Fantasy Impact of MCL injuries
The data shown below on return to play after MCL injury is most consistent regarding games missed. Across all positions, the average games missed is 2.85, with a range of 0-6 games.
An MCL sprain is a relatively minor injury in regards to fantasy football. Most players will miss 2-6 weeks, depending on the severity. However, some, Tom Brady in the 2020-2021 season, admitted to playing through an MCL tear for most of his season. Regardless of redraft or dynasty format, an MCL sprain should have minimal impact on your draft day. Mid-season, however, you may encounter difficult start-sit decisions when a player returns from an MCL sprain. We have seen a production decline upon returning from this type of injury. The data below should help you to make those decisions, and don’t forget to check out our weekly rankings to see what we are predicting.
Players who have had MCL injury
Quarterbacks
| Quarterbacks | Games Missed | PPG Prior to Injury | PPG 1st Game After Injury | PPG Games 2-3 After Injury | PPG Games 4-6 After Injury |
|---|---|---|---|---|---|
| Teddy Bridgewater (2020 Week 10) | 1 | 20.0 | 14.9 (-5.1) | 18.7 (-1.3) | 11.9 (-8.1) |
| Aaron Rodgers (2018 Week 1) | 0 | 21.2 | 16.0 (-5.2) | 17.5 (-3.7) | 24.3 (+3.1) |
| Average | 0.5 | 20.6 | -5.2 | -2.5 | -2.5 |
| Number of Players Who Have Met Their Baseline at Current or Previous Time Points | 0/2 (0%) | 0/2 (0%) | 1/2 (50%) |
RUnning backs
| Runningbacks | Games Missed | PPG Prior to Injury | PPG 1st Game After Injury | PPG Games 2-3 After Injury | PPG Games 4-6 After Injury |
|---|---|---|---|---|---|
| Mark Ingram (2022 week 8) | 3 | 4.4 | 1 (-3.4) | ||
| Ezekiel Elliot (2022 week 7) | 2 | 11.5 | 17.2 (+5.7) | 16.3 (+4.8) | 14.3 (+2.8) |
| Josh Kelley (2022 week 6) | 4 | 4.3 | 3 (-1.3) | 3.5 (-0.8) | |
| Elijah Mitchell (2022 week 1) | 7 | 15.5 | 9.3 (-6.2) | N/Aμ | N/Aμ |
| Darrell Henderson (2021 Week 16) | 5 | 10.4 | N/A | N/A | N/A |
| Aaron Jones (2021 Week 10) | 1 | 12.3 | 2.3 (-10.0) | 17.0 (+4.7) | 12.2 (-0.1)* |
| Alvin Kamara (2021 Week 9) | 4 | 17.8 | 22.5 (+4.7) | 5.5 (-12.3) | 17.9 (+0.1)* |
| Clyde Edwards Helaire (2021 Week 5) | 5 | 10.8 | 14.6 (+3.8) | 13.7 (+2.9) | 8.8 (-2.0)* |
| David Montgomery (2021 Week 4) | 4 | 17.6 | 9.0 (-8.6) | 8.1 (-9.5) | 14.7 (-2.9) |
| Gio Bernard (2021 Week 3) | 1 | 7.7 | 10.5 (+2.8) | 1.5 (-6.2) | 4.1 (-3.6) |
| Phillip Lindsay (2020 Week 12) | 0 | 7.3 | 2.6 (-4.7) | 5.1 (-2.2) | 6.0 (+1.3) |
| Myles Gaskin (2020 Week 8) | 4 | 12.0 | 13.1 (+1.1) | 23.6 (+11.6) | N/A |
| Nick Chubb (2020 Week 4) | 4 | 14.3 | 18.6 (+4.3) | 18.3 (+4.0) | 18.0 (+3.7) |
| Raheem Mostert (2020 Week 2) | 2 | 18.5 | 13.4 (-5.1) | 9.0 (-9.5) | 6.5 (-12.0) |
| Derrius Guice (2019 Week 14) | 3 | 14.8 | N/A | N/A | N/A |
| Aaron Jones (2018 Week 15) | 2 | 18.5 | N/A | N/A | N/A |
| Melvin Gordon (2018 Week 12) | 3 | 24.0 | 12.9 (-11.1) | 8.1 (-15.9)* | N/A |
| Kerryon Johnson (2018 Week 11) | 6 | 13.4 | N/A | N/A | N/A |
| Gio Bernard (2018 Week 4) | 4 | 12.1 | 4.6 (-7.5) | 3.6 (-8.5) | 4.9 (-7.2) |
| Devonta Freeman (2017 Week 17) | 0 | 10.8 | N/A | N/A | N/A |
| Aaron Jones (2017 Week 16) | 1 | 6.5 | N/A | N/A | N/A |
