Why did the Ravens back out of their deal for Maxx Crosby? An inside look at NFL physicals.

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As the biggest trade of the NFL offseason fell through, when he came to terms with the nightmarish end to his football fantasy — that Maxx Crosby would be playing for the Ravens in 2026 — Eric DeCosta sat in his office Tuesday afternoon, stunned speechless.

Four days earlier, the Ravens general manager had agreed on a blockbuster deal with Raiders general manager John Spytek that would have sent two first-round picks to Las Vegas in exchange for the Pro Bowl defensive end. On Monday, Crosby arrived in Baltimore to consummate the trade.

On Tuesday, it fell apart.

“This is a tough thing that we have to deal with in this business,” DeCosta said Wednesday. “I don’t really know what we could do differently than what we did.”

The nixed trade offered a rare window not only into Crosby’s physical health but also the Ravens’ assessment of it. The Banner spoke with medical experts and former NFL front-office officials to help unpack how such a massive deal could come undone so quickly.

When did Crosby get hurt?

Crosby said on his podcast, “The Rush,” that he knew in September that he would need offseason surgery on the meniscus in his left knee. He later suffered a left knee injury in an Oct. 19 loss to the Kansas City Chiefs. Crosby played through the injury before being shut down for the final two games of the Raiders’ season.

Dr. Neal ElAttrache, a renowned orthopedic surgeon who’d previously operated on Crosby’s shoulder and knee, performed the surgery in January. Crosby told local reporters later that month that his recovery was going “great” and added: “We’re doing everything right and checking every single box and taking it one day at a time.”

Why is the meniscus important?

The meniscus is a C-shaped pad of cartilage in the knee that acts as a shock absorber and stabilizer between the tibia (lower leg bone) and the femur (thigh bone). It also protects healthy cartilage in the knee.

Without a healthy meniscus, healthy cartilage would be subjected to “a lot more stress” and would start to wear out quicker, said Dr. Jonathan D. Packer, an associate professor of orthopedics for the University of Maryland School of Medicine. A damaged meniscus could lead to arthritis, a disorder in which bones grind on bones during joint movement after the cartilage that cushions the ends of bones is gradually worn away. It could also cause a cartilage defect, a less severe condition that Packer likened to a “pothole” in the affected area of the meniscus.

What does a meniscus repair entail?

In January, Crosby underwent a meniscus repair. A partial meniscectomy, known as a meniscus trim, removes the torn areas of the meniscus and preserves the viable areas. A repair, however, is recommended for tears that affect a “very large part” of the meniscus, Packer said.

“It’s really best to try to stitch it together and get it to repair and heal together,” said Packer, who has not treated Crosby and is not privy to his medical information. “And then you can save the function of that meniscus.”

Rehabilitation can be time-intensive. After undergoing meniscus repairs, patients are typically advised to avoid putting weight on the affected leg for six weeks, Packer said. They can typically begin running three months after the operation.

ElAttrache told ESPN on Wednesday that Crosby was “doing very well” in his rehab from surgery to treat “a significant meniscus tear and the related stress injury to the bone and cartilage in his knee.”

Said Packer: “The more cartilage damage there is, the more likely that there’s going to be pain in the future. And that is something that’s much harder to fix than a torn meniscus. So certainly, if I was evaluating somebody and there was a lot of cartilage damage, I would be more concerned about the long-term prognosis.”

What happened during Crosby’s physical?

DeCosta did not comment directly on Crosby’s medical condition Wednesday. Instead, he acknowledged that, after bringing him to Baltimore, “we were not able to complete the process of acquiring the player based on our assessment of the situation.” NFL deals are contingent upon players passing a physical.

Dr. Matthew Provencher, a surgeon at The Steadman Clinic in Vail, Colorado, who served as the New England Patriots’ medical director and head team physician from 2013 to 2016, said electronic medical records are “unlocked” during the player acquisition process. Team officials can review medical records, treatment histories, and imaging from examinations on players from as early as their rookie year, Provencher said, and in some cases, their college days.

During physicals, players are examined and may undergo additional testing. But Packer said it can be “very difficult” to evaluate a healing meniscus with an MRI, partly because of the related muscle atrophy. “Sometimes there are exam findings that you can’t really get from imaging,” he added. A “full picture” would come from evaluating imaging from before and after a surgery as well as a manual physical examination, Packer said.

