Note: One of the hottest topics here in South Carolina this week has been Clemson’s chase for the college football national championship. When Shaq Lawson injured his knee in the semifinal playoff game, a ton of Clemson fans asked me if he would play. I am not involved in his care, so I don’t really know. I did think that it would be educational to explain, though, how we treat MCL injuries of the knee and how well athletes can play in the days after such an injury for my latest newspaper column.

“Have you seen many hoverboard injuries?” That might be the only question I have been asked lately more than the status of Shaq Lawson. Will the star defensive end be able to play Monday night as Clemson plays for the national championship?

Knee injury early in the Clemson win

On the second play of the Orange Bowl, Lawson came off a stunt and felt his “knee buckle a little bit,” he described to Nikki Hood of TigerNet after the game. Lawson returned for the second possession and sacked Oklahoma quarterback Baker Mayfield before exiting the game again.

“When I moved, something in my knee felt kind of weird,” he explained to reporters about trying to keep playing. “I tried to give it a go with a new brace on, and I felt like I couldn’t go.”

The junior, who leads the nation in tackles for a loss, remained on the sidelines with his helmet off and an ice pack on his knee for the remainder of the first half. He came out of the locker room after halftime in sweatpants, and he was ruled out for the remainder of the game.

Also read:
Medial Collateral Ligament (MCL) Injuries
Do knee braces prevent injuries in football?

Lawson believed he suffered an MCL injury

Sport-Medicine-Simplified_Master_2014-01-03Lawson told the media after the Tigers’ semifinal win that he thought he had suffered an MCL sprain but would know more after an MRI the next day.

As reported by Aaron Brenner of The Post and Courier, Clemson head coach Dabo Swinnney addressed Lawson’s status heading into Monday’s title game in Glendale, Arizona. “So far, so good. We’ll see him out there today, but I think the prognosis is good at this point. We’ll get him out there and run around a little bit and kind of go from there. I’m very optimistic he’ll be able to play.”

To be perfectly clear, I am not Clemson’s team doctor, nor have I spoken to Tigers’ team physician Larry Bowman. I haven’t examined Lawson or have specific knowledge of the All-American’s MRI results. I don’t even really know if an MCL injury is what he has or his only injury if he has one. My commentary here is intended only to educate readers as to the nature and treatment of an MCL injury for any elite athlete trying to return to play soon after the injury.

What is an MCL injury? How do orthopedic surgeons treat it?

The medial collateral ligament (MCL) is a thick ligament on the medial side of the knee (inside or side closest to the midline of the body). It stabilizes the knee against side-to-side stress. Injuries to this ligament are graded 1-3 based on the severity of the injury. The time required for the ligament to heal may vary based on the grade. Grade 1 MCL sprains take up to two weeks. Grade 2 MCL injuries can take up to four weeks, and grade 3 MCL tears can take up to six weeks. Fortunately patients with isolated MCL injuries rarely need surgery.

Generally orthopaedic surgeons treat athletes with MCL injuries with rest and a brace to limit stress on the ligament. Once he regains full knee motion and strength and the ligament has healed enough to allow activities, he works with physical therapists or athletic trainers to progress through functional drills. Depending on how those movements and exercises go, he can increase activity and then practice and play.Football injury

Often we will put an athlete in a custom-made brace that can protect the MCL while he tries to play. Those braces, which are worn by college and pro lineman to actually prevent MCL injuries, can help an athlete return to the field even before his knee is 100%.

Another treatment option for a top athlete trying to play quickly after an MCL injury is platelet-rich plasma (PRP). Former Pittsburgh Steelers wide receiver Hines Ward played in Super Bowl XLIII two weeks after suffering a grade 2 MCL injury in the AFC Championship Game. Steelers team physician Dr. James Bradley injected Ward three times with PRP to help decrease his pain and possibly speed healing of the ligament.

Also read:
Ask Dr. Geier: MCL injuries
Ask Dr. Geier – Knee Braces for MCL Injuries

Challenge of playing with an MCL injury

It can be hard to predict just how well the athlete can play soon after the injury. Straight-ahead movements like sprinting usually aren’t a problem. Since the MCL provides side-to-side stability, pushing off and cutting can be difficult early on, even in a brace. That is the reason athletic trainers put the athlete through drills in the days leading up to the game and even on game day to see if his knee will allow those movements.

Again, I don’t know the exact nature of his injury, so don’t use this column to speculate specifically if and how well Shaq Lawson will play Monday.

Regardless, Tigers fans hope his knee doesn’t keep him off the field as Clemson battles for its first national championship in 35 years.

Note: A modified version of this article appears as my sports medicine column in the January 7, 2016 issue of The Post and Courier.

Clemson’s Shaq Lawson expects to play with bad knee in title game. By Aaron Brenner. The Post and Courier. January 4, 2016.

Shaq Lawson guarantees he will play in championship game. By Nikki Hood. TigerNet. December 31, 2015.