NBA Injury Report

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It’s time to give you a fantasy injury column different from anything you’ve read. In this column, you’ll receive more than just the latest updates on NBA injuries and related advice for which players to target. You’ll be presented with injury analysis only a trained medical professional can offer. David Braunreiter, M.D., a certified sports physician with over 16 years of experience, is here every week to break down players’ injuries on a more educated level. While I explain the injury situation for each player and dole out fantasy advice (Status), David will explain how these injuries occur (Doctor’s note). He’ll offer specific explanations for an injury’s origination as well as cite recuperation tendencies for each affliction.

You won’t just be a more knowledgeable fantasy player. You’ll finally be able to understand the process of injuries, how they originate and the types or recuperation activities associated with a return to full health. The goal is to help educate you to the point that you know what to expect the next time another player gets hurt. This is free medical knowledge, folks. And we all know how rare that is in this country. Let’s tear it up, for lack of a better term:

KEY INJURIES

Francisco Garcia(notes) (SG/SF, SAC)
Injury: Broken radius in right forearm, ligament damage in right wrist
Likely return: Mid-season

Status: Sometimes you just can’t make up the way injuries are incurred. Garcia was lifting weights on an exercise ball when it burst, causing him to land awkwardly. Those things look so harmless, don’t they? Unfortunately, owners might have to bypass the talented Garcia for most – if not all – of the season. This means rookie Tyreke Evans(notes) takes on an bigger role than expected in the offense. It’s also created a scoring role for Omri Casspi(notes), the first Israeli-born NBA player.

Doctor’s note: This is a bad injury. When the radius bone is fractured along with the wrist ligament injury, it’s known as a Galeazzi fracture-dislocation. The radius fracture usually needs hardware to be properly aligned. The ligaments holding the radius and ulna together at the level of the wrist need to be repaired to prevent recurrent instability. The recovery time will be extensive – maybe even the entire season.

Pau Gasol(notes) (PF/C, LAL)
Injury: Right hamstring strain
Likely return: Undetermined timetable (possibly Fri. 11/6)

Status: Pau’s a worried man. He’s missed 10 straight games (6 preseason, 4 regular season) through Nov. 3 with a hammy injury suffered near the beginning of the preseason. He felt unusually sore after his lone practice attempt in mid-October, and he’s admitted that his high offseason workload the last two summers (’08 Olympics, ’09 Eurobasket) might have contributed to this injury. Now there’s word he has a small tear in the hamstring. Lamar Odom’s(notes) fantasy owners just pumped their fist.

Doctor’s note: Hamstring strains are very common in high intensity, explosive sports. The injury is often graded in severity from grade 1 (stretch injury) to grade 2 (partial tear) to grade 3 (complete tear). The more severe the tear, the longer the recovery and the higher the risk for recurrence. This is a type of injury that may also recover faster and more effectively with platelet-rich plasma therapy, which can facilitate bone growth and cut recovery time.

Blake Griffin(notes) (SF/PF, LAC)
Injury: Left knee stress fracture
Likely return: Mid-December

Status: Of course he got hurt. The Clipper Curse acted especially swiftly on poor Mr. Griffin, who hurt the knee after landing from a dunk during an October 23 preseason game. He’ll endure bone stimulation and special blood treatments while participating in swimming sessions during his rehab. In the meantime, Chris Kaman(notes) will thrive as the team’s primary post presence and Rasual Butler(notes) should get more burn now that he’s a new member of the starting lineup. Griffin is worth hanging onto as long as his return doesn’t creep into 2010.

Doctor’s note: The patellar stress fracture is a very uncommon injury, although they’re most likely seen in a jumping sport such as basketball. The repetitive tension of the quadriceps muscle places a tension stress on the patella (kneecap). Eventually, the bone may crack along the front surface horizontally. The bone stimulator is a device that emits high frequency ultrasound waves to the injured bone in the hopes it will stimulate increased blood flow and speed up healing. (Platelet-rich therapy can also be used.) It may be overly idealistic to expect that Griffin will return to full activity by mid-December. In order to return to full NBA-level running and jumping, he will likely need additional conditioning time (in addition to swimming) to return without incurring risk of re-injury.

