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NBA Injury Analysis: In Street Clothes...

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

Greg Oden

Last season we opened the injury discussion in the NBA with the number one pick in the draft, Portland center Greg Oden, who ended up missing the entire 2007-08 regular season after undergoing miocrofracture surgery in his right knee. We're opening the 2008-09 season with the same player. You can call it ironic. I just think it's unfortunate.

Oden had finally recovered from the knee injury and subsequent surgery that kept him on the bench all last season, and even earned a contract extension in the mean time that will keep him with the Blazers until 2010... all this before suiting up for his first game in the NBA. He had a somewhat productive preseason for a rookie, averaging 11.5 points, and 7.8 rebounds in roughly 23 minutes, but his NBA debut lasted only 13 minutes after an awkward fall in the first half of Tuesday's opener in LA. Oden stepped on Derek Fisher's foot while trying to gather himself under the basket, and inverted his right ankle.

That type of mechanism usually results in an ankle sprain, but his injury was described as a lateral foot sprain. Lateral simply means to the outside of the body, or away from the midline, and a sprain is an injury to a ligament. Usually this is not a big issue, one that should heal well with a few weeks of rest and a progressive return to basketball, but there are reports that there were some avulsion fractures as well.

Ligaments and tendons attach to bones. Sometimes when excessive stress is placed on one of these structures, they tear, either partially or complete. The result of a ligament injury is a sprain... a tendon injury, a strain. Avulsion fractures occur when the ligament or tendon tears off a small piece of the bone. Usually they are not as bad as they sound... the piece of bone doesn't displace that much and it eventually heals in virtually the same spot where it avulsed. But sometimes that little bone fragment can become suspended in an area it shouldn't be and athletes can have long term stability problems.

Reportedly the avulsions in Oden's foot are not serious and will not require surgery. For now we can only hope. The initial prognosis is he'll be out two to four weeks. He's probably in a walking boot that supports his midfoot and ankle, but should be able to start physical therapy right away. With some rigid taping or a brace you hope to see him running again in a week or two and a return to the court soon after. I know there are a lot of people out there who have already lost faith and are set to label him one of the biggest busts the league has ever seen. The term "I told you so" will be thrown around a lot if he's not back in the lineup by the end of November, but we should give it time. Yes this is the third straight season he will miss significant time due to an injury, and the current one definitely bears watching for any setbacks, but as we all know in this business, it's not where you start the season, it's where you finish. Hopefully for Oden and the Trailblazers, that's on the court in shorts and sneakers, not on the bench in street clothes like last year.

Andrew Bynum

On the other side on the court Tuesday night, we saw Andrew Bynum make his return from season ending knee surgery last year. He put up only 8 points and 3 rebounds in 28 minutes that first game, but returned the following night to score 12 and pull down 9, in 25 minutes of a blowout win over the Clippers. He's a young player just coming into his own and one of the center pieces on one of the best teams in the Western Conference. He also signed a huge contract extension recently... I expect his numbers to only get better as the season rolls along.

Deron Williams

Now back to that classic ankle sprain. Jazz point guard Deron Williams, another extremely wealthy young man, has been out of action since spraining his left ankle during a preseason game October 18th. Ankle sprains are usually classified in three degrees, third degree being the worst. Inversion sprains occur when the ankle rolls onto the outside of the foot and usually affect one or more of three lateral ankle ligaments. His was listed as a second degree sprain, one that usually requires at least two to three weeks of recovery time. He has started running, a big step in the rehab process, but has yet to complete a full practice with his teammates, so his return is still a few days away at best. He won't play in the home and home versus the Clippers this weekend but hopes to make it back for the November 5th game at home against the Blazers. Don't be surprised if you see a relatively slow start from Williams, but going forward, it shouldn't take long for him to cement his spot as one of the premier point guards in the league.

Mike Dunleavy

The Indiana Pacers are still without the man Larry Bird described as their "best all around player," swingman Mike Dunleavy Jr. He has been battling patella tendonitis in his right knee for over a month and likely will need at least another week before suiting up for the Pacers. Tendonitis, like the ankle sprain, is something we will talk about all year. It's so common in running/jumping sports like basketball that most of the players diagnose themselves before team doctors or athletic trainers have a chance to see and start treating it. And that's part of the problem. Tendonitis is a chronic injury that affects the point a tendon attaches to bone. In this case it's the patella tendon, which is an extension of the quadriceps muscle, and its attachment to the tibia just below the knee cap. That's an extremely strong muscle pulling on a relatively small spot on the tibia, so often it will become inflamed and painful. The problem with players waiting to report these injuries is that its progressive, meaning it will only get worse over time if not treated or rested properly. Pacers fans had better hope it hasn't got to the point where that tendon starts to tear or fray because then he could be headed for surgery to correct the problem. Now it's way too early to put Dunleavy into an operating room, but it does happen. Hopefully another week or two is all it will take to get him back into the lineup. It will take much longer for him to get into 35 plus minutes-a-game shape, but some progress will be nice.

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

Article first appeared on 10/31/08