Kyrie Irving back on the court after battling a knee injury

2015-05-28 16:09:43 by Dr. Joe Congeni - Director of Sports Medicine, as posted on the inside.akronchildrens.org blog.

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As an avid Cleveland sports fan, I’m proud to call our Cavs Eastern Conference champs. Go Cavs!

It was great to see Kyrie Irving back on the court last night after struggling with a knee injury. After a trip down to Florida to see internationally revered Dr. James Andrews, he got a new treatment plan that included the second “r” in rest and rehab. It’s really encouraging for Cavs fans as we advance to the finals.

This week, I visited in studio 1590 WAKR morning show host Ray Horner to discuss Kyrie’s injury, along with Stephen Curry’s tough blow the other night. We also talked about 3 tips to keep kids safe and ready for the sports season next fall.

Below is an audio file and transcript of our discussion.



HORNER: In our studio right now is Dr. Joe Congeni, Sports Medicine Center, Akron Children’s Hospital. Always appreciate the time Joe takes with us, an avid Cleveland sports fan.

seeing the Cavaliers last night Kyrie on the court … 22 minutes, 16 points. reaggravated the knee and such. Joe, talk a little bit about Kyrie’s injury.

DR. CONGENI: Yeah, I mean, uh, this happens quite frequently in sports medicine, so I want to use it as an example again, Ray.

What happened with Kyrie, it seemed like the first week or so everything was all about trying to diagnose him. You know, they weren’t sure what it was and take him out and back in. … You know, they were just telling him to rest. But with so many sports injuries, particularly injuries that are overload injuries like this, it’s rest and rehab.

And so, the good news about getting the MRI, going down to see James Andrews (MD) … in Florida a new treatment plan. And the new treatment plan was that second ‘r’, rehab. It isn’t just rest.

So, Kyrie would go out there after 5 days of rest and within a week it was weak and he couldn’t get off the ground. And, what was most exciting last night is they say the rehab and the strengthening, the strength’s coming back in the knee. You could see a little more push-off. You could see a little more lift.

Dr. Joe Congeni Dr. Joe Congeni

Was he still not 100 percent? Sure. He was not 100 percent, but definitely better. Now 8 days to strengthen. It isn’t just rest, it’s rest and rehab and getting that strength back was really encouraging for Cavs fans last night.

HORNER: So with that type of injury, him on the court, is it necessarily a bad thing? I mean, there’s always a chance of reaggravating it. I kinda get that. But, with him running and playing 22 minutes that’s kinda like a rehab, but just a little bit more intense.

DR. CONGENI: That’s a very good way to put it. It’s like he did the 50-minute workout, you know, before game 3. Last night his work out was in the game. They limited his minutes.

They watched him because they know the difference between a structural tear like torn meniscus or an ACL, that was ruled out, versus an overload injury.

But the key thing is … everybody was chasing their tail trying to figure out what it was and rest him, now they started rehabbing him after he went down to see Andrews.

And, it’s the same thing in our place. A lot of parents and things don’t understand that rehab is really the key.

They’re basically, you know, 18 hours a day getting him strengthening and rehabilitating, and since then, I saw a noticeable change for the first time in the play-offs last night.

HORNER: Well, Joe, speaking of the play-offs, Stephen Curry (Golden State Warriors) took quite a blow the other night. When he went down, I’m going, my goodness, he’s gonna be out. He came back and played in the second half. Talk about that type of injury.

DR. CONGENI: Yeah, he did. And everybody was concerned. And you know what? We were concerned about of course falling on the wrist. get wrist fractures, that’s common. He didn’t land directly on the wrist. The shoulder you can get dislocations the way he landed.

HORNER: Snapped his neck, though.

DR. CONGENI: But, he had that snapback. His head hit the ground. He did walk off looking a little dazed. There’s no doubt. We all saw it through the TV. Um … when they say head contusion, it means, you know, a skull injury, soft tissue, not the brain, by way of their evaluation.

But there are such things as what we call a Monday morning concussion, where in the next few days people aren’t feeling quite right. He does have a history of a concussion in 2013, so that puts him at a little bit more risk for having that.

And so, if he was one of my high-school kids I would watch him very carefully for 48 to 72 hours. I would retest him. I would watch him. I would see how he feels.

