Green Zinger Tea - Kristaps Porziņģis 2023-24

DeadlySplitter

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I am really annoyed it wasn't even the 4th quarter play, it was some standard rebound

They did a great job with injury avoidance in the regular season... and he still is made of glass
 

HurstSoGood

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fiskful of dollars

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You guys all know this: I am NO DRS...

The wording of this is unclear so I'm still a bit unsure what the actual injury is. With the caveat that the diagnosis is a bit muddled, here's my take: A torn medial retinaculum increases the risk of patellar dislocation. It helps the medial patellofemoral ligament (MPFL) keep the patella well seated within the femoral groove. It is often torn when the patella is dislocated laterally (most common) due to trauma. The retinaculum is a tough band of connective tissue that holds tendons in proper anatomical position. These structures are often injured with trauma. It is a BIT unusual to see/hear of an isolated retinaculum injury because usually other, more recognizable structures are injured as well...i.e. patellofemoral ligament, patella, meniscus, etc. It is unclear if KP dislocated his patella but I don't think that is terribly likely given the nature of his injury and what I was able to observe. A patellar dislocation can be treated easily on the court - you simply straighten the leg out and the patella snaps back into place. I do this all the time in the ED without sedation - it's that quick/easy...usually, there are exceptions.. He MAY have subluxed his patella - (slid out, and right back in). Some of you may remember when Patrick Mahomes dislocated HIS patella a few years ago. He was playing 2-3 weeks later. So, this injury could require surgery (worst case - and probably eventually for a pro athlete) OR simply a brace to stabilize the joint. Those are the two treatment endpoints acutely - in my admittedly uninformed opinion. If his MPFL is also torn, he is 100% done for the playoffs. Tendons don't really dislocate so that verbiage is a bit unclear to me. I suspect there was an error in transcribing the diagnosis but I'm not sure. I THINK (but do not know) that him walking limp free w/o a brace indicates that he has not torn the larger more "important" knee stabilizing tissue nor has he dislocated his patella. A bit speculative, I know. I wish I had more to go on. Actually, I think "day to day" is pretty accurate. If pain and swelling are well controlled and he can wear a brace to stabilize the joint, he might be able to play again this series.
 

Ed Hillel

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Just some things I observed Sunday:

1. KP looked totally healthy in the first half.
2. After that knee knock with Lively in the early 3rd, he came back out with what I personally thought looked a bit like "minor dead leg." It didn't appear he really had an injury and it wasn't affecting his demeanor in any way, but he looked very slightly hitched. However, his play up until the subsequent ankle turn in the fourth seemed fine. Maybe not top of his game, but he was effective and a net positive out there. I believe someone in the gamethread noted that Maxwell noticed the same thing after the knee bump, he looked a bit ginger.
3. After that subsequent turn he was done, and it was clear he needed to be off the court ASAP.

My guess: I think the KP we saw in the 4th is unlikely to be the KP we see moving forward, barring further injury. I think he got a very minor ankle turn that would not have impacted him again in Game 3, and I would guess that's fine now. I would guess the KP from the 3rd is the guy we'll get, but that he'll be at risk to become the KP from the 4th or worse at any moment (this is my guess for what will happen). I think if we're lucky, he can still be effective, but you also need to now factor in how this will impact KP mentally and how hard his brain will allow him to play knowing what can happen at a moment's notice.
 

fiskful of dollars

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As long as there is no ligamentous tear, I doubt surgery would be needed. MPFL injuries are often managed non-operatively. This would not usually be considered be a career threatening injury. Each case is different, of course. My sense is that he's hobbled (think mod knee sprain) but plays this series in a somewhat limited role w/ a brace. After the season (the Championship, I hope!), he can take some time to rehab and see how the knee responds. Likely non surgical for this isolated injury but who knows what else his L knee may need?
 

m0ckduck

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As long as there is no ligamentous tear, I doubt surgery would be needed. MPFL injuries are often managed non-operatively. This would not usually be considered be a career threatening injury. Each case is different, of course. My sense is that he's hobbled (think mod knee sprain) but plays this series in a somewhat limited role w/ a brace. After the season (the Championship, I hope!), he can take some time to rehab and see how the knee responds. Likely non surgical for this isolated injury but who knows what else his L knee may need?
Thank you!

(sorry, I deleted my original post because I saw similar questions being answered in the other thread).
 

Ed Hillel

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This was what he went to the locker room for prior to the 4Q. Then he returned to the game and I suppose that awkward landing aggravated it.
No, it was the opposite leg/ankle in the 4th. And I don't think he went to the locker room in the 3rd, did he? I thought he left after the 4Q briefly and then returned. He played pretty well in the 3rd/early 4th until the right ankle turn.
 

