Trainer Gary Vitti on Kobe’s Knee

Lakers head athletic trainer Gary Vitti joined us for an extended interview about several topics on Thursday, among the more interesting his detailed overview of Kobe Bryant’s current health situation with his right knee, and what we might expect heading into next season.

The discussion went back to the summer of 2010, when Bryant had arthroscopic surgery on his right knee in July to clean things up, after he had problems with the knee in the playoffs in particular. It was the third time upon which that knee was operated, and as a result, it wasn’t until training camp that Bryant was really able to do much. Training camp was in Europe, which made things more difficult from a preparation standpoint, L.A. simply not having as much practice time as it would at home. Alas, when the regular season opened on Oct. 26, Bryant wasn’t really close to full strength.

“Kobe was behind all the time and could never really catch up, which has something to do with the surgery, something to do with the sheer miles of wear and tear and the attrition the game has on him,” said Vitti, who as a result was central in the decision to hold Bryant out of practices for much of the season, preferring that Bryant use what he had in games instead of on the practice floor.

The downside, in addition to a negative impact on team chemistry developed in the gym, was that Bryant was playing catch up all season, not able to build up strength in his knee and legs so much as just maintain a high enough level to play.

That said, in his exit interview after this past season, Bryant noted that there is “another level” he can reach physically. Vitti?

“We have to do some things so that he feels more comfortable and explosive with that right knee,” said the 27-year LAL trainer. “Once we get to that place, then we’d like to see him practice more, but we don’t want the time that he spends on the court being spent on frivolous things. You gotta get him out there when he needs to be out there, and get him off the floor when he doesn’t.”

With such a philosophy, we asked Vitti if he agreed with Kobe that Bryant would be stronger next season.

“Yes, I do think he has more progression there, but structurally there are some issues that cannot be reversed, but can be dealt with,” he explained. “There are a couple of cards we have up our sleeve that we plan on playing, and he and I have been in daily communication about that.”

Makes sense. However, to understand what’s really going on with Bryant’s knee, we needed more details from Vitti:

What happens with older players — and this isn’t Kobe’s situation – is that tendinitis turns into tendinosis, and the tendon doesn’t have the same properties that it used to have. As a result it slows them down, and once you become a step slow in this league, it’s very, very difficult to compete. That’s not Kobe’s problem, however. His is an articulating cartilage problem. The way I describe that to people is that if you look at the end of chicken bone where it’s nice and white, well, that’s not bone, it’s cartilage. Sort of like a Teflon surface that when two bones come together, that cartilage is there so that bones don’t rub on each other. Now, the fact that it’s nice and white tells you it doesn’t have a good blood flow to it, and that means it cannot heal or regenerate. So, over time, as that cartilage wears away, you end up with osteoarthritis. Kobe doesn’t have an arthritic knee, but he has a knee that has some joint degeneration to it. His issues and his age are such that it eliminates some procedures, like microfracture and that type of things. But he is a candidate for certain other things, and we know all the procedures all around the world that are available to him, and the appropriate decisions will be made, he’ll have the best care.

In conclusion, Vitti cleared up a New York Post report from January in which Peter Vescey quoted Kobe as saying his right knee was “almost bone on bone.”

“He does have cartilage left, so it was an inappropriate line,” Vitti said. “It’s just a question of preserving what is still there.”