Bill Self, Joel Embiid

A doctor explains Joel Embiid’s foot injury

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With Joel Embiid’s foot injury adding so much confusion to the NBA draft, I asked Dr. Ben Wedro of MD direct to help provide a little clarity – at least about the top-rated center. If you’re looking for help on the Andrew Wiggins/Jabari Parker debate, this isn’t the place (though I’ll have more on that tomorrow).

Q: What might have caused Embiid’s foot injury?

The navicular is located in the mid foot and is responsible for helping maintain the arch of the foot from heel to toe and transverse stability of the foot. It and the ligaments that attach to the mid foot to flex at the beginning of a stride and lock as the foot pushes off.

They are responsible for taking the load of the weight of the body as it comes down an distributing it. So, when you’re 7-foot-whatever and 300 pounds [ed: Emiid’s listed weight was 250 pounds at Kansas], that takes more load than if you’re me and and 5-9, 160. It’s one of those things that happens unfortunately. I don’t know if we’re built to be 7 feet.

Causes include increasing activity too quickly, poor equipment (in this case, perhaps poorly fit or supportive shoes) and bone insufficiency. Normal with the latter, it is due to osteoporosis but in a large 7 footer, it may be that the bones in his foot may not be able to support the size of his body.

When it is injured, it often takes time to make the diagnosis of the navicular stress fracture because it is not easily seen on x-ray.

Q: Considering his back injury also, is it possible Embiid’s bones are weak?

Unlikely. He’s a healthy guy. The think you think about with people with back fractures and bone problems is osteoporosis, and that’s more a disease of aging. You see that in older people, especially women who haven’t deposited calcium in their bones earlier on in life. They have a calcium deficit. So, that’s unlikely the case.

His bones are probably fine. His height is a problem.

Not a problem. You can’t teach height. But it puts more stress on the anatomy of the bones in the body to distribute all that pressure that comes through jumping and running.

As to the relationship with his previous back injury, the only relationship I can think of is being deconditioned and increasing practice and play time too quickly.

Q: What do you make of two screws being inserted into his foot?

The fracture needs to be stabilized and the screws are used for internal fixation. This is the expected procedure.

With either operative or non-operative approach, up to 90% of athletes can return to their  level of competition.

Q: Do you think that percentage is lower for elite athletes, because they must climb back further to a higher level?

They have more incentive to do that or facility to be able to do that. They have more people around them to get them there.

He goes eight hours a day, six days a week. That’s their full-time job, and he has a team of people – from a chiropractor to massage therapist to a physical therapist and a doctor – working on your foot six hours a day.

Q: How can he and his team minimize of suffering another injury?

Part of his rehabilitation and evaluations of his injuries in his rehab will be looking at his footwear and seeing how they can help him with that – whether that’s orthotics or a specially built shoe for him – would probably be appropriate.

You have to work hard on his mechanics. The people will be looking hard at how he lands, how he takes off, how he runs and try to minimize the amount of stress on his feet by doing that.

They’re not going to tell him not to run fast. They’re not going to tell him not to jump high. They’re going to try to work with his natural athletic ability and maximize it.

So, if Embiid returns to full health, preemptively limiting his minutes to avoid future injury would be no more effective than employing that strategy with any other player?

That’s right.

As long as they’re comfortable that his mechanics are together. Let’s say they find – and I don’t know this – but let’s presume he has mechanical issues with his gait or his jumping or whatever. if they don’t correct, then that’s a different story – or if he cannot correct that.

If they find that he is mechanically sound and he’s fully recovered and he has no pain, then he should enjoy a long, healthy career.

That leaves a lot of ifs, though it is helpful to know exactly where the uncertainty remains.

Is he a normal 22-year-old? Is he the next Greg Oden? If we all knew the answer, we could predict the future.

Kevin Love shut down at the rim by Bismack Biyombo (VIDEO)

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Once again, Bismack Biyombo was a force in the paint that the Raptors leaned on heavily during their Game 4 win against the Cavaliers.

His biggest play of the night was this clean block of Kevin Love at the rim. Love passed to LeBron James in the post, caught his defender napping and cut the rim, got the pass back from James and… denied.