Auger34

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As long as there is no ligamentous tear, I doubt surgery would be needed. MPFL injuries are often managed non-operatively. This would not usually be considered be a career threatening injury. Each case is different, of course. My sense is that he's hobbled (think mod knee sprain) but plays this series in a somewhat limited role w/ a brace. After the season (the Championship, I hope!), he can take some time to rehab and see how the knee responds. Likely non surgical for this isolated injury but who knows what else his L knee may need?
I think the injury that he sustained is in his foot/ankoe and not his knee?
 

joe dokes

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Even if his patella has been liquified into a puddle of fatchamadda sauce, he's probably *still* a better defender than Doncic.
 

radsoxfan

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Probably should have posted this in here too….

The number of comically wrong social media posts on this injury already is funny. Holy smokes.

A few quick thoughts:

- rare injury, though I have seen it a handful of times

- this is an injury to the thin “ligament-like” band that holds on the the medial ankle tendons behind the inner side of the tibia, the medial malleolus (That bump you feel on the inside of the ankle).

- if torn, the tibialis poster tendon can side in front of that bump instead of staying behind. That’s the “dislocation”.

- I’m the short term, he can probably try to play, though might be painful and feel awkward. Likely decreased mobility

- most likely will require surgery in the offseason though no big rush

- this is essentially a “reverse Schilling”. Schilling tore the peroneal retinaculum on the outside of the ankle allowing the peroneal tendons to slip out of place. Same idea here, but different tendon on the inside of the ankle.

- crazy bad luck for KP. I hope he can play a bit and be an upgrade of kornet/Tillman. But we’ll see.
 
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radsoxfan

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Also, a lot of the disconnect on social media and here is the confusion between the medial patellofemoral retinaculum (MPFL) at the knee and what Porzingis injured at the ankle.

MPFL injuries are very common and entirely unrelated to what happened to KP.

The medial flexor retinaculum at the ankle keeps your medial ankle ligaments in place. He didn’t have a knee injury, patellar dislocation, or anything like that. He hurt his ankle.

Most likely he’s going to need offseason surgery. He can still try to give it a go for a week or two and see how effective he is.
 

Ed Hillel

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Also, a lot of the disconnect on social media and here is the confusion between the medial patellofemoral retinaculum (MPFL) at the knee and what Porzingis injured at the ankle.

MPFL injuries are very common and entirely unrelated to what happened to KP.

The medial flexor retinaculum at the ankle keeps your medial ankle ligaments in place. He didn’t have a knee injury, patellar dislocation, or anything like that. He hurt his ankle.

Most likely he’s going to need offseason surgery. He can still try to give it a go for a week or two and see how effective he is.
So KP said the injury happened when he bumped left knees with Lively in the early 3rd, but then he appeared to roll his right ankle in the early 4th, which was when he clearly needed to come out. I think his entire play up until that right ankle roll was post-injury (for what we are speaking about now), and I think they are separate, unless the weakness in the left caused the roll of the right. This dude is like an advent calendar of leg injuries.
 

fiskful of dollars

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Also, a lot of the disconnect on social media and here is the confusion between the medial patellofemoral retinaculum (MPFL) at the knee and what Porzingis injured at the ankle.

MPFL injuries are very common and entirely unrelated to what happened to KP.

The medial flexor retinaculum at the ankle keeps your medial ankle ligaments in place. He didn’t have a knee injury, patellar dislocation, or anything like that. He hurt his ankle.

Most likely he’s going to need offseason surgery. He can still try to give it a go for a week or two and see how effective he is.
Ah gotcha. I was confused. I saw an MPFL injury (here) and a video showing a Valgus type mechanism which would be consistent with a medial knee injury. Now it makes sense. Thanks for the clarification.
 

BigSoxFan

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Also, a lot of the disconnect on social media and here is the confusion between the medial patellofemoral retinaculum (MPFL) at the knee and what Porzingis injured at the ankle.

MPFL injuries are very common and entirely unrelated to what happened to KP.

The medial flexor retinaculum at the ankle keeps your medial ankle ligaments in place. He didn’t have a knee injury, patellar dislocation, or anything like that. He hurt his ankle.

Most likely he’s going to need offseason surgery. He can still try to give it a go for a week or two and see how effective he is.
Thank you. I presume there are no, umm, shots that could KP manage the pain?
 

HomeRunBaker

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No, it was the opposite leg/ankle in the 4th. And I don't think he went to the locker room in the 3rd, did he? I thought he left after the 4Q briefly and then returned. He played pretty well in the 3rd/early 4th until the right ankle turn.
Reporter on Twitter confirmed he went to locker room prior to him returning to game in the 4Q. I forget who it was.
 

