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.

Anthony Davis doing it all for Pelicans

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DETROIT – Anthony Davis repeatedly entered and exited the visitors’ locker room after the Pelicans win over the Pistons on Sunday. At a time most players go from their locker to the shower and back then leave, Davis was busy. He visited with people in the hall. He breezed back by his locker then left to attend to other matters. He returned again and, before showering, turned to the assembled media.

“Y’all need me?” Davis asked.

Davis is used to getting pulled in every direction and still being needed even more.

The superstar is having another MVP-ballot-caliber season. Yet, New Orleans is just 15-15, 11th in the Western Conference.

It’s for a lack of effort by Davis. He has expanded his game offensively. Playing center regularly, his defensive responsibilities are as great as ever. And he leads the NBA with 37.0 minutes per game.

“You don’t have Secretariat run half the race then step out because it might be too far,” Pelicans coach Alvin Gentry said. “No. You’ve got a great player, you use him the best you can.”

New Orleans has little choice but to lean heavily on Davis. With him on the floor vs. off, the Pelicans score 9.7 more points and allow 6.2 fewer points per 100 possessions.

Put another way: New Orleans plays like a 59-win team with Davis and a 20-win team without him.

Here are the leaders in win-rate difference with off-court on the left, on-court on the right and difference between (minimum: 300 minutes):

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It helps Davis plays a large majority of minutes with Jrue Holiday, who actually rates better by this metric. But Davis is clearly driving New Orleans’ success.

Not only does Davis lead the NBA in real plus-minus (+7.11), he does so with an unparalleled two-way efficiency. Nobody nears his combination of offensive (+3.73) and defensive (+3.38) real plus-minus.

Here’s every NBA player by offensive and defensive real plus-minus with the positive outliers’ photos:

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Davis is producing in all his usual ways – 28.1 points, 12.4 rebounds, 2.8 blocks and 1.7 steals per game. But he’s also averaging 4.7 assists per game, more than double his previous career high.

The Pelicans increased their pace and passing last year, and the system did wonders for setting up Davis. But they lost key component Rajon Rondo in free agency last summer, and replacement starting point guard Elfrid Payton has missed most of this season due to injury.

So, Davis has stepped up.

He’s done it while continuing to protect the ball, an overlooked but important aspect of his game. His assist-to-turnover ratio is better than 2-to-1, impressive for a big.

Davis faces frequent double-teams and generates many of his assists by passing out of those:

After scoring so well in transition for so long, Davis is now taking advantage of his speed by playmaking in the open court:

Davis has also become adept at flipping short passes to a teammate then walking into a screen ball screen. That threat has sparked more creative options with Davis’ improved distributing abilities:

Davis’ teammates appear invigorated to receive his passes.

They run the court with him on fastbreaks. They cut actively. They re-position themselves around the 3-point arc to create passing angles.

With Davis attracting so much defensive attention, openings abound.

“He just finds me, and it’s an easy look,” said Nikola Mirotic, who’s shooting 70% on 2-pointers and 52% on 3-pointers off passes from Davis.

Davis keeps putting more on his plate. He said he has to play nearly perfectly for the Pelicans to win, and he hasn’t shrunk from that responsibility. In fact, he keeps raising his personal standard.

New Orleans is trying to keep up. The Pelicans are reportedly one of the most active buyers on the trade market, but they lack trade chips beyond their draft picks. Davis is propping up a mediocre supporting cast.

Of course, Davis will be eligible for a super-max extension – which projects to be worth about $240 million over five years – this offseason. That will be the moment of truth for his future in New Orleans.

Most players so good on teams so bad would have left already.

But Davis – for now, at least – is still with the Pelicans, still doing everything he can to carry them.

“Being the guy on the team, the leader, franchise player you say,” Davis said, “the team asks a lot of me. So, anything less than what they expect, it’s on me.

“Anybody who wants to be that great player, it comes with the territory.”

Jimmy Butler may miss 76ers-Pacers

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Coming off just their second home loss of the season, a 127-124 defeat to the visiting Brooklyn Nets on Wednesday, the Philadelphia 76ers now have to deal with the freight train that is the Indiana Pacers at 7:30 p.m. on Friday at Wells Fargo Center.

Indiana has won five straight, including a 16-point win over the Milwaukee Bucks on Wednesday night, the team’s seventh win in nine games. The Pacers have crept up to within a half-game of Philadelphia in the standings at 18-10 (the Sixers are 19-10) by relying on one of the deepest offenses in the league.

