Gurley's knee also was an issue after a season-opening victory over the Oakland Raiders, when Gurley rushed for 108 yards and caught three passes for 39 yards and a touchdown.
"It was a similar situation," McVay said.
Gurley said Thursday that he, "Felt like s---" after the Monday night game in Week 1.
"It was bad," Gurley said. "I was contemplating on giving the Rams back their money and everything. It was bad. It was real bad."
Before the season, the Rams awarded Gurley, the defending NFL Offensive Player of the Year, a four-year extension worth $60 million, with $45 million guaranteed, to make him the highest-paid running back in NFL history.
Despite the pain, Gurley felt in the aftermath of the opener, he said that his knee felt better two days later.
That hasn't been the case with his latest knee issue, which includes inflammation and soreness that has lingered since a Week 15 matchup against the Philadelphia Eagles.
Gurley was inactive last Sunday in a road win over the Arizona Cardinals, and his status is again in question for the regular-season finale against the San Francisco 49ers on Sunday at home. A victory over the 49ers would secure the Rams a first-round bye in the playoffs.
"Some days you wake up feeling pain," Gurley said. "Some days you wake up feeling much better."
Gurley was sidelined for a series in the third quarter before he returned to the field in a 30-23 loss to the Eagles. He said there was no single play that caused the discomfort in his knee.
"Came back on the sidelines and just you can tell when something doesn't feel right, you know your body," said Gurley, who has rushed for 1,251 yards this season. "Obviously, kind of went back in the game and played. Did what I could do and then just kind of dealt with the consequences the next day."
Gurley sat out of practice last week but participated in a pregame workout ahead of last Sunday's game in Arizona. After the workout, Gurley and the Rams' medical staff determined it was in his best interest to sit out.
"I could've played," said Gurley, who has scored a league-best 21 touchdowns. "But who knows how long I would've been able to play."
In his absence, the Rams started veteran C.J. Anderson, whom they had signed only five days earlier. Anderson rushed for 167 yards and a touchdown.
Gurley has not practiced this week, and it's uncertain if he will test his knee before pregame warmups Sunday.
"It's just one of those day-by-day things," Gurley said. "I'm just going to have to see when Sunday gets here."