My first thought is that this is just our brains trying to make sense of randomness. Yes, it seems like there have been a lot of MCL injuries lately. But perhaps that is simply because they’ve happened to such prominent players. If the same number of MCL injuries fell upon special teamers and reserve players, we’d never notice. In my database, I show 31 confirmed MCL injuries in 2014. Obviously my 2015 database is not complete, but so far at least, the number of MCL injuries this year does not appear to be out-of-whack. We’re halfway through the season, and I’ve logged 18 so far.

Even if we do end up with more MCL injuries this season, I’d say that it might be nearly impossible to find one culprit to pin them on. Just in thinking about this over the last day, I can think of four distinct possibilities. The first possibility could be that field turf and athletic cleats have become “grippier.” MCL injuries often happen when a player’s foot is dug into the ground while he receives a blow from a helmet to the outside of his knee. (You can read more like this in my MCL overview). Obviously, the goal of both good turf and shoes is to provide traction, so you can’t really fault them for having too much traction.

Another possibility here is that we could just be seeing more injuries because the players are bigger, stronger, and faster. Muscles can be strengthened, but ligaments and tendons cannot, so they are often the weakest link on an athlete’s body. This is charming narrative for two reasons. On the one hand, we love to think the athletes of today are absolutely the best ever. On the other hand, their puny ligaments make them just like us. It’s like seeing celebrities shopping at Walmart in sweatpants and a Day-Glo green fanny pack.

One more possibility here is that tacklers are going lower on the body so as to avoid the head hits that they will most likely be penalized for. This is another seductive narrative as it gives us a very simple cause and effect, while also making us think that the new safety regulations are either helping or hurting player safety, whichever side we want to collect casual evidence for.

I would suggest that there is one culprit though that is actually fairly likely. This is something close to my injury-blogging world, so I have all sorts of bias here as well. I would guess that any possible increase in MCL injuries might come down simply to how injuries are reported and covered in the media. With the rise of fantasy football came a thirst for better, more specific injury information. Rather than settle for a vague term like, “knee injury,” fans and reporters started digging in a little more. People were more likely to ask whether a knee injury was an ACL, PCL, MCL, LCL, hyperextension, deep bone bruise, or something else. From my own (biased) experience, I can tell you that there’s often a point of diminishing returns when I try to pull details on an older NFL injury. Even injuries from as recently as 2005 or so will often have scant medical details reported, leaving me with a dead end. But with recent injuries, I can often find very specific information. Older reports often refer to an injury as simply a, “knee injury,” or, “knee sprain,” whereas modern reports would break it down to specific ligaments. It’s thought that the MCL sprain is the most common knee injury, so it’s safe to say that a great deal of these older, “knee sprains,” were specifically MCL injuries. In my opinion, it’s more likely that over the last few years the reporting has changed much more than the actual game or athletes. Just my thoughts though… feel free to go ahead and narrative the shit out of this if it makes you happy.

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MCL Sprain/Tear RTP

Because of my callous dismissal of MCL sprains, I was surprised to see that the Tampa Bay Times was saying that Dotson could miss, “as much as 10 weeks,” with this injury. It’s not even that this 10 weeks estimate is incorrect, it just surprised me because it was so severe. Typical media reports tend to revolve around the best-case-scenario rehabs, and hardly ever take into account the more pessimistic possibilities. Without knowing anything about Dotson’s specific injury (aside from the fact that it’s an MCL sprain of course) I would’ve expected the media to sort of parrot something in the, “two to four weeks,” ballpark. Other sources went with, “six to ten weeks.” Indeed, Dotson himself said that he hopes to be back in six weeks. Still, that’s odd. Not necessarily wrong, but odd.

Take a look at that RTP chart again. Do you see how few people need six or more weeks to come back from this injury? I’ll be the first to admit that Dotson certainly knows more about his exact injury than I do, and that he has his reasons for shooting for that six week return. But I don’t get it. Even oft-injured G/T Roger Saffold missed only seven weeks with a severe (grade 3) MCL sprain in 2012. Saffold followed that up by missing only four weeks with another MCL sprain (of unknown severity) in 2013. So why the pessimistic mention of ten weeks as a possibility? I don’t know. Perhaps the team is being overly cautious. Perhaps they’re planning a roster move such as injured reserve with designation to return, and they’re simply working backwards based on when he’d first be eligible to return. Or maybe there is something really messed up with Dotson’s knee. I’m not saying that we’re not getting the whole truth… yet. I’m just saying that this one stood out to me.

