CHARLOTTE, N.C. – Carolina Panthers running back Christian McCaffrey has missed 18 of the past 24 games because of injuries, including five straight because of a strained hamstring. Despite returning to practice Wednesday, there’s a decent chance he misses Sunday’s home game against the New England Patriots (1 p.m. ET, CBS).

He has become what ESPN injury analyst Stephania Bells calls the “poster child’’ for hamstring and other soft-tissue injuries, particularly the hamstring that is the NFL’s leading cause for missed time, according to Bell and the NFL.

Beyond McCaffrey, Tennessee Titans wide receivers Julio Jones and A.J. Brown, Dallas Cowboys wide receiver Amari Cooper and New York Giants wide receiver Sterling Shepard, to name a few, have missed time this season because of hamstring ailments.

“This is not an isolated Christian McCaffrey case,’’ Bell said. “There’s a reason [the NFL Scientific Advisory Board in July] put out a $4 million grant to a group [led by the University of Wisconsin] to study hamstring injuries.’’

If players and teams don’t change their approach, particularly as it pertains to how they return to game action from these injuries, Bell and other medical experts say the problem will persist.

“The biggest problem that I've seen with professional athletes is getting back too soon and reinjuring it,’’ said Dr. Drew Morcos, a physical therapist who works with Seattle Seahawks quarterback Russell Wilson and NBA star Carmelo Anthony.

Research, according to Bell, shows that 11.5% of players who suffer a hamstring injury will sustain another one in the same season. And there’s a 24% chance the player will get another injury not hamstring-related.

The risks increase for players such as McCaffrey, who in 2018 and 2019 took more than 90% of his team's offensive snaps. Fantasypredictors.com research shows the likelihood of suffering a soft-tissue injury doubles for players who take more than 80% of the snaps.

Based on that, Bell said, the 25-year-old McCaffrey was an outlier in avoiding injury his first three seasons.

“It’s almost like he’s catching up to that stat,’’ she said.

That this all has happened to McCaffrey after the Panthers made him the highest-paid back in the NFL with a four-year, $64 million extension could lend credence to critics who suggest running backs shouldn’t get big second contracts because injuries lessen their value.

Bell and Morcos argue it doesn’t have to be that way. They agree fewer repetitions and minutes of action decrease the risk of injury and not all teams and personal trainers adhere to that.

That’s particularly true in returning to play.

“The medical thought would be, let’s give him zero to 10 reps in that first game and see how he feels,’’ Morcos said. “Then the following game, give 15 to 20.

“The last thing you want to do is Game 1 coming back, he goes 35 reps.’’

Easing injured players back into action

Last season, after missing six games because of a high ankle sprain, McCaffrey got 28 touches and played 72% of the snaps in his first game back. He suffered a shoulder injury in that contest, a quadriceps injury a month later and missed the rest of the season.

Bell said the Panthers (4-4) would be better off spreading the workload among Chuba Hubbard, Ameer Abdullah and Royce Freeman, as they did in Sunday’s 19-13 road win against the Atlanta Falcons, in which they combined with quarterback Sam Darnold to rush for a season-high 203 yards.

“McCaffrey can still be their workhorse guy, but it doesn’t have to be you’re not playing to you’re playing 90% of the offensive snaps,’’ Bell said.

She agreed returning to game action should be a progression, not giving the player a full load simply because he’s cleared, as coaches often do.

“You’re playing for the long haul,’’ she said.

Carolina coach Matt Rhule admitted a running game by committee may be smart, particularly until McCaffrey proves he can take a full load. He emphasized McCaffrey was “very limited’’ in his return to practice Wednesday.

Remember, after initially suffering the injury in Week 3, McCaffrey was limited in four practices ahead of Week 6 and then placed on injured reserve.

Also remember when healthy the first two games, McCaffrey had 59 carries to 10 for Hubbard. He played 89% of the snaps in the opener and 71% the following week with a Thursday night game four days away.

So the Panthers have leaned heavily on McCaffrey, who in 2019, became the third back in NFL history to have 1,000 rushing and receiving yards in the same season. And McCaffrey is the first to say he wants to play every down.

He likely would have played more Week 2 had he not left in the third quarter to get IVs for what he described as “onset’’ cramps. Morcos believes that should have been a warning sign the hamstring was weak.

“The non-contact injures and soft-tissue injuries are the ones that can be prevented,’’ Morcos said. “If they were doing something different, there is less likelihood of getting reinjured.’’

Soft-tissue injuries don't need to be the norm

Morcos said too often the team and player focus so much on rehabbing the injury that they allow other muscles to weaken. Then another injury occurs without fully addressing the “why?’’ for the first one.

He’s not surprised McCaffrey developed a quad injury after missing six games last season with a high ankle sprain. He’s not surprised players in general have setbacks that they won’t call setbacks.

Because Morcos doesn’t know McCaffrey’s full training and rehab program, he can’t say for sure what needs to be done. He just knows hamstring and other soft-tissue injuries don’t have to be the norm for him and others.

“Definitely he needs to change something,’’ Morcos said. “Because whatever he's doing isn't working longevity wise for him.’’