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Update: SB Nation's medical expert Dr. Ali Mohamadi explains the potential outcomes of a partial tear over a complete tear.
The diagnosis of a "partial tear" of a knee ligament is based on MRI findings, and although it sounds far better than a complete tear, in truth the course of treatment may or may not be different. Ultimately, it comes down to the level of stability that Griffin has in the injured knee, and this makes the physical examination that Dr. Andrews will perform vitally important.On one hand, the MRI may have shown a fair degree of tearing of the LCL and ACL, and yet Dr. Andrews may find that Griffin's knee is otherwise stable and can improve with rest and rehab alone. In this case, he could be back to football activities well before the start of the season.On the other hand, the ligaments may not be significantly torn but Dr. Andrews may still find a good deal of laxity in the joint. In this case, he may recommend surgical repair, in which case you're back to a 9-12 month timeline and the possibility of missing much or all of the 2013 season.If Dr. Andrews recommends a non-surgical approach, one thing in the back of mind would be: does this put Griffin at a higher risk of fully tearing the ligament in the future than if he goes ahead and repairs it surgically? Given Dr. Andrews' track record, you have to assume he would have considered this thoroughly and decided reinjury is not likely if he tells the Redskins that Griffin doesn't need surgery.
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Mark Maske, a well-informed NFL insider for the Washington Post, just posted what we've all been hearing: RGIII may have ACL and LCL damage.
Redskins Coach Mike Shanahan said Griffin is scheduled to be examined Tuesday in Pensacola, Fla., by orthopedic surgeon James Andrews to determine whether the test results show new or previous injuries.
This is unfortunate news and could mean RGIII's timeline for playing in 2013 is in jeopardy. Of course, this information is all preliminary and the team will likely deliver more information at a later date. RGIII is set to see Dr. James Andrews on Tuesday to find out more information.
Earlier today I spoke with SB Nation's medical expert Dr. Ali Mohamadi who ironically is a DC resident and life-long Redskins fan, and he provided some insight on ACL and LCL tears. His bio is impressive in case one has any doubts.
Dr. Ali's information is based off of full ACL and LCL tears -- not partial tears, as RGIII's is reported to be -- so it's not quite the same. Partial tears can be theoretically rehabbed without surgery. But we'll be following up with Dr. Mohamadi now that we have specifics about the exact injury. For now, start learning about ACLs and LCLs...
Dr. Ali: Recovery from combined ACL and LCL tears is a grueling and time-consuming process, and when you're dealing with a patient like Griffin with a prior history of an ACL reconstruction on the same knee, even moreso. The progression to physical activity is very slow to ensure that the grafts are sufficiently strong to endure motion and weightbearing. Typically, patients remain in a brace for at least 6 weeks, during which time they are advised not to fully bear weight on the affected leg and aren't allowed to fully bend the leg. Strength training and range of motion exercises progress slowly to a point where the patient has built up enough mobility and regained muscle to begin running, usually at 6 months after surgery. For most athletes, notwithstanding Adrian Peterson's amazing full recovery from ACL and MCL tears in about 9 months, many experts will tell you that it can take a full year for an athlete to feel like he or she is back to 100 percent function.
The added factor for Griffin is that he has a prior history of ACL reconstruction. For an athlete with no prior history of an ACL tear, the recovery is a daunting process to begin with and usually takes longer than for other knee ligaments. Studies show that while the risk of re-injury is about 5% among patients who have had ACL reconstruction, the risk for failure doubles after a second ACL repair, and this study didn't just look at athletes who endure the wear and tear that football players do. It doesn't mean Griffin shouldn't be able to play -- and play well -- after a second ACL reconstruction, but it does add a level of concern over the possibility that it could happen yet again.