sake, Moreno rushed for 1,038 yards and caught 60 passes after getting the treatment during the 2013 offseason, but Johnson and Charles never quite returned to their pre-stem-cell form. Both Johnson and Charles were also 29 when they got their stem-cell injections; Moreno was 26; Gurley will turn 25 in August. Granted, these aren’t large sample sizes, and the nature of each player’s injury was different. But Gurley’s usage will likely be affected—he has 1,229 touches since entering the league, far and and away the most in the NFL during that span, so he’s been integral to what the Rams do. Last week at the combine, GM Les Snead acknowledged that Gurley’s experienced some “wear and tear” and suggested the team would have to consider some kind of “Batman and Robin” combination to lighten Gurley’s workload. L.A. had brought in C.J. Anderson to sub for/spell Gurley at the end of last season, and even if Anderson were to walk in free agency, it seems all but certain the Rams would find another character (or two) to play the Robin part.

Last summer, Gurley signed a contract extension that, by next week, will have guaranteed him $34.5 million, plus another $10.5 million in injury guarantees—a good bit of security regardless of where things go from here.