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In Street Clothes

Covering sports injuries from the perspective of a certified athletic trainer and backed by analytics.

Sean Lee and the Unhappy Triad

Linebacker Sean Lee has been the motor of the Dallas Cowboys defense since taking over the starting position in 2011. Unfortunately injuries have limited his availability as he has suffered a myriad of significant ailments. Since being drafted in 2010, Lee has suffered a shoulder contusion, concussion, dislocated wrist, torn ligaments in his toe, and a sprained neck. His lower extremities muscles have also been a problem as he has strained his quad, hamstring (three times), and lower back.

Hoping to be a weapon in the 2014 season, Lee returned to the field for the first organized team activity on Tuesday. His return was brief as he was helped off the field after participating in a drill with the offensive live.

The diagnosis is bleak with Mike Fisher of 105.3 The Fan and DallasBasketball.com reporting the team fears Lee suffered multiple injuries to his left knee that make up the “Unhappy Triad.” The so-called Triad includes damage to the anterior cruciate ligament (ACL), the medial collateral ligament (MCL), and the medial meniscus.

The ACL and MCL are two of the four primary stabilizing ligaments in the knee. Together, along with the two cartilage menisci, they are designed to prevent excessive movement of the knee and absorb the various stress placed on and through the joint. However if the force or stress applied to the knee is excessive and forces the ligaments beyond their yield point, the ligament tears. An injury to the MCL often includes medial meniscus damage, as fibers of the ligament are attached to the disc.

knee

The unhappy triad often occurs when the joint is twisted and an outside load is placed through the knee. In football, this is a common occurrence as a player’s leg rotates while planted just as a player or teammate falls onto the outside portion of the knee. The list of players to suffer the triad is lengthy and includes players like Adrian Peterson, Tom Brady, and Rob Gronkowski.

The ACL tear and medial meniscus damage require surgery to fix while the MCL is often left to heal without surgical intervention. The expected recovery for an injury of this magnitude is generally eight months yet players like Peterson and Wes Welker have pushed the limits and returned in as little as six months. However these two are the exception and not the norm and Dallas will likely be without Lee’s services for the entire 2014 season.

Lee will have a dubious advantage entering rehab since he has experienced the injury before. He missed the entire 2008 collegiate season after tearing his right ACL in the offseason. He also suffered a Grade 2 ACL sprain in his left knee during his time at Penn State. Surgery will be performed in the near future, depending on the final evaluation. An isolated ACL tear would allow surgery to be performed earlier, though it would do little to improve Lee’s overall timeline. Now with the draft over and training camp on the horizon, the Cowboys will be forced to scramble for a replacement. Hopefully it will be one that can stay on the field and out of the athletic training room.