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NBA Injury Analysis: In Street Clothes...

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

Tony Parker

Anyone who has been involved in basketball on any level has seen an ankle sprain like the one Tony Parker suffered last week. He tried to plant his foot to take off for a lay-up but instead landed on the foot of another player and inverted his right ankle. It seems like they happen more often on the way down from a jump, not the way up.

When I see a bad sprain like Parker's, it always surprises me that it doesn't happen more often -- the mechanism so simple, Especially at that level when the players are so big, so fast, and get so far off the ground.

For the Spurs, the issue now is how long they'll be without their starting point guard -- and current second leading scorer in the league (behind Lebron James).

A grade two or three ankle sprain involves drastic swelling. They typically blow up appearing twice their size or more and the pain can be excruciating. Usually players are unable to walk without crutches for at least a day or two. Diffuse ecchymosis or "black and blue" shows up a day or two after the injury and usually stays around for a week or more. The swelling is really the challenge for these athletes and their sports medicine teams to tackle. Gravity pushes all that extra fluid down to the foot and the toes, so therapy is aimed at getting it back up the leg and eventually circulated out of the area completely.

Never is the term RICE (Rest, Ice, Compression, and Elevation -- a common acroynm used by sports medicine professionals) more appropriate. Rest is necessary because of the pain. In this case it will be a few weeks at least before he can even attempt to run. Ice helps to slow down the inflammation and reduce pain and swelling. Compression and elevation is used to work that fluid away from the ankle so they can regain full range of motion and eventually strength. Unfortunately this doesn't all happen over night. Just ask the Jazz who finally had their All-Star point guard Deron Williams back in the lineup this week after he twisted his ankle all the way back on October 18th.

Luckily for Utah, they got off to a hot start even without Williams. The Spurs... not so much. A 2-5 start won't bury anyone, especially a veteran team like San Antonio, but they are already without Manu Ginobili, who had off season ankle surgery, until December at the earliest. Now it looks like Parker will be on the shelf the same amount of time. The big man in the middle will definitely have his work cut out for him the next few weeks in a typically tough Western Conference.

Kirk Hinrich

Another point guard went down last week, the Bulls Kirk Hinrich. He left a win over Phoenix on November 7th with a sprained right thumb he suffered attempting a steal from Amare Stoudamire. The injury is to his ulnar collateral ligament, -- not the one in the elbow that affects tons of baseball pitchers every season -- the one in the thumb. The ligament is located in the webbing between the thumb and index finger, and serves to prevent excessive movement of the thumb away from the rest of the fingers.

When that ligament tears completely, usually from the exact mechanism it's meant to prevent, it's nearly impossible to grip anything effectively, especially a basketball. Surgery to reattach the ligament was done earlier this week, but it usually takes at least three months before a basketball player can make it back onto the court, especially when it involves a point guard's dominant hand.

So what next for the Bulls? We know they're loaded in the back court, maybe not with overwhelming talent, but definitely with numbers... and should have Larry Hughes back from his dislocated shoulder soon... but Hinrich's absence is likely to put even more pressure on first overall pick Derrick Rose, already Chicago's leading scorer.

Jason Richardson

We recently learned that Jason Richardson had exploratory surgery on his right knee this week. I'm sure this comes as a surprise to most of his owners out there, but it doesn't sound like a big deal -- at least not yet. Exploratory procedures are done to assess some kind of pain or swelling that doesn't have an obvious cause evident with normal diagnostic tests like x-ray, MRI, CT scan, etc. There's really nothing done during the surgery, just a look around through a scope, and all reports apparently are very positive.

There was no major structural damage in there so he should only miss a few days, just enough to give the small incision where the scope was inserted a chance to heal. That being said, there had to be some inflammation or pain to prompt the surgery so this may not be a done deal yet. I expect him to be back on the court in a few days, a week at most, but this is still a situation that bears watching.

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

Article first appeared on 11/14/08