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.
When Can I Walk Off Knee Pain — And When Should I See A Doctor?
June 7, 2022
Whether you wake up with a stiff knee, sustain an injury, or start feeling knee pain for seemingly no good reason, you might wonder what to do. Should you immediately rush off to the doctor? Can you just ignore it and hope it will get better? Can you treat it yourself? Knowing when you need a doctor’s intervention can be a tricky decision to make.
We see people at the start of injuries and after they’ve been ongoing,” says Nancy White, M.D., a sports medicine physician at Henry Ford Health. “While the sooner you see an expert, the better, there’s really no right or wrong to it. However, there are a few key signs that it’s a good idea to get it checked out.”
Dr. White recommends seeing a doctor if:
► You are waking up with consistent knee stiffness. If there’s no history of an injury involved, it could be due to osteoarthritis or rheumatoid arthritis.
► If your knee pain isn’t going away.
► Your knee is swollen and you can’t bear weight on it.
► You can’t fully flex or extend your knee.
► Your knee is warm to the touch. This could signal inflammation.
If your pain is mild — or you’re trying to decide whether to see someone — Dr. White recommends icing it on a scheduled basis. “That means two to three times a day,” she says. “Apply the ice to your knee. It will get cold. It will burn, then it will get numb. Remove the ice when it gets to the numb stage.”
She also recommends elevating your leg and putting a compression wrap or sleeve on your knee. If the pain is bad, you can try taking ibuprofen or naproxen for a few days.
Common Causes of Knee Pain
But if your knee is not getting better, it’s a good idea to see a doctor, as common causes of knee pain include:
► ACL sprains and tears. Short for anterior cruciate ligament, the ACL is one of four ligaments in the knee that allows it to flex and extend. The ACL can tear when your foot is firmly planted in place, and the knee locks and twists or pivots at the same time.
► MCL sprains and tears. Short for medial collateral ligament, the MCL connects your shinbone to your thighbone. It can tear when landing after a jump, or after an exterior blow to the knee (usually during contact sports). Luckily, most MCL injuries heal on their own.
► Meniscal tears. The menisci are your knee’s shock absorbers; they're two discs made of soft cartilage. Abrupt movements (like pivots, stops, turns, squats or lifts) can cause them to tear.
► Kneecap dislocation. A direct hit to the knee — or a sudden twist or pivoting of the leg — can make the kneecap can shift out of place.
► Patellar tendonitis. This is also known as Jumper’s Knee, as it’s a common injury in basketball and volleyball players. The patellar tendon connects the bottom of the kneecap to the top of the shinbone, and can become inflamed from overuse, excessive force or repetitive stress.
Knee bursitis. The bursa is a small, fluid-filled sac located near the knee joint. Knee bursitis occurs when the bursa becomes inflamed, often because of a knee injury or overuse from frequent kneeling.
How to Help Prevent Knee Pain
And if you want to help prevent knee pain in the future? “Exercise regularly so that you’re strengthening your quadriceps, hamstrings and gluteal muscles,” says Dr. White. “It’s also important to stretch to increase quadricep and hamstring flexibility.”
Wearing shoes with sturdy soles and proper arch support can also help ease pain and issues you may already have, says Dr. White. “I would say the top reasons people get into trouble with their knees are things they could prevent by changing lifestyle habits. This includes maintaining a healthy weight, as being overweight can also lead to increased wear and tear on the joints.
To learn more about your orthopedic condition or to find a provider, visit henryford.com/ortho.
Dr. Nancy White is a sports medicine physician at Henry Ford Health. She sees patients at Henry Ford Medical Center – Novi, and Henry Ford Medical Center — Bloomfield Township.