[MavKikiNYC]

The Long Road Back

By GEOFF VAN DYKE
Zach Randolph was worried. It was March 2005, and the 24-year-old Portland Trail Blazers forward had decided to undergo surgery to repair cartilage in his right knee, injured two months earlier. The procedure, called microfracture surgery, is daunting: an orthopedist removes loose cartilage and drills holes in the end of the femur. These "microfractures" bleed and clot, leading to the formation of new cartilage. The list of players who have had the surgery and struggled to return to peak level reads like an all-star team from the late 90's: Penny Hardaway, Jamal Mashburn, Allan Houston, Chris Webber. "You hear stories of guys not coming back, or coming back less strong," Randolph says. "This was my first surgery, and everything I was hearing about it was bad." On March 31, he went under the knife. Then the hard work began. Here's how Randolph got his knee back.
April
The Blazers' orthopedist, Dr. Don Roberts, and the team's athletic trainer, Jay Jensen, started Randolph on ehabilitation almost immediately after the surgery. For one week, eight hours a day, Randolph's knee was placed in a continuous-passive-motion machine, which flexes the joint without a person's having to use his muscles. He was on crutches for less than three weeks. Jensen compares this post-op period to planting a lawn: not putting any weight on the joint "allows us to begin the seeding process, the laying down of the replacement cartilage."
May
The hardest part of the rehab, Randolph says, was rebuilding his leg strength. Shortly after the surgery, he couldn't do a simple straight-leg raise (in which you recline on a table and raise one leg with your knee locked) because he was unable to tighten his quadriceps muscles.Jensen focused instead on exercises done in a pool, like running, straight-leg raises, hip abduction (lifting the leg to the side with the knee locked) and swimming. This hydrotherapy allowed Randolph to flex his knee and build strength without putting weight on the joint. By late in the month, he had regained his full range of motion.
July
Three months into the rehab process, Jensen started Randolph on the bike, increasing the length of his rides as the weeks progressed. Randolph also started shooting baskets with minimal movement and began weight training and leg raises with resistance to strengthen the atrophied muscles. "My major concern outside of Zach's knee was, How am I going to keep his weight down?" Jensen says. Randolph, who began the 2004-5 season at 253 pounds, overhauled his diet, eliminating red meat and pork. Through a combination of diet and exercise in the weeks to come, he was able to take off five pounds, reducing the load on his knee.
August
At this point, Jensen says, the two of them "really started hitting it." They stepped up the strength building with "closed chain" exercises — squats, quarter-squats and lunges — in which the feet are planted on the ground to reduce the stress on the knee. Randolph's knee still had swelling, which decreased as his leg became stronger. Jensen also emphasized cardio fitness, increasing the length and frequency of the bike rides. "I like the bike as a tool because it builds strength without the impact, and it's fun," Jensen says. "He had to keep up with me, and I had to keep up with him, so we both stayed in shape."
October
By September, Randolph was back on the court, but hardly in playing condition. He used pickup games to work on basketball-specific moves like pivots, backpedals and defensive slides.Jensen also put him through agility drills, like running with bungee cords for resistance, single-leg jumps to build explosive power, and power skipping, in which Randolph elevated as high as he could on each skip. Training camp began in October, and Randolph completed nearly all of the practices. "Riding the bike helped him regain strength, but it didn't help him get his basketball instincts back," Jensen says. "We tried to use training camp to do that, and to his credit, I think he only missed one practice."
December
By the beginning of the month, Jensen felt that Randolph had gotten "to the point where he's the old Zach." But Randolph wasn't so sure. "I wouldn't say that," he said, "but the knee is back to about 75 or 80 percent. It's a long process." By year's end, however, Randolph appeared to have regained his form:he was averaging 18 points and 9 rebounds, and had the game of his career right before Christmas, scoring 37 against Detroit. Even better, he had missed only one game.