All posts by Justin Kong

All Blogs, Ankle/Foot, Basketball

Lance Stephenson Toe Sprain

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In the early fourth quarter of the Lakers game against the Pelicans on February 27th, Lakers’ small forward Lance Stephenson sprained the second toe of his left foot. He walked off the court into the locker room and did not return.

X-rays of Stephenson’s foot taken after the game did not show a fracture. It’s not clear exactly what the injury is.  Stephenson was ruled out of the Lakers game against the Clippers on March 4th.  His condition is described as day-to-day, and that he will likely play again this week or next.

Generally, sprained toes heal with time and it is safe to keep playing.  Pain can limit a player’s effectiveness.  Earlier in the season, Golden State Warriors’ Draymond Green missed two games after spraining a toe. Stephenson’s teammate Tyson Chandler also missed a game in February due to a big toe sprain.

A sprain is a partial or complete tear of the ligaments that hold two bones together at a joint.  A sprained toe is not the same as a broken toe, which is injury to a bone rather than just a ligament.

The pain from a sprained toe can be treated with ice packs and foot elevation. Occasionally a form of immobilization is used for comfort.

All Blogs, Basketball, Leg Fracture

Mo Bamba Left Leg: Tibial Stress Fracture

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On Saturday, February 2nd, the Orlando Magic’s rookie center Mo Bamba missed his team’s game vs The Brooklyn Nets due to a sore lower left leg.  He had tests done the following Monday and was diagnosed with a left tibia (shinbone) stress fracture on Tuesday.

Stress fractures are areas of the bone where small cracks occur more quickly than the bone can heal or remodel.  The idea of “overuse” injury is largely overstated, but tibial stress fracture seems to be one problem that is due to activity surpassing the body’s generally excellent capacity for healing.  Another example is thrower’s elbow.

 

The accumulation of repeated stress on the bone leading to an area of reduced strength of the bone usually develops over weeks or months.

Stress fractures are known to affect big men in the NBA.  Yao Ming of the Houston Rockets ended his career due to stress fractures of the navicular bone in his left foot.  Legendary center Bill Walton’s career was also hampered by a series of stress fractures to both his feet.  In general, players with stress fractures recover and avoid recurrent issues.

The general course of treatment for a stress fracture is relative rest with some low impact exercises for about six to eight weeks while the bone heals itself.  Bamba, however, underwent an unspecified procedure on February 7th.  Professional athletes often choose surgery more readily than the average person.  These differences between what athletes do and what any one of us might do are the reason that Sports Injury Blog exists.  We can only speculate why Bamba decided to have surgery right away, but presumably he felt it would help him get back to play sooner.

Orthopedic surgeons sometimes refer to this as “the dreaded black line”.  To some degree that reflects the feeling that rest will work, but it can be difficult to get elite athletes to rest.

Bamba does not yet have a timetable for return.  The Magic organization will continue to watch how Bamba responds to rest and rehabilitation, but it seems likely he will miss the rest of the season.

Achilles/Patellar/Quadricep, All Blogs, Basketball, Knee, Tendon Rupture

Victor Oladipo Knee Injury

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On Wednesday, January 23rd, the Indiana Pacers’ starting shooting guard Victor Oladipo injured his right knee late in the second quarter of a game vs the Toronto Raptors.  The injury occurred when Oladipo planted his right foot while running after the Raptors’ Pascal Siakam on a fast break.  Oladipo had to be carted off.

He had ruptured his quadriceps tendon.  The quadriceps is the large muscle in the front of the thigh.  It straightens the knee.  The quadriceps tendon attaches the muscle to the knee cap (patella).  The patellar tendon attaches the patella to the lower leg (tibia).

Quadriceps rupture is fairly obvious on examination.  The ubiquitous “athlete MRI” that seems to be obtained routinely and largely unhelpfully can be useful in this circumstance to plan surgery.  A completely ruptured quad tendon prevents an individual from straightening the knee.  Without surgery, it would be difficult to walk let alone play basketball. This injury is ready to take force after about 6 months, but it will take a while to strengthen the muscle and get back into game shape.  Oladipo may be ready to play by the beginning of next season.  Former San Antonio Spurs starting point guard Tony Parker also ruptured his quadriceps tendon in early May 2017 during the NBA Playoffs.  He received surgery two days after the injury and returned to play six-and-a-half months later.

It is worth noting that Oladipo has missed nearly a dozen games this season due to an undisclosed right knee problem.  A normal quadriceps tendon is unlikely to rupture, so that problem may have been quadriceps tendinopathy.  Quadriceps tendon ruptures generally occur in people over age 40, with most cases occurring in people in the 50-60 age range.  Quadriceps rupture is very rare among NBA players, and 26-year-old Oladipo is relatively young for this injury.  Charles Barkley and Tony Parker both sustained the injury later in their careers at age 36 and 34, respectively.