Knicks Morning News (2024.02.22)

cgreene, I, for one, have had consternation since the injury took place. My kid’s shoulder was broken down by the repetitive stress of hitting a volleyball. She played in pain for years and was never really 100%, but avoided surgery and has no pain in all ofher aspects of life. So over the years, I have done tons of research on the structure of the shoulder joint and associated injuries, treatments, etc. I think the shoulder is the single most complicated joint in the body. There are numerous components, and a ton of ways for things to go wrong. The two most common things we hear about are the labrum, which is essentially a cartilagenous cup for the ball of the shoulder, and the rotator cuff, which is a complex array of soft tissue and bone that keeps the shoulder intact and functional.

As soon as Randle came up with a limp arm and holding his shoulder, I knew that the best case scenario was a dislocation, but that even that meant that there were almost certainly associated injuries to the labrum and rotator cuff. There is simply no way to pop a tight shoulder out like that without tearing something. If it were, athletes would be dislocating their shoulders all the time.

So for Julius, it became a question of the degree of damage. What I’ve learned is that you can play through a minor labral tear. Because we’re talking cartilage, like meniscus tears in the knee, these tears do not heal on their own. However, if the tear is minor enough, and there are no complete tears of any of the essential rotator cuff tendons, you can tighten up the shoulder enough so that it is “functional,” thereby postponing the need to go in and repair the labrum. But generally, this is not a “good as new” situation. My daughter had a slight tear on the top of her labrum, and muscled through it by being extremely dedicated to weight training and PT, but it was sometimes tough to watch. The good thing was that the pain and weakness would dissipate quickly and in a few days she was back to relatively full strength.

That seems what Julius is trying to do…tighten up the joint enough to minimize (but not eliminate) the risk of reinjury and maximize range of motion. In a way, that was the best case I envisioned at the time of the injury. Being that he is even trying, and the reports are that things are going well, I’m pretty optimistic that he will give it a go, probably sometime in late March. But at the very least, my guess is that he will have to play through pain, probably significant pain, for the rest of this season and playoffs. It’s his off arm, but that only matters with shooting. I’d be shocked if he is at 100% at any point before the off-season.

So the only residual question for me is whether he will need off-season surgery. Shoulder surgery is also not a “good as new” deal, especially with the labrum…most high-impact athletes lose some capacity permanently. But being that he’s not a pitcher, quarterback, or volleyball hitter, it probably won’t affect him much…he will be close to 100% recovered for the way he uses his shoulder, maybe with some residual soreness, but otherwise fine. The recovery time from surgery is typically 3-6 months, so if he is going to have the surgery and be ready for start of next season, the earlier the better.

So long story short, yeah, I’m bummed that this happened at this time, and yeah, it could put a lower ceiling on this season. But that we’re even talking about a possible return gives me some solace.

“Remember when Tanaka was sure to have TJ surgery and was better off getting it sooner rather than later?

I feel like the Randle discourse is going in the same direction.”

TJ surgery involves a single ligament that has either completely ruptured or is hanging by a thread…totally different thing.

With Randle, there is obviously not either a ruptured ligament or massive damage to the labrum cartilage cup or supporting ligaments. If there were, he would already have had surgery.

Here’s a good article from 2021 regarding NFL players who had first-time dislocated shoulders (far more common in football than basketball for obvious reasons.)

My takeaway from this and many other articles is that it should be okay for Randle to delay surgery until the offseason, but that he will likely be better served by having some kind of repair once the season is over. He might choose not to, but those who opt out of surgery tend to have shorter careers. There does not seem to be a significant long-term risk involved in waiting until the offseason to have a procedure vs. having surgery right away. If he can tolerate the pain and stiffness in his off shoulder, he should be reasonably close to 100% effective.

It may also be the case that sports medicine in this surgical area has advanced since 2021, as it has with achilles repair (see: Aaron Rodgers). But from reading several articles, probably not much has changed. It’s a long recovery, but with a very high success rate of return to prior performance, except for throwing shoulders of pitchers and quarterbacks, who tend to permanently lose some zip.

“Your periodic reminder that “incineration” means — and only means — “a trade of an asset for an asset in the exact same asset class that is worth less.”

It is not a term synonymous with “stupid.””

It is totally synonymous with “stupid”, as in, it was a stupid word choice for the situation described above. Always has been. Always will be.