Buffalo, N.Y. (WBEN/WGR 550) - While Von Miller is not set to suit up for the Thursday night game against the New England Patriots, the Buffalo Bills pass rusher is optimistic about his chances to return next week, as he hopes to be ready to face the New York Jets on Dec. 11 at Highmark Stadium.
"I do have some lateral meniscus damage and it's going to have to be addressed, but I do feel like I can play through that," Miller said on his Bleacher Report podcast on Tuesday. "So I'm just going to wait a little bit and let the swelling go down for about 7-to-10 days and hopefully, right before the Jets game, I will be back."
Breaking down the injury
"Your knee joint is a combination where your thigh bone comes together with your lower leg bone, your femur with your tibia. In-between those two bones, you have these two cartilage cushions that act as, relatively, shock absorbers for the joints and those are called your menisci. Those are kind of a spongy type of cartilage that helps to prevent the bones from impacting each other. Now, because those are a little bit soft, they can be prone to damage and these things can get damaged in a lot of different ways," explains Dr. Jason Matuszak, Chief of Sports Medicine at Excelsior Orthopedics.
Dr. Matuszak explains meniscus-related injuries come in many different forms and sizes, and treatment is very contingent on severity.
"When you get two bones pressing down against the spongy cartilage and then rotating, this can create little tears of that soft cartilage," Dr. Matuszak said. "They come in all different shapes and sizes, they come in different types. The body has a mechanism for being able to heal a lot of these small tears that might occur in the meniscus. Large tears, though, oftentimes do require surgery. So there's a lot of variability as to the as to what types of treatments might be required, depending on the amount of damage and the degree of the damage."
Although Dr. Matuszak is not Miller's doctor or affiliated with the Bills, he knows that even if Miller is suffering from a small tear, he could experience sharp pain if he's positioned incorrectly.
"I equate it to having a hangnail, and most of the time that you have a hangnail, you don't really notice it. But if you tweak it or catch it just right, then it can be really sharp, severe pain in the cases of the smallest meniscus tears," he explained. "That might be the only symptoms that you get when you're trying to be active, is that most of the time, you might not feel anything, and then you twist or you pivot the wrong way or you shift your weight the wrong way and then all of a sudden it catches and that can be more painful."
Playing on the injury and possible surgery
If Miller is returning for the game against the Jets, will he have to be cautious with his injury? Dr. Matuszak says only if Miller can't perform or is in pain, given the report that Miller wants to come back as soon as he's ready.
"We can presume that it's probably a small meniscus tear, and that with adequate support like the brace that he's been speculated to be able to use, he would be able to participate with minimal symptoms unless he tweaked it the wrong way," Dr. Matuszak said. "There is some potential risk for more injury. When you have a small meniscus tear, you could always make a small meniscus tear bigger, but in most cases, that's not going to happen. In most cases, the athletes will be able to participate if they can tolerate the pain, and if you're able to perform their activities without having episodes where the knee is impact giving out or buckling."
It has been reported that Miller will have to undergo some type of surgery, but Dr. Matuszak says if the tear is small enough and pain ceases, surgery may not be necessary.
"You might never need a surgery for this during the season or after the season, if it's small enough and the body heals it or cleans it up the way that it can," he said. "It's best to take a wait-and-see approach with these, because you always want to give the body a chance to do what nature intended in the first place. If you can tolerate it, if you can live your life and do your activities and be productive and get out there doing that, then it's best to let it happen."
Hear more of our conversation with Dr. Matuszak available in the player below: