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In Street Clothes

Covering sports injuries from the perspective of a certified athletic trainer and backed by analytics.

Wizards’ Bradley Beal Out With Stress Injury

Wizards guard Bradley Beal was recently diagnosed with a stress injury in the proximal end of his right fibula and now faces a two-week period of rest. Following the recovery period, he will be reevaluated and an appropriate decision will be made regarding his return to play workload.

The majority of bones in the human body endure some sort of stress with day-to-day activity. As you elevate your levels of exercise, the amount of force applied to your bones increases as well. Your body’s natural line of defense responds to these stresses and will actually remodel your bone to keep up with the high demands. In bone remodeling, worn out tissue is absorbed and new healthy bone tissue is formed and fills in the gaps. However occasionally reoccurring and constant stress is placed on a bone and the remodeling process is unable to keep up. If new tissue formation is unable to keep pace, a stress injury occurs.

A stress reaction is the precursor to a true stress fracture. Stress reactions are often accompanied by localized pain and require a period of rest to allow for the remodeling process to catch back up. If activity is continued or resumed prematurely, a stress reaction can easily develop into a stress fracture as the involved bone breaks. Stress fractures, particularly in the foot and knee, can be very problematic and even require surgical intervention.

Stress injuries are relatively common in basketball given the high demands of an 82-game schedule. The most frequently injured bones include the metatarsals of the foot, the back, and the patella. The lower leg bones, the tibia and fibula, are also vulnerable to stress injuries but the tibia seems to be more prone to injury. This makes sense considering the tibia bears a larger amount of weight.

Still here we sit with Beal nursing his second stress injury in his right fibula in less than a year. His first injury occurred late last season when he missed the final eight regular season outings with a stress reaction in the distal end of his fibula. It kept him from participating in Team USA minicamp and summer league but appeared to be behind him entering the season. The newest ailment is being called a stress injury but given the two-week window, it seems reasonable to believe it’s a stress reaction. The location of the injury is also unique as it involves the proximal end of the bone, closer to the knee than the ankle. Stress fractures to this area are actually fairly rare, appearing more often in military recruits.


Even if Beal’s current injury is just a stress reaction, he is not out of the woods just yet. Consider Manu Ginobili. In the 2008-09 season Ginobili missed 19 regular season games (five weeks) with a stress reaction in his fibula. He appeared in six straight games before he was diagnosed with a true stress fracture in the same bone, ending his season and sidelining him through the playoffs.

Given the possibilities and his previous injury history, look for Washington to handle Beal extremely conservatively. It would also be beneficial to determine the root of the problem and find out why the guard continues to have issues with his area of his leg. In the meantime the Wizards will turn to a committee of backcourt players including Trevor Ariza, Martell Webster, and potentially Garrett Temple and Glen Rice Jr. to fill the void left by the team’s leading scorer.