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NBA Injury Analysis: In Street Clothes...

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

Chris Bosh - TOR [PF]

Chris Bosh finds himself in street clothes again after leaving last Friday's game with a seemingly minor knee injury. He simply walked off during a time out, but as it goes in professional sports, he had an MRI anyway. No reason to worry though as results showed no structural damage, only some irritated scar tissue and swelling. Reports at the time were that he would miss a week, three games in all, no big deal.

Unfortunately, the latest from Toronto indicates that the pain is no better than it was at this time last week, so it seems something is amiss. To me, two things stand out. First, if there's swelling then he's obviously in some amount of pain and something in his knee is irritated somehow. Second, hearing that there is scar tissue in there to begin with tells me there was an injury at some point, whether treated or untreated, that has become an issue.

Scar tissue is what the body uses to replace damaged tissue, not unlike those that form over a good gash on someone's forehead, just inside the body, but it reacts much differently than healthy tissue. It's not as flexible so a part of the body that has considerable scar tissue will often be stiff and lose range of motion, leaving athletes susceptible to future injury. That could be an old meniscus tear, some other cartilage problem, tendonitis, or a muscle strain of some kind. Either way it looks like it may be a while before we hear any more concrete news regarding Bosh, and even longer before he gets back on the court.

The Raptors play again tonight, then have eight more games in the next two weeks, six of which are on the road. I'm not suggesting there is nothing there but is it possible the playoff bound Raptors are just being cautious and resting a major player during a tough stretch? Or is there more news to come? We will have to wait and see.

Caron Butler - WAS [SF]

Unlike Bosh, Caron Butler's hip injury is becoming more and more clear to Wizards fans. What was originally treated as a hip flexor strain was further diagnosed last week as a slight labrum tear. The treatment would be the same either way -- mainly rest and stretching exercises, some strengthening and anti-inflammatory medication, but the prognosis for a full recovery could be much different. A labrum injury can be acute (as in a traumatic dislocation) or chronic (like arthritis) but doesn't heal like a muscle strain. It can be treated to alleviate the symptoms, but it's not going away.

Usually when we speak of labrum tears, we're referring to the throwing shoulders of professional baseball players due to the wide range of motion available there. Rarely do we speak of labrum tears in the hip because it is so much more stable and protected by various ligaments and muscle tissue.

The labrum is a ring of cartilage that surrounds these ball and socket joints, adding depth, stability and a certain amount of cushioning to the joint. When a piece is torn, it may cause the hip to "catch, pop, or buckle" and cause a significant amount of pain as the meeting of the two bones, the femur and the pelvis, becomes irritated, inflamed and even chronically unstable. Intra-articular injections are a possibility if the pain does not subside, but so is surgery to remove or repair the tear.

Basically it sounds like Butler is getting ready to try practice again soon. The treatment he's getting may make it tolerable to play, but he'll be watched closely by the team's athletic training staff, and will undoubtedly get shut down for an extended period of time if he's still not right. The advice here is not to be surprised if he remains on the injury reports for a while.

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

Article first appeared on 3/6/08
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