Russell Westbrook’s Knee Injury Breakdown

by Stephen Caronia

On April 24, during game 2 of the 1st round of the Western Conference Playoffs,  the Oklahoma City Thunder’s title chances were dashed when Russell Westbrook sustained a knee injury in the most frustrating of ways.  Casually dribbling across halfcourt to call a timeout, Westbrook took a shot from the Rockets’ Patrick Beverly that left him limping and angry.  As it turned out, Westbrook had a tear in his lateral meniscus that required surgery.  Here’s a look at how it happened:

If looks could kill…

You can see that Westbrook’s knee does a little bit of a plant and twist when he got hit.  This is a classic mechanism for a meniscal tear.

The menisci are C-shaped and comprised of fibrocartilage, meaning it’s a little tougher and can withstand compressive forces a little better than other types of cartilage.  There are 2 menisci in each knee: medial (inside) and lateral (outside).  They lie on top of the tibia (shin) and have a concavity like an amphitheater to fit the femur (thigh).

The menisci are designed to absorb shock, provide a smooth, form-fitting surface for the femur to glide on, and withstand compressive and torsional forces to the knee.  You can see that the medial and lateral menisci are each shaped differently.  The lateral meniscus is more circular and has less attachments to ligaments in the knee compared to the medial meniscus.  While it is torn less often than the medial meniscus, the lateral meniscus actually takes on more twisting forces during cutting, jumping, landing, and running.

Tears happen when the knee is planted on the ground and the person twists on top of it.  The cartilage is essentially compressed and the bones grind together, catching the tissue and ripping part of it.  The location and size of the tear is crucial for determining whether surgery is required.  Small tears close to the outer edge of the meniscus have a good chance of healing on their own with rest and rehab, as the edge of the meniscus  has good blood supply.  However, larger tears are more difficult to heal on their own, and the further towards the middle the tear, the poorer the blood supply.  No blood, no dice.  Sometimes, the torn piece of cartilage will just be snipped out or even left alone if the blood supply is bad enough.

Westbrook’s tear required surgical repair, meaning there was a significant tear in an area with a decent blood supply.  The torn part of sewn back to the base, and rehab begins.  Typically, you’re on crutches for 4-6 weeks before you can put weight on the leg.  Gradually, range of motion, strength, balance, leaping, ankle-breaking, and vicious dunking are restored, all essential components of Russell Westbrook’s game.

No glory for the poor, dejected menisci until they get torn.  It’s unfair, really.

About a month ago, Westbrook underwent a second surgery due to recurrent swelling.  Fortunately, there wasn’t any more damage or compromise to the repair.  Doctors reported a loose stitch being the culprit, which the body will treat as a foreign object, creating swelling and possibly pain.  The recovery from that is relatively quick, and Westbrook was able to return to action Sunday.

Westbrook shot only 5-16, but went 11-14 from the line and finished with 21 points and 7 assists in an OKC win.  He should improve each week he’s back in action, but he may never quite be 100%.  Once the weight bearing surfaces of a joint are damaged, they don’t quite behave the same.  That’s not to say he’s going to injure it again, necessarily, but he’s at a slightly greater risk for breaking down over time.

He’s a nihilist. He doesn’t care.

For now, I look for Westbrook to shake off the rust and get back to playing his game.  This will be just in time for people to get back to criticizing him despite being him one of the most dynamic guards to play in the last 10 years. Oh well.

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