You see that the gait is off, the upper torso lurched forward just a bit to compensate for what the knee cannot offer. You sense as he shuffles along that something is wrong, terribly wrong. You feel his pain.

"You see him walk down the hallway," Kevin O'Connor said, "and you think, 'How does he play?' "

Good question.

With a left knee that is virtually void of cartilage and likely will some day have to be replaced, the fact that Jeff Hornacek makes it from one end of that hall to the other without yelping out loud is amazing in and of itself. That he plays in the NBA, and is one of the best at what he does, seems something just short of a medical miracle. The rest is gravy.

So how does he play?

As the Jazz prepare to open their first-round Western Conference playoff series with the Seattle Sonics on Saturday, O'Connor — the Jazz's vice president of basketball operations — is not the only one who wonders.

"There may be someone else in the league who has as bad a knee and still plays, but if there is I don't know who it can be," said Dr. Lyle Mason, the Jazz's orthopedic surgeon. "We see people who miss games, or are out a whole year, for things that aren't even in the same ballpark as what he has."

Tim Duncan of the defending NBA-champion San Antonio Spurs is currently sidelined by what is being described as a "partial meniscus tear."

Hornacek has no lateral meniscus whatsoever — in other words, he has lost, primarily due to pounding, wear and tear over the years, that crescent-shaped cartilage that absorbs weight, acting as a cushion-like pad and providing stability within the joint. Mason calls it "tri-compartmental disease," a case in which the medial part of the joint, the lateral part of the joint and kneecap itself all show evidence of arthritic degeneration.

The result: With no meniscus, bone rubs on bone within Hornacek's knee. Bones, mind you, have nerve endings.

It is not a pleasant sensation.

"Bone on bone," said Dr. Russell Shields, the Jazz's team internist, "doesn't work."

So how does he play?

The answer has a whole lot to do with Hornacek, who intends to retire from full-time NBA play after the Jazz finish this playoff run, plus the work of a rather unlikely coalition of health-care professionals who help make the pain as tolerable as possible and the joint as functional as it can be.

And that is not easy, considering Hornacek's knee has degenerated to the point that he cannot extend his left leg all the way forward or flex it back beyond much more than 90 degrees.

Sit on a chair. Try to straighten your leg by kicking it forward. Hornacek cannot; it stops 8-to-10 degrees before being straight. Now, still sitting, put your foot back on the floor. Try to touch your hamstring with your heal. Hornacek cannot. In fact, he can hardly flex backward like that at all. Now get off the chair and try squatting, with your knees extended and your buttocks low to the ground. Hornacek? Don't even think about it.

Yet here he is, ending his 14th and final NBA season as the leading free-throw shooter and second-best 3-point shooter in the league. Hornacek was the Jazz's third-leading scorer this season with an average of 12.4 points per game, and — if the knee holds up — he could hold the key to the Jazz's success in the playoffs this season.

Still, Hornacek, in his own oh-gee-golly sort of way, insists it's no big deal.

"I don't know how to explain it," he said. "You have an injury, you play through it. And get used to it."

Hornacek laughs, ever so subtly: "Like my Dad would say: 'Don't be a . . .'

Sissy.

Yeah, that's what he said.

So Hornacek adapted his father's philosophy on pain, then took it to an extreme.

"He has an arthritic knee. You can notice when he walks that he cannot extend his knee because of the arthritic condition in there, and that's because of the years he's played, and the injuries he's had to that knee," said Mike Shimensky, who is in his sixth season as the Jazz's trainer. "The fact that he's able to play at this level, and intensity, is a feat. You have to take off your hat to him, because a lot of players wouldn't be able to do that.

"I think a lot of it is Jeff himself," added Shimensky, who is amazed by the fact that as a right-handed shooter Hornacek is constantly pushing his left knee — the bad one. "You know, I'm sure there are times he shouldn't have played, because the knee was swollen, and also because of the pain."


Ah, the pain.

Hornacek's knee has hurt ever since that day at Iowa State when snap and crackle welcomed pop to the club.

"A guy went up for a rebound, fell backward, and I kind of hyperextended it," Hornacek remembers of the college injury. "He landed right on top of me, and it kind of went backward. I tore it then."

The ripped cartilage was surgically removed, marking the start of the end of normalcy for the knee. He has had multiple surgeries since, cleansing the joint of everything from bone spurs to bad cartilage.

"About my third year in the league, I stepped wrong ... and I felt it," he said. "It was a stupid thing. I kind of limped on one leg, played the rest of the game, woke up the next morning, and I could barely walk. More of that same side of the cartilage was torn off, so they removed that."

Doctors for the Phoenix Suns, Hornacek's NBA team at the time, told him the knee would prevent him from playing much more than five more years in the league. The Suns wound up trading Hornacek to Philadelphia, whose own doctors went in and scraped the knee clean.

"That," Hornacek said, "is when they were going, 'Oh, I don't know how much longer you can play.' "

Even in his own mind, Hornacek figured he was close to done.

