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.

Rumor: Grizzlies had to choose between Marc Gasol and David Fizdale

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David Fizdale has been linked to most of the NBA’s head-coaching vacancies.

He developed a legion of backers as lead a Heat assistant, and he did good things guiding the Grizzlies before they unexpectedly fired him. He deserves consideration.

But he also must explain his fractured relationship with Memphis star Marc Gasol. They weren’t speaking for a while.

And maybe the problem was even worse than that.

Marc Berman of the New York Post:

According to a source close to Fizdale briefed on the Grizzlies’ decision, it was ownership having to make a choice — trade their All-Star center Marc Gasol, who has fallen in love with its small-market city, or fire the coach. Their relationship had gotten that bad.

If Grizzlies ownership felt it had to choose between Gasol and Fizdale, it’s not clear why.

Fizdale benched Gasol down the stretch during the coach’s last game, and Gasol publicly expressed his frustration.

But Gasol denied issuing a me-or-Fizdale ultimatum. Fizdale said focus on his relationship with Gasol was “overblown,” adding he cared far more about whether he could win with a player than whether they got along personally.

Memphis obviously sided with Gasol – probably too strongly.

LeBron James bought Cavs teammates matching designer suits to wear to game tonight

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I’m still trying to decide if this is cool or a little too Stepford.

The Cavaliers rolled into the Bakers’ Life Fieldhouse in Indianapolis tonight wearing matching designer suits, all paid for by LeBron James and custom fitted to each player.

If a college team rolled into a game in four-digit designer suits, the NCAA would have questions. And not about the vests.

The Cavaliers are LeBron’s team, and if he wants to buy his teammates suits and tell them to wear them it’s going to happen. Is it a bonding thing that helps bring them together? Sure. Is it in place to make sure LeBron remembers which ones are his new teammates? Probably not.

Do the suits help on the court? No. And the Cavaliers better bring it in Game 3 because if they go down 2-1 in this series — something that is a realistic possibility — the whispers of doubt are going to get a lot louder.

Report: Knicks to discuss coaching vacancy with Hawks’ Mike Budenholzer

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Mike Budenholzer is restless in Atlanta, seeing a rebuild coming and looking at other jobs (something Hawks management is fine with). He went down the road a ways with the Suns before pulling out of that process, but he’s still looking around.

The Knicks are casting a wide net in their search, talking to virtually everyone looking for coaching jobs.

So, this seemed inevitable, right? Budenholzer and the Knicks are going to talk, according to Michael Cunningham of the Atlanta Journal-Constitution.

This will be very preliminary. The Knicks have already had some level of conversation with Mark Jackson, David Fizdale, Jerry Stackhouse, David Blatt, Mike Woodson, and TNT analyst Kenny Smith (Jackson and Fizdale are the rumored early leaders). Budenholzer has established a style and culture in Atlanta, giving the franchise a path forward. New York could certainly use that.

However, the Knicks job comes with real challenges, too. That starts with James Dolan as owner and the erratic, at times paranoid culture he has created there. Also, expectations in New York are always high, but the team will be without Kristaps Porzigis for at least half (maybe all) of the upcoming season as he recovers from an ACL injury, and that puts a ceiling on the team in the short term. Is all that worth leaving Atlanta for?

 

Stephen Curry to begin “modified” practices with Warriors

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Golden State has flipped the switch in the first round, going up 3-0 on overmatched San Antonio. The Warriors have been outscoring the Spurs by 20.2 points per 100 possessions in the series, allowing less than a point per possession on defense and scoring when and where they want. Kevin Durant is averaging 27.3 points per game, Klay Thompson is shooting 63.3 percent from three and scoring 25.7 points per game, and the Warriors are clicking.

But they are not yet whole — they need Stephen Curry back. Not for this round, but before the Western Conference Finals for sure.

Curry was re-evaluated Friday and will begin practicing with the team in a limited — or “modified” to use the team’s term — way.

The target has always been a return somewhere during the second round, and that still seems to be on track. That is also a little faster than traditional for a Grade 2 MCL sprain, which can take up to two months to heal (not the 4-6 weeks of the Warriors timeline), but the Warriors are being cautious here for now.

Eventually, the Warriors will need him back — their offense is built around Curry and his ball movement and movement off the ball. Curry’s gravity to draw defenders, even when he doesn’t have the ball, opens up the floor for others. Put simply, if he’s 28 feet from the bucket on the weak side defenders still have to watch and be near him, and help defenders need to be aware, which pulls the defense to wherever he is. Without Curry and the Warriors take more midrange jumpers, it’s just in the first round series against the Spurs they are hitting them.