As running back Ray Rice recovers from a bruised knee that could keep him from playing Sunday in Pittsburgh, medical experts say it will take one thing before Rice is back to his previous form — time.
Rice, who missed a scheduled appearance with Baltimore Mayor Stephanie C. Rawlings-Blake Tuesday at the Inner Harbor as part of a health campaign, said via Twitter that he hopes to return "asap," and a source close to Rice said Tuesday that the injury "is not that bad. He's walking around like his regular self. He should be good for this week. [The Ravens] gave him a little crutch after the game, as a precaution, but he definitely could play this week — depending on how he feels and how the doctor and coaches feel."
Still, his availability after leaving Sunday's 24-17 victory over the Cleveland Browns will likely depend on a series of factors, including the amount of swelling that subsides, his tolerance to pain and his ability to maneuver on the knee, according to Dr. Les Matthews, chief of orthopedic surgery at Union Memorial Hospital in Baltimore and a team physician for the Ravens.
"What's going to happen out there is they're going to be as hopeful and as aggressive as they can in getting him over this as quickly as possible while realizing that some of it is in your control and some of it is totally out of your control," Matthews said. "If he meets all the criteria to be able to play safely without injuring himself further and be able to contribute the way he normally can, he'll play. And if he can't, then they'll be better off resting him because it's a long season and the next man up."
According to Matthews and Dr. Alexis Colvin, an orthopedic surgeon specializing in sports medicine at the Mount Sinai Medical Center in New York, a knee bruise involves damage to soft tissue in the knee that results in internal bleeding and swelling. Although the injury does not require surgery, the biggest concern is that the damage could go deeper to the bone, which could delay a quick return.
Treatment usually entails alleviating pain and reducing the swelling, but rest is the most crucial aspect of the healing process.
"The good thing is it's not something that needs surgery, but on the other hand, you're kind of waiting on your body to heal it," Colvin said. "And there's not much you can do to speed up the healing except to rest it. … [Heat and ice] don't accelerate it. If you're having pain, you can treat the symptoms, but that's not going to make it heal any faster."
Once Rice's knee heals to the point where he can put weight on it, there's a series of on-field tests he must pass to satisfy the team's medical staff, Matthews said.
"You simply go through a progression where you've got to be able to exercise comfortably before you can get out and do what Ray does on a football field," he said. "You've got to be able to walk before you run, you've got to be able to run before you can cut, you've got to be able to cut before you can do contact. So you go through that progression and how quickly he can hit each of those milestones is hard to predict. One step has to lead to the next."
Despite Rice's event cancellation Tuesday, Harbaugh held out hope Monday that Rice could play against the Steelers. Matthews wasn't so sure.
"It's certainly possible that he can play and contribute the way he normally can," Matthews said. "It's equally possible that he's just not where he needs to be and he can't run comfortably and he can't cut and he can't do what he needs to do, and the decision is made — both for his safety and also for the fact that he won't be able to contribute at the level that he normally could — that you're better off putting somebody else in the lineup. These things are just real difficult to predict what Sunday's going to be like on a Tuesday. It's just real hard to say."
edward.lee@baltsun.com
Baltimore Sun reporters Mike Klingaman, Jamison Hensley and Ken Murray contributed to this article.
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