Macomb Lutheran North Standout on Mend After Knee Injury
October 3, 2023
Macomb Lutheran North freshman Emiliana Manzo has already achieved a long list of accomplishments, including a 3.8 grade-point average while juggling two sports she loves.
As a point guard, she led her basketball team to an undefeated season in its division. She is also a center attacking midfielder, sometimes playing forward, on the 2009 Nationals Girls Academy Blue soccer team, ranked No. 1 in Michigan and 14th in the country.
In June of 2022, Emiliana hit a detour on her sports journey when she was participating in a club soccer national championship in Oceanside, Calif. With a few seconds left in the game and her team up 2-1, she ran 20 yards full speed to get to the ball. Hyperextending her left knee, she felt two pops. It was the first time she experienced an injury.
“I was screaming and crying and got taken off the field on a golf cart,” explains Emiliana. The trainer felt she was OK. Fortunately, she had the next day off and her knee was feeling better. The following day she played again, and 20 minutes into the game she knew there was an issue.
“Someone hit me from behind and I heard the pop again. I knew there was a problem.”
Emiliana’s father Vince Manzo said she experienced swelling, and the athletic trainer thought she may have a meniscus injury; however, she was able to continue to walk around during the championship in California before heading home.
Finding the Right Provider
Back in Michigan, Emiliana saw a few surgeons during her evaluation to seek treatment. When she met with Vasilios Bill Moutzouros, MD, chief of Sports Medicine at Henry Ford Health, she felt she met the right match.
“He treated me like an athlete and made me feel really comfortable,” she says.
Vince adds that both he and Emiliana were also appreciative of something Dr. Moutzouros said during her evaluation: “He emphasized to Emiliana that she was an athlete before this injury, and she would be an athlete after the injury.”
A detailed evaluation by Dr. Moutzouros revealed Emiliana had a complete anterior cruciate ligament (ACL) tear and medial and lateral meniscal tears. The meniscus, a C-shaped piece of tough, rubbery cartilage, acts as a shock absorber between the shinbone and the thighbone. It is one of the most common knee injuries. The ACL, one of the strong bands of tissue that help connect the thigh bone (femur) to the shinbone (tibia), is also prone to injury during sports when there are sudden stops or changes in direction.
Emiliana required physical therapy to get the swelling down and increase mobility before surgical repair.
Dr. Moutzouros reconstructed her ACL with her own patellar tendon graft and repaired her medial meniscus.
“She handled the surgery well and has been working very hard in her rehabilitation,” he says. “Her high-level soccer experience likely helped in her recovery as her range of motion and strengthening advanced so quickly.”
Understandably, Emiliana was nervous and scared when she went into surgery but expressed appreciation for the little things from Henry Ford like hearing “great music” as she was entering surgery, which gave her a sense of calm.
“That’s when I knew I picked the right doctor,” she said.
The Road to Recovery
As part of her recovery, after surgery which took place in July of 2022, Emiliana has undergone six months of physical therapy to increase mobility and strength training to get her leg strong again.
She also participated in the Return to Sport Program at the Henry Ford Center for Athletic Medicine to optimize recovery.
“We loved it,” says Vince. “It gave us peace of mind.”
Dr. Moutzouros explains that ACL prevention and rehabilitation programs are critical, especially for women because they have a four times greater risk of ACL tear than men. He says performance training post-surgery, along with an injury prevention program for those playing cutting sports, can markedly reduce the likelihood of future ACL injury.
“At Henry Ford, we work with physical therapists across the Midwest as well as our own. They do a great job in following our Henry Ford specific post-ACL reconstruction protocol,” he says. “After therapy runs its course, we strongly encourage our athletes to undergo performance training to allow a smooth transition back to sport.”
Nick Parkinson, supervisor of Athletic Training and Sports Performance at Henry Ford Health, emphasizes that the return to sport program is designed to bridge the gap between rehabilitation and returning to full activity in your chosen sport.
“Many times, insurance limits rehabilitation to regaining activities of daily living and not necessarily rebuilding the skills needed to play a sport or return to activity,” Nick says. “This program provides an affordable option to fill this need and return athletes to competition at the highest level.”
