Ask the doc: Kevin Durant’s knee

The Golden State Warriors are experiencing some unwelcome déjà vu with the recent knee injury to Kevin Durant. After Stephen Curry’s unfortunate knee sprain during last season’s playoffs, Warriors’ fans were hoping the team could dodge major injuries this season.

Alas, it wasn’t meant to be so. For those of you who missed it, here’s what happened:

After an MRI and an evening fraught with worry, the Warriors reported that Durant suffered a grade 2 MCL sprain and a tibial bone bruise. He’s ruled out indefinitely, to be reevaluated in four weeks.

To learn more about this injury, we turned to our on-call injury expert — Dr. Elliot Yoo, a physical medicine and rehabilitation physician and pain medicine fellow at Massachusetts General Hospital.

DISCLAIMER: The discussion below is general in nature. Golden State of Mind and Dr. Yoo are not providing any medical diagnoses and are certainly not giving you medical advice. If you’re hurt, stop reading and go to your doctor.

Jason Lee: Sad to say, us Warriors’ fans are no strangers to MCL sprains. But what’s different about Durant’s grade 2 MCL sprain compared to the grade 1 sprain Curry suffered last season?

Dr. Elliot Yoo: A grade 1 MCL sprain happens when that particular knee ligament gets stretched out without suffering a major tear. While this can be painful, the ligament is intact and continues to keep the inside part of the knee joint stable.

A grade 2 MCL sprain is a more significant injury because the ligament is partially ripped. These sprains are more concerning because a partially torn ligament doesn't do as good of a job keeping the knee joint stable.

J.L.: What's the typical recovery procedure?

Dr. Yoo: Thankfully, most MCL sprains can be rehabbed without surgery. The procedure for an isolated grade 2 MCL sprain — where the meniscus and ACL are undamaged — is similar to a grade 1 MCL sprain.

In the beginning, the focus is on bringing the swelling down, maintaining range of motion and cautiously starting to strengthen the muscles that support the knee — i.e. the quads and hamstrings. It’s also important to limit activities or movements that cause pain.

Activities slowly progress from balance exercises and light aerobic activities to more sport specific activities. If these are well-tolerated an athlete can resume play, usually with a knee brace.

You may have heard about platelet rich plasma or stem cell injections to facilitate quicker recovery of injured ligaments. These are promising, but more research is needed.

J.L.: There are less than six weeks left in the regular season and potentially three months until the championship round starts. Hopefully Durant can return at some point in that time frame. Generally, what's the ideal timetable for returning to play?

Dr. Yoo: Obviously, the timing of recovery can vary quite a bit from person to person. The sport specific activities phase I described above typically starts in the fifth or sixth week of recovery. The ideal time to return to play is when an athlete feels no pain and feels confident in performing sports specific activities.

J.L.: What about the earliest one could potentially return?

Dr. Yoo: If the injury is isolated to the MCL, the tear is minimal and swelling goes down quickly, an athlete might be able to return in 3-4 weeks with a protective brace.

J.L.: What about the effect of this kind of injury on basketball-specific movements?

Dr. Yoo: The MCL prevents the knee from buckling inwards and stabilizes the knee while the leg tries to rotate or pivot. An injury to the MCL might effect a basketball player’s ability to plant a foot and change directions quickly as well as their ability to move from side to side. So performing a move like a Euro step might be a little more nerve wracking, as it combines both these motions.

J.L.: How does the bruised tibia play into this?

Dr. Yoo: The tibia is the shin bone, which bears most of the weight in the lower leg. So with a bruised tibia, even walking can hurt. A bruise to this region could also involve surrounding shin muscles, which could lead to muscle spasms.

Tibial bruises can often occur with MCL sprains, but should get better within a few weeks with a little TLC.

J.L.: Any long term effects or increased risk of re-injury with this kind of sprain?

Dr. Yoo: Probably not. But if someone relies on a brace to return to play it can alter the mechanics of running and slashing compared to not wearing anything around the knee. Generally, ligaments heal and do okay long term.

Our thanks to Dr. Yoo. We will be checking in with him periodically throughout the season as injuries pop up.