While scoping out the world wide web, I came across this gem (Delaware’s Hottest Spot For Sports Blogging News.)
The writer, David Hale, sat down with the 76ers medical guru and spit out the medical afflictions that Utley’s dealing with and waited for the answers. Important stuff in red and there was really no need for the actual questions:
DR: Chondromalacia, otherwise known as patellar pain, is a very common diagnosis, anywhere from kids all the way up. When kids have it, it’s typically not associated with arthritis, but when adults have it, it can be. When they first said the diagnosis as patellar tendonitis, it’s probably because they had a typical chondromalacia picture, but the expectation was he would get better, so why not give a diagnosis with a short-term improvement. Now that he’s not improving as quickly, that diagnosis would change to one that is probably the more specific diagnosis, and that explains why he might not be getting better.
DR: It’s a chronic condition. It tends to recur. You can have it, you’re great, come back, five months later you can develop it again because the same activities that caused it the first time are typically the same activities he’s doing on a repetitive basis. So the things you would do is to try to get him better and try to prevent a return. Typically the way you do that is flexibility exercises, a good strengthening program and an appropriate practice schedule.
In his case, it’s interesting because here’s a guy who has a condition that seems so benign in patellar chondromalacia, no big deal. Yet, this is the same guy that had hip problems, thumb surgery, and has bounced back. So it just makes you start to wonder if it’s a little bit more of a serious patellar chondromalacia than you see in the average individual, just based upon his history. It’s a common problem, but it’s clearly more severe with him.
DR: First of all, surgery is rarely, rarely, rarely appropriate for this condition. You rarely do it. If you look back at the typical sports medicine doctor’s practice, and you look at the number of times he operates on cartilage tears or ligament tears vs. the number of times he operates just on a kneecap problem like this, it’s really rare. The plain and simple reason is most people do get better. If you are forced to operate, there’s two reasons: First, it portends that this is a worse condition. The second thing is the surgery is incredibly simple – it’s called a patellar chondroplasty, you simply smooth out the cartilage. You make the rough ends smoother. The procedure itself is like a 15-minute operation. So when you talk about a professional athlete who says, ‘Boy, it’s taking me a year to get back,’ you start to wonder if it’s the actual procedure or more likely it’s the underlying condition that’s still bugging him.
DR: Baseball players don’t like to use the term arthritis, but it’s clearly arthritis. That’s pretty much what they have. Even though he’s 32 years old, given the type of activities he’s done and the intensity he’s played with, it could easily cause arthritis. A lot of times, the teams, the doctors, the players don’t like to use the word. It’s a negative word, and that’s understandable. It’s just an arthritic condition. Basically any wear under the kneecap, by definition, it’s an arthritic condition.
DR: Surgery is not something you push for unless it’s literally getting to the point where nothing else is working. Most people if they’re getting to this point, whether they’re pro athletes or just regular average joes, do get better without surgery. So that’s always in your favor. The big negative here is that he’s on a timeline, and that timeline is probably the only thing that would push you to consider surgery for this condition.
DR: Since we know now, it’s not just patellar tendonitis, I’d say if this guy is not better by the beginning of the season, he’s going to get scoped. That’s my opinion. He’s had a long enough timeline for conservative care, he is in great shape, most likely he kept himself in good shape in the offseason. … Beyond that injection, certainly they could try another one, but if he’s not playing at the beginning of the season, you’ve got to do something.
That’s about it. Definitely not end of the world stuff, but as an Utley owner I’m definitely preparing for at least a couple 15-day stints on the DL. I get the feeling that in Head-to-Head leagues, you’ll want to take this quite seriously because Philadelphia is a playoff favorite and they’re liable to rest him leading into the playoffs. Given Philly’s rotation, they can probably cruise into the playoffs without Utley, but it’ll take a healthy Utley to win it all.