As for Emiliana, who hopes to play soccer in college and pursue a career in the medical field, she says this experience has taught her to not be afraid of injuries and treatment. She has also used the experience to volunteer for a program through the Girls Academy which serves as an advisory board to come up with ideas to help with mental and physical issues girls her age may be facing.
“For other kids who experience injuries, I’ve learned that this does not define you,” she said. “You can push through it, recover from it and be way better than you even were before.”
To find a sports medicine doctor or athletic trainer at Henry Ford, visit henryford.com/athletes.
Symptoms of a Meniscus Tear — and When to Seek Treatment
April 2, 2024
Meniscus tears are not one size fits all: Sometimes they cause no pain, other times they’re excruciating.
Once in a while they heal or adapt on their own, but more often than not they require physical therapy or surgery.
“Your meniscus is a fiber elastic cartilage that acts as a shock absorber for the knee,” says Ahmad Bazzi, M.D., a sports medicine physician at Henry Ford Health. “It also helps stabilize the knee joint. But when it tears — which can occur in young athletes after a pivot injury or in older people who have arthritis — it can be painful.”
Here, Dr. Bazzi shares symptoms of a meniscus tear and when to see a doctor.
What Does A Meniscus Tear Feel Like?
Depending upon the level of injury and type of tear, meniscus tears can either be asymptomatic or cause symptoms like:
- Locking. When the meniscus tears, a piece of it might move into the knee joint, causing mechanical issues like stiffness and locking of the knee joint.
- Catching or clicking. This often feels like a sudden ‘click’ in the knee joint, where it suddenly gives out while you’re walking or doing certain movements.
- Localized pain on the inner or outer part of the knee. In young athletes, a meniscus tear often causes an impaired range of motion and localized pain on the inner or outer part of the knee.
- Pain and swelling. In older people, a meniscus tear often causes swelling and an overall aching pain in the knee.
Treatment Options For Meniscus Tears
A meniscus tear can only heal on its own if the tear is on the outer part of the knee where it has better access to blood supply. If you’re experiencing pain a few days after injury and you have limited range of motion, instability and/or swelling in the knee, Dr. Bazzi recommends seeing a doctor to get an examination and, if needed, an MRI for diagnosis.
“It’s hard to tell what type of meniscus tear you have if you haven’t seen a doctor,” says Dr. Bazzi. “If you have a mechanically unstable tear and it goes untreated, it could lead to worsening range of motion and stiffness, or worsening arthritis. It’s important to get seen by a doctor to get an accurate diagnosis and the proper treatment. It may take one to three months for a full recovery.”
Here, Dr. Bazzi shares treatment options:
Surgery
If someone is having mechanical symptoms like locking or catching, surgery may be considered right away, especially if it’s an athlete younger than 40 years old. “Meniscus tear surgery has a shorter recovery compared to other knee surgeries,” says Dr. Bazzi. “Surgery could either consist of a meniscectomy, which is partial or complete removal of the meniscus, or sometimes just a meniscus repair.”
Hyaluronic acid or cortisone injections
Non-operative treatments are often recommended for older people who have degenerative tears due to arthritis. “This is because meniscus surgery doesn’t often relieve their pain since they have underlying arthritis, meaning they have cartilage loss in the meniscus,” says Dr. Bazzi.
Instead, a cortisone injection, which is an anti-inflammatory medication that can be injected into the knee, can reduce inflammation, swelling and pain caused by arthritis.
A hyaluronic acid injection may also be considered, which adds cushioning in the knee. “Hyaluronic acid is one of the substances that make up our cartilage, so this injection helps us mimic the lost cartilage,” says Dr. Bazzi. “It also has anti-inflammatory properties.”
Physical therapy
Physical therapy is another great option, especially for older people who need non-operative treatment options. It can help the knee adapt to the tear, reduce pain and encourage full range of motion. “Physical therapy for meniscus tears focuses on balance exercises and exercises to strengthen the muscles around the knee,” says Dr. Bazzi. “This helps to uphold the knee joint to achieve full range of motion and strength while being pain-free.”
To find a sports medicine provider at Henry Ford Health, visit henryford.com/athletes or call 313-651-1969.
Reviewed by Ahmad Bazzi, M.D., a sports medicine physician who sees patients at Henry Ford Medical Center – Fairlane.