A doctor explains Joel Embiid’s foot injury

13 Comments

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.

Some NBA players reportedly expect families can’t come to Orlando until September

Getty Images
Leave a comment

Nothing is set in stone until the owners vote on Thursday, but the NBA’s return likely will have teams reporting to the “bubble” (or campus, or whatever term of art the league ends up using) in Orlando in mid-July. Games would start July 31 and run into late September and maybe even October.

For players, that’s a long time to be stuck in a hotel without seeing family or loved ones, so families joining the players has long been part of the plan. Except, now comes a note from Tim Reynolds at the AP that some players think their families may not be able to join them until deep into the postseason.

The smaller the bubble, the easier it is to maintain with extensive testing, which is why not all 30 teams are expected to be invited and the size of team traveling parties will be smaller. It has been expected that families wouldn’t be invited to join players at least until after the first round of the playoffs (when a lot of players left).

However, if games start July 31 and the league plans to play a couple of weeks of regular-season games, followed by a play-in tournament for the final playoff spot, then it will be September by the time the NBA gets to a final eight teams. Which will have players separated from their families for a couple of months.

It’s easy to understand the players’ frustrations with that. No matter what direction Adam Silver goes with this restart, there are going to be some unhappy teams and players.

 

Sixers head into playoffs with healthy Ben Simmons but new, untested starting five

Jesse D. Garrabrant/NBAE via Getty Images
Leave a comment

Philadelphia heads into the NBA’s restart — in whatever format it takes — as a team that, on the surface, benefits some from the break.

Ben Simmons was expected to return from his back issues in time for the playoffs, but it was going to be close, and he wouldn’t be fully rested and ready. Now, the All-Star is healthy and not the only player trying to shake off the rust from a long break. That’s 16.7 points, 7.8 rebounds, and 8.2 assists a game, and some strong defense back in the lineup.

But that lineup has never really fit together this season in Philadelphia, which is why heading into the restart playoffs the Sixers will have a new one.

Philly is expected to roll out a starting five of Simmons, Shake Milton, Joel Embiid, Josh Richardson, and Tobias Harris, reports The Athletic’s Derek Bodner. That lineup has played zero minutes together this season (Milton hit his groove with the team late and by that point Embiid and Simmons were battling injuries). Learning chemistry on the fly in what will be, at best, a shortened and condensed regular season before the playoffs start, is a tough way to go.

It’s also the right move, Milton brings the shooting and floor spacing this roster needs. Philly had envisioned Al Horford as a floor-spacing four (who could spell Embiid at the five), but it hasn’t worked out. When Simmons, Embiid and Horford have been on the court this season, the team has scored less than a point per possession (defensively, they also gave up less than a point per possession, the Sixers basically played their opponents even in those minutes). It hasn’t meshed.

When Milton, Simmons, and Embiid have played together this season — in limited minutes and different situations than the one proposed — the offense has been only slightly better and the defense has been a mess. That’s likely not the case with Richardson and Harris on the court, but nobody knows exactly how this will work. It looks good on paper, but we’ve thought that all season about the 76ers.

Which makes Philadephia one of the most interesting teams to watch when games restart. All season long this team has not lived up to expectations (for which coach Brett Brown’s seat is very hot, even if blame for the roster issues should go higher up the ladder). Now comes a real test. If the 76ers suddenly get it together they become a real threat to the Bucks in the East (if the league keeps an East/West format). Or, this could be the latest Sixers lineup to fall short.

Either way, they become must-watch television.

Jaylen Brown drove 15 hours from Boston to Atlanta to lead peaceful protest

Maddie Meyer/Getty Images
Leave a comment

While many NBA players have spoken out on social media and attended rallies in the wake of George Floyd’s death at the hands of Minneapolis Police, maybe none has been as vocal and active as the Celtics’ Jaylen Brown.

Saturday, he drove 15 hours from Boston to Atlanta to lead a peaceful protest at the Martin Luther King National Historic Park.

Brown was joined by the Pacers’ Malcolm Brogdon.

View this post on Instagram

@malcolmbrogdon @jusanderson1

A post shared by جيلين براون (@fchwpo) on

Brown’s protest still had a run-in with Atlanta police.

This protest is one of many nationwide happening for a fifth straight night in the wake of the death of Floyd at the hands of Minneapolis police. That death happened not long after the death of Ahmaud Arbery, a 25-year-old black man killed while jogging in a Georgia neighborhood.

Derek Chauvin, the man pictured kneeling on Floyd’s neck — which he did for more than eight-and-a-half minutes — was fired from his job in the Minneapolis Police Department and was arrested on Friday and charged with third-degree murder.

Brown, like many nationwide, hope these protests and this frustration can be channeled into real change. Something this nation needs.

Pistons’ Dwane Casey’s says “we all have to be and do better” in wake of George Floyd’s death

Getty Images
Leave a comment

A lot of NBA players have spoken out about the death of George Floyd at the hands of a Minneapolis Police officer. Stephen Jackson, a friend of Floyd’s, has been the most vocal. Recently players have spoken out about the racism they felt at other times in their lives.

Few have had the experience of Pistons’ coach Dwane Casey. He grew up in Kentucky during desegregation and was in the midst of some of the uglier days of our nation.

Casey released this statement in the wake of Floyd’s death.

“Fifty-four years ago I was an eight-year-old boy living in rural Kentucky when the schools were desegregated.  I walked into a white school where I was not wanted nor welcomed.  At that time there were no cell phones to record my treatment, no cable news stations with 24/7 coverage, no social media to record the reality of the situation or offer support nor condemnation.  But I can remember exactly how I felt as an eight-year-old child.  I felt helpless.  I felt as if I was neither seen, nor heard, nor understood.  As I have watched the events unfold in the days following the murder of George Floyd in Minneapolis, a city where I coached and once called home, I see how many people continue to feel those same feelings – helpless, frustrated, invisible, angry.

“I understand the outrage because it seems the list continues to grow: Ahmaud Arbery, Breonna Taylor, George Floyd.  The injustices continue to mount and nothing seems to be changing.

“Fifty-four years later, my son is now eight years old and I look at the world he is growing up in and wonder, how much has really changed? How often is he judged on sight?  Is he growing up in a world where he is seen, and heard, and understood?  Does he feel helpless?  Will he be treated like George Floyd or Ahmaud Abrey?  What have we really done in the last 54 years to make his eight-year-old world better than mine was?  We all have to be and do better.

“We have to change the way we see and hear each other.  We have to work together to find solutions to make the justice system just.  Black, white and brown people have to work together to find new answers.   The only way we can stop the systemic problems that people of color have faced all our lives is through honesty and transparency.  We have to understand why people are at their limit at this moment.  It takes empathy, in its truest form.  It takes a culture shift, it takes action.  Let’s stop the injustice now.  Let’s not allow another generation to continue to live in a world where they are treated as unequal.  Now is the time for real change.”

Now is the time for change, but we need to act to make it happen, not just hope.