Late in the fourth quarter of the NFC Championship Sunday, the Chicago Bears were methodically marching down the field. Close to pulling off one of the most improbable comebacks in NFL playoff history, the Bears’ fans were roaring, chanting the name of the quarterback leading their surging team.

The quarterback? It wasn’t their prototypical star with the huge arm for whom they had traded their prior quarterback and valuable draft picks a couple of years earlier. It wasn’t the Vanderbilt-educated, celebrity-dating golden boy. No, it wasn’t Jay Cutler. It was a third-string nobody from Colorado State. And Bears fans were, and still are, furious.

The decision to hold out Cutler, or for Cutler to pull himself out, or whatever happened Sunday has been one of the most scrutinized medical decisions in football history. This was the NFC Championship. A quarterback who had just won his first playoff game the week before had a chance to lead the mighty Chicago Bears back to the Super Bowl. Instead, he stood on the sidelines staring at his feet while over 60,000 fans in the stadium and hundreds of millions of television viewers glared at him in disbelief.

“It’s his knee.” “He’s out with a knee injury.” Maybe we doubted Cutler because of his history of discontent in Denver, or because of his reputation for partying, or because of his lack of on-the-field success despite seemingly limitless physical tools. But whatever the reason, Jay Cutler did not get the benefit of the doubt Sunday. The media, current players, and former players questioned his heart and his toughness.

Only two people truly know whether or not Cutler could have returned to play – the Bears’ team physician and Cutler himself. I don’t have any idea of exactly what happened in the Bears’ training room, but there are some key points to keep in mind before we judge Cutler.

Planting your foot and pushing off with an MCL injury is very difficult until the ligament heals.
From multiple media reports, Cutler was felt to have an MCL injury. This was supposedly believed to be the injury based on the physical exam performed by the doctor during the game and reportedly was confirmed by MRI on Monday. The Chicago Sun-Times reported that the MCL was more specifically a grade II injury.

The medial collateral ligament (MCL) is a thick ligament on the inside (closest to the midline of the body) of the knee. It typically is injured by being hit on the outside of the knee, opening up the inside. While it might be too simple, there are three grades of MCL injuries. Grade I injuries are typically sprains, or stretch injuries, while grade II injuries are partial tears, and grade III injuries are complete tears. While the ligament typically heals on its own without surgery, it is hard to push off or change directions effectively with an MCL injury.

As I’ve said in this column previously, a team doctor has to answer two questions when deciding whether a player can return to the game after an injury. First, can the player protect himself from injury, or does he risk doing further damage? Second, can he effectively do his job on the field?

The answers to one or both of these questions must have been no, but again, only the doctor and Cutler truly know the answers. The doctor really cannot discuss Cutler’s medical condition without the player’s consent, and in professional sports, it is understood that any and all medical information should go to the media through the team itself.

Could the doctor have put Cutler in a brace to protect the knee, and did they try? Did Cutler try to push off or try to cut and change directions but couldn’t do it effectively? Did his knee open up to stress enough that the doctor feared Cutler could damage it further, such as tearing his ACL?

Unfortunately we don’t know, and may never know, Cutler’s true ability to finish the game. But millions of people have made up their minds already.

Note: This post appears as a column in Wednesday’s edition of The Post and Courier.