On Wednesday in the 113-97 win over the Bucks, Indiana had six players in double-figures (Milwaukee had four) and the Pacers’ reserves outscored the Bucks’ 34-25. Indiana’s backups also stifled a Milwaukee offense that shot 41 percent from the field and 25 percent from 3-point range, with Giannis Antetokounmpo finishing with just 12 points.

“That second unit is back intact and we want to continue to build off of what we are doing and establish ourselves as this team that keeps guys out of the paint and focuses on limiting rotations so that teams are trying to beat us over the top,” head coach Nate McMillan said. “That way we can stay at home with our man, box out and rebound.”

With Victor Oladipo back from a knee injury that sidelined him 11 games, Indiana is back at a full complement of players and climbing in the East.

“Guys stepped up and played huge,” Oladipo said after his first game back. “Myles (Turner), Thad (Young), D.C. (Darren Collison) hit big shots down the stretch. I’m just glad to be back to help.”

Oladipo’s return complicates things for the 76ers, who could be without star Jimmy Butler for the second straight game with a strained groin. Butler’s absence was missed against the Nets on Wednesday as Brooklyn shot 51 percent from the field, with Spencer Dinwiddie contributing a career-high 39 points off the bench.

“When you look at the bench scoring, we got hurt there tonight; I give their bench credit,” Philadelphia coach Brett Brown said. “I give Brooklyn a lot of credit. I think that they are a good team to begin with. I do not feel like their record reflects how good they are, I especially know that no matter what their record said, we struggle with that type of team and we did tonight. It doesn’t discount for me that we do struggle with that type of team.”

Even with Joel Embiid‘s 17 rebounds to go along with 33 points, the Sixers still managed to just tie the Nets in boards at 41 while Brooklyn made it to the free-throw line for an absurd 43 attempts, making an even more impressive 37 of them.

“I think that some of it was bad defense, some of it was let down schematically, some of our good shooters still getting off shots, I think it’s a hybrid of them making some shots, us being a C- at times with our aggression and maybe a C schematically trying to execute a game with their individual players. I would put some blame proportionally all over the place.”

Lakers defend Rockets with hands behind their backs (video)

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James Harden made 18-of-19 free throws in the Rockets’ win over the Lakers last night.

Think that got to the Lakers? At times, they defended with their hands behind their backs.

LeBron James, via Dave McMenamin of ESPN:

“Just trying to defend without fouling,” said James, who briefly locked his hands behind his body on a Rockets possession in the third quarter. “That’s a point of emphasis any time you play Houston. They got guys that can sell calls really good — Chris [Paul] and James [Harden] — so you got to try to keep your hands out of the cookie jar.”

This is what Harden – and, to a lesser extent, Paul – do. Harden is so good at drawing fouls. That’s a skill – one that pays off in numerous ways.

It generates efficient free throws. It puts opponents in foul trouble. And it irritates opponents.

The Lakers sabotaged themselves to prove a point. That’s how in their head Harden and the Rockets got.

Maybe it’ll pay off in the long run, with referees second-guessing fouls Harden draws. But last night, it just exposed the Lakers’ frustration.

Report: Kentavious Caldwell-Pope looking for Lakers to trade him

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Lakers guard Kentavious Caldwell-Pope has come up in trade discussions with the Suns (for Trevor Ariza) and Rockets.

But this isn’t necessarily driven by Los Angeles, Phoenix or Houston.

Tania Ganguli of the Los Angeles Times:

While sources confirmed that there have been discussions about trading Caldwell-Pope, the legwork is being done on Caldwell-Pope’s side to find him a better situation.

Caldwell-Pope is playing just 21.6 minutes per game, by far his fewest since his rookie year. Ostensibly, Caldwell-Pope – a 3-and-D shooting guard – would thrive with LeBron James. But Josh Hart has proven to be an even better match with LeBron and seized most minutes at shooting guard. This just might not be the optimal personality fit for Caldwell-Pope.

Because he’s one a one-year contract and would have Early Bird Rights afterward, Caldwell-Pope automatically gets the right to veto any trade (as he’d lose his Early Bird Rights with a new team). He also shares an agent, Rich Paul, with LeBron. So, Caldwell-Pope has a lot of power in this situation. The Lakers don’t have to trade him, but if they deal him, they must send him to a destination he prefers.

Caldwell-Pope is incentivized to accept a trade, though. If dealt tomorrow – the first day he can be traded – he’d earn a $1,189,831 trade bonus. That amount decreases $10,169 daily.

Caldwell-Pope’s $12 million salary is reasonable. He’s just 25 and has a skill set most teams crave. If he wants to leave Los Angeles, the Lakers should likely find a trade that works for everyone.