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This probably falls into the category of, “more interesting to me than to the reader,” but I’m posting it anyway because it’s history in the making. As of today, October 27th, Trumaine Johnson has smashed all of my database records by sitting out nine (9!) games with an MCL sprain. He missed the final preseason game and has been inactive for all seven regular season games. Plus that week four bye. So yeah, we’re looking at nine weeks that he’s missed with this injury, and I can’t find anything saying that he’s close to returning. When he went down back in August, the rehab timeline was estimated at about six weeks:

MRI revealed a sprained MCL for Rams corner Trumaine Johnson. Likely a 6 week timetable

— Jason La Canfora (@JasonLaCanfora) August 24, 2014

MCL sprains are an injury I have pretty well covered in my database. I have records on 31 players who suffered this injury between 2010 and the end of the 2013 season. The average return is after missing 2.35 weeks, and almost all of them are back by about four weeks. In fact, of those 31 players, only two missed more than five weeks. LT Roger Saffold missed missed seven weeks with an MCL sprain back in 2012. RB Javon Ringer technically missed 12 games in 2012 with the injury, but it’s thought that he was so far buried in the depth chart that the team put him on the IR shelf just to free up some space, not because his injury was that significant.

Where does that leave us with Trumaine Johnson? We know that he’s a starting-caliber CB and that St. Louis needs him back. That rules out a depth chart issue (meaning that he truly is injured as opposed to some questionable roster manipulation). So either Johnson has the most severe MCL sprain that we’ve seen in recent times, or he has a more serious injury. I’m not smart enough to tell you which option is correct. A big part of the purpose of my database is to catch and note injury outliers like this, so I’m not going to just write this off as a more serious knee injury masquerading as an MCL sprain. But it does bear watching, as this simply is not adding up.

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Crap, I have to write a whole piece about this guy without accidentally calling him David. I can’t even do that in casual conversation. Honestly, I have a piece of paper next to the keyboard right now with the name “Derek,” just so that I can be sure I’m talking about the right Carr. Damn you, journeyman QB David. Also, before we go any further, what exactly is Derek doing with his left hand in that photo above? This is just one man’s opinion, but it looks to me like some disinterested imaginary nipple tweaking.

Derek Carr (the one who hasn’t yet proven how stinky he is) went down in Sunday’s game with what is now being reported as a left knee MCL sprain and a left high ankle sprain. Things can always change as more tests are run, but so far, Derek has said about the dual injuries, “Both of them are sprained.” We’ll see whether or not that’s the extent of the injury, but, since that’s all that’s been said so far, let’s just take that as the truth for right now, shall we?

It’s Sunday evening as I write this, and I’ve yet to see the usual crop of premature estimations popping up. I’m interested to see what the consensus turns out to be, but I’ll go ahead and be the brave one and offer mine up first. He’ll be out three weeks. If you want to give me the usual wiggle room that all reporters desire, I’d get as vague as, “Carr will miss two, three, or four weeks.” Before I go on, let me nail that down to specifics, as tons of reporters get even more vague when they try to apply their guesses to actual schedules. The Raiders have a Week 5 bye. I’m saying that Carr will not play Week 6 versus San Diego. I see him coming back for the Week 7, Week 8, or Week 9 game. But if I just have to pick one, it’s that Week 8 at Cleveland.

In my ridiculous database, I have plenty of examples of players with either MCL sprains or high ankle sprains. (In fact, high ankle sprains are somehow my favorite injury to log, as they’re still often wrapped up in mysterious cloudy coachspeak). In fact, I have 31 good, “clean,” examples of MCL sprains, and 66 good, “clean,” examples of high ankle sprains. By “clean,” I mean that the player returned during the season rather than going on injured reserve or finishing the season on the bench. Let’s take a look at how these look, represented in basic bar graphs:

MCL Sprain return to play

As far as I can tell (and there’s totally some guesswork in there), the two injuries will not have conflicting rehabs. Neither of them should require surgery, and they should both require a lot of, “taking it easy.” Carr should pretty much stay off of that leg for either injury, so it’s not like one injury compounds the other…. as long as we’re still talking about two pretty straightforward sprains as Carr told us. Given that background, I think we can pretty much just overlay those two charts into one to get us a (really really) rough guess. Sure, that’s probably fudging all sorts of proper statistical work, but let’s do it anyway:

