H-Wave
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@TheHWave
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JOEL EMBIID- WHAT’s NEXT??? Now that Joel Embiid has had his arthroscopic knee surgery, here are some important questions (that probably won’t be answered), and also rehabilitation/return to play considerations. With this being his second knee surgery for a lateral meniscus tear, how much lateral meniscus is remaining in his knee? The meniscus is an important shock absorber, and the more you lose, the more likely arthritis will begin to develop on that side of the knee (even in younger individuals), especially with repetitive high impact loading. Also, what is the condition of his knee joint at present? Is there much wear and tear or early arthritis? Even prior to this new injury/tear, he would get “knee soreness” with play, and this suggests some element of wear in the knee, either in the lateral compartment where he had meniscal issues, or in the kneecap region (patellofemoral joint) where many basketball players show signs of wear and tear. When a surgeon looks in the knee with an arthroscope, these important (longer term) questions are readily answered. In terms of postoperative rehabilitation, there are several phases, and this is true for anyone who has had knee surgery, but particularly important for professional athletes. PHASE I- early postoperative recovery period (1–2 weeks): -reduce swelling with muscle stim (i.e. H-Wave unit), ice, and limited walking/standing. Possible short course of anti-inflammatory meds if needed. Transition off crutches as swelling decreases and limp subsides. -try to maintain cardiovascular conditioning, or at least minimize loss of conditioning. With sore swollen knee, this takes some creativity. Use upper body ergometer, water-based exercise (once stitches out). Also, overall upper body and core strength, as well as gentle exercises to limit atrophy in the operated leg. Continue to strengthen the non-involved leg/knee. -do not gain weight, in fact try to lose some weight (not muscle!). This can be challenging with decreased activities, so adjustments are needed in nutritional/caloric intake. -maintain positive attitude, which I believe helps influence healing and recovery. PHASE II- usually 2–3 weeks postop: -work harder on cardiovascular conditioning and progress to stationary bike (great for knees as it specifically increases quadriceps strength and endurance) and/or elliptical as knee allows. Aquatherapy (Sixers have Hydroworx water therapy unit at training facility) and water running (a great lower impact alternative). Increase leg/knee strengthening as knee allows. -start increasing daily activities to tolerance. No running/jumping yet, but shooting baskets hopefully tolerated. PHASE III- transition phase (3-4 weeks): -if swelling subsides, and strength returning, start walk/jog interval training and if knee tolerates it, gradually increase running component. Monitor for soreness and/or swelling. Cut back if needed. Every knee is a little different in this regard. -continue to enhance overall strength and cardiovascular conditioning PHASE IV- (4-8 weeks) return to play: -if tolerating all of the above activities, without significant knee symptoms and/or swelling, and strength full, he will be cleared for light practice and then progress to full practice and then cleared for return to play. Again, monitoring every step of the way. These timelines are average, and many things can change during the recovery process. He no doubt will be monitored closely, and adjustments made to the plan. The good news is that the 76ers have top-notch physical therapy and athletic trainer staff who will guide Joel through these phases, hopefully for a full and speedy recovery. @howardeskin *photo via Sports Illustrated*
