Fred Jackson May Not Be Out Long with LCL Injury

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Fred Jackson tears his lateral collateral ligament against the Jets (Mel Evans/AP)

Nothing is worse than seeing one of your starting RBs go down in Week 1 with an injury.  If he tears his ACL, then from a fantasy perspective it’s easy because you know he’s out for the season and you can drop him, free up a roster spot, and move on.  The tough fantasy decisions come when you get an injury and the timetable for his return is unclear, which has been the case with Fred Jackson since Sunday’s game.  If you handcuffed FJax with C.J. Spiller then you have nothing to worry about, you can just start Spiller and wait for Jackson to return.  If you didn’t, and your buddy who drafted Spiller is taunting you on your league message board, your stress level may be a little higher.

I will try to shed some light on Jackson’s injury and help you make some informed decisions if sharks in your league are already sending you trade offers for him.  Immediately after the game, the Bills reported that Jackson had an isolated LCL sprain.  Things didn’t get any clearer when an MRI on Monday didn’t reveal any information on the ligament, and they also announced he would likely be out for 3-4 weeks.  I’m sure the team will get a repeat MRI soon to get a better idea of what is going on.  After reviewing the pics and video of the injury, I believe the mechanism of the injury could definitely fit with an isolated LCL tear.  This is a fairly rare knee injury, even in the high-speed contact world of the NFL.  More specifically, it is a rare injury to occur in isolation.  I have seen two isolated sprains (not complete tears) in the last four years in my practice.  Usually when the knee is injured in such a way as to tear the LCL, then many other structures are also injured at the same time (e.g. ACL, meniscus, popliteus/posterolateral corner).  These require surgical reconstruction and are potentially career-ending.

If Jackson truly has an isolated LCL injury, even if it is a complete tear (also called a grade III sprain) of the ligament, then I don’t believe that he will miss a lot of time.  A study in the American Journal of Sports Medicine from 2009 which examined 10 years worth of NFL data from 1994-2004, showed that only 9 players sustained an isolated grade III LCL tear during that time.  Four of those nine were treated with surgery and missed the remainder of the season.  The other 5 of those 9 that were treated without surgery missed an average of only 2 weeks, and one of those players (identified only as a DB) didn’t even miss a game.  Even though the numbers were small, I draw two conclusions from this study – these injuries are better treated without surgery, and players can come back fast.

I don’t believe Fred Jackson will miss many games with this injury unless he has additional injuries and the Bills aren’t telling us the whole story (the MRI giving no information smells fishy to me).  I wouldn’t be surprised to see him back in Week 3 or 4 with a brace on his knee.  If you have Jackson, I’d hold on to him.  If you need a RB, then take advantage of this situation and pull off a trade for him.  If I’m wrong, I won’t be heartbroken because in my league I’m the guy who drafted Spiller and has been taunting the Fred Jackson owner since Sunday night.