Auger34

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I have been following these threads and the reporting on Twitter and I think some of the things posting are confusing to anyone trying to keep up with what is going on.

As @radsoxfan stated, the injury is to his ankle.
 

Ed Hillel

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Reporter on Twitter confirmed he went to locker room prior to him returning to game in the 4Q. I forget who it was.
I believe it was after the 3rd quarter and before he came back in? Either way, he did look effective for all of the 3rd/early 4th until he rolled over his right ankle.
 

Ed Hillel

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Does anyone have the play at 3:27 left in the 3rd? Is it that knee on knee or something else?
I believe it's that knee on knee above. KP said he did it boxing out and banging knees with Lively going up for a rebound.

Just went back and watched, and it's definitely his right leg/ankle he's favoring in the 4th when he has to come out. This reported injury is to his left leg. However, it does seem perhaps he turned his right ankle because he was a bit hesitant to put pressure on the left. Essentially how his calf got hurt lol.
 
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radsoxfan

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Thank you. I presume there are no, umm, shots that could KP manage the pain?
They can try, it might help a bit.

It’s not just a pain issue though, the tibialis posterior tendon is the largest tendon on the inside of your ankle. If it’s sliding outside its normal groove, it’s going to be a bit awkward to move around and feel strange for him.

I doubt they know how he’s going to respond honestly, just hoping for the best. I would doubt a Schilling bloody sock surgery repeat...but that’s the kind of short term procedure he would need if this bothers him so much he can’t play. Probably way harder to do such a thing and have it stay in place for a basketball player.
 

mikeford

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- this is essentially a “reverse Schilling”. Schilling tore the peroneal retinaculum on the outside of the ankle allowing the peroneal tendons to slip out of place. Same idea here, but different tendon on the inside of the ankle.
With that in mind, I'm assuming we can't go Bloody Sock 2.0 because it's the tendon on the inside?
 

m0ckduck

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So, just to be clear: he suffered a significant injury on a routine sequence (banging knees with Lively on a FT) that would have effectively ended his season had it happened at any point in the season... and it just happened to occur in G2 of the Finals?

We are insane for caring about pro sports.
 

Red Averages

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They can try, it might help a bit.

It’s not just a pain issue though, the tibialis posterior tendon is the largest tendon on the inside of your ankle. If it’s sliding outside its normal groove, it’s going to be a bit awkward to move around and feel strange for him.

I doubt they know how he’s going to respond honestly, just hoping for the best. I would doubt a Schilling bloody sock surgery repeat...but that’s the kind of short term procedure he would need if this bothers him so much he can’t play. Probably way harder to do such a thing and have it stay in place for a basketball player.
What odds would you put on him trying to play game 3?

What odds would you put in him playing effectively (call it 75-100% of what he’s given in this series) if he does?
 

schillzilla

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You got to shoot him up, tape it up, brace it up and see if he can give us 15 decent minutes for the next 2-3 games.
 

joe dokes

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Obviously, the type of offense/defense "platoon" we sometime see around time outs in late game situations is impossible over a whole game, but my first thought is that he's more important for the offense (though I could be convinced otherwise).
 

wade boggs chicken dinner

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You guys all know this: I am NO DRS...

The wording of this is unclear so I'm still a bit unsure what the actual injury is. With the caveat that the diagnosis is a bit muddled, here's my take: A torn medial retinaculum increases the risk of patellar dislocation. It helps the medial patellofemoral ligament (MPFL) keep the patella well seated within the femoral groove. It is often torn when the patella is dislocated laterally (most common) due to trauma. The retinaculum is a tough band of connective tissue that holds tendons in proper anatomical position. These structures are often injured with trauma. It is a BIT unusual to see/hear of an isolated retinaculum injury because usually other, more recognizable structures are injured as well...i.e. patellofemoral ligament, patella, meniscus, etc. It is unclear if KP dislocated his patella but I don't think that is terribly likely given the nature of his injury and what I was able to observe. A patellar dislocation can be treated easily on the court - you simply straighten the leg out and the patella snaps back into place. I do this all the time in the ED without sedation - it's that quick/easy...usually, there are exceptions.. He MAY have subluxed his patella - (slid out, and right back in). Some of you may remember when Patrick Mahomes dislocated HIS patella a few years ago. He was playing 2-3 weeks later. So, this injury could require surgery (worst case - and probably eventually for a pro athlete) OR simply a brace to stabilize the joint. Those are the two treatment endpoints acutely - in my admittedly uninformed opinion. If his MPFL is also torn, he is 100% done for the playoffs. Tendons don't really dislocate so that verbiage is a bit unclear to me. I suspect there was an error in transcribing the diagnosis but I'm not sure. I THINK (but do not know) that him walking limp free w/o a brace indicates that he has not torn the larger more "important" knee stabilizing tissue nor has he dislocated his patella. A bit speculative, I know. I wish I had more to go on. Actually, I think "day to day" is pretty accurate. If pain and swelling are well controlled and he can wear a brace to stabilize the joint, he might be able to play again this series.
Probably should have posted this in here too….

