It’s not a big deal to miss one week. Anthony Barr sat out the Minnesota Vikings’ 27-24 loss to the Cincinnati Bengals and most of camp with a knee injury. Even if Barr would have made the difference, it’s just one game. But what we know about that injury and the problems Barr has experienced over the last few years could be cause for alarm. Considering how much the Vikings struggle with knees, it makes sense to take a moment to learn about them.
In Barr’s rookie season, he suffered a “slight tear” in his meniscus in December. Nobody thought much of it since the Vikings had just been eliminated from playoff contention with a loss in Detroit. Barr was ready in plenty of time to play the 2015 season, where he would earn Pro Bowl and second-team All-Pro honors. It’s behind him, right? Perhaps not.
Recall a few weeks ago, when Mike Zimmer was commenting on Irv Smith Jr.’s season-ending meniscus surgery. When talking about it, Zimmer mentioned that the season-ending version of the surgery was the best idea for Smith’s future health and career. When you suffer a slight meniscus tear, there are a few options.
The meniscus is a fairly large sheet of tough, rubbery cartilage that absorbs shock in the knee when you jump or walk or do basically anything on your legs. Think of it as your leg’s brake pad. Meniscus tears can be pretty common in a sport like football, where your legs are constantly absorbing impact and stress. So if that sheet of cartilage is torn, you can do two things. You can either cut out the damaged bits (that’s called a meniscectomy) or try to repair that damage. A full replacement is possible as well, but that’s rare.
Cutting out the damaged bits is a lot easier. It’s usually an arthroscopic procedure, making the recovery time shorter than a more invasive open surgery. The problem is fairly intuitive: You have less meniscus now. With less cartilage (a smaller brake pad), you’re not going to be able to absorb as much shock over time. With less cartilage to do the work, the cartilage will degenerate faster. Knee degeneration is also known as arthritis. To be fair, the severity of this is debated in the medical community.
The benefit of a full repair is that you keep all that cartilage. It’s a more invasive surgery, which makes for a longer recovery time but proves to have more long-term appeal. Once you’ve recovered from a meniscus repair, things in your knee return to more or less normal. That’s the basic decision that the surgeon had to make with Smith’s knee. He chose the long-term option.
That brings us back to Barr, who also had a medical procedure on his meniscus in 2014. It does not appear to be public information which procedure he had, so we can only make an educated guess. At the time, Mike Zimmer called the tear a “slight” one and the procedure a “minor” one. That implies an arthroscopic meniscectomy, but we can’t be sure. If it is the less invasive trim, however, that could have long-term complications down the road. Here we are, seven years later, down the road.
Barr practiced on Wednesday, woke up with some soreness on Thursday, and has been held out since. Flare-ups after robust activity are a common symptom of arthritis, so is general soreness when bending the knee. Arthritic pain develops for years before most people go to the doctor. The first sign of knee arthritis is stiffness and loss of flexibility.
Over his career, Barr has dealt with several injuries. He broke his hand in 2015 and tore his pec on a tackle last year. He also suffered a groin strain in 2015 and missed a game in 2019 with another groin strain. He also missed three games in 2018 with a hamstring strain. All that overstretching and over-exerting happened on that same right leg. This is a bit of a reach, as it’s perfectly plausible for Barr to have over-exerted a few times over his career separately from the knee problem, but the pattern is worth pointing out.
Zimmer has mentioned that Anthony Barr is “a concern maybe a little bit with his health.” They treated him with kid gloves, sitting him out for the entire preseason before attempting practice. This also tracks if Barr’s knee is arthritic. Since flare-ups and soreness will be common for the rest of Barr’s career, if not his life, it makes sense to avoid exerting his leg any more than he has to. Since he doesn’t exactly need training camp development at this stage in his career, it probably wouldn’t have been responsible to play him in camp.
That brings us to the first week of practice. If I were in the room with Eric Sugarman and Mike Zimmer, deciding when to start giving Barr some action, the first day of regular-season practice would have been my recommendation. It’s highly concerning that Barr’s knee flared up after one day of practice and a month of rest. How much rest will he need this time to prevent a flare-up?
All is not lost. Some of the most notable athletic achievements in history were achieved on arthritic legs. The list includes Wayne Gretzky, Phil Mickelson, and even Dorothy Hamill. Arthritis is a common issue with common treatments. The problems are with both pain and a loss of flexibility. Both stem from inflammation around all that degenerated cartilage, which means anti-inflammatories can help. Over-the-counter drugs like Advil may not pack enough punch, so NFL teams often use Toradol or cortisone shots.
Toradol is a suped-up anti-inflammatory drug, like Advil on steroids that you inject. It only has minor side effects in single uses, but it can damage someone’s liver or cause internal bleeding long-term. This offseason, the NFL urged players to curb their use of Toradol as a general painkiller over the course of the season. Albert Haynesworth recently had a kidney transplant, and he blames Toradol for needing one. If you’re willing to accept all that risk, Toradol injections can help manage the pain and stiffness caused by an arthritic knee.
Cortisone shots are a much more common treatment for arthritic pain and inflammation. But it’s not without its caveats. Repeated cortisone shots could damage the cartilage around the injection site. That’s why they’re typically a one-time solution, but as with all things, the NFL tends to overdo it. These are difficult decisions for Barr to make.
Assuming his knee is arthritic, we’re not waiting on it to heal per se. We’re waiting on some swelling to go down, and Barr will probably play when he is at a point where he can manage the pain and stiffness. As for a timetable, that would explain why the Vikings have behaved optimistically (i.e., they declined to put Barr on short-term IR). The question is how long Barr can play for and if he will be the same athlete he was when we last saw him.
More importantly, Barr will have to choose between an ability to play football and his long-term health. Barr will likely have to have a knee replacement or otherwise major surgery at some point in his life. That date could even come before he’s ready to hang up his cleats. As for the short term, he’ll have to manage arthritic pain for the rest of his career. If Barr and his trainers decide that it’s not worth the long-term risk, it would be difficult to blame him.