Having A Functional Knee

Over the last 2 months or so, I haven’t been playing basketball but rather going back to my original physio after my knee swelled up from playing basketball over the summer. After getting another MRI, it turns out I have a thickened plica and some minor cartilage damage, but nothing serious. To top it off, my physio said I have symptoms of Patellofemoral Pain Syndrome which has to do with the joint not tracking correctly.

My focus over the last few months have been strength, since my right quad and VMO are still noticeably smaller than my left non-operative leg. The gains have been slow, and no matter how hard I push or lift, it seems like I’m not making any progress, but I keep on telling myself that each rep, each set, and each repetitive task adds up to a stable and strong knee.

Building Muscle Vs. Function

But what’s the point of getting my right leg to the same exact size as my left? I’ve been thinking about this more and more from a functional perspective, and my physio has helped me realize the mental dilemma I’m putting myself in every time I notice the difference in size between my two legs. Long story short, I used to think that having the exact same power and strength on my operative leg is the goal of coming back to basketball, but I realized that I just need to have a functional leg.

Having super huge quads is great if I’m trying to squat 2X my body weight, but doesn’t necessarily help on the court. There are certain ranges of motion that also make my knee feel uncomfortable like a deep squat or a reverse lunge on my operated leg, but these are all rare positions that I would find myself in an actual 5-on-5 game. I used to think that I cannot feel any pain or discomfort in these specific positions but I’ve relaxed this constraint to focus on what really matters: having a functional knee for basketball.

Having said that, I returned to play about 4 weeks ago playing 20-30 minutes tops per session going about 50-75% effort level. No considerable swelling or discomfort after I play which is awesome! But a few days ago I played two nights in a row and for a longer period and now my knee is a bit swollen on the posterior side. It’s definitely not as bad as the time after I played over the summer, but I’m starting to see the limits of my playing time and functionality

Dilemma Of Not Challenging Your Knee

The biggest challenge I’m facing is knowing when to ease up on the gas and stop playing vs. putting my knee through the stresses and change of motion scenarios to stretch the functionality of my knee. This is a new dilemma I’ve never had to face because in the past, I just played until I was tired from an endurance standpoint, or whenever it was convenient to stop playing. Now, if I play too long I get the swelling which is bad, but if I don’t play enough then I’m not putting sufficient stress on my knee to ensure it can handle a heavier load in the future.

The tough truth is that as we get older, our knee joints and especially the meniscus and cartilage wear down, it’s just a matter of time. I wonder if the discomfort I feel after I play would’ve happened regardless if I had the surgery or not. It sucks to come to this conclusion, but thinking that I can put my knee through the original motions and load I could before is simply insane. The bigger question I’m asking myself now is am I ready to make that lifestyle change to less basketball, and transition to a more “gentle” training regimen like swimming or biking?

I don’t have the answer, and I’m not willing to give up entirely on basketball just yet. Before my injury, I was comfortable going all out on the court and that was my attitude ever since I picked up a basketball in 4th grade. Now more than 20 years later, it’s time to take a step back and look at what really counts.

The goal should be having a healthy knee for life instead of for the short-term highs of playing basketball and risking further damage.

But boy oh boy, the pure joy I felt the day my physio told me to go back to playing for 20 minutes or so. I laced up and pretended like nothing had changed, and was actually making an impact on the court with layups and fast-breaks. Saving that story for the next post.

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