The number of comically wrong social media posts on this injury already is funny. Holy smokes.

A few quick thoughts:

- rare injury, though I have seen it a handful of times

- this is an injury to the thin “ligament-like” band that holds on the the medial ankle tendons behind the inner side of the tibia, the medial malleolus (That bump you feel on the inside of the ankle).

- if torn, the tibialis poster tendon can side in front of that bump instead of staying behind. That’s the “dislocation”.

- I’m the short term, he can probably try to play, though might be painful and feel awkward. Likely decreased mobility

- most likely will require surgery in the offseason though no big rush

- this is essentially a “reverse Schilling”. Schilling tore the peroneal retinaculum on the outside of the ankle allowing the peroneal tendons to slip out of place. Same idea here, but different tendon on the inside of the ankle.

- crazy bad luck for KP. I hope he can play a bit and be an upgrade of kornet/Tillman. But we’ll see.
Txs both of you for posting and clarifying things.

Can KP use some sort of sleeve or brace to keep the tendon from popping?
 

radsoxfan

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Txs both of you for posting and clarifying things.

Can KP use some sort of sleeve or brace to keep the tendon from popping?
He can try a tight brace or wrap, might help a bit, I doubt it will be super succesful though. You really need that reticulum tightly in place. If the tibialis posterior tendon was dislocated on the MRI, that means it's really unstable since he was obviously not even moving it at that time. Generally you don't want your tendons popping in and out of place. Painful, feels weird, and generally not good for mobility.

A pretty unfortunate and uncommon injury, I doubt many docs have experience with players playing through it acutely for long periods of time. Sometimes it will scar down well enough, but I expect he'll probably need surgery in the offseason. I have a feeling they don't know if he will play at all, and if he does play, they don't know what to expect.
 
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radsoxfan

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With that in mind, I'm assuming we can't go Bloody Sock 2.0 because it's the tendon on the inside?
I think it's a lot less likely to be successful in a basketball player running around, jumping, and cutting. Seems like way too much torque to be able to suture it in place and have everything be stable right away without any actual time for the soft tissues to heal, it's a lot different than pitching. Would be interesting if they tried something along those lines, but I doubt it.
 

TripleOT

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KP has suck bad luck with injuries.

Maybe his game one explosion was his Willis Reed moment, and his teammates have enough to close this thing out without him.

I’m guessing they tape him up good and send him out there for game three, whenee maybe he can have a more accurate Willis Reed moment by hitting a few shots before they have to shut him down.

If he can’t go, I wouldn’t go with either Luke or Tillman. I want to keep the offense five out, so just play JT in a small line up where hopefully Hauser and or PP can get hot from three, or play Brissett for five minute each half and stretch out Horford
s minutes.

I’m betting KP plays, and actually impacts the game in short minutes.
 

SteveF

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Doctor has seen the Porzingis injury once in 25 years and then claims "A lot of times the ankle and the tendon can be taped to allow play."?
I think people should be assuming he's done for the season. If he plays and is effective I'll be shocked and incredibly happy.
 

jmcc5400

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Doctor has seen the Porzingis injury once in 25 years and then claims "A lot of times the ankle and the tendon can be taped to allow play."?
I think people should be assuming he's done for the season. If he plays and is effective I'll be shocked and incredibly happy.
I just hope that if he plays, the Mavericks are too classy to bunt on him.
 

Saints Rest

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For me, the biggest question past pain management is whether playing on it creates a possibility of a more severe injury. If the current level of injury means offseason surgery is likely, then does playing in it simply change that surgery likelihood from 50% to 100%?
 

radsoxfan

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Oh no not Morse again.....

In response to Saint's Rest, I wouldn't worry about a more severe worsening injury to the retinaculum. It's probably pretty badly injured/stripped off already if his tendon is dislocating this easily. Sounds like surgery is pretty likely regardless.

I suppose there is a theoretical risk of injury to the tibialis posterior tendon if it is sliding in and out of place, creating more friction etc. In general, it's very rare to tear this tendon so the risk is probably very low and I'm sure there are going to let him play if he can physically perform.