Duke baseball star is playing in NCAA Tournament with a torn ACL. How? A doctor explains

There were plenty of exceptional performances in the regional round of the NCAA baseball tournament, but what Duke's MJ Metz did is unheard of.

During four games of the Conway Regional, the graduate transfer went 8-for-18 (.444) with four home runs and eight RBI, including a three home run game in the opener against UNC Wilmington.

All while playing on a torn ACL.

"It was nuts," Metz told reporters Wednesday.

One of four main ligaments in the knee, tearing the anterior cruciate ligament is one of the most serious injuries in sports, often ending seasons with an extensive rehabilitation timeline.

But Metz didn't let the torn ligament in his left knee get in the way of him leading his squad into a super regional matchup with No. 7 Virginia. And USA TODAY Sports spoke with a doctor who shared how Metz is doing it, and the potential risks.

NCAA BASEBALL SUPER REGIONALS: Matchups, schedule, times and TV for 2023 tournament

How did MJ Metz come back?

Metz suffered his injury during a loss to NC State in the ACC Tournament May 23. The San Diego-native said it was a "freak accident," where he landed on his knee wrong while headed into the dugout. Metz later got an MRI to confirm the torn ACL, but his season didn't end there.

The athletic training staff got him a brace, in hopes of having a possible return in the regionals. But getting back in the batting cages, Metz was surprised with how good he felt despite the injury.

"I pretty much knew that I wanted to give it a shot the whole week going up," Metz said. "The night before the first game, talked with coach and he basically said 'Look, are you ready to go?'

"I said, 'Yeah, I want to give it a shot.'"

How can MJ Metz play with a torn ACL?

Dr. James Tibone, co-director of sports medicine at Cedars-Sinai in Los Angeles, said ACL tears make it nearly impossible to play in sports that involve pivoting, like football and basketball. But in baseball, it remains possible to play if the player isn't playing in the field, which is what Metz is doing. Typically an infielder, Metz has been the designated hitter since he returned.

"The fact that he's just DH'ing, that's why he can do it. I think it makes it easier," Tibone told USA TODAY Sports. "DH'ing is probably the lowest risk you could have compared to other sports."

Metz said he has made some minor adjustments to his swing, but it hasn't been affected too much by the injury. The biggest obstacle has been running the bases. Tibone said rounding the bases would be the hardest thing to do on the base path.

The biggest concern with playing through the injury is if it damages other parts of the leg.

"Because your knee is moving around more than normal, you can tear your meniscus or damage the joint surfaces," Tibone said. "It could definitely give away and cause more damage."

If he were the team doctor, Tibone said he would let Metz know about the potential risks of playing through the injury, and "as long as they accept that," then being a DH for the team works.

'It's been awesome'

Being able to play was one thing, but Metz making a major contribution for the Blue Devils had social media abuzz over the weekend, especially during his three home run game.

"I've had a ton of people reach out. It's been awesome. Couldn't have asked for all this attention," Metz said.

Metz will be available against Virginia in the Charlottesville Super Regional at noon Friday, which makes sense to Tibone. He said another factor in Metz being able to play is it being the end of the season. And as a graduate transfer, this is Metz's last season, with a chance to get his team to the Men's College World Series for the first time in over 60 years.

"The injury is what it is, and I'm really not trying to do anything different. So being there for my teammates, I'm still as excited as I would be, near-ACL or no ACL," Metz said. "It's all the same, just really happy to be in this position."

This article originally appeared on USA TODAY: Duke baseball star MJ Metz plays NCAA tournament with torn ACL. How?