"Once they said that," he said, "I figured I'd go for the five years, and that would be it."


Hornacek lasted less than two years with Philadelphia before being dealt to Utah in 1994. Enter Team Jazz, a curious collection of health practitioners who have not only cared for his knee — but also helped to extend his career.

"Jeff has had constant care," Shimensky said, noting that Hornacek even keeps his own portable electrical stimulation unit at home for as-needed use. "What we try to do is basically make it as easy as possibly we can for him — basically 24-hour treatment."

Shields, the internist, oversees team medical care. Mason is an orthopedic specialist. Shimensky, who holds a master's degree in athletic training, is with Hornacek on a day-to-day basis, as are additional members of the training staff. And other members of the medical staff play key roles as well, perhaps no one as regularly as team chiropractor Dr. Craig Buhler.

Without their daily work, Hornacek figures he would not be able to play more than two games in a row. Even with it, it is still, in Mason's words, "a real challenge," for Hornacek to move side-to-side and cut off the leg — basketball basics.

"(Mike) Shimensky does some things that help loosen up muscles (and) loosen up things around the joint. Dr. Buhler keeps everything in line. You go right down the line: We have a massage guy (Doug Birrell) that helps," Hornacek said. "I mean, it's kind of a teamwork job there to keep it going."

Whatever it takes.

"We have both philosophies," Shimensky said of the rather unique presence of chiropractic and orthopedic experts — a combo that in the medical community is not always seen at the same parties.

"You've got the M.D. side, then you have the chiropractic side. So we're trying to blend the two of them, and trying to get him as ready as possible for games."


Considering the circumstances, it's amazing Hornacek has played any games at all these last few years.

This season he has missed just five of 82 games, all due to either the knee and/or related problems — chiefly, a strained lower back sustained as a result of compensating for the joint problems.

"Because he doesn't have the cartilage, because he's bone-on-bone, because he has pain, and swells up quite frequently," Buhler said, "his body is constantly trying to find ways of adapting."

Preventing the adaptations from becoming too problematic has allowed Hornacek to play in as many games as he has. His five absences are part of an NBA-low 11 man-games lost this season by the Jazz, who are by far the least injured team in the league. Missing the games he did has allowed him to play in as many as he has.

"I played (35) games, then it got to the point where I just needed to take a week off," said Hornacek, who turns 37 on May 3. "Then I played another (35) games, (and took two more games off, earlier this month).

"Then it felt great — you know, I felt like I was 30 again."

A big help was surgery performed this offseason, again to clean out the joint. As a result of that, Hornacek said, "It felt better this year than it has — especially last year, and maybe even the year before."

There was, though, a stretch during a busy March that was especially tough to get through — but, with help, Hornacek made it. Buhler, who said his focus is "maintaining the integrity of (Hornacek's) biomechanics," treats him regularly.

"He plays with pain all the time," said Buhler, who often travels with the team, "but at least we can keep his function, so he can continue to play."

Sometimes, though, even Hornacek cannot continue.

The worst moments are when the knee locks, and he cannot unlock it on his own. That's even happened during games this season, but each time — following treatment — he has returned to play.

"Six or seven games (in March) it was OK, but it wasn't feeling (good)," Hornacek said. "Once you know how it feels to be good, you want to get back to that spot, and that's when we took a couple more off (in early April)."

Now, Hornacek said he is back to feeling as good as can be — at least on a knee as bad as his.

"The last three games, it felt pretty good," he said. "I could run out on the court, get out on the fastbreak, run through, and that stuff."

As for the future, however, he seems reluctantly resigned to running head-on into the inevitable: total knee replacement.

"I guess it probably will happen," Hornacek said. "But when I'm not pounding on it — even now, if I can keep it in line and do other things — it's a real headache once-in-a-while, but it feels pretty good. So hopefully I can put that off as long as possible."


Minimizing the stress may help, but it won't heal.

It is only because Hornacek is a determined athlete, and the medical care he receives, that he has not had to have the entire joint replaced already.

If someone off the street walked into Mason's office with a knee like Hornacek's, in fact ... well, let the good doctor explain:

"If you had his leg, with nobody attached, and you had his X-rays, not knowing whose they were, you'd say this, 'This is a candidate for knee replacement,' " said Mason, who regularly performs such procedures.

One day, actually, Mason had Hornacek's X-rays hanging in his office when a colleague strolled by.

"He said, 'Looks like you have a total knee to do,' " Mason said. "I said, 'No, that's Hornacek's knee.' He said, 'That's Hornacek's knee?' "

So how does he play?

"This is an usual fellow with tremendous competitive fire. He's bit bullets," said Shields, who agrees with Buhler that Hornacek's career has been extended by the care he has received from the "training, chiropractic and medical staffs.

"But the most help Jeff has," Shields said, "is his own character."

"Certainly the medical team has worked extremely hard in getting him able to participate," O'Connor said. "But I have to give all the credit to Jeff, for just being able to gut things out."

By playing, that is. However he does it.


You can reach Tim Buckley by e-mail at [email protected]