Randon Hall, MD
NBA Spurs -Understanding Kawhi Leonard's Quadriceps Injury
What's the Background on Kawhi Leonard's Injury
Kawhi Leonard, small forward for the San Antonio Spurs, has been dealing with a quadriceps injury that has limited his action in the 2017-2018 NBA season. Reports state that he was diagnosed with quadriceps tendinopathy. With overuse of the quadriceps muscle, Kawhi likely first developed irritation and inflammation of the tendon, called quadriceps tendonitis. Most athletes can play through this type of injury and will undergo physical therapy. Over time, if the tendonitis persists, the tissue can undergo changes that cause the tendon to develop a more chronic pain. The underlying changes to the tendon do not usually have definitive inflammation, and therefore the name changes to tendinopathy, rather than tendonitis. The changes to the tendon can include degeneration of the tissue and increased nerve and blood vessel growth. The combination of these changes cause the tendon to be unable to handle the same stress it could handle before and be more sensitized to pain.
Kawhi's ordeal is similar to anyone else who develops tendinopathy. The pain develops over time and can be chronic in nature. Also, it is very difficult to treat. Athletes can rest and do months of physical therapy, only to return back to activity and have the same pain return. Although most medical providers rely on an MRI for more information regarding sports injuries, tendinopathy can many times be seen with a simple ultrasound of the area. If the tendinopathy has progressed to Kawhi's stage, you can likely see the degenerative tissue within the tendon.
What TREATMENT OPTIONS DOES KAWHI HAVE NEXT
The big question is what is going to get Kawhi back to normal? If he has failed the physical therapy options discussed in the quadriceps tendinopathy post, he may consider an ultrasound guided needling of the tendon. Basically, this works by using a needle to disrupt and stimulate the degenerative tissue under guidance of the ultrasound. Some medical providers will also inject the patient's own blood or serum at the same time, as there is thought to be growth factors that can help healing. The hope is that after the procedure the body will fill these areas back in with normal, healthy tissue. The healing process takes time. If this is something he would consider, he won't likely be returning any time soon.