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.

Did Hornets GM tell Kobe Bryant on draft night, ‘We couldn’t have used you anyway,’ as Bryant claims?

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Kobe Bryant spent 16 days as a Charlotte Hornet.

Long enough to develop resentment for the Hornets.

Charlotte drafted Bryant No. 13 in 1996 to trade him to the Lakers for Vlade Divac. Divac threatened to retire, but eventually relented on joining the Hornets. After the moratorium, Bryant went to Los Angeles, where he had a Hall of Fame career.

He hasn’t let go of draft night, though.

Bryant on the Knuckleheads podcast:

You get drafted, you get on the phone with the GM of the team that drafted you and all this stuff. So, I get on the phone with the Charlotte GM. He just tells me, “Hey, you know what’s going on.” Like, “Yeah. Yeah, yeah.” And you’ve got media in front of you and all that. And he goes, “Well, it’s a good thing we’re trading you, because we couldn’t have used you anyway.” You motherf. OK. OK. Alright. So, that’s what happened on draft night. So, I was already triggered. I was triggered. I was ready to go to the gym. Like f— the media. I don’t want to do any more interviews. I’m trying to – what are you telling me that for? I’m 17. What are you telling? OK. Alright.

The Hornets’ general manager was Bob Bass. He died last year, so he can’t tell his side of this story.

However, in previous tellings, Bryant said Charlotte coach Dave Cowens delivered that message. Cowens denied it.

Did Bryant forget whether he talked to the general manager or coach? Forget which position Cowens held? That’d be perfectly understandable decades later.

Or maybe both Bass and Cowens were on the call. Perhaps, Bryant initially thought Cowens said it and more recently learned it was Bass. That could explain Cowens’ denial.

But…

Stephen A. Smith of The Inquirer at the time:

On Wednesday, the Hornets took Bryant with the 13th pick of the NBA draft. Within minutes, there was talk of Bryant’s going to L.A. Dave Cowens, the Hornets’ new coach, was among those who raised the possibility, dismissing Bryant as “a kid” who would have a hard time playing for Charlotte.

That was a reasonable expectation. Bryant was just a teenager. Charlotte had veteran wings like Glen Rice and Dell Curry.

But Bryant was that special. He quickly became a contributor with the Lakers then developed into an all-time great.

In part because he fanned his competitive fire with perceived slights like this one.

Bryant is right: Who would say that to a 17-year-old? It just sounds cruel. Of course, Bryant would want to avenge being treated that way.

Here’s my guess: Someone from Charlotte – either Cowens or Bass – tried to comfort Bryant in a chaotic situation by saying the trade would work out for the best because the Hornets wouldn’t have played him much. It was supposed to be nice. Bryant took it as an insult.

But that’s just a guess. It was a private conversation many years ago. We’ll probably never know exactly what was said, let alone what was intended.

Report: Rockets signing Thabo Sefolosha

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The Rockets’ minicamp has produced a signing – Thabo Sefolosha.

Marc Stein of The New York Times:

This is surely for the minimum. It’s unclear how much is guaranteed.

Houston has just 10 players with guaranteed salaries, including Nene’s dud of a deal. So, there’s room for Sefolosha to make the regular-season roster.

Sefolosha should fit well in Houston. He’s a smart, versatile defender and can knock down corner 3s. James Harden and Russell Westbrook will allow Sefolosha to concentrate on his strengths in a limited role. The biggest question is how much the 35-year-old Sefolosha has left in the tank.

NBA to better define traveling rule, increase enforcement, explain rule to players, fans

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Gather and two steps.

That is how the NBA has defined the traveling rule for many years now. A player can take a step if he is in the process of “gathering” a dribble or pass, then has two steps. Players such as James Harden have stretched that to the limit, frustrating opponents and non-Rockets fans, but it’s legal.

Now the NBA is looking to better define that “gather” step, then crackdown on enforcement of the rule. With that will come an education program for everyone from players to fans. All of this was approved at the NBA’s Board of Governors’ meeting in New York on Friday.

“One of the most misunderstood rules in our game is how traveling is interpreted and appropriately called,” Byron Spruell, NBA President, League Operations, said in a statement. “Revising the language of certain areas of the rule is part of our three-pronged approach to address the uncertainty around traveling.  This approach also includes an enforcement plan to make traveling a point of emphasis for our officiating staff, along with an aggressive education plan to increase understanding of the rule by players, coaches, media and fans.”

That “aggressive education plan” should be interesting.

At the meeting, the owners also made gamblers everywhere happy by saying that starting lineups now need to be submitted by coaches 30 minutes prior to the start of the game. In past years that had been only 10 minutes (and road teams complained that was not evenly enforced between home and road teams all the time).

This is a good bit of transparency by the league, as have been some of the recent changes in requirements of announcing injuries. But make no mistake, this rule change is all about gambling.

Under new anti-tampering rules, Adam Silver empowered to suspend execs, take away picks, void contracts

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LeBron James publicly courted Anthony Davis. Many free agents seemingly struck deals before free agency even began. Kawhi Leonard‘s uncle/advisor reportedly sought prohibited extra benefits from teams.

The NBA finally reached its breaking point on tampering and circumvention.

After late apprehension, the league will enact stricter enforcement.

Adrian Wojnarowski of ESPN:

I’m not surprised this passed unanimously. NBA commissioner Adam Silver wanted this to happen and wasn’t going to have owners vote unless he knew it’d pass. At that point, any protest-voting owners would just put themselves at odds with the commissioner. Not worth it.

We’ll see how long this crackdown lasts. I think that anonymous general manager represents many. If nobody is tampering, it’s fine not to tamper. But if some teams tamper, nobody wants to be at a disadvantage.

This could slowly creep back toward the old status quo. But if there’s a clear violator early, Silver will have an opportunity to send a message. We’ll see whether he takes it.

This should be less about which communication is or isn’t allowed. It’s about fairness.

That’s why it’s important the NBA has rules it will enforce and only rules it will enforce. That hasn’t been the case. If it is now, this will be a success.