It has been nine days since Boston Celtic Kyrie Irving did not return in the second half of a game against the Indiana Pacers on March 12. He missed the remainder of the game for what was deemed as left knee soreness. This is the same knee that back in the 2015 NBA Finals that he fractured and at times since surgery he has dealt with lingering knee issues.
His left knee has flared up again and has missed time this season due to his left knee not being 100%. While he is afforded the rest over the next few weeks with Boston going to make the playoffs and guaranteed home-court advantage potentially throughout the entire Eastern Conference Playoffs, he has been resting.
Danny Ainge confirmed Kyrie Irving "has some surgery that may need to happen" at some point. But Ainge expects Irving to be fresh and healthy for the playoffs. https://t.co/VCSEbS9dlB
— Jay King (@ByJayKing) March 15, 2018
But with that said, since he has been resting and has missed a few games over the course of resting. With that being said there have been new reports on his left and that he is going to seek a second opinion.
There remains no structural damage in Irving's sore left knee, league sources tell ESPN. Belief is still rest is the best remedy for his eventual return. https://t.co/8iMGkb9OHT
— Adrian Wojnarowski (@wojespn) March 20, 2018
With lack of progress on his ailing left knee, Celtics All-Star Kyrie Irving plans to travel for a second opinion later this week, league sources tell Yahoo.
— Shams Charania (@ShamsCharania) March 20, 2018
Since information is very limited on what type of knee injury it is, if we’re thinking it is related to the patellar fracture he suffered several years ago possible issues (but certainly not limited too): patellar tracking issues, chronic pain due to surgery, chronic muscle weakness, posttraumatic/postsurgical stiffness and tightness. Compensations also could have developed thus shifting biomechanics which could have lead to his knee discomfort coming back to the forefront.
The quadriceps muscles transitions and attaches to the patella via the quadriceps tendon. Then there is a continuation of the tendon which attaches the patella to the tibia forming the patellar ligament. Since there are four head that all blend together to form the quadriceps tendon, stiffness or tightness in one of the individual quadriceps muscles can disrupt the ability of the patella to track normally. That disruption in tracking can cause knee pain.
The patella itself sits neatly in a groove on the femur. In a healthy knee, the patella moves in that groove smoothly and doesn’t cause any pain, but if there are muscles that are tight that alter the pattern of the patella.
There are numerous muscles that crossover the knee joint that could all be influencing his knee pain. We have the quadriceps muscles (responsible for extending his knee), there is the hamstring (responsible for bending his knee), there are muscles that cross the knee on the lateral side or the medial side of the knee, but those muscles play a role moreso in the movement of the hip.
What is great news is that there is no structural damage in his knee. So there is no structural damage to the ligaments or the muscles (nothing torn), there is not structural damage the tibia, fibula, patella, or femur (no breaks, no stress fracture). So what we could be dealing with is strictly a muscular injury or a compensation/overstress injury.
What I Could Do:
I’ll start with not only examining his left knee but only assessing his left hip and his left ankle. Aside from knowing he had surgery to repair a fractured patella, you have to evaluate adjacent joints in his hip and his ankle. Often times movement impairments at the ankle and/or the hip can cause the knee to compensate thus develop knee pain.
Also working on the soft tissue that directly connects to the patella (quadriceps, suprapatellar and infrapatellar tendon/ligament) can cause tracking difficulties if the tissue is “stiff” or “adhesive.” So I’ll do a lot of manual work on the hip, lower leg, and knee itself.
A great low-tech exercise you could do if you see the knee caving(which can contribute to knee pain) in on your assessment and the patient complains of knee pain. It is known as the side bridge.
He’ll be back for the playoffs. He could potentially receive injections to help with the pain and manage the pain. He’ll continue to get rehabilitation done on the knee to prevent any potential structural damage and to help with pain management. But he’s going to play in the playoffs.
Whenever his season is done, there will most likely be a [hopefully] small procedure to clean up the knee, clean up the kneecap and hopefully eliminate the pain that he has been dealing with.