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The Knee's the Thing: Focus on the Meniscus

The torn meniscus is on pace to become the most pervasive injury among all athletes. Here, we tell you what exactly a meniscus is, why tearing it is so common and what you can do about it. Plus, we compare and contrast A-Rod and Chipper Jones’ headline-grabbing cases this year.

Chipper Jones of the Atlanta Braves stretches during a spring training workout on February 21, 2011 in Lake Buena Vista, Florida.

Meredith Moore knew something was wrong. It was the winter of 2010 and the runner and soccer player was doing squats in the gym when she felt a peculiar pain in her right knee. She stood, squatted again, and that same knee buckled underneath her. When the pain persisted a few days later, Moore, 30, marched into her doctor’s office in Washington, D.C., hoping he’d say it was a simple IT-band inflammation and send her on her way. But an MRI revealed a diagnosis Moore had been dreading: She had torn her meniscus. She needed surgery. And it would be at least six weeks before she ran another step.

This is the diagnosis no athlete ever wants to hear. It’s the feeling no athlete ever wants to feel: A twist...a pop…a sudden sharp, knife-like pain—and then your whole knee goes weak beneath you. Menisicus tears, while not usually career-ending, are nagging injuries that, when left untreated, can weaken the knee enough to derail an entire season—or longer.

Just look at Texas Rangers reliever Mike Gonzalez—his meniscus gave out on him in Game 7 of the 2011 World Series, shrouding his status for next season with a big question mark. Yankees slugger Alex Rodriguez tweaked his knee after hesitating during an attempt to run to home plate last June, missing 38 regular season games as result of arthroscopic surgery to remove a portion of his meniscus. And Atlanta Braves veteran Chipper Jones suffered the same injury in the same month, spending 15 days—and 12 games—on the disabled list after his surgery (see sidebar, for a side by side comparison). Then there are countless other baseball, football, hockey, and soccer players and other athletes who suffer similar fates each season.

“Meniscus tears, unfortunately, are very common among athletes in all sports. The higher the velocity of the sport, the greater the risk of injury, so we see them a lot in hockey, basketball, tennis, and any sport that involves cutting and stopping,” says Dr. Craig Levitz, MD, Director of Sports Medicine and Chairman of the Department of Orthopedics and Orthopedic Surgery at South Nassau Communities Hospital in Oceanside, NY. “The meniscus is a relatively mobile structure with low blood supply. That’s why it’s susceptible to injury.”

There are an estimated 650,000 arthroscopic meniscal procedures, with a total number of 850,000 meniscal surgeries performed in the United States every year. And with contact sports on the rise among younger athletes, the rate of meniscus tears and similar knee injuries is skyrocketing among patients under the age of eighteen. In fact, according to doctors at the Children’s Hospital of Philadelphia, meniscus tears have increased by 13.95 injuries per year from 1999 to 2011. All of this means torn menisci are on a fast-track to becoming the most pervasive injury among all athletes.

The Meniscus, Explained
So what is the meniscus, anyway? You actually have two per knee, each situated between your femur (thigh bone) and tibia (shin bone). Named for the Greek word meniskos (“crescent"), these rubbery, C-shaped discs cushion the medial (inner) and lateral (outer edges) of each knee. Each time a basketball player pivots and shoots or a soccer pro cuts to the left to avoid an oncoming defender, the meniscus absorbs the shock, promotes the movement of lubricating fluid around the joints, and makes the knee bend smoothly.

When compromised by a tear, however, it becomes exceedingly difficult to balance weight across the knee; pitchers have trouble scrambling off the mound, for example, and a slugger will feel weakness on the bad knee as he twists to hit the ball. What’s more, over time, this uneven weight distribution causes excessive bone-on-bone force, which in the words of renowned sports medicine specialist Dr. Lee Kaplan, is like “sand in a gear box” and can cause early arthritis around the knee joint.

“Arthritis is definitely something to be concerned about with this injury,” says Levitz. “By the time the symptoms are painful or horrible, the likelihood to repair is much less.”

 

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Comments (1)

I see, I suspope that would have to be the case.
Vicky
5/3/2014 7:23 AM
I see, I suspope that would have to be the case.
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