Medical Watch - Rick Ankiel

Ray "I'm not a doctor but I play one on the internet" Mileur, says "Ankiel could be out for about six weeks."

The news out of the St. Louis Cardinals spring training camp, is that 26 year old, outfielder, Rick Ankiel is suffering from a patellar tendon injury.

A tendon is a band of dense fibrous tissue forming the end of a muscle that attaches muscle to bone. The patellar tendon attaches the kneecap to the bones in the leg. Patella refers to the kneecap.

Ankiel hurt his knee a couple of weeks ago in a coaches game, going after a fly ball.

Usually an injury to the patellar tendon is caused overusing or overstretching causes knee pain. Overuse can occur in exercise routines and sports. Twisting with feet fixed, rapid squatting, or sharply extending the knee beyond its range of motion can cause this injury. Sometimes irregularities of the knee joint that cause pain around the kneecap can accompany an overuse injury of the knee.

Clearly Rick is suffering to some extent from this injury in that there is some pain, the inability to full extend or bend the knee and some swelling of his left knee.

If there is any good news, it's that the patellar tendon is not completely torn (ruptured), as such the Cardinals trainers can treat Rick by;

  • Placing ice packs on the kneecap to help reduce swelling and promote healing.
  • Raising his injured left leg above the level of his heart whenever possible.
  • Continued rest.
  • Apply a knee brace with an open area over the patella or wrap an elastic bandage around the injured part for support.

If Rick's patellar tendon was ruptured or gets ruptured by returning too soon, a doctor may have to repair the tendon by surgery.

The effects of this injury will last as long as there is stress to the patellar tendon. Healing takes an average of 6 weeks, so don't expect to see Rick playing again before the season starts.

Normally a return to activity after this type of injury is gradual. Rick will be required to do a lot of stretching before and after exercising or he risks aggravating the injury.

While I was in camp with Rick, he wasn't able to perform even the most basic warm up and stretching exercises with the team. Watching him on the sideline swinging a bat, while the rest of the team went through their very low impact exercises and stretching, gave me some cause for concern. As such, I wasn't surprised to learn that the Cardinals plan on starting him on the disabled list when the season starts.

What was amazing to me was, that while Rick didn't participate in stretching, running and warm up exercises, he was still able to hit very well in the batting cages. Some of his bombs, were the longest balls I saw hit this spring. For sure, Rick doesn't look like a pitcher with the bat.

If the Cardinals asked me, (don't hold your breath waiting for that to happen) I would keep Rick at extended spring training to monitor his progress.

He will need to do some strengthening and rehabilitative exercises for his left knee to include gently stretching the front quadriceps and back hamstring muscles of his thigh.

Don't be surprised to see the Cardinals add shock-absorbing insoles (esthetics) to his shoes to lessen the impact on his knee, when Rick returns to the field.

There is some that would dismiss Ankiel as being a legitimate prospect. It should be noted, in his first season as an outfielder, Ankiel hit a combined 21 home runs with Quad Cities (A) and Springfield (AA) and as the minor league season was winding down, Ankiel hit .272 with 25 RBI and seven home runs in the month of August.

Originally drafted by the Cardinals in the second round (72nd overall) of the June 1997 free-agent draft. Clearly Rick made significant progress in his first season as a position player with the Cardinals, and as far as I'm concerned, that can't be dismissed.

There is some reason for concern about this injury, but remember great players like Mickey Mantle and Andre Dawson played their entire careers with knee problems and there is no reason to think that this injury is career threatening for Ankiel.

Remember Rick has come back from left-elbow surgery in 2003 & 2004 and that is after missing about four months of the 2002 season with left elbow tendonitis and a strained left flexor muscle. Take away, he decided to quit pitching, there doesn't appear to be any quit in him.

With proper treatment, conditioning, stretching, etc., Rick should be able to play this season. I would suggest the Cardinals send him to Double-A Springfield, once he completes his rehab at extended spring training, if the Cardinals go that route.

For the record, the only thing that kept me from becoming a doctor? Third grade. :)

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