| Demarco Murray (2017 Week 16) | 3 | 11.3 | N/A | N/A | N/A |
| Raheem Mostert (2017 Week 12) | 5 | 0.2 | N/A | N/A | N/A |
| Aaron Jones (2017 Week 10)μ | 2 | 11.8 | 8.0 (-3.8) | 2.8 (-9.0) | 1.3 (-10.5)* |
| Malcolm Brown (2017 Week 9) | 4 | 3.5 | 0.5 (-3.0) | 2.5 (-1.0) | 8.1 (+4.6)* |
| Average | 3.1 | 12.2 | -2.5 | -3.1 | -2.2 |
| Number of Players Who Have Met Their Baseline at Current or Previous Time Points | 6/17 (35%) | 7/15 (47%) | 9/14 (64%) |
Wide Receivers
| Wide Receivers | Games Missed | PPG Prior to Injury | PPG 1st Game After Injury | PPG Games 2-3 After Injury | PPG Games 4-6 After Injury |
|---|---|---|---|---|---|
| Corey Davis (2022 week 7) | 3 | 9.4 | 1.4 (-8) | N/Aψ | N/Aψ |
| Kenny Golladay (2022 week 4) | 4 | 1.2 | 0 (-1.2) | 2 (+0.8) | |
| Deandre Hopkins (2021 Week 14) | 4 | 13.0 | N/A | N/A | N/A |
| Jarvis Landry (2021 Week 2) | 4 | 16.0 | 6.2 (-9.8) | 5.1 (-10.9) | 9.6 (-6.4) |
| Devonta Smith (2021 Preseason) | 0 | N/A | 16.1 | 3.5 | 10.3 |
| Auden Tate (2019 Week 14) | 3 | 6.6 | N/A | N/A | N/A |
| Tyler Boyd (2018 Week 15) | 2 | 13.1 | N/A | N/A | N/A |
| Cooper Kupp (2018 Week 6) | 2 | 17.4 | 17.4 (0) | 7.3 (-10.1) | 21.7 (+4.3) |
| Rashard Higgins (2018 Week 5) | 3 | 7.6 | 3.4 (-4.2) | 6.1 (-1.5) | 6.4 (-1.2) |
| Doug Baldwin (2018 Week 1) | 2 | 10.8 | 6.6 (-4.2) | 6.4 (-4.4) | 6.6 (-4.2) |
| Tyler Boyd (2017 Week 5) | 4 | 3.0 | 1.0 (-2.0) | 5.6 (+2.6) | 8.7 (+5.7) |
| Average | 2.8 | 10.9 | -4.2 | -3.9 | -0.4 |
| Number of Players Who Have Met Their Baseline at Current or Previous Time Points | 1/7 (14%) | 3/5 (50%) | 2/5 (40%) |
Tight Ends
| Tight Ends | Games Missed | PPG Prior to Injury | PPG 1st Game After Injury | PPG Games 2-3 After Injury | PPG Games 4-6 After Injury |
|---|---|---|---|---|---|
| Tyler Kroft (2022 week 2) | 5 | 1.9 | 1.1 (-0.8) | 0 (-1.9) | 1.7 (-0.2) |
| Dan Arnold (2021 Week 12) | 6 | 6.9 | N/A | N/A | N/A |
| Adam Trautman (2021 Week 11) | 3 | 3.8 | 0.9 (-2.9) | 8.3 (+4.5)* | N/A |
| Jordan Reed (2020 Week 3) | 5 | 9.0 | 0.8 (-8.2) | 5.8 (-3.2) | 7.3 (-1.7) |
| George Kittle (2020 Week 1) | 2 | 14.9 | 32.6 (+17.7) | 13.4 (-1.5) | 8.0 (-6.9) |
| Austin Hooper (2019 Week 10) | 3 | 16.6 | 4.2 (-12.4) | 7.6 (-9.0) | 8.0 (-8.6)* |
| Evan Engram (2019 Week 5) | 1 | 15.3 | 1.1 (-14.2) | 10.0 (-5.3) | 5.0 (-10.3) |
| Jonnu Smith (2018 Week 14) | 3 | 8.2 | N/A | N/A | N/A |
| Evan Engram (2018 Week 3) | 3 | 10.3 | 3.6 (-6.7) | 8.8 (-1.5) | 9.4 (-0.9) |
| Average | 3.4 | 10.6 | -3.9 | -2.6 | -1.9 |
| Number of Players Who Have Met Their Baseline at Current or Previous Time Points | 1/7 (14%) | 2/7 (29%) | 2/7 (29%) |
Anatomy/Cause of MCL injury
The MCL provides stability to the knee’s medial (inside) portion. It runs from the femur to the tibia and helps prevent a dynamic knee valgus moment (inward collapse).1 This can be seen below. In football, this ligament will typically be injured when making a cut or if tackled from the outside with the athlete’s foot planted. The MCL is the most commonly injured ligament in the knee, accounting for 7.9% of all knee injuries.2
