It is not uncommon for players to have offseason surgery shortly after a long and grueling season. It's not uncommon to have surgery just before the start of a World Cup.
Given the tight schedules of so many of the world's best footballers, there's really no good time to have the kind of minor knee procedure Luis Suarez just underwent, but it's a bit more complicated than that. The Uruguay and Liverpool star is taking some long-term risk in order to be ready for the World Cup.
The Uruguayan Football Association announced Thursday that Suarez had a minor meniscus procedure, an arthroscopic procedure to remove damaged tissue from the cartilage inside his knee. While you will occasionally see the term "repair" used to describe the surgery, this is not technically the case. What surgeons will do is remove or debride the damaged meniscus, as shown in the video here.
If Suarez were to have the meniscus actually repaired—that is, stitched back together and left intact—the recovery period is significantly longer, about three months. Given the timelines, there is no chance that this type of surgery is what Suarez had.
It is likely Suarez has been playing with this condition for a while. According to the Daily Mirror, the injury occurred in a training session with Uruguay, though the Uruguayan FA has blamed it on a tackle by Newcastle defender Paul Dummett in Liverpool's final match of the Premier League season.
The Uruguayan FA said Suarez had "intense pain" during training, which is common. The meniscus damage can catch or move inside the joint space and cause this kind of pain. It is quickly fixed by surgery.
The rehab is very simple for this kind of surgery. Suarez will be back on his feet almost immediately, though he will be braced to keep the knee stable. He won't be allowed to make sharp movements or to excessively load the knee with things like stairs or jumping to make sure that the area fixed is not damaged while acute. He could keep up his cardio with things like arm bikes or even a stationary bike in the days immediately following surgery.
By the time he's a week out, he'll be walking normally and perhaps running. In the two- to three-week period, he'll be running and doing drills. At this stage it's more about comfort and stability. For some, they will be back to normal at about 15 days and could be in competition if necessary.
For an established player like Suarez, the Uruguayans will be a bit more conservative and focus more on having him as healthy as possible for Game 1 of the World Cup on June 14. That game against Costa Rica is key for the team given the tough group that also includes England and Italy.
"We know the surgery was a success and that the injury is not serious. We have to wait and see how he recovers," Uruguayan FA president Wilmar Valdez said, per ESPN.co.uk. "We had very little time to react and, without knowing the extent of the injury, we didn't want to raise the alarm to the public."
Valdez added: "These are injuries that, considering Suarez's fitness and if the recovery is good, will not take long for him to return to play. We have to calculate if he will arrive for the first, second or third [group game at the World Cup)."
The questions shift once Suarez returns from the World Cup to his importance to Liverpool. Having the meniscectomy gives a short-term result with some long-term risk. Suarez will be missing at least a portion of the meniscus, which can lead to degenerative changes, articular damage inside the knee and further, more serious problems.
Helping Uruguay's World Cup chances may hurt Liverpool's title hopes down the line. There's been no indication that the club has been involved or even consulted on this decision, but they have to be concerned. While world football doesn't have quite the centralized medical structure of American sports, it will be interesting to see who does the surgery and who handles the immediate rehab.
Many athletes have returned, safely, from this kind of surgery in a very short time. Perhaps most famously, Mary Lou Retton had her knee scoped just days before the 1984 Olympics, going on to win gold and become America's Sweetheart. The arthroscopic technology was new and seemingly miraculous at that point.
Recently, MLB's Cincinnati Reds saw outfielder Jay Bruce return from a similar procedure in just 15 days. The NFL regularly schedules players to have this kind of surgery over the bye week, allowing players to have knee surgery without missing a game.
Luis Suarez was a monster in England this last season, and combining his quickness with some of the experienced Uruguayans threatens England and Italy in the group. B/R's Sam Tighe did a great job breaking down how key Suarez is to the style Uruguay hopes to take into the World Cup. This surgery shouldn't significantly change that, assuming the recovery has no issues.
One thing Suarez will have in his favor more than the length of time before the tournament begins is the off days during the World Cup. The schedule has La Celeste playing every fifth day, which would allow the medical staff to get any swelling or soreness down on Suarez in between games if necessary.
Suarez has every chance to come back from this surgery, but how the Uruguayans handle his rehab will be key, not only for their hopes in the World Cup, but for Liverpool in coming years. Watch to see that Suarez is back up and running in early June.
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