Biyombo also got LeBron James at the rim but was called for a foul much to the dismay of Biyombo, Raptors fans, and the ESPN broadcast crew (it was the right call — watch Biyombo leap across the lane, he is anything but vertical, he contacts LeBron’s body, that’s a foul).  Either way it’s worth watching.

NBA VP explains decision not to suspend Draymond Green; says very different play than Dahntay Jones

OKLAHOMA CITY, OK - MAY 22:  Draymond Green #23 of the Golden State Warriors drives against Steven Adams #12 of the Oklahoma City Thunder in the second quarter in game three of the Western Conference Finals during the 2016 NBA Playoffs at Chesapeake Energy Arena on May 22, 2016 in Oklahoma City, Oklahoma. NOTE TO USER: User expressly acknowledges and agrees that, by downloading and or using this photograph, User is consenting to the terms and conditions of the Getty Images License Agreement.  (Photo by Ronald Martinez/Getty Images)
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All day long NBA Twitter — and the Warriors, and the Thunder — waited for the shoe to drop on a decision about suspending Draymond Green for a kick to the “groin” of the Cavaliers’ Steven Adams.

Everyone just waited. And waited. And waited.

It took that long because the league wanted to be thorough — watching the film, looking at similar incidents (and the punishments there), talking to the players and the referees, and thinking it through. It was a decision with a huge impact on the series (Golden State was not winning Game 4 without Green).

So why did NBA executive vice president of basketball operations Kiki VanDeWeghe decide not to suspend Green, rather upping the foul to a flagrant 2 and taking on a $25,000 fine?VanDeWeghe talked in some detail to Sam Amick of the USA Today in a piece you should read right now. This is just a highlight.

We have professional investigators that conduct the investigation. They talk to the players, they talk to all the referees, including the replay officials, and they all come back and report to me. I obviously discuss it internally, and especially with referee operations, get their perspective. But at the end of the day … every play is different and that’s the problem. You take into account everything. You take into account t what the referees have said. They obviously went with a Flagrant One last night, and you take into account the comparables. The problem with comparables is they never tell the whole story.

One comparable a lot of people supporting the suspension brought up was the one-game suspension for Cleveland Dahntay Jones just a day before (for a punch to the groin of Bismack Biyombo. Except VanDeWeghe says it was not comparable.

But just to talk about the Dahntay Jones situation, I think that was basically a completely different play. That, you had somebody (who was) tussling for a rebound, and Jones brings back his hand his hand is open. And as he brings his hand back forward and makes contact with Bismack’s (Biyombo) groin area, the fist is closed. And so you have contact with a closed fist, so to me that’s a very different scenario and, to me, a different fact pattern, so it’s very different from what we’re talking about with Draymond, that I viewed as a flail that is becoming, you know, pretty common amongst our players in trying to sell calls. Draymond does it a fair amount, Westbrook does it a fair amount, and a number of other players. Unfortunately, in this particular one, Draymond’s leg connected in the same Adams groin area, the same area, as the Jones one, but everything else about the call, or the play, was really different.

That is what the Warriors tried to sell, and the league came to find — Green was fouled but in trying to sell that call a little he accidentally kicked Adams where men least like to be kicked.

None of this is going to change anyone’s mind — if you’re convinced Green’s kick was intentional, and he should have been suspended, there is no evidence that will get you to think otherwise. This is just context, it helps everyone understand the process and the decision. More information is a good thing.

Raptors race out to lead, hang on to beat Cavaliers 105-99, even series 2-2

TORONTO, ON - MAY 23: Kyle Lowry #7 of the Toronto Raptors handles the ball in the fourth quarter against LeBron James #23 of the Cleveland Cavaliers in game four of the Eastern Conference Finals during the 2016 NBA Playoffs at the Air Canada Centre on May 23, 2016 in Toronto, Ontario, Canada. NOTE TO USER: User expressly acknowledges and agrees that, by downloading and or using this photograph, User is consenting to the terms and conditions of the Getty Images License Agreement.  (Photo by Tom Szczerbowski/Getty Images)
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Now this is some adversity.

