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NBA Injury Analysis: In Street Clothes...

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

Yao Ming - HOU [C]

Yao Ming was sidelined earlier this week with a stress fracture in his left foot; terrible news for a team that is otherwise rolling through a 13 game winning streak. Reports indicate he's been in pain since the All-Star game so he finally underwent an MRI on Tuesday, revealing the stress fracture. Apparently the news was a shocker to the Rockets but that's often the case with stress fractures.

Nothing happened that night; there is rarely a traumatic injury or event with these types of fractures so the diagnosis can be unexpected. Stress fractures develop over time from constant pressure or stress, causing tiny little cracks that eventually become bigger and bigger, and more and more painful. That's why you normally only see them in the weight bearing bones of the lower extremities. So if the pain didn't start during the All Star game, it would have come soon anyway. Human bone is constantly being broken down and built back up by the body. In these cases, bones break down faster than they are grown back His injury is to his navicular, the bone that attaches the midfoot to the ankle. It's located in the back of the arch, behind the long first metatarsal and the medial cuneiform, two boned that make up most of the inside of the foot. Team physicians have said that the injury was caught relatively early, making the long term prognosis good, but the bone is so weak at this point that he may need surgery. Pins or screws could be inserted into the bone across the fracture to strengthen it and facilitate a better recovery. The screws would stay, but after about 4 months, he could be back on the court. The other option is to cast it for a period of time, probably two to three months, and stay off it completely for a few more weeks in a boot or walking cast so it has a chance to heal. He is reportedly seeking a second, and maybe a third opinion, but either way, the rehab process will be long and arduous.

Because he'll be non-weight bearing for such a large part of it, atrophy, or muscle weakening from lack of use, will slow him down but that's hardly on anyone's mind today. Instead, it's the reality that we won't see Yao in uniform again until the summer Olympics come around this August and he's on next season's fantasy cheat sheets.

Gerald Wallace - CHA [SF,PF]

The foot injury that kept Bobcats star Gerald Wallace out the last couple weeks is hardly an issue now after the scary scene on the court last Friday in Charlotte when he was carted off, unconscious, after talking an inadvertent elbow from the Kings Mikki Moore.

Concussions, no matter how mild, involve temporary injury to the brain as it basically bangs up against the inside of the skull. They are also called mild traumatic brain injuries because they do impair brain function. Symptoms include headaches, nausea, fatigue, dizziness, amnesia, ringing in the ears, and sensitivity to light and noise which could last weeks. His was diagnosed as a grade three concussion, the most serious, due to the fact that he was largely unconscious from the time he went down until he arrived at the hospital for tests. A CT scan was done ruling out any intracranial bleeding, and an x-ray cleared him from any cervical spine injury, so he was released from the hospital to rest.

The issue with Wallace is that this is his fourth reported concussion in the last four years, and symptoms tend to last longer with repeated injuries. As we often see in football, they also can occur with less and less force each subsequent time. The team has indicated that the player nicknamed "Crash" for his aggressive play, will be out at least two weeks, but I would say that is optimistic to say the least. The plan after these injuries is to wait until the athlete is completely symptom free: no headache, no anything, then very gradually return them to light exercise and finally full contact practice.

As I said, this is fourth "reported" concussion in four years -- he may have had others that he didn't tell anyone about. That is often the case with athletes who have sustained multiple concussions because they know most of the symptoms and the severity compared to others they've had. They also know that they'll likely be held out for a period of time, so they don't report them. I'm not saying this is the case here, but symptoms could realistically last for weeks into months. We won't know until reports from Charlotte are out, but expect caution, and rightfully so. Then the team will face the real challenge of getting a player with his aggressiveness and talent to "tone down" his style of play after a lifetime playing that way. Much easier said than done.

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

Article first appeared on 2/29/08