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NBA Injury Analysis: In Street Clothes...

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

Dirk Nowitzki - DAL [PF]

Chances are the Mavs will be without reigning MVP Dirk Nowitzki for the remainder of the regular season after the high ankle sprain he suffered in last Sunday's loss to their interstate rivals from San Antonio. Apparently, as most reports out of Dallas indicate, he was lucky it wasn't much worse, but you won't find many Dallas fans out there who agree if the team goes say 2-8 down the stretch and misses the playoffs.

A high ankle sprain is different from the common ankle sprain we hear so much about in basketball in a couple ways. First the mechanism is different -- usually resulting from an inversion sprain, when the foot turns outward (as opposed to an inversion sprain when the foot rolls inward). An inversion sprain causes injury to the ligaments on the outside of the ankle around the prominent bone (the lateral malleolus, or the distal end of the fibula) that makes up the outside of the ankle.
A high ankle sprain may cause injury to the lateral ligaments of the ankle but also involves the syndesmotic ligament that sits above the ankle joint and wraps around the distal end of the tibia and fibula. Normally this ligament holds the tibia and fibula tightly together when people are bearing weight. When injured, the two bones may spread apart, ever so slightly, causing severe pain and instability in the ankle.

For this reason the length of time for an athlete to return to sports can be much longer, a minimum of three to six weeks, but can take months, especially on the hardwood. Many times athletes must be completely non-weight bearing for the first week or so as the swelling is treated and the syndesmotic ligament begins to heal. Then range of motion exercises and light resistance exercise starts, along with underwater or body weight adjusted treadmill running. Finally, when he is close to pain free walking, he'll start some light running and hopefully after a few more days, will pick up a ball and get back into practice.

The knee sprain is obviously secondary and should heal by the time his ankle is ready to go. The playoffs start roughly three weeks from tonight so he is right on that edge. My guess is he is out for the rest of the regular season, and assuming the Mavs make the playoffs -- no guarantee at this point -- he'll give it a shot. With the long layoff, he might not be the player we all expect, but by then there is really nothing left to lose.

Brandon Roy - POR [SG]

From the reigning MVP to last year's Rookie of the Year, the news is not much better. Brandon Roy makes this column again after he was removed from last Tuesday's win over Washington with a strained right groin. Most of the athletes out there know the groin is a group of muscles the runs from the inside part of the knee to the inside part of the hip, and acts to adduct the leg, bringing it from a position away from the body towards the center. A healthy groin is essential for any athlete, especially those that run, constantly changing speed and direction like in basketball.

We have mentioned that strains involve injury to muscles, while sprains, (like Dirk's) involve ligaments. So he pulled his groin, a common athletic injury we've seen all year, but one that can cause players to miss significant time. Initially he said at least a week, maybe two, but realistically he's not going to be 100% for the rest of the regular season.

Treatment involves stretching exercises followed by strengthening, a gradual return to straight running and finally cutting. You can definitely hope for the best and the four or five game estimate being accurate, but in my opinion, his goal of helping the team finish above .500 may have to be done from the bench.

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

Article first appeared on 3/28/08