After winning 10 straight games to open the playoffs, the Cavaliers struggled in Game 3 in Toronto last Saturday, but that felt almost like a setback rather than a change of direction in the series. At least it did until Game 4 tipped off.

Toronto again came out with fantastic energy again on defense, scrambling and contesting everything. The Cavaliers were not attacking (well, except LeBron James) and were kicking out for threes — and missing. As a team, Cleveland was 3-of-22 from three in the first half. Meanwhile, Kyle Lowry was hot on the other end, both hitting long threes and setting up teammates. Lowry was 8-of-11 shooting in the first half, 4-of-6 from beyond the arc, and had three assists as well.

Raptors led 57-41 at the half. They needed every point of that down the stretch.

Cleveland started the second half on an 11-0 run and came back behind Kyrie Irving (15 second half points), LeBron, and a more focused defense. With six minutes to go in the game Cleveland even took the lead. It felt like this was when the Cavaliers would assert themselves as the best team in the East.

Except the Raptors out hustled and out executed the Cavaliers down the stretch. Bismack Biyombo was grabbing key rebounds inside (Patrick Patterson had a huge offensive rebound as well), and Lowry and DeRozan remained hot — the guards combined for 21 points on 8-of-11 shooting in the fourth quarter — not taking threes (0-of-1) but attacking and getting to the basket an the line.

The result was a 105-99 Toronto win that evens the Eastern Conference Finals at 2-2 heading back to Cleveland Wednesday for Game 5.

“I thought we come back, had control of the game, was up three points, then we made some defensive mistakes you can’t do down the stretch, and they cost us — each time we made a mistake they made us pay,” Cavaliers coach Tyronn Lue said postgame.

This was another game where Toronto played with great defensive energy and the Cavaliers responded by settling — they took 41 threes in Game 3 (hitting 13), Monday they were 13-of-42. J.R. Smith was 3-of-11, Kevin Love 2-of-7 (and sat out the fourth quarter with a potential injury, he was limping). The guys that kept the Cavaliers in it in the fourth (besides LeBron, who was fantastic again) were Richard Jefferson and Channing Frye, who combined 17 points on 7-of-8 shooting. But it was not enough.

“We’ve got to be more well balanced,” LeBron said on a night he finished with 29 points on 11-of-16 shooting. “We started the game, we had some great looks, but when they’re not going you’ve got to be able to switch it up and get into the paint and do what you can do. I was able to get into the paint a little bit, Kyrie as well, but we just haven’t shot the ball from the three point line.”

Offensively, the Raptors were carried by Lowry and DeRozan, which was the case all season. Lowry had 35 points on 20 shots and looked every bit the All-Star version of himself.

“He’s made shots,” Lue said. “He’s being aggressive. He’s making shots. Tonight he made some early baskets that gave him some confidence, I thought, in the first quarter, and he carried it throughout the game.”

DeRozan had 32 points on 23 shots and was getting to the spots on the floor he liked. Once in Toronto both Biyombo and Patterson have done a good job of switching up their screen angles on the pick-and-roll, and the Cavaliers get flummoxed by this.

“We’ve got to find a way to be more consistent,” Lowry said. “(He and DeRozan) need to find a way to be consistent throughout a whole series.”

Then again there was Biyombo, the free agent to be making the case he should get paid big this summer. He finished with 14 boards — including a number of key ones late — and three blocks. His presence inside has the Cavaliers hesitant to attack the paint.

This sets up a lot of interesting questions heading into Game 5 Wednesday.

Can Toronto play with the same energy on the road? Can Cleveland adjust to the Toronto defense and get back to attacking the paint? Will Lowry stay hot? Will Love regain his stroke?

The bottom line is this is a series now — best of three. And the Cavaliers are no lock to advance.

Watch Kyle Lowry’s red-hot shooting second quarter

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Kyle Lowry found his shot back home in Toronto.

After a rough first couple games (actually a rough couple rounds to start the playoffs), Lowry has gotten hot back home, and that seemed to peak in the second quarter when he shot 6-of-7 overall and 3-of-4 from three. He had 15 points, 20 in the quarter, and the Raptors were up 16 at the half.