“You just sort of don’t know [a player’s medical history] until the system’s unlocked,” said Provencher, who also has not treated Crosby and is not privy to his medical information.

Because of how recently Crosby underwent knee surgery, Provencher said Ravens officials would have had to “make some decisions on what this looks like several months down the road.” The knee’s swelling, range of motion and recovery timetable all would have been evaluated as part of that determination. A thorough examination of the knee itself could have also dampened or brightened the long-term prognosis.

“It puts together a more complete picture of how the knee is predicted to do when NFL play and load are resumed,” Provencher said. “So a stress injury can add to that potentially in a negative way. Meniscus [injury] can add to that potentially in a negative way. Cartilage injury can add to that in a potentially negative way. So those are things that are potentially additive when you’re putting together the complete picture of how this knee is going to behave under load.”

Provencher said that in New England, he worked closely with the team’s physical therapy staff and then-coach Bill Belichick, also the Patriots’ de facto general manager, in their evaluation of player physicals. Former New York Jets general manager John Idzik Jr. said it was important that his medical staff “had blinders on” as they evaluated players’ health, ignorant of their salary or cost in a trade. But both acknowledged that coaching decisions, player use, and load management all factored into a team’s risk management.

“You make recommendations based on the best medical evidence to determine what this looks like for the player and for the team,” Provencher said. “What is this? Is this something that is a simple break in the tibia? The bone’s going to heal and there’s no joint injury? That’s a full recovery. Versus, is there something else that’s a little bit harder to script out? But then we know from years of data and years of doing this and experience that a player like this may have potential concerns down the road.”

Will the Raiders still trade Crosby?

Crosby’s trade value is unclear. It wasn’t just Ravens doctors who evaluated him Tuesday; Dr. Daniel Cooper, the Dallas Cowboys’ head team physician, also reportedly reviewed his medical information and consulted with Ravens officials before they backed out of their trade. Cooper is considered an expert in the treatment of complex knee ligament injuries, having performed surgeries last year on New York Giants wide receiver Malik Nabers and Chiefs quarterback Patrick Mahomes.

A failed physical is not necessarily a death sentence in a player’s career, but it can be a warning shot. After the Ravens voided a four-year, $29 million contract with wide receiver Ryan Grant in 2018 over a failed physical relating to an ankle injury, he went on to play 14 games that year for the Indianapolis Colts. After two games with the Oakland Raiders in 2019, however, he never played in the NFL again.

In 2020, the Ravens backed out of a three-year, $30 million deal with defensive lineman Michael Brockers because of concerns about his ankle that surfaced during a physical. Brockers went on to start 36 games over the next three seasons for the Los Angeles Rams and Detroit Lions, signing two new deals in that span worth a combined $48 million.

“There are 32 different clubs that are going to have 32 different levels of risk,” Idzik said. “They’re going to have 32 different medical viewpoints. Football viewpoints, background viewpoints, tolerance levels vary with club.”

Raiders officials have not yet commented on Crosby. In a tweet Wednesday night, he addressed his topsy-turvy week for the first time, writing: “Everything Happens For A Reason. Believe Nothing You Hear & Half Of What You See. Im A Raider. I’m Back. Run That Sh*t.”

The Ravens have already moved on from their dalliance, agreeing to terms with former Cincinnati Bengals defensive end Trey Hendrickson, a Pro Bowl pick with his own injury concerns.

Crosby’s future is less certain. He’s under contract through 2029 after signing a three-year, $106.5 million extension with the Raiders before the 2025 season. His prognosis and market could change markedly in the five-plus months before the 2026 season kicks off.

“Every team is going to handle their roster a little bit differently, correct?” Provencher said. “So other teams may be reaching out to Maxx Crosby and his agent to say, ‘Look, that was a fail for one team, but we’re looking for this, and this might be a good fit for us.’

“And that’s the beauty of the NFL. Every team has different needs. There’s a big roster. It’s roster management. It’s risk management. And I bet he’s going to be hired by a team that fits their needs and his needs.”

Banner reporter Giana Han contributed to this report.