Diagnosing Eagles’ Wendell Smallwood’s season-ending knee injury
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Last Sunday, Philadelphia Eagles running back Wendell Smallwood sustained a knee injury against the Washington Redskins, effectively ending his rookie season.
Smallwood sprained the Medial Collateral Ligament (MCL) of his knee, resulting in a Grade II tear.
The MCL is a ligament located on the inner aspect of the knee and connects the upper thigh bone (femur) to the lower shin bone (tibia). The ligament is stressed from blows to the outside of the knee, and is commonly injured in football, as players typically fall on the outside of the knee while the foot is planted. This results in tears to the fibers of the MCL.
Ligament tears are diagnosed in three grades:
Grade I is relatively minor with no disruption of the ligament,
Grade II is a partial tear involving disruption of some, but not all, of the ligament,
Grade III is a complete tear of the MCL.
Injuries to the MCL are painful and decrease the stability of the knee, which can result in the player not being able to take the field again until enough healing occurs.
Since the MCL is not located "inside" the knee joint, it is not exposed to joint fluid that can inhibit healing in this area. This means the MCL has the ability to heal itself, if protected. In most cases, MCL tears are stabilized and protected with a brace during healing, and the athlete will typically use crutches for several days before progressing to full weight bearing activity.
Occasionally, but more infrequently, the MCL is torn so significantly it requires surgery, which was the case for the Vikings' Adrian Peterson who underwent season-ending surgery for a complete MCL tear earlier this season. Fortunately for Smallwood, his partial MCL tear should heal on its own.
So when can we see Smallwood back on the field?
Return to play is often based on the extent of the injured MCL, and there is great variability. Athletes with Grade I tears often return to play in one to two weeks; Grade II tears take longer with the player returning between two and three weeks; and complete Grade III tears take the longest to heal, often requiring at least six weeks of recovery before returning to the game.
Since Smallwood's injury was a Grade II tear, he could have been back on the field in early January. However, since the Eagles only have three weeks left in their season, they've placed Smallwood on the Injured Reserve list, essentially bringing his season to a close.
I expect Smallwood should make a full recovery from this injury, and return to the same form that he demonstrated prior to the injury.
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