MCL sprain and high ankle sprain combined projection

See where I’m getting that three week estimate now? Looking at each of the separate MCL sprain and high ankle sprain charts, you can tell that general two to four weeks missed range is pretty fat. Put those charts together though, and WHAM-O, it’s obvious. If you trust my mashed up injury timeline (and I’m still not convinced that you should), then by far the most frequent return would be after missing exactly three weeks. That’s when 29% of players have come back from MCL OR high ankle sprains (not trying to mislead you… I have no record of players with this exact combination). Cast that net a little wider into the, “two to four weeks,” range, and you now see about 61% of the players returning during those three exact weeks. So there, I’ve at least shown my work and you can get a basic idea of where I’m coming up with my guess. Let me know if you see any reporters doing the same. Unlike a lot of my criticism of NFL coverage, I actually have a feeling that most people might go too pessimistic in their estimates, as they’re not aware that the two rehabs pretty much dovetail into the same rehab timeline. I’ll be sure to keep tabs on this and point out how incredibly right I am.

Update, October 12, 2014: Holy crud…. he’s back! I did not see that one coming. Carr ended up resting for the bye week and then coming right back to play today, meaning he missed only one week. That’s an amazingly quick comeback, and, what’s more, he even looks good playing against San Diego now. I had guessed he’d be out three weeks, or at least something in the two-to-four-week range. Wrong-zo. Now I have to do some digging and try to prove that his injuries were less severe than we were led to believe. Nope, I have no real information on that, but it’s either make that case or admit that I missed the mark on this one. In my defense, my cobbled-together chart up above shows my estimate that maybe 12% of players might come back after missing only one week. Still, I never thought that would be the case here, and I certainly never would’ve thought that Carr would be playing so well so soon after returning.

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First up, Ravens TE Dennis Pitta. In yesterday’s game, Pitta had a horrible injury where he dislocated and fractured his right hip. It required all sorts of gross surgery that I don’t even want to think about, and I’m not entirely convinced that Dennis isn’t still pushing around a wheelbarrow containing his detached leg. Now obviously Pitta is done for the year. But some people do come back from dislocated and fractured hips. People like Dennis Pitta! In 2013, he suffered the exact same injury and came back to play the last four games of the season. Big difference is that, last time around, Pitta had the forethought to injure himself in July rather than September. That difference in timing should guarantee he doesn’t get back on the field this season.

Next up, Cardinals DB Antonio Cromartie. Yesterday Cromartie did a foolish thing and hyperextended his knee. Those can be scary, as there’s always a decent chance that the player suffered something more extensive as well, such as more severe ligament damage. From what’s come out so far though, it sounds like Cro (yes, people call him that) escaped with just the hyperextension. Well played Cro, well played. To get a good idea of how that might sideline him, we’d have to look all the way back to…. Antonio Cromartie in 2013. During an ugly season with an ugly team, Cromartie hyperextended his knee. He didn’t miss any games, although he was picked on pretty mercilessly by the Steelers in his next game. At least this year he has a bye week to work with.

Last one, Panthers RB Jonathan Stewart. In Sunday’s game, Stewart sprained his knee. I’ll be the first to point out that terms like, “sprained knee,” are a little too vague for me, and that there’s still plenty of details out there that I’d like to hear before I’m more comfortable with this comparison. A lot of different things within the knee could be sprained. This is like taking your car to a mechanic and telling him, “the motor’s busted.” But from my experience as an injury obsessed blogger, I can tell you that, “sprained knee,” ends up being specifically an MCL sprain fairly often. Sometimes it’s an LCL sprain, sometimes it a meniscus sprain, but mostly it tends to be MCL. You know where I’m going with all this by now, so let’s just get to it… Stewart sprained his MCL last season. It happened towards the end of the season, and he missed five weeks with the injury. Well technically, he might’ve missed more. We’ll never know, as he was inactive for a playoff loss, so he never did make it back into a game. (Damn, I know it was only last year, but Carolina in the playoffs!?! Did that really happen?)

I’m not saying that things will unfold exactly the same way they did in 2013 for these three players. But I am saying that I’ll probably never find a better comparison, so I’m not digging any further. I’m a busy man with important things to do.

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