“Nine months I would expect him to be good barring any complication of any sort,” Dr. Gibson said.
The primary variable that could cause a longer timeline would be potential cartilage damage in the knee, but that’s not an element that has been reported anywhere or that I’ve heard.
Dr. Williams said cartilage damage “doesn’t typically happen, but could happen in an injury like this. MCL, meniscus repair, things of that nature, whether you fix them or not wouldn’t typically change the timeline … Most elite level athletes, six months until you are cleared for full training. Most of those guys would return to full play somewhere in the nine-month to 12-month range, that’s pretty much accepted.”
When news broke that the ACL and MCL were torn, with even damage to the meniscus and other ligaments in the knee, the biggest question came from the addition of the MCL tear to the expected ACL issue and what that means for severity. It sounds like a setback. Both stated that’s not the case.
“Typically, it doesn’t make that much additional difference,” Gibson said. “Most MCL injuries that are mild you can actually leave alone and they will heal by themselves without even addressing it. If it is grade one or two, a mild MCL, it has the ability to scar down because it is an extra-articular ligament, it’s not inside the joint. So it will actually scar down and tighten up. But if it’s more severe and if as a pro athlete they might be more aggressive, if it’s more severe they would just repair it at the same time and it should really not affect his rehab time, overall prognosis or anything at all. It’s really not that big of a deal even if he needs it repaired.”
Williams stated the combination of ACL/MCL actually happens around one-third of the ACL cases he sees and is fairly common. It’s not an alarming development, as much as it sounded like one at first.
[discussion of the optimal length of time to wait before operating]
There are a number of different quarterbacks and others that can be held up for a template when looking for comparisons to Burrow’s injury.
The most obvious happened at Paul Brown Stadium nearly 15 years ago.
Carson Palmer tore his ACL and MCL with a dislocated kneecap and cartilage damage in January of 2006.
He returned the next preseason. In fact, in 2006, he threw for over 4,000 yards, went to the Pro Bowl and enjoyed his highest yards per attempt season while in Cincinnati and third-most in his career.
Looking at more recent examples at quarterback, Deshaun Watson tore his ACL in November of his stellar rookie season and was part of the Texans’ May OTAs the next year and has missed one game since.
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Carson Wentz tore his ACL and LCL in December of 2017 and was held out of the first two games of the 2018 season as Philadelphia was conservative while relying on Super Bowl MVP Nick Foles to buy them time.
Tearing the LCL is actually worse than if you also tore the MCL, according to Gibson.
Other quarterbacks to recover from ACL injuries during their career include, but are not limited to, Tom Brady, Sam Bradford (twice), Robert Griffin III and Teddy Bridgewater.
Bridgewater’s would be widely viewed as one of the worst in NFL history and while the recovery took a couple of years, he’s returned to play fantastic football the last couple of seasons.
There is zero worry about the long-term viability of Burrow judging by this diagnosis, according to the doctors, and this isn’t in the same vicinity of the Bridgewater disaster.
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All of this returns back to the original point. All expectations are for Burrow to play in 2021. Will he miss a couple of games at the beginning? Potentially, it’s too early to pinpoint a more specific timeline. But given what we know of the diagnosis, medical opinion and precedent, it’s possible he could play all 16 games in 2021.
