Knees 101: the ‘reality’ of Big Ben’s injury

By now everyone has seen the alerts, the blogs, and the reports that Steeler’s QB Ben Roethlisberger tore his meniscus in yesterday’s game against Miami.

Ben hurt his knee in the second  during the play in which he threw an interception, to Miami CB Reshad Jones, after being hit in the right ankle by pass-rusher Jordan Phillips. Ben left the game, gingerly walking off the field on his own accord to the locker room, but did return to play.

We have also seen media personnel give their “expert” opinion on if, or when, he will return this season, to continue his MVP winning ways.

As a medical professional, as well as sports writer, here are the anticipated specifics, as to what we can expect in the next coming days and weeks.

First, Meniscus tears are among the most common knee injuries. Athletes, particularly those who play contact sports, are at risk for meniscus tears.

However, anyone at any age can tear a meniscus.

When people talk about torn cartilage in the knee, they are usually referring to a torn meniscus: three bones meet to form your knee joint: your thighbone (femur), shinbone (tibia), and kneecap (patella). Two wedge-shaped pieces of cartilage act as “shock absorbers” between your thighbone and shinbone.

These are called meniscus.

They are tough and rubbery to help cushion the joint and keep it stable. Per AAOS

(American Academy of Orthopedic Surgeons website, and American Orthopaedic Society for Sports Medicine reference), sudden meniscus tears often happen during sports. Players may squat and twist the knee, causing a tear. Direct contact, like a tackle, is sometimes involved.

The athlete might feel a “pop” if they tear a meniscus. Most people can still walk on their injured knee. Many athletes keep playing with a tear.

Over 2 to 3 days, however, your knee will gradually become more stiff and swollen.

As reported first by Ron Cook of the Pittsburgh Post-Gazette, Ben had a “slight” tear of his meniscus, which is good news, as there was no other ligament (ACL or MCL) involved in the injury. This is significant, because, if the tear is small and on the outer edge of the meniscus, the surgeon may try a non-surgical means of treatment, called the RICE protocol.

The RICE protocol is effective for most sports-related injuries. RICE stands for Rest, Ice, Compression, and Elevation.

  • Rest. Take a break from the activity that caused the injury. Doctor may recommend that crutches are used to avoid putting weight on leg.
  • Ice. Use cold packs for 20 minutes at a time, several times a day.
  • Compression. To prevent additional swelling and blood loss, the athlete would wear an elastic compression bandage.
  • Elevation. To reduce swelling, the athlete reclines when resting, putting his/her leg up higher than their heart.

However, Ben’s tear was “lateral” and that can be slightly harder in the healing process than a medial tear, because of the way the knee moves.

Now back to the good news: if a meniscus “repair” was in order, this means actually suturing the torn pieces together; they must heal together, so recovery time is much longer. Luckily (if there is a lucky part here) Ben had a Partial Meniscectomy (menisc – the ligament, ectomy – to remove or take out), and in this procedure the damaged meniscus tissue is trimmed way.

Recovery time for this procedure, is 2-4 weeks, as compared to 3 months or more for the repair. (Also, Dale Lolley of the Observer-Reporter reported Monday morning that Ben’s procedure was successful.)

Much of the recovery and rehab time will depend on Ben, his overall health and conditioning, and how big of a tear it was.

Based on the information we have seen so far, after Ben “felt something pop,” he went back into the game and played in the 2nd half. Based on this, and the MRI details, according to the Post-Gazette, Ben will likely miss the Patriots game this weekend.

The Steelers then have a week 8 bye, and if all goes well, we could see him back for the Ravens game on November 6th.

That’s one game missed as a best case scenario, of a 2-4 week recovery time. (Even an arthroscopic clean up is 10 days minimum.)

As for this week’s home game versus the Patriots, Landry Jones is taking the first team reps in practice and expected to start. This isn’t Jones’ first relief appearance, coming off the bench multiple times last season for either Ben, or former Steeler Michael Vick.

Let’s hope that the plan is to get the ball to Le’Veon Bell as much as possible and score early: Jones’ favorite target last season when Ben was out?

Martavis Bryant.

Since Bryant is suspended for the year, Jones will need to find some chemistry with Antonio Brown and Sammie Coates.

The good news is that both Bryant and Brown were far more productive with Jones under center, than Vick. The Steelers played .500 ball, going 2-2 without Ben; at least it looks like they won’t be missing their franchise quarterback for the same length of time as last season.

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