Le’Veon Bell’s MRI Will Be A Crystal Ball For The Steelers

The Pittsburgh Steelers regular season MVP Le’Veon Bell sustained a right knee injury during the third quarter of last night’s game against the Cincinnati Bengals when safety Reggie Nelson made contact with Bell’s right leg just above the knee. It’s likely that every fan at Heinz Field and watching from home held his breath until the running back jogged off the field. The most important question after clinching the AFC North division and a home field game in the wild card round remains:  will Bell be on the field this Saturday night when the Steelers face their ultimate rival, the Baltimore Ravens?

If you freeze the image of the hit, it’s clear that Bell hyperextended his knee, and head coach Mike Tomlin confirmed that in his postgame comments. Tomlin also stated “structurally it appears to be fine so we’ll see if he’ll be available to us here in our next game…We’re thankful that it’s not anything major.”  Obviously, Bell’s knee must have felt stable on exam, but the true determination of whether there is any ligament damage will be made by an MRI, which was done today. And that will answer the key question of whether the Steelers must face their first (of hopefully 4) playoff game with only 2 rookie running backs.

Interestingly, during his evaluation on the sideline, both Bell and the team doctor watched a replay of the injury. Perhaps they were examining the angle of his knee to speculate on the extent of the damage. The immediate conclusion is that Bell was lucky that his cleat didn’t plant firmer. If his foot had remained fixed in the turf, the torque on his knee would have been much greater, putting extra force on the ligaments.

So what can happen with a hyperextension and what is the potential recovery time?  First a quick anatomy lesson. The knee joint connects the thigh bone to the bones in the lower leg, the tibia and fibula. Tendons connect bone to muscle; it is the ligaments that join the bones to each other. The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) keep the femur from slipping forward or backward, and the medial and lateral collateral ligaments (MCL and LCL) prevent the femur from sliding to either side.

A simple physical exam by an experienced physician or trainer can tell a lot about possible ligament injuries. The Drawer Test checks for ACL and PCL injuries by pushing back and pulling forward on the lower leg with the knee bent and the foot held in place. The Valgus Test checks for side-to-side instability to assess the MCL and PCL. These assessments were likely done as soon as Bell got to the trainer’s table.

Things looked hopeful last night when Bell left Heinz Field walking without crutches, which again suggests knee stability. Also encouraging was a tweet from teammate and running back Josh Harris

Then again, athletes always say they are fine and will play as soon as they get injured.

According to Adam Schefter, the MRI done today “did not show ligament damage” in Bell’s knee. But Bell could easily have a grade 1 ligament sprain rather than a full tear (grade 3). In this case, the ligament is mildly stretched but the knee remains stable. We may learn more from Tomlin tomorrow, but the overwhelming likelihood is that the team will play it close to the vest and withhold specific findings of the MRI.

The final determination of whether Bell can play will depend on swelling and pain. According to a few reports, Bell could hardly walk on Monday.

For now, the treatment is ice and rest…and wait. There is no question that Bell will not be his typical 2014 MVP self if he sees the field this weekend. And the Steelers may not want to put him at risk against a brutal Ravens defensive line that has caused many injuries in the past. There is probably a 50% chance that he plays in the wild card round at this point, and how he progresses during the week will be the basis for that decision. But if the Steelers can take care of business at home, Bell has an excellent chance to contribute significantly in the divisional round.

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