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NBA Injury Analysis: Training Camp Notes

Jeff Stotts

Jeff Stotts works as a Certified Athletic Trainer (MAT, ATC, PES, CES). He won the 2011 Best Fantasy Football Article in Print from the Fantasy Sports Trade Association.

With players reporting to training camp this week, it's time to take a look at the injuries fantasy owners should be considering when entering drafts over the next couple weeks.

Dwight Howard
The Dwightmare is over and the end results have the threeĖtime defensive player of the year donning Lakersí purple and gold. However, before he can join his teammates on the court, he has to completely recover from back surgery that prematurely ended his final season in Orlando.

In late April, Howard underwent a lumbar microdiscectomy to relieve a herniated disk in his lower back. To help people understand what is occurring when a vertebral disk herniates, I always use the analogy of a jelly-filled donut. The baked dough on the outside of the donut is comparable to the outer portion of an intervertebral disc known as the annulus fibrosis. Like the jelly inside the donut, in the middle of the outer portion of the disc sits a softer center known as the nucleus pulposus. When constant pressure is applied to the disc, or if the disc is violently wrenched, the pulposus can bulge out just as jelly would squirt out of the donut if you were to squeeze it in your hands. However, a bulging disc can be much more problematic than a flattened donut. The bulging disc will often irritate neighboring nerves in the back, causing shooting pain and radicular pain in the lower extremities. A microdiscectomy is carried out to remove the bit of disc that is impinging on the nerves. The surgery is minimally invasive, with a small incision being made along the midline of the back. By performing the surgery this way, the ligaments and the muscles are left untouched, speeding up the recovery process.

Several players including Rudy Fernandez, Martell Webster, and Baron Davis have undergone surgery for disc-related problems in the past and all bounced back. However, those three didnít have the physical stature of Howard. He will need longer to completely recover, and itís likely the Lakers will continue to be conservative with their handling of their new big man. He has spent the last few months rehabbing the area and strengthening his core muscles. His hard work has allowed him to be a limited participant in the early days of training camp, but his status for the preseason and the start of the regular season remains in question. I think weíll see Howard in the regular season opener against the Mavericks, but the Lakers are talented enough that they can give him as much time as needed.

John Wall
Someone might want to wrap Kyrie Irvingís and Anthony Davisí knees in bubble wrap. Since Greg Oden was drafted in 2007, four of the last six No. 1 overall picks have missed substantial amount of time with knee injuries. Oden has been forced to miss multiple seasons after requiring microfracture on both knees. Rose, the first pick of the 2008 draft, is currently recovering from a torn anterior cruciate ligament (ACL) in his left knee. 2009ís first pick, Blake Griffin, missed his entire rookie season with a stress fracture in his left knee, and now John Wall joins the list with a similar injury.

The Wizards recently announced that Wall would miss eight weeks, and likely the first month of the season, recovering from a nontraumatic stress injury in his left knee. A stress injury indicates the ailment is not likely a true fracture but does show signs of bone tissue damage. The body treats the injury just as it would a fracture, laying down new bony tissue to repair the area. Unfortunately for Wall, the biomechanical properties of the kneecap can make recovery difficult and unpredictable.

The knee, or patella, is a sesamoid bone, meaning it ďfloatsĒ within the tendon of a muscle. In this case, the patella is imbedded within the tendon of the quadriceps muscles. This location allows the patella to increase the moment arm of the tendon, increasing the moment or torque and subsequently improving range of motion. However, for the patellar to move and adequately perform its job, it has to come in contact with various aspects of the joint, particularly the femur. This repetitive contact makes it difficult for a fracture to heal and often prolongs the rehab process.

With a new cast of characters in Washington, a healthy Wall remains an intriguing fantasy option. However, the injury can be difficult to manage, and as a result, he needs to be moved down draft boards.

Fast Breaks

Chris Paul: Paul needed offseason surgery to repair a torn ligament in his right thumb. Following a surgery of this nature, the primary focus in rehab is regaining range of motion. Reports suggest Paulís range of motion is not an issue and that the point guard is making good progress in his rehab efforts. The team expects he will return to full activity soon, and he remains an automatic first-round fantasy selection.

Blake Griffin: The other big name on the Clippers is also recovering from surgery after needing offseason surgery to repair a torn medial meniscus. The injury prevented Griffin from taking part in the London Olympics and raised some questions about his durability. The left knee has been an issue throughout his career, but Griffin has looked fresh in training camp and hopes for another big year. His risk for injury remains higher than most, and he should be drafted accordingly.

Derrick Rose: Rose continues to make strides in his return from ACL surgery and plans on making cuts for the first time in the near future. Still, complete recovery from an injury and surgery of this magnitude can take up to a year to occur. I still think we see Rose at some point this season, but itís impossible to guess when that will be. Donít be shocked if itís after the All-Star break.

Chris Kaman: A minor back sprain limited Kaman during his first few practices in Dallas, but he has returned to action and hopes to play in the teamís first preseason game in Germany. Kaman has had trouble staying healthy, but this latest ailment appears minor.

Royce White: It is well known that the Houston rookie suffers from an anxiety disorder that makes flying extremely difficult. What people tend to overlook is White also suffers from obsessive compulsive disorder, complicating the situation. The Rockets and White are working on a system that will enable White to travel by bus to certain games, easing his anxiety while providing structure and routine to his schedule. However, the travel could eventually take a toll on his energy levels, and a dip in productivity could result. White remains in line for minutes but may not provide the consistency needed to make a significant impact in fantasy.

Jeff Stotts is a Certified Athletic Trainer, MAT, PES and the Injury Analyst for You can follow him on twitter @RotoWireATC.