The Los Angeles Lakers are now tied with the Boston Celtics in the NBA Finals 3-3. Kobe continues to play at the top of his game and his fractured finger seems to have little effect on his playing. That finger massage must be working its magic. (see previous blog)
But now, on the other side of the injury spectrum is Andrew Bynum. The Lakers center has been dogged by knee injuries for three straight seasons. Then, in an unfortunate turn of events, Bynum was diagnosed with a torn meniscus in his right knee following the Lakers first-round playoff series against Oklahoma City. This injury has limited him since. Bynum admitted that the pain is “there every step” – but he chose to continue playing and delay surgery until after the finals. If someone had asked me, which nobody did, I would have had him do the surgery right away.
The tear in the meniscus (the cartilage which is the soft tissue between the bones of the knee) is very small – probably the size of a pea.
In the off season he’ll have arthroscopic surgery – they’ll come in with a couple tools about the size of a pen and, using a microscopic camera for guidance, they’ll cut out the part that’s torn and he’ll be good to go. He should be playing ball again in 7-10 days after the procedure. What’s often misunderstood is that they are looking at doing something very minor and non-invasive. If they do go in for something non-invasive and they end up finding a bigger problem, they usually pull out and have a conversation and decide what to do later.
But now, since the tear remains, Bynum’s biggest issue is dealing with the body’s compensatory response to the injury: the swelling. Any time there’s damage or an insult to the soft tissue in a joint, like an ankle, a knee, an elbow or a shoulder, the body responds with a lot of swelling and then the swelling becomes the problem. It’s hard to move the joint through all that swollen tissue. In Andrew’s case, the fluid needs to be drained regularly – maybe once a week or so. In addition, he needs to ice his knee every few hours to keep the swelling down.
I was recently asked if a torn meniscus is a common injury. My response was yes and no. Common, yes, for a 7 foot 2 inch 320 pound pro athlete. I imagine if we looked up the statistics of how many athletes on professional teams – football, baseball, soccer, basketball – have had minor knee surgery for this type of problem, I think it would be staggering. Someone like John Elway, probably had his knees done about 5 times each.
The way it works is like this – as soon as you take something up to an elite level and you increase force, you increase injury. The two most important factors in determining the force of an impact are an object’s size and the speed of its movement: a combination of mass and acceleration. If you’ve got one of these athletes at the top of their game you’ve got at least one of those factors at play pretty strongly. And you’ve got a recipe for some pretty good injuries.
But no, this is not a common injury for the rest of us. I would say that if we separated impact injury from non-impact injury in the general population very few would have these tears. But knee problems are often misdiagnosed. Without having a car accident, or a bike accident or falling out of a tree or something of the like, a normal person rarely has a torn meniscus. Now of course there are many people out there with chronic knee problems. The difference is, they’re feeling the discomfort of the swelling, but it’s not because of a tear. It’s because of all the tightness and compression. I think a good way to look at it is when your knee has a lot of tightness, that forces a certain level of swelling. You get into a relationship between swelling and compression – more compression equals more swelling which makes the joint more achy. Whether the joint is responding to an insult or to chronic tightness and misalignment, the end result is the same, which is pain.
At Dorfman Kinesiology we frequently resolve this more common type of knee problem through a combination of massage, stretching, and biomechanic adjustment. So, if you are one of those people walking around with a bad knee or two (or ankle, elbow, shoulder or wrist) give me a call at 619-742-9934 to schedule an appointment or send an email to email@example.com. If you have been diagnosed with a torn meniscus and want a second opinion I can help with that too.
Meanwhile, keep it jumping Andrew. When you’re ready for rehab give me a call.