Devin Harris(notes) (PG, NJN)
Injury: Right groin strain
Likely return: Mid-November

Status: Harris is out for at least a week after aggravating a groin muscle he originally hurt Oct. 13. (He returned shortly after the first occurrence.) He’s stated he’ll take this recovery process more slowly than the first, so as not to keep this persisting all season long. Rafer Alston(notes) will log heavy minutes at point in his place, and he should be targeted in most formats. He averaged a 12/5 as an everyday starter for the Rockets and Magic last year.

Doctor’s note: The groin muscles (hip adductors and internal rotators of the hip joint) are very important in basketball. They are critical in allowing for lateral movements and stabilizing the hip joint. Reports in the news state that Harris’ injury is not serious, as an MRI did not reveal significant damage. This would place the severity at a mild level. He should be able to return as advertised.

Josh Howard(notes) (SG/SF, DAL)
Injury: Offseason left ankle/right wrist surgery
Likely Return: Possibly late November

Status: Mr. Howard had arthroscopic surgery on both body parts on May 22 – and he’s still out. He had been complaining of soreness in his ankle, which has given him problems since his senior year at Wake Forest in 2002-03. However, he’s stepped up his physical activity lately and looks to be on a straighter road to recovery.

Doctor’s note: The news reports contain commentary that his ankle required debridement (clean up) of scar tissues likely accumulated over time from repeated injuries. I am certain the team is more concerned about the state of the joint integrity rather than the reconstruction, which should have been healed in three to four months after surgery. The debridement may have included some attempt at generating some scar cartilage to replace any worn areas in the joint surface, or to remove excessive scar tissue from recurrent injury. It is much better to be slower and more careful in return to full-time play in this circumstance than to rush back.

Antawn Jamison(notes) (SF/PF, WAS)
Injury: Right shoulder partial dislocation
Likely Return: Mid-to-late November

Status: The injury train kept rolling for the Wizards, as this time it’s Jamison, uncharacteristically, who was ruled out of the team’s first eight to 13 games. The power forward has played fewer than 79 games just twice in his past nine seasons. He’s able to lift weights (stay off the exercise ball, Antawn!) and dribble, but shooting is out of question given his injury. Owners should flock to Andray Blatche(notes) for fantastic replacement value.

Doctor’s note: Shoulder dislocations occur when the humerus (upper arm bone) breaks through the restraint of its ligament capsule and away from the socket (glenoid), which is a part of the shoulder blade. When a complete dislocation occurs, the capsule tears, sometimes breaking off a piece of the glenoid with it. When there is a partial dislocation, this usually means that the humerus did not actually come fully out of joint and stay out. Thus, the ligamentous capsule is often intact. This is called a subluxation. Subluxation injuries are much like ankle sprains, and can be treated with physical therapy designated to restrengthen the muscles supporting the joint. The therapy often takes up to a month to be effective. If he is not recovering according to plan, this may necessitate at least a thought towards surgery.

Michael Redd(notes) (SG/SF, MIL)
Injury: Left knee patella tendon strain
Likely Return: At least mid-November

Status: Yes, we can call this a Redd alert. The sharpshooter with a Midwestern flavor (Ohio State, Milwaukee Bucks) is bothered by the same knee which underwent ACL and MCL tears last year. Although the recent soreness is apparently unrelated to the tears, Redd’s persistent knee troubles the past few years create doubt for his future effectiveness. Carlos Delfino(notes) and Charlie Bell(notes), who will fill in for Redd, will have minimum fantasy impact.

Doctor’s note: There are theories that the injury occurs from repetitive landing on hard surfaces. As the foot hits the floor, the quadriceps muscle contracts to act as a shock absorber for the impact. Repetitive jumping can cause repetitive microscopic or small tears in the patellar tendon. Over time, the attempts at repairing these tears leads to a pile-up of scar tissue in the tendon that is less resilient. It is uncommon for the tendon to tear completely; however, if he is suffering from swelling in the tendon, it may be a more significant injury than advertised. A return to play is not predicated upon complete tissue healing but upon symptom resolution. When swelling is present, it may indicate partial tearing of the tendon. This is a particularly problematic issue in basketball, as it may linger for an entire season.

