Sports doctor explains Embiid’s knee injury, prognosis originally appeared on NBC Sports Philadelphia
The Sixers announced on Wednesday that their finalist MVP has a small lateral meniscus tear in his right knee. The team classified Joel Embiid as “day to day” and said he would receive physical therapy and other treatments.
What is a small lateral meniscus tear, and what is the prognosis for Embiid beyond the general “day-to-day” designation?
NBC Sports Philadelphia discussed Embiid’s situation on Wednesday with Dr. John Vasudevan, athletic physician at Penn Medicine and assistant professor of clinical physical medicine and rehabilitation. Vasudevan does not deal with Embiid.
What is the injury?
“The most significant (meniscus injuries) are the medial meniscus – inside the knee,” Vasudevan said. “Whereas the lateral meniscus – on the outside of the knee – is not where most of your weight occurs. For the average person, it is less likely to lead to surgery. The problem is, it’s Joel Embiid and he plays a multidirectional professional sport. Thus, a lateral meniscus could have more consequences than for the average person. “
The Sixers called Embiid’s injury a “little tear” and he was able to complete his typical pre-game training before Game 5 of the Sixers’ first round series against the Wizards.
Instability, according to Vasudevan, is “much more of a concern” with tears in the meniscus than pain or swelling, although the Sixers will need to watch for these symptoms.
When could he come back?
Decreased pain, decreased swelling, and “at least 90% strength on the opposite side” would be general indicators supporting Embiid’s return, according to Vasudevan.
Ideally, physical therapy will help on these fronts.
“For the first part, on the pain and swelling, they will use ice, heat and massage and many modalities to try to help – with drugs or injections – reduce that pain and swelling. . … What they do is gradually challenge not only the muscles around the knee, but also the muscles in the hip and ankle region, so that they can support his knee, ”Vasudevan said. “No matter how well his knee is in the weeks to come, he’s still going to face some pain. The question is whether he can play with the help of the hip and ankle… to do the movements he needs.
What are the potential disadvantages of playing with pain?
Vasudevan called the question of “power versus should” one of the most difficult problems for any sports doctor.
“It really requires excluding the big stuff and the bad stuff,” he said. “One, no fracture or instability. Then you’re going to look, what’s the trajectory of her pain and swelling? The first three weeks will be his most difficult. Can he play through? Sure, but (he) is going to be sensitive to the pain or swelling. And that can dictate how long he’ll spend on the ground. “
Although Embiid said he was bothered by the brace he was wearing after suffering a bruise on his left knee in March, Vasudevan said he would not be surprised if the 27-year-old wore a knee brace to his return. However, wearing a brace may not be fully aligned with Embiid’s physiotherapy goals.
“The whole hope is that he progresses in rehabilitation without a knee brace,” Vasudevan said, “because a knee brace will give you some support, but it also hinders the muscles you want to strengthen. But the caveat is, at when and when you are (in the playoffs), if he needs anything beyond what his body gives him.
“The knee brace, what it does is not just stability. The medical term is proprioception, but that means it kind of reminds you of where you are in the field. The more you lean and the more you play, the more tissue in this brace tells your knee and brain, “You don’t want to go that far.” Right now, he’s going to have to be a little more careful not to exacerbate this pain and swelling. “
What will Embiid’s offseason look like?
Embiid will likely have “a lot of rehab” in the offseason, Vasudevan said.
It looks like surgery isn’t on the table right now, unless Embiid has a big setback, but could he be after the season ends?
“It comes down to the physical results, the imaging results, and the trajectory of her progress.… It’s from six to 12 weeks that you really determine, can you get back on your feet? At six weeks, s ‘He doesn’t really see any improvement, that’s worrying, “Vasudevan said.” And within six weeks I would expect him to see improvement. But the question is at six to 12 ( weeks), if they really try to push him harder, does he continue to have a recurring or unpredictable exacerbation? I think in weeks 6 to 12 you will know if he needs surgery or no.
At first glance, Embiid’s official day-to-day status and the fact that the Sixers saw no issues with him during his regular pre-game training on Wednesday both seem encouraging.
We will know more in the days and weeks to come. The Sixers’ hope will clearly be that he is moving in a direction positive enough to play and do so at a high level.