Bill Self, Joel Embiid

A doctor explains Joel Embiid’s foot injury


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.

Sixers CEO: Ben Simmons will play for Sixers this season

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Ben Simmons is out with a broken foot — a Jones fracture — and that has led to rampant speculation about when the Sixers’ No. 1 pick might return to the court. Coach Brett Brown said January (the short end of the timeline) then walked those comments back, while there are rumors people in Simmons camp may want him to sit out the season.

Sixers CEO Scott O’Neill was on TCN’s Breakfast on Broad and made it clear Simmons will be back this season. He blew off the idea that Rich Paul (Simmons’ agent) wants him to take the season off.

“No, it’s not true,” O’Neil said. “Yeah, he’ll be back.”

There is no timeline for Simmons’ return, which isn’t just the team managing expectations (well, it’s partially the team trying to manage expectations). Jones fractures involve the bone that runs from the base of your little toe up to near the ankle, and the problem is that area of the foot does not have great natural blood flow, which means healing can be slow and harder to predict. We know that Simmons had surgery to repair the break, but recovery times will be flexible.

Brett Brown told me in a ProBasketballTalk Podcast how much he just wants to get Simmons, Joel Embiid, Jahlil Okafor, Dario Saric, and Nerlens Noel all healthy at the same time so he can start to see what lineups work, which guys play well off each other and which don’t (we learned last season Noel and Okafor are not a great fit). Maybe Simmons can be part of that process in the second half of the season.

Mavericks’ Devin Harris sprains big toe, out at least three weeks

DALLAS, TX - SEPTEMBER 26:  Devin Harris #34 of the Dallas Mavericks poses for a portrait during the Dallas Mavericks Media Day held at American Airlines Center on September 26, 2016 in Dallas, Texas. 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 Pennington/Getty Images)
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Devin Harris is the kind of veteran, versatile player Dallas coach Rick Carlisle likes in his backcourt — he can run the point or be a small two-guard off the ball. Carlise wants multiple ball handlers on the court and Harris allows him to do that with a number of different combinations.

Or rather, Harris will allow Carlisle to do that once he gets healthy. From Earl K. Sneed of

Harris had surgery on the big toe on his other foot, this injury is to the “good” one. Harris can be a bit injury prone and the Mavs likely will bring him along slowly.

This likely means more J.J. Barea and Seth Curry in the short term in Dallas.

Should Knicks let Derrick Rose run more pick-and-roll?

CLEVELAND, OH - OCTOBER 25:  Derrick Rose #25 of the New York Knicks drives to the net in the first quarter past Kevin Love #0 of the Cleveland Cavaliers on October 25, 2016 at Quicken Loans Arena in Cleveland, Ohio. 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 Jamie Sabau/Getty Images)
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Late in the blowout loss to the Cavaliers Tuesday, it was clear the Knicks were making a point of trying to run more triangle sets — it’s an offense a lot of their players are still just starting to learn and the game turned into a glorified practice.

On the night as a whole, Derrick Rose was his old self on his way to 17 points on 17 shots: 41.2 percent of his attempts came after seven or more dribbles and after he held the ball for at least six seconds. He took six shots as the pick-and-roll ball handler and hit two of them. (Carmelo Anthony shot 2-of-7 as the pick-and-roll ball handler.)

Should the Knicks put him in more pick-and-roll situations where he’s comfortable? Here are some postgame quotes, via Ian Begley of ESPN.

“Towards the end, when you saw us running it, it was just us trying to get used to it so it’s not that foreign,” Rose said. “We got a lot of room to make up on that side of the ball too.”

“He had that good explosion,” Hornacek said of Rose, who scored 17 points (7-for-17 shooting) in 29 minutes. “He’s just got to figure out all of the stuff that we’re doing, and he’ll be a big part of our team and really help us.”

“We want guys to feel comfortable with kind of who they are,” Anthony said. “We don’t want to try to change anybody’s game. If Derrick feels comfortable being up there in high pick-and-roll, that’s his game. You can’t take him away from that. You want to utilize guys’ strengths. That’s who he is, that’s who he’s always been. We want to rely on that. We don’t want to take that away from him.”

The triangle offense takes time to learn, and Rose has been honest that it’s going to take time. Which is the norm. When Phil Jackson took over the Shaq/Kobe Lakers in 2000 and led them to a championship the triangle got credit, but that Lakers’ offense had an almost identical points per possession as the season before (what won them the title was a vastly improved defense). It was in future years that the offense started to click with the players, after they had run it for a season or two.

The Knicks want to make the playoffs now, which may mean some triangle sacrifices. New York certainly played faster for much of the game against the Cavaliers, which should get them some easy buckets. They should let Rose run some pick-and-rolls where he’s comfortable, particularly drag screens early in the clock. Mostly, the Knicks need to keep the ball moving and the players moving, not let it stagnate into defendable isolation basketball (even if Anthony and Rose can make some plays that way). And in the halfcourt, run the triangle — but keep the ball moving.

One game against the defending champs is not going to define the Knicks season, but they also see where the bar is set. They have some work to do this season.

LeBron James, Dwyane Wade make fashionable World Series bet

CLEVELAND, OH - OCTOBER 30: LeBron James #23 of the Cleveland Cavaliers and Dwyane Wade #3 of the Miami Heat shake hands during the first half at Quicken Loans Arena on October 30, 2015 in Cleveland, Ohio. 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 Jason Miller/Getty Images)
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LeBron James is an Akron guy born and raised, who is caught up in Indians fever like the rest of Northeast Ohio.

Dwyane Wade is Chicago born and raised, a Cubs fan who wants to see the team end its 108-year drought.

So the two have made a World Series bet — loser has to show up at the winner’s arena in the World Series champ’s gear.

After Game 1 — on the night he was collecting his latest ring — LeBron has to feel pretty good.

Either way, the payoff should be good.