From surgery to doubt to dominance: How the Bengals’ Joe Burrow returned to form

CINCINNATI — There were a couple of things on Joe Burrow’s mind in the hours leading up to a surgery that had many unknowns.

One of them was whether all passengers on airplanes had parachutes. When Jake Browning, the Cincinnati Bengals’ backup quarterback behind Burrow, texted Burrow good luck ahead of a wrist surgery last November, Burrow replied with the question about evacuation methods for an emergency landing.

“That’s just how he is,” Bengals receiver and longtime teammate Ja’Marr Chase said last December. “He’s just never thinking about ‘in the moment.’ He’s thinking about something else.”

But the other thought on his mind was more pressing. As someone who had a surgery during his rookie year in 2020, when he tore ligaments in his right knee, Burrow knew one of the toughest parts wasn’t going under the knife but the wait to start the recovery process.

“You’re just excited to get that process going,” Burrow told ESPN. “Because it doesn’t start until surgery happens. Sometimes a month, sometimes six weeks after surgery. Those weeks are always tough because you know what’s coming up, and it hasn’t started yet.”

On Thursday, Burrow will suit up under nearly identical circumstances to when he sustained the injury last season — a Thursday night contest on the road against the Baltimore Ravens. On that night last November, Burrow was tackled and ruptured a wrist ligament in his throwing hand. The specific injury was one that no NFL quarterback is known to have experienced. His return has been one that not everyone expected.

Burrow has not only recovered but is playing the best ball of his career. Through nine weeks, he’s second in QBR at 76.3, behind the Ravens’ Lamar Jackson at 77.3.

Burrow has been at his best at a time when the Bengals have never needed it more. Cincinnati (4-5) is trying to get back to .500 and fighting to not miss the playoffs in consecutive seasons; the Bengals have reached the postseason each time Burrow has finished a season healthy. And from the time he went down last season until now, he has rebuilt himself into a franchise quarterback.

Even that was never a sure thing.

“You can throw all you want, but you’re not really sure how it’s going to work out until you get out there,” Burrow told ESPN. “That’s with every injury when you’re coming back from it. That’s part of it.”

THE BENGALS WERE trailing the Ravens 7-3 late in the second quarter on Nov. 17 when Burrow threw a short pass to Joe Mixon, who ran in from 4 yards out for a touchdown. As Mixon was crossing the goal line, Burrow was flexing his right wrist, which he landed on during the previous play.

That was the last play of Burrow’s season. He briefly went to the locker room before returning to the sideline, tried to throw a couple of passes, dropped into a deep squat and winced.

Burrow suffered a ruptured scapholunate ligament injury in his wrist. Eleven days after the injury, he went to Pennsylvania to have surgery performed by Dr. Thomas Graham, team sources confirmed to ESPN.

There was no blueprint for an estimated time of return. Unlike his previous injuries that had precedent for quarterbacks — an ACL and MCL injury that ended his year in 2020, a ruptured appendix in 2022, a strained right calf at the beginning of 2023 — this was unique.

Around the locker room, Burrow found solace in teammates who had recovered from the same ligament injury.

A glimpse of what Joe Burrow is dealing with on what the team now says is a right wrist injury: pic.twitter.com/nOW3qR0RhR

— Adam Schefter (@AdamSchefter) November 17, 2023

When Bengals linebacker Joe Bachie was at Michigan State, he broke a wristbone in 2016 and then blew out his scapholunate ligament against Michigan in 2017. He said he doesn’t remember what happened in the game other than his fingers went numb. He wore a cast on the wrist, played through the rest of the season and then had surgery.

Bachie said he has no pain in his wrist following the procedure. However, he does have a limited range of motion compared to his other wrist, something Burrow has not had to deal with.

“Me and him do different jobs,” Bachie told ESPN. “I can’t bend it all the way. But I have no pain.”

Dr. Steve K. Lee, the chief of the hand and upper extremity service at Hospital for Special Surgery in New York, said approaches for repairing the scapholunate ligament vary among orthopedic surgeries. Once completed, Lee told ESPN, concerns for recovery include having the same velocity and accuracy as before the procedure, a risk of reinjury, and arthritis in a ligament that Lee called the “keystone” ligament in the wrist.

“If that falls apart, the wrist mechanics get all thrown off, kind of like an unbalanced washing machine,” Lee told ESPN.

Burrow put in the work to be ready for the upcoming season. By the time the Bengals started their offseason program in April, Burrow was in uniform and throwing, staying on track for the next step in his recovery process.

THE PROCESS OF throwing again began with tossing small medicine balls, Burrow told ESPN in May. When the offseason program started, Burrow was less than five months removed from the surgery.

And while Burrow was participating, his workload had to be managed. When Burrow did not throw one day, Bengals coach Zac Taylor revealed it was a mandated rest day to protect Burrow from doing too much.

Bengals offensive coordinator Dan Pitcher told ESPN recently that the coaching staff installed this year’s offense around a throw limit for Burrow, which made sure things went as smoothly as possible.

“Maybe he goes through individual drills and then doesn’t throw a ball,” Pitcher said.

When the team wrapped up mandatory minicamp, Burrow stood next to Chase, who was a limited participant because of a contract dispute, flexing his wrist as a spectator. In order to help improve his wrist dexterity, Burrow started watching YouTube videos to learn how to play the piano.

That was his idea. Eventually, he picked up a few songs. The string of notes that serve as the intro and main melody of Kanye West’s “Homecoming” became one of his favorites to play.

In his last news conference of the offseason, before the players departed for the summer break, Burrow acknowledged that the accumulation of injuries over the course of his career made him ponder his “football mortality.”

“They stack, and you continue to think about how you can get better from those,” Burrow said on June 11, “how you can come back an improved player when maybe you aren’t getting the reps you had because of your injuries.

“It’s always a challenge, it always is. But I’m built for it.”

DESPITE ALL OF the injuries he’s suffered in his five NFL seasons, Burrow has never missed Week 1. The openers haven’t always been pretty, such as in 2022 when he threw four interceptions in a loss to the Pittsburgh Steelers just weeks after being hospitalized for an emergency appendectomy.

In this season’s opener against the New England Patriots, Burrow had six pass attempts of 10 or more air yards, according to ESPN Research. That 16-10 loss was one of the biggest upsets in recent years.

The next week, the Bengals faced Kansas City, a team Cincinnati played in the AFC Championship Game following the 2021 and 2022 seasons. The Bengals won the first meeting to go to the Super Bowl, where they lost to the Los Angeles Rams, and lost the following year on a field goal with three seconds left.

It was only Week 2, but after what happened the week earlier, Burrow knew what was required.

“[The Patriots game] ended up being a little tighter than I expected and didn’t work out the way we wanted,” Burrow said. “After that, there was not really any other option other than to go out and let it rip.”

Burrow had 258 yards and two touchdowns in a game the Bengals lost on a walk-off field goal. Since then, Burrow has showed the form he had before the injury and has started to hit new career heights.

So far, that hasn’t translated to consistent winning. But if there’s hope the Bengals can turn it around and make a run, it starts with the 2020 first overall pick, who threw five touchdown passes in a rout of the Las Vegas Raiders on Sunday.

“I know we have one of the best quarterbacks in the NFL,” Bengals special teams coordinator Darrin Simmons said. “That’s always a great place to start.”

He isn’t playing as much piano as he used to and hasn’t been flexing his wrist as much either. After a stretch in his career that has been as good as any, Burrow is no longer contemplating his football mortality.

“I don’t know what to tell you,” Burrow said, sitting at his locker before looking up and flashing a wide grin. “We’re back.”