In Street Clothes...

In Street Clothes...

by Jeff Stotts
RotoWire Injury Expert




The life of a NBA player can be physically taxing. 82 games is a grueling schedule that is extended by a long postseason. With very few days off and many players involved in international competition in the offseason, it is not surprising to see chronic injuries beginning to creep up on some players. Muscles and joints begin to ache and fantasy owners must keep a close eye on day-to-day lineups to insure their players are lacing up the sneakers that night.

Joakim Noah
Chicago's Joakim Noah is battling rotator cuff tendinitis and recently received a cortisone injection to manage the injury.


The shoulder joint, in particular the glenohumeral joint, is stabilized primarily by the musculature that surrounds and engulfs the area. The deltoid, pectoralis major, and several other muscles provide the primary support while a group of muscles known as the rotator cuff supplies additional reinforcement. Made up of the supraspinatus, infraspinatus, teres minor, and subscapularis, the rotator cuff not only supplies stabilization but allows for the motions necessary to reach overhead when rebounding and shooting. The tendons of the cuff tightly adhere to the joint capsule of the shoulder and can be impinged by the surrounding bony structures often leading to chronic rotator cuff injuries.


Additionally, like in Noah's case, the tendons can become inflamed and irritated causing pain when the muscles are used.  While a period of rest, followed by a strengthening program, is the most efficient course of action, Noah and the struggling Bulls don't have the luxury of time. Instead Noah recently received a cortisone injection in his shoulder. 


Cortisone is a strong anti-inflammatory steroid naturally produced in the human body. In a cortisone injection, synthesized cortisone is injected into an area of the body to treat the inflamed area. As the inflammation subsides, the athlete often gets a relief from the pain associated with the injury. Noah should be able to continue to play but if the pain returns and is too severe, the second-leading rebounder in the league may have to sit a game or two.

Allen Iverson and Louis Williams
Allen Iverson is back with the team that drafted him but a variety of injuries have slowed the veteran's return. The Answer is currently dealing with a stress reaction in his right fibula as well as arthritis in his left knee. The fibula is located on the outside of the lower leg and is the smaller of the two lower leg bones. Often repetitive stress associated with running and jumping can lead to the development of a stress reaction, a precursor to a more severe stress fracture. The injuries often produce an achy pain that increases with activity. Iverson has stated that the injury did not bother him in his most recent game but should be monitored to insure it does not develop into a more serious stress fracture.

To complicate things, Iverson is also battling arthritis in his left knee. Arthritis is a chronic condition that occurs when the cartilage surrounding a joint begins to breakdown. Healthy cartilage serves as buffer in the end of most bones and permits easier motion and gliding at joints. When arthritis sets in and the cartilage breaks down, bones in joints like the knee begin to rub on one another causing pain, stiffness, and fluid accumulation. The fluid that collects at the joint is often aspirated, or drained, in an attempt to decrease swelling and allow for more range of motion.  Iverson has had the knee drained twice; including 55 cc's of fluid drained in the initial procedure, and will not play on Friday when the Sixers visit the Celtics.

Willie Green could shift into the starting lineup while Iverson sits but Philadelphia may roll the dice and rush guard Louis Williams back from injury. The guard was in the middle of a breakout season, averaging 17.4 points and 5.1 assists, before fracturing his jaw in late November. He has since missed the last 11 games for Philadelphia. Fortunately for Sixers fans and fantasy owners, Williams has returned to practice and recently had the wiring removed from his jaw. The wiring has prevented him from eating solid food and Williams may need to gain several pounds of weight back before he can be effective.

Chauncey Billups and Larry Hughes
Nuggets point guard, Chauncey Billups, is expected to miss several games while dealing with a strained left groin suffered in Wednesday's win over the Rockets. While a MRI confirmed the strain, it is believed to be minor. The groin is a group of muscles known as the adductors. Located on the inside and front of the thigh, the main responsibility of these muscles is to pull the leg inward in a motion known as adduction. The ability to adduct is crucial for athletes, particularly guards dependent on the ability to move laterally while making sharp cuts and attempting to play defense. Earlier this season Nets guard Devin Harris suffered a similar injury and missed 10 games but Billups' strain is not considered as severe. Veteran Anthony Carter will likely start in Billups' place with rookie Ty Lawson seeing more minutes off the bench. JR Smith will also handle the ball more while Billups is out. Closely monitor Billups' minutes and productiveness upon his return as groin injuries tend to linger and may bother the point guard for awhile.

Knicks guard Larry Hughes is also dealing with a minor left groin strain and was inactive against for New York on Thursday. Coach Mike D'Antoni relied heavily on his starters to step up in Hughes' absence as four of the five starters played over 40 minutes in the loss to the Bulls. Hughes is expected to miss one more game with the groin injury but like Billups, scale back your expectations for his first several games back.



Article first appeared on 12/18/09

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ABOUT THE AUTHOR
Jeff Stotts
Jeff Stotts works as a Certified Athletic Trainer (MAT, ATC, PES, CES). He won the 2011 Best Fantasy Football Article in Print from the Fantasy Sports Trade Association.
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