Puka Nacua Injury Scare Leaves Los Angeles Rams Waiting As Former NFL Doctor Raises Fresh Knee Concern

Puka Nacua injury status after Commanders game© Image via X/@mlfootball

Puka Nacua finished Sunday with 14 catches, 150 yards and a touchdown. Then the Los Angeles Rams' star receiver hurt his right knee on the final offensive snap of a 20-13 win over the Washington Commanders. He walked off on his own, which gave the team some hope. An MRI on Monday will show the real damage. Early reports say a torn ACL is unlikely, yet one former team doctor sees a different ligament as the bigger risk. The Rams now wait on answers.

What Happened To Puka Nacua's Knee Against The Commanders?

Nacua took a hard hit on a jet sweep and left under his own power, but the knee was flagged after the game. ESPN's Adam Schefter and NFL Network's Mike Garafolo reported the MRI and said the Rams do not believe the ACL is torn.

Former NFL team doctor David Chao studied the replay and shared his view on X.

"Based on video, I agree that an ACL tear is unlikely for Puka Nacua," Chao posted on X. "My concern is a possible aggravation of the PCL injury in the same knee that sidelined him for five games in 2024. The MRI will determine the extent."

He then described the play itself."He gets hit on the right knee on a jet sweep kind of deal and hyperextends the knee," Chao continued. "Expecting contusion and hyperextension injury, but the worry is aggravation of his PCL … (Mike) Garafolo and company have already tweeted it's not an ACL. The video fits, it does not appear to be an ACL by video. The worry is going to be aggravation of the PCL."

Chao is reading video, not scans. Only the MRI and the Rams' medical staff can confirm what happened inside the knee.

Rams Receiver Outlook After The Puka Nacua MRI

Nacua knows this knee well. He hurt it in a joint practice with the Chargers in August 2024, then aggravated it in the season opener at Detroit and went on injured reserve with a PCL sprain. Another scare came that October, but coach Sean McVay said there was no structural damage and Nacua kept playing.

This season has been bumpy too. He has missed two games and appeared on the injury report several times, all without a contract extension. Davante Adams is already out, so the Rams have little depth at receiver.

Los Angeles visits Arizona on Nov. 15, and the bye falls in Week 11. A mild bruise could heal with that extra rest. A PCL aggravation could cost him several weeks. Monday's MRI and his practice status this week will give the first clear answer.