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Marcus Spears of the Cowboys Injures Knee in Final Full Practice

Cowboys fans have had to deal with two major player injuries this week: Dez Bryant and his ankle, and now Marcus Spear and an injury to his left knee. The starting defensive end does not appear to need surgery.  What is the MCL and how does it impact his play and recovery?


The knee is a complex joint, with four main ligaments that stabilize the joint: the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the lateral collateral ligament (LCL) tear, and the medial collateral ligament (MCL).  Together, these four ligaments help to stabilize the knee in all planes of motion.

The MCL is on the inner part of the knee joint. It starts at the thigh/femur bone and ends in the leg/tibial bone.  Part of the MCL attaches to the medial meniscus, a cartilage disc that acts as a cushion on the inner part of the knee.  The main function of the MCL is to prevent the knee from buckling inwards.

The PCL is lives inside the knee.  It starts from the thigh/femur and ends in the back part of the leg/tibia bone.  The main function of the PCL is to prevent the leg/tibia bone from moving behind the thigh/femur bone.  It also has components that help to act as a secondary stabilizer to the knee bucking inwards, outwards, or in external rotation.


The MCL is usually torn by a blow to the outer part of the knee.  The inner part of the knee gaps open and the MCL can tear.  Typically the tear of the MCL is associated with an ACL or meniscal tear.  The patients experience pain over the MCL, swelling, bruising, and possibly instability.  There are 3 grades of an MCL tear:

Grade 1 – This is a partial tear.  Patients may have few symptoms that do not last a long time.  These athletes may miss one to two weeks of athletic activities.

Grade 2 – This is also a partial tear, but these patients have some instability, especially with cutting and pivoting motions.  The return to sports is four to six weeks after the injury.

Grade 3 – This is a complete tear of the MCL.  There is instability, a lot of pain, and swelling.  These athletes usually need a brace for protection of the knee while the MCL heals.  Recovery can take six to twelve weeks.


An isolated injury to the MCL can usually be treated without surgery.  Grade 1 tears can be placed in a knee sleeve, given anti-inflammatories for pain control, and a perid of rest.  Grade 2 and 3 injuries usually require a hinged knee brace.  Grade 3 injuries usually need a period of nonweightbearing.    If there is an associated injury, such as an ACL tear, PCL tear, or meniscal tear, surgery may be necessary.


If you suspect that you have sustained an MCL or PCL injury, you should seek the advice of a medical professional.


For a video animation of “Anatomy of the Knee”, please see the “Education” tab of my website.  Click orthopaedics, then knee, then conditions, then “Anatomy of the Knee”.

Let’s hope the Cowboys make a speedy recovery.

Dr. P


All material published through this blog/website is for informational and entertainment purposes only. Readers are encouraged to confirm the information contained herein with other sources. Patients and consumers should review the information carefully with their professional health care provider. The information is not intended to replace medical advice offered by physicians. Dr. Parekh and Duke University will not be liable for any direct, indirect, consequential, special, exemplary, or other damages arising from the discussions in this blog.

Selene Parekh, M.D.

Selene Parekh, M.D. (also known as the “Fantasy Doctor”) is an orthopaedic surgeon and foremost expert on sports injuries who’s fast becoming the go-to expert for the multibillion dollar fantasy sports industry.

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