It’s been just over a year since Reggie Ragland ran down Reggie Bush towards the sideline, pulled up and fell to the field, ending his 2016 season with a partially torn ACL. Going into the 2017 season, the big question is whether Ragland will be ready to suit up and become the heart and soul of the Bills defense. To understand why there is so much uncertainty going into this season, we must understand why the injury is so severe.
The ACL is a ligament that connects the tibia to the femur and acts as a stabilizer in the knee to prevent the femur from shifting too far forward over the tibia; it also assists in preventing hyperextension in the knee. When the knee is placed into unnatural positions such as cutting and sudden stops, the ACL typically keeps the knee intact, but in the instance of injury, the ligament either stretches out, partially, or fully tears based on the activity. Along with the ACL tear, meniscus and MCL tears occur, referred to as the “Terrible Triad”. This does not occur in every case, such as Ragland’s, but is certainly a cause for concern for long term rehab potential.
There are two types of ACL tears, direct contact and non contact. Direct contact being a direct blow to the knee, such as a chop block. Non contact is when the player changes direction suddenly and the knee gives way, which is what occurred during Ragland’s injury. In Ragland’s case, he partially tore the ACL, leading to instability, similar to what occurred last week with Ryan Tannehill of the Dolphins. Without the ACL providing stability, the individual is unable to stop suddenly or pivot to change direction without the knee giving out, resulting in further damage to the surrounding structures in the knee. These movements are vital for any football player, regardless of position. This would increase missed playing time and significantly reduce the length of careers. It is possible to live a normal lifestyle with an ACL deficient knee, but nearly impossible to resume a high level of play post ACL tear without reconstruction as an adult.
In May 2017, Ragland reported that he has been cleared to return to full contact participation, which is 9 months after his surgery, indicating that rehab went well and that he has passed all the initial conditioning tests. This includes, but not limited to: demonstrating that his left knee is at least 90% strength wise in his quadriceps, and 80% in his hamstrings that of the right knee. He must demonstrate no pain/swelling in the right knee during activity, exhibit full range of motion, demonstrate basic agility activities and resume a running program that is pain free. A general, comprehensive ACL reconstruction protocol can be found here. (Note: this is unlikely the exact rehab protocol used with Ragland, most orthopedic surgeons vary based on personal preferences and training.) Once this has all taken place, he is cleared and able to resume football related activities. A non professional athlete would be able to resume normal activities without restriction, save a stabilizing knee brace for extra protection. In Ragland’s case, he is a multi million dollar athlete that extra precautions will be taken to ensure the surgery success. He will most likely be required to wear a knee brace, but will reduce the incidence of another non-contact ACL tear.
As of now, Ragland appears on track to return to participating in training as a full participant. This has been evident through the first week of training camp, easing back in with the 2nd team to limit reps, according to McDermott. This will allow Ragland to step on the field to knock off the rust, but between rehab and an extended look during training camp will really allow him to round back into football form. Professional opinion, I fully expect to see Ragland return to full form, easing back into game play on a snap count as the preseason begins. Currently, he’s listed as 2nd on the depth chart at MLB behind Preston Brown. This is a great spot for him as this indicates that he will see significant playing time, but not expected to contribute right away while still learning the defense. While there is a risk of retearing the ACL, as seen with RGIII, Casey Hampton, and Thomas Davis, the risks remain low. Expect to see Ragland fine tune his game in the preseason, get back up to game speed, and then released to pick up where he left off in college, shoring up the LB corps and fitting into McDermott’s defense.