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.
Snap, Crackle & Pop: Why Do My Knees Make Noises - And Should I See a Doctor?
April 5, 2022
Do you ever just go about your daily life and then, seemingly out of nowhere, your knee makes a noise?
You might call it a weird idiosyncrasy and not think twice about it—or you might turn to the Internet to try and find all of the potential issues that might be wrong with your knee.
But if your knee pops or cracks once in a while, it’s usually no cause for concern. After all, joints sometimes make noises, and knees are no exception (especially when you squat or sit down.)
“Infrequent knee pops and cracks are more common in the younger population, says Nancy White, M.D., a sports medicine physician at Henry Ford Health. “When you feel that ‘pop,’ it means your kneecap was pulled a bit outside of where it’s supposed to be, and so it’s correcting itself and getting back into position. You can kind of feel that something moved.”
If, however, pain or swelling accompanies a noisy knee, you should have it evaluated by a sports medicine provider. And if your knee is popping or cracking regularly, that's another sign you should have it checked out.
“If you let it go, your knee could get worse,” says Dr. White. “There are recommendations a doctor can make to prevent this from happening, such as strengthening and flexibility exercises.”
What Is Knee Crepitus?
If your knee sounds like Rice Krispies crackling (or you experience a grinding sensation) it likely means you have knee crepitus, which can signify the beginning of osteoarthritis behind the kneecap.
“Knee crepitus is primarily caused by an issue called patellofemoral dysfunction,” says Dr. White. That sounds like a mouthful, but it means that your knee isn’t tracking straight up and down like it’s supposed to.
“There’s cartilage on the back of your kneecap and on the front part of your thigh, and the cartilage on the front part of your thighbone makes a groove so the kneecap can glide straight up and down in a floating position,” says Dr. White. “If the cartilage is worn down (and inflamed, worn-down cartilage signifies osteoarthritis), the kneecap can’t smoothly glide up and down, causing knee crepitus.”
If you are experiencing knee crepitus, you should see a sports medicine primary care physician, especially if it is accompanied by pain. They can recommend a variety of treatments, such as physical therapy and cortisone injections.
Still not sure if your noisy knees are cause for concern? When in doubt, call your doctor. After all, the sooner your doctor can examine it, the sooner you can prevent an issue from getting worse.
To learn more about your orthopedic condition or to find a provider, visit henryford.com/ortho.
Dr. Nancy White is a sports medicine physician with Henry Ford Health. She sees patients at Henry Ford Medical Center – Novi, and Henry Ford Medical Center – Bloomfield Township.