Category Archives: Knee

Andre Iguodala’s Left Knee Contusion

On May 20, 2018 during Game 3 of the NBA Western Conference Finals, Andre Iguodala was hit on the outside of his left knee. He left the game shortly thereafter. The injury was diagnosed as a contusion (a bruise).

Direct injury to the skin, muscle, and bone can cause uncomfortable tissue damage, bleeding, and swelling that makes it difficult to move and jump. But structurally, things are fine.

A bruise is easy to diagnose on examination. A fracture is unlikely in people that are able to walk. It seems like every athlete gets an MRI for every injury, but that is unusual and difficult to justify, at least in everyday practice.

The body heals bruises over time. Treatments such as ice or pain relievers are for comfort only. Media reports often talk about athletes getting “treatment” which sounds mysterious and magical. This creates a misconception. There is no known way to speed the body’s healing process. In fact, some doctors suggest that athletes avoid anti-inflammatory medications because inflammation is an important part of the healing process that should not be slowed or interfered with.

It is safe to play with a contusion.

This blog was created by Paul Bonilla and David Ring.

Dustin Pedroia’s Knee “Cartilage Restoration” Surgery

Pedroia had cartilage restoration surgery on his left knee on October 25, 2017. The stated time to return to play was 7 months.

Pedroia’s knee has bothered him for years. He went on the disabled list twice during the 2017 season due to problems with the left knee. He had surgery to removed part of the left knee meniscus on October 13, 2016. The knee continued to bother him after surgery, many citing his age (he is 34) as contributing to the problem.

Cartilage restoration surgery is unusual. It is only considered for focal cartilage defects, not for the natural changes of age or the long-standing consequences of old injury (arthritis). Being active is good for the knee. Sports would only cause deterioration to the knee if there were specific injuries to the cartilage, meniscus, or supporting ligaments, or a fracture entering the joint.

He was cleared to being running again in January. He started playing with the Pawtucket Red Sox on May 14th. He returned to MLB on May 26th, exactly seven months after his restoration surgery.

This blog was created by Rachel Duncan and David Ring.

Sean Couturier Torn MCL

Sean Couturier, center of the Philadelphia Flyers, was diagnosed with a torn MCL of his right knee after a collision with a teammate in practice on April 17th. He missed game 4 of the playoff series. With game 5 approaching and the Flyers down 3-1 in the series, Couturier played with his injury and even scored the game winner on April 20th. The injury did not seem to affect his play, a testament to his resiliency and adaptiveness. He continued to play in game 6 April 22nd, but Philadelphia lost to Pittsburgh and was knocked out of the Stanley Cup playoffs.
MCL stands for the medial collateral ligament in the knee. This ligament connects the top of the tibia (shinbone) to the bottom of the femur (thigh bone). It runs over the knee along the inside of the leg. This ligament stabilizes the knee joint under valgus stress (attempts to bend the knee outwards). This injury is common in sports and is usually caused by a direct blow to the outside of the knee, which stretches or tears the MCL. The injury results in pain and swelling, and—with severe tears–instability of the knee.
This type of injury can be detected on physical examination. X-rays and MRI’s can be used selectively to rule out fracture and anterior cruciate ligament injury. Most people would not have an MRI for an MCL sprain. Professional athletes may have an MRI to rule out other problems because return to play is safe with mild to moderate MCL sprains.
After the loss and exit of the team from the playoffs, Couturier informed reporters his injury would not benefit from surgery, but that if he were injured mid-season he probably would have stayed out of play for 4 weeks. He accepted the discomfort and some risk for additional damage (for example to the anterior cruciate ligament) if the knee were to be injured again. The MCL injury potentially increases the vulnerability of the knee. It’s important to understand that return to play is always a matter of accepting some risk and discomfort.

This article was made by Alexa Ryder and David Ring