Randon Hall, MD
The Source of Embiid's Knee Soreness is Crucial
Embiid's Knee SorEness is a Big Deal
Joel Embiid’s knee soreness has left every Philly fan waiting to the last minute to find out if he will play in each of the 76ers playoff games. Here is a breakdown of everything you knee to know about JoJo’s knee and the likely scenarios for him throughout the playoffs. No, I am not the man’s doctor, nor do I think I know better than they do, but I can give fans an idea of what to expect.
First off, “soreness” tells us absolutely nothing about what is going on. Here are the key points that matter. Embiid was diagnosed with a meniscus tear in 2017. Keep in mind that after missing three games he returned back to play and he dropped 32 points had 7 assists and 2 blocked shots. Not only did that confirm he is a beast, it confirms that he can play on a torn meniscus. He eventually had surgery 2 months later where a small portion of the meniscus was removed, called a meniscectomy. (remember this, its important). On a complete side note, he goes on to sustain an orbital fracture in the 2018 playoff, which is covered here.
Fast forward to the All-Star break this year, Embiid has recurrence of soreness in his knee and even though he had an MRI that showed no structural damage. He has had significant rest the second half of the season. In fact, he missed 14 of the last 24 games. The fact that he has been dealing with this issue for a while is the concern. If he had something straightforward, he would have had ample time for an intervention or surgical treatment to be ready for the playoffs. If it was as simple as an injection we wouldn’t be still talking about this.
Real Talk On Embiid's Knee
Let’s be clear, no structural damage to the knee on an MRI is only part of the picture. Even if it had been a small discrete tear, it could be removed as Jimmy Butler did when he returned in time for the playoffs with the Timberwolves. He has proven he can play with a torn meniscus, but this would typically show up on an MRI. It is possible that Joel now has some degenerative tearing of that meniscus that is causing his symptoms, but less likely. That leaves us with a few possibilities. He could have a tendinopathy similar to what kept Kawhi Leonard out for a large portion of last season, again a stretch. The only other really possibility is that he has developed some chondromalacia (softening of the cartilage) or true arthritis. If you recall the removal of a portion of his meniscus in 2017 is a large risk factor for developing arthritis over time, depending on how large the piece that was removed. Contrary to popular belief you don’t have to have “bone on bone” to have bad pain and stiffness in the knee. Yes you can see these things on MRI, but they don’t fall within the statement of “no structural damage”.
So now what. The biggest concern was with the brace he was rockin’ before Game 1. The brace is called an unloader brace, which basically has a hinge on one side to take the pressure off that side of the joint. They don’t provide a ton of relief, but one indication is for arthritis and other cartilage issues, a point that @ProFootballDoc has made in the press. If that is the case, it is not something that can be cured, just managed, and that is why his longevity is being called in to question.
Here is the good news. Embiid warming up with a particular brace for one game is no way indicative of how much life he has left in his knee. With regards to the playoffs, every game is likely to be just how bad does it hurt and can you play through the pain. Everything is just speculation at this point, and even if there is some early arthritis that can be managed and is not a career-ender.