Luckily, the MCL has a good blood supply and thus has high healing potential. Most MCL sprains will heal without the need for surgical procedures. After this type of injury, the athlete can expect swelling, decreased range of motion, and pain with weight bearing. Depending on the severity of the sprain, the athlete may be placed on crutches for a few days-weeks while swelling subsides and range of motion is restored.
Rehab Process for MCL injuries
As with most injuries, the injury’s severity will indicate the required treatments. Often after an MCL injury, the athlete may have swelling in the knee and decreased range of motion. They may also have pain with walking and higher-level activities like running and changing direction. Initial rehab focuses on eliminating swelling and restoring range of motion. Mild sprains may only require a few days to return to normal, while moderate-severe sprains may take up to 6+ weeks to return to play. In a study of high school football players, the average return to play after grade 1 sprains was 10.6 days, while grade 2 sprains were 19.5 days.3
In a study of European soccer players, the median time to return to play after an MCL sprain was 33 days.4 Of these athletes, 86% of the injuries are considered “moderate-severe,” and 14% required surgical intervention. The remaining athletes were able to rehab their knees non-operatively. In this study, 71% of the athletes were able to return to play at their prior level. Although we cannot extract this data and apply it directly to NFL players, it certainly gives insight into the expected outcomes after MCL injury in elite athletes who are placed under similar demands to that of an NFL player.
Initial rehab should focus on reducing knee swelling while gradually restoring range of motion. These players may wear a hinged knee brace during this time, but immobilization is not recommended as it may result in a weaker ligament.2 While range of motion is being restored, the athlete should also focus on improving quadriceps, hamstring, and hip strengthening. Depending on injury severity, some individuals can progress through strengthening exercises faster than others. Hip abduction strengthening is imperative to help prevent future injuries in these athletes. With stronger hips, the athlete should be able to control and prevent the dynamic knee valgus motion, which is viewed as the typical mechanism of injury for these athletes.
Sources
- Liu F, Yue B, Gadikota HR, et al. Morphology of the medial collateral ligament of the knee. J Orthop Surg Res. 2010;5:69. Published 2010 Sep 16. doi:10.1186/1749-799X-5-69
- Andrews K, Lu A, Mckean L, Ebraheim N. Review: Medial collateral ligament injuries. J Orthop. 2017;14(4):550-554. Published 2017 Aug 15. doi:10.1016/j.jor.2017.07.017
- Derscheid GL, Garrick JG. Medial collateral ligament injuries in football: nonoperative management of grade I and grade II sprains. Am J Sports Med.1981;9:365–368.
- Lavoie-Gagne OZ, Retzky J, Diaz CC, et al. Return-to-Play Times and Player Performance After Medial Collateral Ligament Injury in Elite-Level European Soccer Players. Orthop J Sports Med. 2021;9(9):23259671211033904. Published 2021 Sep 28. doi:10.1177/23259671211033904
