Imagine it’s November, the end of high school football season, and you are practicing for a big playoff matchup. Shortly after the snap, you plant and twist on your knee and feel something pop. There is pain, but it’s not so severe that you can’t continue. You realize something is wrong, but you don’t want to miss the playoff game. You keep going and play through the pain for the next few days. Despite a valiant effort, your team falls in the playoffs and your knee still isn’t quite right. It’s time to see a doctor.
This is much like what happened to Collier Clay, a senior at Kentucky Country Day School. He came to see me in November 2011 after injuring his knee during a football game. I suspected a meniscus tear in his left knee. The MRI confirmed that not only was it a meniscus tear, but a specific and severe kind of tear called a bucket-handle tear.
The meniscus serves as a shock absorber for the knee, providing cushioning and stability that help protect the articular cartilage from damage. A bucket-handle tear involves nearly the entire meniscus. The middle portion folds over like the handle of a bucket and can get trapped in the notch, or center portion of the knee. Losing the meniscus at a young age means a poor prognosis for the longterm health of the knee, so I had a long discussion with Collier and his mother about whether to repair the meniscus or simply trim out the tear.
The repair procedure involves stitching the meniscus back together. Since the meniscus has a poor blood supply, which limits healing of the tissue, there is no guarantee of success. Rehabilitation can take three to four months, and crutches have to be used for the first several weeks to protect the repair.
Collier was willing to go through the rehab, so we proceeded with the surgery in December 2011. He did very well after surgery with no real setbacks along the way. In April, I cleared him to return to sporting activity. He is now the starting center for his school’s football team. Collier hasn’t had any problems with his knee and plans on playing baseball this school year as well. Not only am I glad that he was able to get back to the sports that he loves, but I feel good knowing that by repairing his meniscus, his knee will be protected well into the future.
Sam Carter, M.D.
Norton Sports Health
Ways to help prevent knee injuries
Warm up! — This is probably the most important thing you can do to help prevent injury. Warm up for at least 10 to 15 minutes in a way that mimics the activities for the sport you are about to play.
Strengthen — Keep the muscles around the knee strong, particularly the quadriceps and hamstrings. Strong hip and core muscles are also important; a weak hip or core can place the knee in compromising positions during fullspeed activity.
Keep good form — When you land from jumping, keep your feet squarely below you and the knees facing forward. Rotating the knees inward during a landing can place high stress on the knee ligaments.
Match shoes to playing surface — Wear appropriate shoes for your playing surface. For field sports, cleats should be long enough to give you the best traction but not so long that your foot sticks in the turf.
Wear bracing — For particularly high-risk positions, such as a lineman in football, specialized bracing can help minimize risk of certain knee ligament injuries. Ask your orthopaedic surgeon or trainer if bracing is appropriate for you.
Visit NortonHealthcare.com/SportsHealth to learn more about how to prevent sports-related injuries or to find a sports health specialist.