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8/31/2009
Matt Cassel's "Leg Injury"
Click for Video of Cassel’s injury.
Mechanism of injury appears consistent to one that would cause an MCL sprain or worse.
Left leg was held by Seahawks' Brandon Mebane while Casell fell on his right side causing a
'valgus' stress to his left knee.
The medial meniscus lies directly attached and beneath the MCL and can tear also. If the
sprain (torn ligament) is severe, the femur and tibia can hit into each other causing a painful
bone bruise, which can take several weeks to heal.
A grade 1 MCL sprain involves partial fiber stretching and some tearing; a grade 2 MCL
sprain involves more fibers grossly tearing; a grade 3 MCL involves complete rupture of all
fibers.
Diagnosis of an MCL sprain is made clinically based on physical exam and confirmed with
an MRI. An MRI will also rule out a meniscus tear or bone bruise.
An x-ray can sometimes show a small avulsion or fleck of bone off the femur from the site of
attachment of the MCL.
With an isolated grade 1 MCL sprain, a player may come back in a couple of weeks usually
with a hinged knee brace. Platelet rich plasma therapy has been touted anecdotally in the
news (but no randomized clinically controlled scientific studies yet) to rapidly aid in healing
and return to play. See Ward Hines.
A player with a MCL sprain can expect stiffness and pain initially, then pain and difficulty
with side to side motion, cutting, pivoting, and planting off the injured leg. If severe, the
knee joint may feel loose and unstable but not to the extent of an ACL rupture.
MCL sprains even complete Grade 3 ruptures, do not require surgery.
NOTE: A sprain is a torn ligament; A strain is a torn muscle or tendon.
Follow NFL Sports Injuries: www.twitter.com/njsportsmed
Matt Cassel's "Leg Injury"
Click for Video of Cassel’s injury.
Mechanism of injury appears consistent to one that would cause an MCL sprain or worse.
Left leg was held by Seahawks' Brandon Mebane while Casell fell on his right side causing a
'valgus' stress to his left knee.
The medial meniscus lies directly attached and beneath the MCL and can tear also. If the
sprain (torn ligament) is severe, the femur and tibia can hit into each other causing a painful
bone bruise, which can take several weeks to heal.
A grade 1 MCL sprain involves partial fiber stretching and some tearing; a grade 2 MCL
sprain involves more fibers grossly tearing; a grade 3 MCL involves complete rupture of all
fibers.
Diagnosis of an MCL sprain is made clinically based on physical exam and confirmed with
an MRI. An MRI will also rule out a meniscus tear or bone bruise.
An x-ray can sometimes show a small avulsion or fleck of bone off the femur from the site of
attachment of the MCL.
With an isolated grade 1 MCL sprain, a player may come back in a couple of weeks usually
with a hinged knee brace. Platelet rich plasma therapy has been touted anecdotally in the
news (but no randomized clinically controlled scientific studies yet) to rapidly aid in healing
and return to play. See Ward Hines.
A player with a MCL sprain can expect stiffness and pain initially, then pain and difficulty
with side to side motion, cutting, pivoting, and planting off the injured leg. If severe, the
knee joint may feel loose and unstable but not to the extent of an ACL rupture.
MCL sprains even complete Grade 3 ruptures, do not require surgery.
NOTE: A sprain is a torn ligament; A strain is a torn muscle or tendon.
Follow NFL Sports Injuries: www.twitter.com/njsportsmed