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NBA Injury Analysis: In Street Clothes...


In Street Clothes...
By Jim Russo
RotoWire Injury Expert


Kobe Bryant - LAL [SG]


NBA fans apparently will have to miss seeing Kobe Bryant compete in the three point contest this weekend, but it looks like he'll play in Sunday's All Star Game. That's a curious decision to me -- because of the recent news that he has multiple ligament tears and an avulsion fracture of a joint in his hand.



He dislocated his right pinky finger during a game against New Jersey on February 5th when he hyperextended it against Jason Kidd's arm. X-rays were negative at the time, and after a sub-par game the next night, he averaged 30 plus the next three games -- all wins. All appeared to be well.



This past Wednesday, he aggravated the injury during a win over the T-wolves and sat out the 4th quarter. They were up by thirty going in so it appeared he was simply resting, rather than being forced to the bench because of an injury. However, another visit to a hand specialist and an MRI yesterday revealed the fracture and torn ligaments. The injury is to his MCP (metacarpo-phalangeal) joint which, from the tip of the finger towards the hand, is the third joint in the finger. It's the one that more or less attaches the finger to the hand. The ligament injuries are to the volar plate, which is the thick ligament on the palmer surface of the joint, protecting that aspect of the joint and preventing hyperextension, and the radial collateral ligament, located between the pinky and ring finger, preventing excessive movement of the pinky away from the rest of the hand. You can see from the anatomy how a hyperextended finger can affect these structures and cause pain, loss of flexibility, and instability. Alone, they usually heal well after a few weeks due to the formation of scar tissue which stabilizes the joint. They don't always look pretty, often swollen in spots, even appearing crooked, but when there's also a fracture in the joint, it is much more serious, especially for athletes who depend on strong hands and fingers to grip, shoot, and pass a ball.



An avulsion fracture occurs when a tendon or ligament tears a piece of bone away from its body. The Lakers are reporting that he will not need surgery and the expected six weeks recovery time, that with treatment, a light splint and/or buddy taping (taping the pinky to the ring finger), he'll get through the season and continue making LA one of the surprise stories of this year. Surgery could be needed however if the fracture affects a large percentage of the articular joint surface or if the torn piece of bone migrates away from the spot it broke off from. It could only be a millimeter or two but if there's no surgical intervention to reattach that piece, it won't heal properly and will lead to long term instability, which is really the concern here. If his finger continually pops out, he won't be able to grip anything effectively, and surgery may be a foregone conclusion. The positives are it is his pinky, the least important finger in terms of overall strength, and all reports are that he has a high pain tolerance and has shown the tendency to play that way. Again, he did average 30 plus in 3 games after the initial injury, so assuming he didn't make it worse, and he doesn't have further problems, he should make it through. Watch closely though, as any time he grabs that hand in pain could signal bad news to come.



Josh Howard - DAL [SF]

Josh Howard bruised his lower back colliding with Sixers Reggie Evans on Monday night. After returning at first, he left for good in the fourth quarter and an MRI revealed only a bruise….painful yes, but not overly troubling if he gets a little rest over the break. He played a couple minutes Wednesday night but missed Thursday's loss to the Suns, and now should get the rest he needs. The Mavs will be cautious however as any back injury can change the way athletes run and bear weight during exercise, risking a multitude of other injuries. We'll check on him again next week, but expect a relatively quick return.



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Michael Redd returned to form this week for the Bucks and some other All Star caliber players, (Ben Gordon and Tony Parker) who won't be on the court Sunday, should see a return to action for their respective teams soon. Kevin Garnett, Caron Butler, and Gilbert Arenas may take a bit longer, but expect them all to be back for the stretch drive. We will touch up on them soon, but for now, enjoy the festivities in New Orleans.



Jim Russo is a certified athletic trainer with a Master's Degree in Exercise Physiology.



Article first appeared on 2/15/08
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