It’s been an exciting season to cheer on the New England Patriots, but the Patriots have also suffered many injuries throughout the year. With the playoffs upon us, many fans are hopeful that the top players will be back on the field in time for the big games. Thomas Wuerz, MD, a sports medicine expert at NEBH looks into some of the injuries we’ve seen this season, including their recovery times, so you can gauge when the players will be back in action.
Collateral Ligament Injuries
Collateral ligaments are the tough, fibrous tissues that connect the lower leg bones (tibia and fibula) to the thigh bone (femur). The medial collateral ligament (MCL) is on the inside of the knee, and the lateral collateral ligament (LCL) is on the outside. These ligaments control the sideways motion of the knee. Injuries to the collateral ligaments are common in football because they’re frequently caused by a direct impact to the side of the leg, for example from a fall or a collision with another player.
There are different grades of injury to the collateral ligaments. A more minor injury is a sprain, where the ligaments are overstretched but not torn. A more serious injury is when a ligament is completely torn. Patriots players have experienced a number of knee injuries this season, most notably, Dont’a Hightower has been out of the game due to an MCL injury, Rob Gronkowski missed playing time because of a knee strain, and Danny Amendola also missed games due to a knee injury.
Most injuries to the collateral ligaments do not require surgery. Treatment typically includes rest, ice, physical therapy and often bracing to strengthen and restore function to the knee. The player will be able to return to the sport gradually, slowly working back to full participation. A player could recover from a very minor sprain in less than a week, but more serious injuries could take 2-8 weeks before he would be healthy enough to return to participate in a game.
The anterior cruciate ligament (ACL) works with the posterior cruciate ligament (PCL) and collateral ligaments to keep the knee stable. It limits rotational movement of the knee and prevents the shin bone (tibia) from moving too far forward on the thigh bone (femur). An ACL injury occurs from overstretching or tearing the ligament, often caused by changing direction quickly, landing incorrectly from a jump, direct contact from a collision, or stopping suddenly.
Similar to the collateral ligament injuries, an ACL injury can occur at different grades, from minor sprains and partial tears to complete tears of the ligament. Unfortunately, partial tears are rare, and most ACL injuries are complete or nearly complete tears. For an athlete looking to return to sports, surgery is usually necessary. Patriots player Dion Lewis tore his ACL, ending his 2015/2016 season in Week 9, and will require physical therapy and surgery before he can return to football next season.
Doctors usually will not perform surgery right away, allowing time to reduce swelling, to restore as much of the knee’s normal range of motion as possible, but also to start strengthening the thigh muscles before surgery. Torn ACLs require reconstructive surgery, in which surgeons perform arthroscopic surgery (a small incision) to rebuild the ACL by using a substitute graft from another part of the body (for example hamstring tendon or a bone-patellar tendon bone unit). This can be taken from the patient’s own body (autograft) or obtained from donor tissue (allograft). Recovery from surgery includes physical therapy, and an athlete can typically return to full athletic participation after 4-6 months.
The ankle is considered a “hinge joint” because it moves in only one direction. It’s composed of the talus bone coming up from the foot, joined by ligaments to the tibia and the fibula from the leg. Ankle injuries occur when the ankle joint twists, rolls, or moves in any direction other than like a hinge.
The most common ankle injuries are sprains, when the ligaments can become torn or ruptured. Patriot Devin McCourty came off the field with a high ankle sprain in the 2015 game against the Houston Texans. Similar to collateral ligament injuries, ankle sprains rarely require surgery. Rest, ice, bracing, and physical therapy can restore strength to a sprained ankle usually in about 4-6 weeks.
Knee and ankle injuries are some of the most common injuries football players incur. Every injury is different, and the time it takes to recover depends on the severity of the injury, the condition the athlete was in before the injury, and the type of treatment, so there’s no way to guarantee exactly when an injured player will be back. It is important, however, to aim for a maximum recovery before returning to play, as previously injured areas are weaker and more likely to be injured again in the future if not properly cared for.
While knee and ankle are common in football, they can also occur during everyday activities. If you experience one of these injuries, make sure to contact an orthopedic expert to receive the same quality care that you’d expect for your favorite players.