This article is part of our NBA Injury Analysis series.
In Street Clothes...
By Jim Russo
RotoWire Injury Expert
The injury story during this holiday week would have to start with a couple troublesome knees and an elbow that will be watched very closely throughout the rest of this season.
Jordan Farmar
One of the knees in question belongs to Jordan Farmar, the Lakers' backup point guard, who tore the lateral meniscus in his left knee last Friday night in Miami. Farmar twisted the knee while going in for a layup and has been unable to play since. An MRI revealed the tear, and after some opinions were shared, the decision was made to clean it up with surgery.
Each knee has a pair of menisci, lateral or towards the outside of the knee, and medial, or on the inside. The two disc shaped structures provide some stability to the knee joint, but mainly serves as soft cushioning material between the tibia and the femur that helps to absorb shock in the joint. The problem is that the material must be pliable in order to serve that purpose, so sometimes when the knee is twisted awkwardly, the tissue can tear.
There are all different kinds of meniscus tears in athletes, and just as many surgical options on how to fix them. Some players won't even feel them initially, only becoming symptomatic after months or years of chronic exposure. Obviously that's the best case scenario. Some are so small that they can just be removed (a partial menisectomy) and the frayed ends shaved down to maintain a smooth surface. Others can tear so badly that knees become locked at certain angles because the tear impedes movement of the two bones. In these cases you often hear of a complete menisectomy, when the cartilage is removed completely, or meniscus repairs, where pins or screws are placed in the meniscus to anchor it down. The prognosis for Farmar is in the 4 to 8 week range, so that tells me he's not having anything repaired. More likely, he's just getting some torn tissue removed so the recovery should be relatively quick. Considering that time range, it is still remarkable to me that players can return from an operation so quickly, especially to a major weight bearing structure, but they often do, so the team is optimistic. The result for the team will be increased time for Derek Fisher, who played 41 minutes in the first two games of Farmar's absence, and should expect that trend to continue as long as he continues to produce.
Paul Millsap
There was another injury scare for the Jazz on Tuesday, December 23rd, when power forward Paul Millsap went down with what he described as a hyperextended knee. Millsap, who has really evolved as a force since Carlos Boozer's knee injury, had a streak of 15 straight games with a double-double snapped in the game, had an MRI on the 24th and is still awaiting word on the results. He described hearing a "pop" when he initially went down, something you never want to hear, but he was able to return for the second half of the game and he's listed as questionable for tonight's contest against the Mavs, pending the results of the MRI. A hyperextension is bad enough by itself, but it often comes with a meniscus or ligament tear. Other times the patella can slip out of joint (a subluxation) or various muscle tears can happen. I have to assume that any major issue was ruled out at the time because he did return to the game, but you never know. When a player is already loose, and into a game, injuries often won't become truly symptomatic until the swelling and pain really start to set in. Either way, watch the reports from Utah for more detail as those results should be available soon.Carlos Boozer
As for Carlos Boozer, it is anyone's guess at this point. He already missed 18 games and is still troubled by the knee injury he has dealt with for more than a month. Reportedly he had another MRI, his third, to assess the joint earlier this week so there could be more reports out soon. At this point it's hard to be optimistic that a return is imminent.Mehmet Okur
Center Mehmet Okur has been battling back spasms lately and is also a game time decision for tonight's contest. He's been improving and was able to take part in most of the Jazz's practice on the 24th so hope for the best.Zach Randolph
Another big man in the Western Conference also went down this week this week with a knee injury that the Clippers have called a sprain. I haven't seen word that Zach Randolph will have an MRI but as is often the case with this column…you just never know. The Clippers have been off since the 22nd, and don't play again until Sunday the 28th, so no decision has really been needed on their leading scorer. As of Sunday night, they play three games in four nights, so that stretch should give us all the information we need on him.Carmelo Anthony
Finally, regarding that troublesome elbow injury, Carmelo Anthony missed a couple games for the Nuggets this week with what the team is now describing as bone spurs in his right elbow. Spurs usually result from chronic wear and tear in a joint that leads to little fragments of bone or cartilage growing into a spot it doesn't normally occupy. They are one way the body protects itself by adding stability to a loose or unstable joint, but it can be extremely painful for an athlete. Bone chips or fragments can result when spurs break off and get stuck inside a joint. In the elbow those fragments usually occupy the back of the joint where the ulna meets the humerus. If they get stuck in the wrong spot, any elbow extension exercise…i.e. shooting a basketball…can be extremely painful. The big problem with spurs and chips is once they're there, there's not a whole lot you can do about them except treat the pain and inflammation and protect the area with a sleeve of some type, or have them removed via a scope. Melo's been bothered by it since training camp, and despite some impressive scoring at times this season, even for him, he finally needed a break. He should be back on the floor either Sunday in New York or Monday in Atlanta, but this is another injury worth watching.
Otherwise, good luck and Happy New Year, and here's to a great '09.
Jim Russo is a certified athletic trainer with a Master's Degree in Exercise Physiology.
Article first appeared on 12/26/08
