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Michael Iupati injury: When can we expect his return?

Left guard Mike Iupati suffered a sprained MCL and has been ruled out to play for two consecutive games. We look at the nature and extent of his injury and when we can expect his return.


Left guard Mike Iupati suffered a sprained MCL during the 49ers loss to the New Orleans Saints. Iupati was carted off during the game and was ruled out to play against Washington, and now the St. Louis Rams.

The MCL is one of four ligaments in the knee.The ligament through runs in the middle of the knee and its purpose is to help provide stabilization of the joint. An MCL sprain usually occurs when something strikes the outside of the knee. A sprain is simply tears to the ligament. A player with a grade I sprain has 10% (or less) damaged fibers. Grade II is diagnosed when more than 10% of damaged fibers occurs. A grade III tear is a complete rupture (50% or more damaged fibers) of the ligament to be torn.

We do not know the actual grade tear of Iupati's MCL injury. However, the 49ers have stated Iupati's injury is not season ending. If Iupati had sustained a grade III tear, it would be 4-6 weeks before he could even bear weight. A return to unrestricted activity would take months. Therefore, it appears to be a grade II sprain.

You may recall LaMichael James sustained a grade II sprain to his MCL in the preseason finale against the San Diego Chargers. I was at the game in San Diego and noticed James attempt to jog off the field. It appeared to me, James was trying to jog through it, but could not bear much weight. He jerkingly jogged and came off the field with a noticeable limp. James did not return to the game and missed the first three games of the season due to his MCL injury. With more than 10% of the fibers of the ligament torn, it creates instability of the joint. It can pop, but the real problem is pain and swelling. It is tough to bear weight.

Iupati was unable to bear weight immediately after the play. However, later in the game, Iupati was seen walking (with assistance) on the sideline. James' injury was a grade II sprain. Even within the same grade, there can be a significant range. I believe Iupati could be on the higher end of Grade II sprain. However, it was good to see him walk on the sideline and bear some weight. Based on the normal protocols of MCL sprains, we are looking at a minimum of three to four weeks out (from the date of the injury).

What helps Iupati is his position does not require him to make several quick cuts or have full range of motion, like other positions. It will be still be a challenge, but it can be worked through. In fact, he can utilize a brace to offer more stability if necessary. In any case, Iupati should be seeing good results by week four or five. Yet, even in the best case scenario, the 49ers will have to make do without our All-Pro Guard for three to four weeks, at minimum.