MISSING IN ACTION

Short term: A right wrist sprain that occurred during the FIBA Americas Championship in September kept Leandro Barbosa(notes) out of Phoenix’s Nov. 3 contest. It’s something to watch as a cyst that has developed on the wrist is too small to surgically remove … Sharpshooter Daequan Cook(notes) strained his right shoulder while doing exercises on a medicine ball and will likely miss his third straight game Nov. 4. Who knew weight room objects could be so dangerous to pro athletes? … Drew Gooden(notes) missed his second straight game Nov. 3 with a hurt right rib cage. X-rays were negative … Troy Murphy(notes) bruised his lower back Nov. 3 and might not return until the weekend of Nov. 7-8 … Michael Pietrus missed his second straight game Nov. 3 with the flu and has an uncertain timetable … Tayshaun Prince(notes) ended his 496-games-played streak Nov. 3 by sitting with a lower back strain. Teammate Richard Hamilton(notes), who hasn’t played since the season opener because of a right ankle sprain, is doubtful for Nov. 6 … Tyrus Thomas(notes), who’s been openly annoyed by his lack of playing time, missed Chicago’s Nov. 3 game with flu-like symptoms; Taj Gibson(notes) took his spot … Ronny Turiaf(notes) is day-to-day with a left knee sprain.

Long term: Glen Davis(notes) is out until at least December with a broken right thumb … Jeff Foster(notes) is out at least two weeks with a high ankle sprain. Look for Tyler Hansbrough(notes) (right shin) to fill in upon his return, likely Nov. 6 … Yi Jianlian(notes) was dealt a big blow when a Nov. 2 MRI unveiled a grade 1 sprain to his right knee. Those injuries usually take 2-6 weeks to heal, so Bobby Simmons(notes) and Terrence Williams(notes) could be instituted into a small-ball role … Kyle Korver(notes) had a bone spur removed from his left knee Oct. 28 and will be re-examined Nov. 9 … Speaking of a painful-sounding injury: C.J. Miles(notes) is disabled for an undetermined amount of time with a ruptured ulnar collateral ligament in his left thumb … In case you’ve been living in Antarctica, Tracy McGrady(notes) (left knee microfracture surgery) is out until at least mid-December and Yao Ming(notes) (broken left foot) is done for the year … Nate Robinson(notes) discovered his kryptonite: a severely sprained right ankle. He’ll miss at least two weeks, making Larry Hughes(notes) a more intriguing waiver wire pickup … Tim Thomas(notes) went through his first live practice Nov. 2 in his return from right knee arthroscopic surgery in late September He still has no timetable … Brandon Wright damaged a capsule in his left shoulder and will be out of commission until mid-February, an unfortunate situation for an extremely promising player. Don Nelson gloomily drank another Bud Light.

BACK IN ACTION

Raja Bell(notes) (torn ligament in left wrist) and Allen Iverson(notes) (partially torn left hamstring) made their season debuts Nov. 2 … Mehmet Okur(notes) returned to action Nov. 2 after missing a game with a mildly sprained left knee and ankle … Caron Butler(notes) (left knee bruise), Vince Carter(notes) (left ankle sprain) and LaMarcus Aldridge(notes) (right knee bruise) were back on the floor Nov. 3.

Bizarre Health Issue of the Week: As you might have seen on SportsCenter, Manu Ginobili(notes) decided to take matters into his own hands on Halloween night by swatting a flying bat to the ground in the first quarter of the Spurs-Kings game. Unfortunately, he killed the poor guy. But the lifeless bat got some vindication because Manu had to receive precautionary rabies vaccinations on Nov. 2 – four in the hip and arm. He’ll go through four more such sessions over the next month to ensure he doesn’t come down with possibly the strangest disease an athlete can incur.

Note about the Doctor’s notes: David Braunreiter, MD holds a private practice in the Houston, Texas area. He is board certified in primary care sports medicine and family medicine and is also certified as an ImPACT concussion consultant. Braunreiter has served as a team physician for the Houston Dynamo MLS club, professional football, as a consultant for many local high schools and has worked in the NBA with the Cleveland Cavaliers, in the WNBA with the former Houston Comets and in the NCAA with the University of Houston football, baseball and basketball teams.

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Kyle is staying away from the exercise and medicine balls in the weight room this week. No need to break any kind of radius bone. Feel free to e-mail Kyle at kylestack@rotoexperts.com.