Dr. Jonathan Glashow, noted orthopedic surgeon and co-chief of sports medicine at New York’s Mount Sinai Medical Center, has worked with athletes for nearly two decades in private practice, treating many top stars in his specialties—knees and shoulders.
Note: Dr. Glashow is not Lin's physician nor has he examined him, but has extensive experience with meniscus tears like the one in Lin's left knee.
Bleacher Report: What is the most common cause of the torn meniscus that Jeremy Lin suffered? Is it more likely from repetition or a single incident?
Dr. Jonathan Glashow: There are two types of ways—an acute event, where someone tears a ligament or cartilage. This doesn't sound like the case here.
A chronic tear is something that happens with many small events over time—tiny tears that, pushed forward, hit a threshold and becomes bothersome. With these chronic tears, often we can take a small piece of the meniscus out, not repairing it, though that's not absolute.
If it is in an area with no blood supply, we take a piece out and it leads to a quicker recovery. If the athlete can play well enough to continue the season, so be it, but sometimes there are complications like arthritis that can cause other issues. But more likely, they are able to recover sooner.
BR: Are there other procedures to speed the healing process?
JG: In some cases, there are orthobiologics like PRP [platelet-rich plasma] that may enhance recovery. Some are responders to these, and others are not. If an athlete is a responder, it's the ideal thing where timing is of the essence.
BR: Lin went from very sparse use to playing 35 minutes a game. Could that have had an impact on this type of injury?
JG: A normal knee can take this kind of playing time, but an abnormal knee with a slight injury over this workload will come out when you push it. I don't think playing all this time caused the tear; rather it likely brought out a subtle injury that accelerated the rate.
BR: What is the normal likelihood for recovery? Can he be 100%?
JG: I think so. If it is just the meniscus, these athletes go back 100%. Even with a significant wear change, they go back—the question may be more three, five, seven years down the road: Does he get secondary problems? In next few years, it would be unusual for him not to recover fully.
BR: Is this the type of injury in which a player may favor the knee and be afraid to use it the same way after he returns?
JG: I think part of it is mental, but more of it is seen as a chronic problem, rather than a single incident, once he gets his confidence back, he'll go just as hard. My guess is, unless he has something else we're not seeing, meaning arthritis, and he does his rehab, it could be 3-6 weeks or until next season.
BR: What is the normal rehabilitation procedure for this type of injury?
JG: One of the things to make sure is that the athlete doesn't neglect the other areas while the injured area is healing, to make sure the core of the body doesn't get out of shape, that he or she doesn't lose cardiovascular conditioning. Sometimes that can be done on a bike or with upper body work, undergoing the right exercise regimen. The focus can't just be on the knee, but on the whole body.
BR: There was a news report that perhaps the team knew about the severity of the injury sooner, and held back the information to not affect postseason ticket sales. How likely is this injury to have been diagnosed earlier? Would he have been able to play at all on the knee?
JG: You can't look at an MRI or a diagnosis of a meniscus injury and know that he's not going to play. Some play for a while and all of a sudden something throws them over the edge. I have to give the team the benefit of the doubt; it may not have been bothering him, and he could continue to play fine. The analogy I like to use is that of a paper clip. You bend it, it looks fine, but after more bending it finally breaks.
BR: Without naming specific athletes, in general, what percentage of those you have treated with a torn meniscus have returned fully, and how many have never recovered?
JG: I would say high 90s. The reason for not coming back from this would be something else, like arthritis, other complications, not wanting to come back, a hole or dent in the cartilage—that is less predicable. If he has to have an injury requiring surgery, this is one of the better things to have.
Jerry Milani is a Featured Columnist for Bleacher Report.