Milwaukee Bucks: What is Giannis Antetokounmpo’s injury?

Our resident physiotherapist takes a closer at what we know about Giannis Antetokounmpo‘s knee injury and what it means for the Milwaukee Bucks’ star.

Editor’s note: Ben is a trained physiotherapist by day, and as such he’s giving us the medical lowdown from the various strands of reporting about Giannis’ knee injury so far.

Four words have caused major pangs of concern among the Milwaukee Bucks fandom over the past few days. Right anterior knee pain.

On one side, you have conservative Milwaukee fans who, at even the slightest sounding of an injury, want to protect their $100 million investment before the 2017-18 NBA season is scheduled to begin.

On the other hand, you have an entire nation of fanatical Greek Basketball fans, who were ready to rally behind their star at EuroBasket 2017, and are now left empty-handed.

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So what does “right anterior knee pain” even mean?

According to reports, Giannis was training with the Greek side when he initially reported knee pain to the Milwaukee staff. Giannis was immediately requested to “stop on court running and jumping for a period to rest”. Milwaukee’s team physician kept in constant communication with counterparts in the Greek setup as Giannis continued to rest.

During Giannis’ most recent appearance in China, he was further evaluated by Milwaukee’s strength and conditioning coach Suki Hobson. Hobson reported that Giannis was still “experiencing significant pain on basic movements”.

At that point, it was recommended that Giannis return to Milwaukee for further testing and to begin rehabilitation, as to avoid further damage. In this time, Giannis has also had an MRI performed on his right knee with all results coming back negative, meaning no damage was found.

Even though reports have been unsurprisingly vague from Milwaukee’s staff, there are three pieces of important information to gather from all this: Giannis is reporting pain in the front of his right knee, this pain is worsening with basic NBA movements (running and jumping), and an MRI has shown no major structural damage.

From all of this, the best and most likely diagnosis that could be made would be Patellar Tendinitis, aka Jumper’s Knee.

What is Jumper’s Knee?

Jumper’s knee is an injury to the tendon that connects your kneecap (patella) to your shin bone (tibia). Common symptoms of Jumper’s Knee include pain in the knee region, which worsens with activity and sport.

It’s more of an overuse injury (as opposed to a direct blow/traumatic injury) and it’s very common in athletes whose sports involve frequent jumping. As the patellar tendon works with your quadriceps muscle group to straighten your knee during running/jumping movements, it can become inflamed if the right balance is not struck with said athlete.

What’s the right balance?

Tendon injuries occur as a result of sudden increased loads and overuse. Too much load and the tendon will become inflamed and if not treated correctly, will begin to degenerate, putting it at risk of overloading and rupturing. Too little load (inactivity) will weaken the tendon and put it at risk of overloading and rupturing if excessive load is applied (e.g. going for a run for the first time after six months of sitting on the couch).

As can be seen, there is a delicate balance of doing not too much, but not too little that needs to be struck in athletes. Get the balance wrong, and the muscles and tendons weaken, putting the athlete at risk of a tendon rupture.

Treatment

At this stage, load management (e.g. reducing the load short term and increasing incrementally) is generally accepted as best practice. Once pain levels have been managed, an increased load is generally applied until the athlete is back to their optimal levels.

In the meantime, pain killing drugs are generally administered while the athlete performs low load, pain-free stretching and strengthening exercises.

To cut a long story short, the best practice here is for Giannis to miss the EuroBasket competition until his knee is pain-free while performing all basketball related movements. This includes running in a straight line, changing direction quickly, jumping and landing.

From there, he can slowly increase his load until he can play a full five-on-five game pain-free. This in the medical world would be best practice and would give Giannis’ knee the best chance to be 100 percent and reduce the likelihood of breaking down in the near future.

In summary, you absolutely cannot blame the Milwaukee Bucks’ staff for being cautious with this injury concern. Having been slugged with leg injuries to two of their stars last season in Khris Middleton (hamstring tear) and Jabari Parker (ACL tear), Milwaukee has every right to be cautious with Giannis.

Giannis is about to enter the first year of a $100 million deal and is the undoubted face of the franchise. If Giannis was to go down with an injury in EuroBasket, Milwaukee’s short and long term franchise plans would be thrown into chaos as they are clearly building this team around the Greek Freak.

So far in his career, Giannis has missed a grand total of 10 NBA games over four full seasons and Milwaukee’s staff want to keep it this way.

Next: Milwaukee Bucks: Giannis Antetokounmpo missing EuroBasket isn’t a positive for Bucks

Based on what’s been reported, the Bucks are just being cautious with their franchise player in what could turn out to be a masterstroke if Giannis can complete the coming 2017-18 season uninjured. After all, Giannis can’t help propel either the Bucks or Greece to dizzying heights in the coming years unless he’s healthy.