by Dr. J. Heath Richter

Whether you’ve been following the NBA or NHL playoffs or took in the English Premier League soccer championships, it’s been an exciting time in sports the past several weeks. The thrill of watching your favorite sports team and player succeed, the camaraderie shared with friends and strangers, and the roller coaster ride of emotions after pulling off a last-second victory is only hampered by the one thing (besides losing) fans dread most – an injury.

Just over one week ago, Golden State Warriors basketball player Stephen Curry, arguably the best player in the NBA, suffered a grade 1 MCL sprain in the first-round playoff series against the Houston Rockets. (The Warriors have since won that best-of-seven series and advanced to the second-round against the Portland Trailblazers.) The injury was expected to have sidelined the point guard for at least two weeks.

We sat down with Dr. J. Heath Richter, orthopedic surgeon at HCA-affiliate Fairview Park Hospital, for his insight into MCL injuries, the other three-letter word sports fans (or athletes!) don’t want to hear – ACL injuries; and recovery time for both. He also gave us his predictions for when Curry will be back on the hardwood.

What is an MCL, exactly?

MCL stands for medial collateral ligament, which runs along the inside part of the knee and stabilizes it for side to side motion. It’s the most common ligament knee injury.

And how does it differ from an ACL?

An ACL, anterior cruciate ligament, is the ligament that keeps the tibia – the bone in the lower leg – from shifting forward when you make rapid changes in direction.

How do MCL/ACL injuries typically occur?

MCL injuries are typically caused by contact made along the lateral side (outside edge) of the knee that stresses the ligaments on the medial side (inside edge) of the knee. Ultimately, MCL injuries are caused by stress to the medial knee – either by contact or a slip or plant of the foot, which seems to have been the case with Curry.

On the other hand, ACL injuries generally occur with non-contact from sudden, rapid direction changes or stops.

What are the signs and symptoms for these types of injuries?  

Both injuries present with a sudden onset of pain.  MCL injuries are less painful and the athlete can sometimes continue walking. If the athlete has a mild MCL injury, they may even be able to immediately return to play with bracing.

ACL injuries are more painful and the athlete will often hear a pop.  The knee typically swells fairly quickly and the athlete is unable to bear weight on the leg.

How is an MCL or ACL injury diagnosed?

A sprain or tear of the MCL or ACL is diagnosed by a physical exam, the patient’s history and verified by MRI imaging.

Which injury is more severe – an MCL or ACL?  And what is the treatment plan?

Usually, ACL injuries are more severe than MCL injuries. We can treat isolated MCL injuries non-operatively, whereas ACL injuries require surgery.  An ACL tear causes complete disruption of the ACL and is treated with reconstruction of the ligament using either tendons from the athlete or from a cadaver.

What is the recovery time for ACL injury? 

Athletes can typically return to sport between six to nine months after an ACL reconstruction.

NBA player Steph Curry was reported to have suffered a grade 1 MCL sprain, and sit out for at least two weeks. Could you explain the grading system?   

Grading refers to the severity of the injury.  Grade I is a minor sprain, Grade II is a severe sprain or partial tear and Grade III is a complete rupture.  Grade III tears are treated with bracing and typically non-weight bearing activity for four to six weeks.  High-level athletes would be out of play for approximately two to three months.

Grade I injuries are minor and treated with bracing and weight bearing to the athlete’s tolerance. Two weeks is typical for return to play.

And with that, all Warriors’ fans breathe a sigh of relief.

Sports are the great equalizer, you see. No matter where you are or who you are, sports has a way of bringing us all together. In the spirit of sportsmanship and competition, no one wants to see a player get injured, especially a great player like Curry.

Visit here for more information on the Fairview Park Hospital Joint Center, including services in orthopedic surgery, joint reconstruction and hip replacement surgery.

See this HCA Today article here

June 6, 2016 by Kathryn Johnson, OD, F.A.A.O
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