RGIII injury: Assessing what we know about the Redskins QB

Al Bello

There are several outcomes possible for Robert Griffin III's knee injury, with treatment ranging from rest to surgery. Here's a look at what we know while waiting for the MRI results.

Driving down the field in the first quarter, en route to a touchdown that would put the Redskins up 14-0 yesterday against the Seattle Seahawks, what seemed to be a new high for Washington and quarterback Robert Griffin III turned out to be a turning point that ultimately helped end the team’s 2012-2013 campaign.

Rolling to the right on a pass play deep into Seahawks’ territory, Griffin planted to throw a pass to receiver Pierre Garcon. As he finished his follow through and began backpedaling, the QB came up hobbling, having aggravated a sprained right lateral collateral ligament (LCL) injury suffered in the team’s Week 14 victory over the Baltimore Ravens. Although Griffin would connect on a 4-yard touchdown pass to tight end Logan Paulsen several plays later to put his team up two scores, he limped through an ineffective performance thereafter, finally leaving the game late in the fourth quarter after awkwardly hyperextending his already gimpy right knee while trying to corral an errant shotgun snap.

Now the tenor of the Redskins’ entire offseason hinges upon the results of an MRI of Griffin’s right knee, which will determine whether their Pro Bowl QB will need surgery to repair any additional damage he may have suffered yesterday. To be clear, at this time there is no information regarding the severity of yesterday’s injury, although Griffin himself was far less reassured in his comments following the game than he was immediately after suffering the initial injury.

Several media outlets reported that Griffin went for an MRI last night after leaving FedEx Field, which is similar to the procedure the team employed after the injury against Baltimore. Unlike that time, however, the team did not immediately release results of the exam, which has sent Redskins fans into a panic over how to interpret the team’s lack of communication Monday morning. While we await the results of the MRI, there are several possibilities to consider based on what often occurs when an LCL injury is aggravated.

The knee is a joint connecting the femur (thighbone) and tibia (shinbone), with ligaments running along the sides and front to hold the bones together. The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) run along the front and rear of the knee, respectively, with the medial collateral ligament (MCL) runing along the inside and the LCL on the outside. An injury to any of these ligaments can cause instability of the joint, with sprain injuries -- by definition a degree of stretching or tearing of the ligament -- being the most common type. The severity of and prognosis for recovery from knee sprains are often a source of confusion, primarily due to confusion over what exactly the different "grades" of sprains actually mean.

In brief:

  • A Grade 1 sprain is a mild injury that takes place when there is slight stretching and minimal damage to the fibers of the ligament. Individuals can usually place pressure on the foot and walk afterward.
  • A Grade 2 sprain is an injury of moderate severity with partial tearing of the ligament. When the knee joint is examined, abnormal looseness (laxity) of the joint occurs.
  • A Grade 3 sprain is a severe injury in which a complete tear of the ligament occurs.

If the knee is pushed or pulled in certain directions, significant instability can be felt. Redskins team officials went on record as stating that Griffin’s initial injury, the one suffered against Baltimore, was a Grade 1 LCL sprain, which explained his speedy return to action after missing the team’s Week 15 win over Cleveland.

In one scenario following yesterday’s game, Griffin could have suffered a higher grade sprain, the degree of which would determine the timetable for recovery. If he suffered a Grade 2 sprain, treatment would almost certainly not require surgery and could be accomplished with rest and treatment for pain and swelling over the course of the next 3-8 weeks. In other words, no risk to his preparation for the 2013 season. In the case of a Grade 3 sprain, the usual course of action for an athlete of Griffin’s level would be surgical repair. With an LCL injury, this could be accomplished by reattaching the severed ends using stitches or staples in some cases, although in many cases surgeons believe the best approach is to perform reconstructive surgery by taking tendons from the patient’s own hamstring or patella.

There is a fairly wide range in terms of the usual recovery time from surgical repair of a torn LCL, often quoted as anywhere from 4-8 months. But it would be likely that Griffin could play from Week 1 of the 2013 season if the injury is isolated to the LCL alone.

Interestingly, when looking at Griffin's final play, in which his right knee bent awkwardly attempting to retrieve the errant snap, it appeared that a significant traumatic force was applied to the outside of the joint. This would actually be consistent with an MCL injury, which is less commonly treated with surgical repair. If completely torn, physicians may opt for surgery (more commonly performed in elite athletes than the general population for an MCL), which carries a recovery time that is slightly shorter than an LCL and therefore would be less likely to jeopardize the start of Griffin's 2013 season.In a worst-case scenario, however, Griffin could have sustained damage to other knee ligaments on top of the LCL.

What is most worrisome would be the ACL, which Griffin previously tore as a sophomore at Baylor requiring complete reconstructive surgery. This is a particular concern as we await results of Griffin’s MRI, as severe LCL (or MCL) injuries are frequently associated with ACL injuries as well. Although this season Adrian Peterson proved that athletes can return to top form as quickly as nine months following complete reconstruction of the ACL -- and MCL, in Peterson’s case -- the recovery time from an ACL tear is often longer than this and would put Griffin in serious jeopardy of missing the start of the 2013 season.

This is all speculative, and the picture won’t be clear until the Redskins reveal the results of Griffin’s MRI. But if you sense a great deal of anxiety coming from the Nation’s Capital until then, it certainly is warranted until that time comes.

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