49ers’ RB Elijah Mitchell suffered his second sprained MCL of the season in yesterday’s win over New Orleans, this time in his left knee.
Poor Elijah Mitchell. The #49ers believe he is dealing with another MCL sprain.
— Inside Injuries (@InsideInjuries) November 28, 2022
While they don’t think this one is as serious, a recurrence is very concerning. Don’t be surprised if he misses multiple weeks again.
The injury occurred early in the second half on a first-down carry for zero yards. After the game, he said his knee got twisted up on the play but that it didn’t feel as serious as the sprain he suffered during Week 1 in Chicago. Initially, he was ruled questionable to return but after undergoing tests for the majority of the third quarter he was ruled out.



Mitchell had returned from the Week 1 sprain just two weeks prior to this week, missing seven games and eight weeks in total. He returned in Week 10 against the Chargers and looked good, putting up 89 yards on 18 carries. The following week against Arizona he looked good again with 59 yards, though he was limited to just nine carries. Before spraining his MCL again on Sunday he had seven carries for 35 yards and two catches for 8 yards.
The MCL sits on the inside of the knee, connecting the thigh bone (femur) to the shinbone (tibia), and its primary function is to prevent the leg from extending too far inward, but it’s also part of the mechanism that stabilizes the knee and allows it to rotate. When sprained, the structural integrity of the ligament is compromised, meaning the knee itself can overextend and cause additional damage.



The good news is that our algorithm predicts his spain is a Grade 1, meaning there is no tearing present, only stretching. With that, his Injury Risk is High (34%) and his Health Performance Factor is Below Average (46%).
We’ve calculated his Injury Risk to be 14 days from injury, meaning he should sit out Week 13 and return in Week 14 against Tampa Bay.