Of course they’re gonna be doing that, but they’re gonna be doing that in the middle of . They need to win a game tonight. If they lose tonight at home, do they wanna go back to Houston? This is a big game.

And so, not the ideal situation for a day that you’d watch somebody, at least a high-school player. These guys are paid a lot, but I would keep a very close eye on Steph Curry.

People sometimes don’t feel quite right. … They’re a little nauseous. They have other symptoms and so, 24 to 48 hours Monday morning concussions are things we want to see.

Of course, I’m not saying I wanna see that for the Cavs. Of course I want to see the Championship series at full strength, but just keep an eye on Steph Curry tonight.

HORNER: Joe, one thing I wanted to bring up is we’re heading to the end of school, but end of school doesn’t mean the athletes stop. What you see all summer long are kids, for example, cross-country and track and all these sports are kinda working out and getting ready for next fall.

For families that have kids saying, hey, I wanna do cross-country. I’m gonna be running, you know, 3, 4, 5 days a week coming up in the summer. Talk to those families about the kids regiment. What they’ve got to do to prepare and what they shouldn’t do.

DR. CONGENI: Yeah, it should be a gradual buildup. That’s the best. The biggest problem and why places are just bursting at the seams in August is kids don’t do anything ‘til the first day of practice and then they break down. They go from 0 to 150, you know, and they do too much.

A gradual buildup is good, but it’s also good to kinda get away from things, too. Family vacations. This is a great time for those types of things, um, but make your buildup gradual.

And so, start at 20 percent and build up to 40 percent and then 60 percent. Know what your mileage goals are. Get your goals in place and then build up to those goals. Both on the side of aerobic conditioning, like you were talking about running, but also from the standpoint you’re gonna lift some.

Don’t go from 0 to doing too much lifting either. Build yourself up gradually, and you have plenty of time to do it in the summer.

And then the 3rd part is to acclimatize to the heat, so your body gets used to the heat over 3 days, 5 days, 7 days, not in 1 day. So that’s why the heat illness comes in August again if people have not done anything in the heat.

Those 3 things I think are the mainstays for getting kids exercising in the summer.

HORNER: Baseball is full tilt now as we get into late May and into June. Talked with a travel coach, oh, couple of weeks ago and he was asking me about curveballs.

And I said, “Well, our kids don’t throw curveballs, maybe a couple of games,” and he said, “Oh, my kids have been throwing them for a couple of years.”

What’s your viewpoint from a medical standpoint with youngsters throwing curveballs?

DR. CONGENI: You know, pitching generally for young kids starts around 8. I do hear earlier than 8 in my office, but 8 to 14 .

During that age range in order of things to do is:

1. Learn to throw with velocity.
2. Learn to throw in the strike zone.
3. Learn to command the strike zone, so you can throw an inside corner, low and outside, .
4. Change speeds.

That’s what you do between 0 to 14 years of age. At about 13 or 14, when the elbow and shoulder are fully mature, then you start looking at breaking pitches. That’s basically the development of a young pitcher to keep them safe. That’s the best guidelines.

HORNER: Okay, what age did you say there?

DR. CONGENI: 8 to 14.

HORNER: Okay.

DR. CONGENI: So, throwing strikes, command the strike zone, change speeds. … If you could be changing speeds by 12, 13, 14, you’re gonna be doing yourself a lot of good.

Horner: Alright. Curveballs at that young age, tough isn’t it?

DR. CONGENI: I know it is. One more thing I wanted to mention.

HORNER: Please.

DR. CONGENI: Coming in to see you today — and I love when I get to come down here and be one-on-one ‘cause you ask questions and I love the interchange — I do miss a guy and I gotta say that, uh, you know, I always loved coming down and seeing Chuck Collins. And so, if I didn’t mention the loss of Chuck.

You know … we grew up in the same hometown a couple streets apart from each other. We didn’t know it until I came down to WAKR and we would talk about what we called “Warrensville tough.” You learned to grow up in Warrensville, Ohio, and the tough streets, but it really was a great community and I shared a lot with Chuck and I miss him.

HORNER: Yeah, I think we all do.

Originally aired on 1590 WAKR-AM on May 27, 2015

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