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NBA Injury Analysis: In Street Clothes...

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

There was a big scare in the NBA on Wednesday night when the Rockets hosted the Dallas Mavericks. And it wasn't the swollen ankle that kept Josh Howard out of the Mavs' lineup.

Howard's ankle shouldn't be that big of a deal; no one seems to be too worried. Of course there are tests pending and you never know with ankle injuries... more on that later.

Yao Ming

It might be a different story for Houston who was without center Yao Ming for the contest, and almost played minus Ron Artest and Tracy McGrady as well. Yao supposedly sprained his ankle during Monday's game, and just needed a rest. But after some tests were done on Tuesday, he was on the bench Wednesday awaiting word on whether it would be just a day or two, or a few months. That's a rather big window to deal with, and there hasn't been anything real concrete reported since, so we will all have to wait and see. Could he have aggravated the area of his foot that still has a surgical screw in it from last season's surgery? Sure. Is it also possible that he just tweaked his ankle a bit and team doctors are just being cautious early in the season with a vital player? Of course. When will we know the answer? That's difficult to say, but hopefully soon. The Rockets play in Washington tonight so there should be some more news before tip-off. Those getting ready to scream that he had no business playing in the Olympics this summer will have to stay tuned.

Ron Artest

Yao's teammate Ron Artest left Monday's game early but it only turned out to be a mild ankle sprain. He missed practice Tuesday but played 43 minutes against the Mavs Wednesday.

Tracy McGrady

Right now Artest is not the concern, but Tracy McGrady seems like he'll be a constant worry this year. Earlier this week he mentioned shutting himself down for a while to rest his ailing knee. He referred to the pain he felt Monday as similar to what led him to surgery in the first place. That's not very promising news from a player that has battled his share of injuries over the last few years. Optimistically, he had an MRI scheduled on Tuesday, but cancelled it, and unlike Artest, he was able to practice on Tuesday and played in the game Wednesday so maybe this is just a fatigue issue more than anything else. He'll probably get some more rest in between games and reduced minutes during them. He played only 29 on Wednesday. And he'll need to spend time strengthening the whole lower extremity while treating any swelling that develops along the way. If he develops a plan that helps alleviate the symptoms and still be productive for the team, it could work for McGrady. If not he really could be facing a similar situation to what he endured last spring and be in for a very long season plagued by injury. You hate to think that I know but anything is possible and we are again reminded that no surgery has a perfect outcome 100% of the time.

Josh Smith

As for the dreaded sprained ankle, we have to add a few more to the list. Josh Smith originally went down November 7th against the Raptors. He spent a week on crutches, then a few days in a walking boot, and is now approaching the early side of the two to four week estimate he was expected to miss. He's been able to walk on a treadmill but hasn't stared running so I think it's safe to say at this point that he won't make that mark. Coach Mark Woodson expects Smith to miss another four or five games at least. That doesn't sound like much, but it still takes him at least into the first week of December for a couple home games against Memphis and New York.

Michael Redd

Michael Redd sprained his right ankle a few days before Smith, during a November 22nd Bucks win over the Knicks. Initially he was listed as day-to-day but that turned into doubtful, and now he's up to nine games on the shelf. He has been involved in team shoot-arounds the last few days and could be nearing a return, maybe even Friday's contest against the same Knicks, but it wouldn't surprise me to see him miss a few more. It's still early and these November games will be a distant memory when playoff position is on the line in the spring. Keep that in mind.

Deron Williams

Finally what are we to think of Deron Williams's situation? He originally sprained it during a preseason game on October 18th, finally making it back the Jazz lineup November 11th. That's about what you can expect from these injuries but what surprises me is not that he played 30 plus rather unremarkable minutes in that first game, but that he returned the following night to play another 30. That's a lot of run after a long layoff, especially with that injury and at that position. Williams openly admitted that he rushed back too soon, and may have over-done it. Coach Jerry Sloan seemed to leave it all up to Williams who, as most athletes do, told his coach he was fine when he clearly wasn't.

The bottom line is that he hasn't played since, and is still undecided for this weekend's games versus the Spurs and Grizzlies. He has practiced the last few days which is obviously a good sign but like I said earlier, with ankle injuries in the NBA, you never know.

Carlos Boozer

The Jazz are probably also going to be without forward Carlos Boozer for a time because of a strained left quad he suffered Wednesday night in a win over the Bucks. Right now he's considered doubtful for the weekend. Quad strains can be every bit as debilitating as hamstring strains. You don't hear about them as much in basketball because of the sheer size and strength of the quad muscles compared to their counterparts in the back of the thigh, but this is still something to watch. Again, it's early.

Other Updates

Jason Richardson is still a few games away from returning to the lineup for the Bobcats. So far there's nothing major to report from the exploratory surgery he had on his right knee last week, just another few games to allow the inflammation to go down. Still, keep an eye on his return.

The Pacers' Mike Dunleavy, who we covered a few weeks ago, was said to be battling patella tendonitis in his right knee, but a later report from coach Jim O'Brien tells us he may have a bone spur in there as well. That makes sense because he really hasn't improved over the last few weeks, and is still unable to practice with the team, let alone start playing in games. Tendonitis, as we will see all year, is a chronic condition that affects the point a tendon attaches to a bone. In this case it's the patella tendon, which runs from the bottom of the kneecap to a spot on the tibia a few inches below it. Bone spurs can develop anywhere in the body when there is constant pull or irritation placed on bone, especially in a knee affected by tendonitis. In response the bone actually grows out from where it should be anatomically in an attempt to cover more space and protect the injured area. It's a defense mechanism the body uses to help stabilize joints, especially in aging people, but it can be extremely limiting and painful to an athlete if those spurs irritate other soft tissue around it. In this case the spur could be either on the kneecap or the tibia, but either way it's obviously causing pain. Supposedly surgery in not an option yet, but be prepared because it very well could be. You can take all the anti-inflammatory medication you want, and do all the rehab possible, but once a spur forms, its there for good. It may have to be shaved down at some point and forget it if it breaks off and ends up floating around the end of that tendon. Then it will have to come out. He might be able to play after some more rest. He may learn to tolerate the pain, and get through games with a reduced workload in practice in between, but this doesn't sound like something that's going to go away soon.

As for Manu Ginobili and Gilbert Arenas, they appear to both be on schedule but are still a few weeks away at the earliest. Manu looks like early to mid December, and Arenas more towards the end of December. Stay tuned for more updates as they become available.

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

Article first appeared on 11/21/08