Meniscus Injuries in the NBA and Why Patrick Beverley Is An Exception

Meniscus injuries have always been a problem in the NBA but they’ve gained notoriety this year thanks to Russell Westbrook and Derrick Rose. This year Rose, Westbrook, and 11 other players have missed time following or recovering from a publicly reported meniscus injury or surgery with two additional players undergoing surgery in the offseason. This total isn’t overly concerning despite being twice as high as last season’s number total of six, though four additional players did require offseason some sort of meniscus surgery prior to the 2012-13 season.   The rate of occurrence for meniscus injuries since the 2008-09 season sits just over eight meniscus injuries a season when offseason surgeries are excluded. Similar numbers were discover in a study performed in 2013 in which 129 isolated meniscus tears over a 21-season span were cataloged. However it doesn’t change the fact that this type of injury can be very problematic to manage and can alter a player’s career.

 

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To better understand the injury itself the anatomy of the knee should be examined. The menisci of the knee act as shock absorbers for the knee, similarly to the intraverterbal discs of the spine. However the discs of the knee are uniquely designed to withstand a high degree of stress while maintaining a degree of elasticity. Each knee has a medial and lateral meniscus with the latter playing a larger role in weight bearing. The lateral meniscus also plays a bigger role in joint motion and fluidity and as a result is designed to be more mobile.

Unfortunately their position between the femur and the lower leg bones leaves the menisci vulnerable to injury. If the knee is forcibly twisted, the discs become pinched between the tibia and bony bumps located on the femur. Meniscus injuries often accompany an additional knee injury like an anterior cruciate ligament (ACL) or medial collateral ligament (MCL) sprain.

The most recent player to suffer a meniscus tear, Houston’s Patrick Beverley, presents a unique case as it appears the defensive-minded guard will avoid surgery and plans on returning this season. While this seems odd for an injury that has required surgery in over 95% of reported cases in the NBA, it remains extremely possible based on the location of the tear.

 

zones

 

Both the lateral and medial menisci are broken down into zones based on the amount of blood supplied to the area. The outer edges of each disc are considered the red-red zone and are well supplied with blood. As you progress inward, the amount of available blood decreases until the avascular white-white zone is reached. Blood does not circulate to this area, negatively affecting the body’s natural ability to heal. If a meniscus injury is small and located within the red-red zone of the disc then a quick recovery is very possible and surgery can be avoided. I have not been privy to Beverley’s MRI but based on Houston’s confidence in his return I suspect this is where his tear is situated.

In the meantime the Houston medical team, led by athletic trainer Keith Jones, will utilize modalities and other forms of treatment to aid and manage any associated symptoms like pain and swelling. When those things are resolved Beverley should be able to return to the court. The risk of reinjury will remain but it’s nice to see an injury that won’t alter the playoffs plans of a player and his team. Hopefully the remaining members of the 2014 playoffs will be equally as lucky.

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