Oh how medicine changes in 25 years. Recently, Nebraska All American offensive lineman Spencer Long suffered a season ending MCL injury, early in the Purdue game, and it reminded me of 1986. Why? I recalled my college career as a student athlete.
<< Me with hair.
As I tell my patients, I have more scars than letters from my college football days at the University of South Dakota, but if it were not for those injuries that ended my playing career, I may not have stayed for summer school and attended medical school. In early 1986, I was a new freshman linebacker working my way up the depth chart. During a scrimmage, I went in to make a tackle and in the process, a lineman landed on my leg. Instant pain and I thought I had broken my leg. Instead, I looked down and saw my left leg bent, and where my knee cap was supposed to be…there was a void! My kneecap was dislocated and on the side of my knee. Fortunately our experienced athletic trainer gently straightened out my knee and it slid back to where it was meant to be….there was INSTANT relief. I learned at that time that I had also torn my “MCL”.
This was at that time, a foreign language for me. It meant the inside band of tissue, or ligament of my knee, the one that helps keep my leg from being wobbly side to side, or from bending inward too much, had torn. I needed surgery I was told. So off to the team orthopedic doc. After the surgery to put a “staple in my ligament”, I would be casted for 3 months, use how to navigate crutches in the South Dakota snow and start my rehab after the cast was removed. Mind you this cast was from my crotch to my ankle. Once they removed the cast( I will spare what my sense of smell recalls, it is engrained in my memory), I saw a chicken leg of what once was a leg that could squat half the weight room.
At my last post operative visit with my surgeon, he had the revelation to share: “ I just got back from a medical conference and we don’t surgically repair these anymore!” What a thing to say to an 18 year old that respected his elders and didn’t want to reach over and hurt the man.
Point is, that today it is not as common for MCL tears to require surgery. Bracing for up to 2-3 weeks, physical therapy and rest, for a grade I, may be the treatment of choice. Grade 2 may take up to 4 weeks to heal. A player may return to straight line running, then planting and pivoting. Once cleared, Grade 1 and 2 usually return within 4 weeks and it is recommended that they wear bracing during competition. If a grade III MCL tear is suspected, many times there is also a torn medial meniscus or ACL , which may require being addressed with arthroscopy or reconstructive surgery. These are longer recoveries and could represent a season or career ending injury. MCL injured players require surgery much less than even 25 years ago!
All things happed for a reason. I would do it all again, or I would not be here writing as a physician!