With Luis Suarez’s recent knee surgery on his meniscus dominating the back page headlines – everyone in the footballing world is now asking the question; will he be fit in time for Brazil?
England fans in particular are keen to know if the Uruguayan striker, the top scorer in the Premier League this year, will be back on the pitch for their June 19 Group D clash.
Kerry Glendon, specialist physiotherapist at Perform St. George’s Park, explains how Suarez’s swift knee surgery highlights the importance of early detection and appropriate management to return athletes to competition as quickly as possible.
It is widely reported that the Liverpool star injured his knee during training from a twisting injury and had surgery to repair the damage to his meniscus the following day on Thursday.
Menisci are c-shaped cartilage structures located within the middle of the knee joint; one on the inside and on the outside (medial and lateral). The blood supply only runs to the outside part which can make healing tricky. The menisci absorb weight and shock and add stability to the joint, which is why they are so essential for running sports like football.
Removal of just 10% of the meniscus can increase the load on the joint surfaces by 65% and if the whole meniscus is removed this can increase by 200%. To give the athlete the prospect of a full career, repair of the meniscus rather than removal is of upmost importance.
Surgery immediately after injury usually leads to a far better chance of full recovery and smaller tears closer to the outside edges, and therefore a better blood supply, will heal quicker. Some surgical techniques are reported to increase the rate of healing as are experimental PRP (plate-rich plasma) and Hyaluronic acid injections to the site of repair. Finally early repair, longitudinal tears on the outside of the meniscus with no other trauma to other knee structures can mean an earlier return to competition.
The restrictions during rehabilitation depend entirely on the site, size and severity of the tear and so rehabilitation programmes should always be bespoke. It is important the lower limb muscles are strengthened, but the athlete is able to control the position of the knee during twisting and running. This is imperative to prevent further injury.
When running, the forces across the knee joint are increased eight-fold. The menisci work to distribute these forces across the knee joint so running too soon can damage the repair process and delay when the athlete can return to competition.
Footballers treated at Perform, St. Georges Park for meniscal injuries have benefited from state- of-the-art equipment enabling athletes to resume running earlier in their rehabilitation.
The Alti-G is an anti-gravity treadmill allowing the athlete to run at 0% body weight, gradually increasing by increments as low as 1% until they’re able to run with full body weight. Our underwater treadmill has allows athletes to run against the resistance of the water with adjustable water jets adding more resistance to strengthen leg muscles. The underwater camera allows the athlete and therapist to see how their legs move so any necessary adjustments to running style can be worked on.
Any athlete’s foremost concern is always; when can I return to competition? This depends on the site, size, severity of the injury and type of tear. Surgical techniques, injections, access to equipment to reduce body weight whilst running and vigorous rehabilitation regimes can expedite recovery. As to when an athlete will be fully-fit again, however, the answer is always unpredictable!