Just 11 days after making a celebrated return to the court, Kobe Bryant will again miss time after suffering a fracture to the lateral plateau of his tibia. The injury occurred in a Lakers’ win over the Grizzlies. Bryant was attempting to back down Tony Allen when he took an awkward step, hyperextending his left leg. He fell to the ground and immediately grabbed his knee. However he would finish the game, leading the Lakers with 21 points. However, further testing later revealed the break.
The tibia is the bigger of the lower leg bones and bears the majority of the body’s weight. At the end closest to the kneecap, the tibia widens forming the tibial plateau. The menisci of the knee sit between the ends of the femur and the tibial plateau, allowing for proper knee articulation. Fractures of the area are particularly uncommon and generally occur in car accidents or falls from a great height. In both cases excessive force is driven through the femur and into the softer bone tissue of the tibial plateau. Unable to withstand the extreme force, the tibia succumbs to the stress and breaks. Indirect trauma can also lead to a tibial plateau fracture especially with excessive torsion.
On the plus side, Kobe’s fracture is non-displaced and will not require surgery. It also appears he avoided any significant soft tissue or meniscus damage. The basic treatment program is rest. Time will be needed for the bone to repair and the Lakers will take various steps to insure the bone properly aligns. The use of a bone stimulator could also help accelerate the process. However time remains the best option and don’t be surprised if this takes longer than initial estimate of six weeks. For comparison sake consider Tyson Chandler’s recent injury. Chandler suffered a non-displaced fracture of his fibular head and missed five and a half weeks recovering. Chandler’s injury occurred in a location of close proximity to Bryant’s but there is one glaring difference. The tibia bears a much heavier weight load that the fibula, suggesting it will need additional time to recover.
Furthermore previous NBA players to sustain this type of injury missed more than six weeks. Yao Ming and Lorenzen Wright both suffered tibial plateau fractures during their careers. Coincidently, like Kobe both players suffered their injuries in December. Wright was injured on December 9th, 2001 and returned on February 14, 2002 nearly 10 weeks and 33 games later. Ming went down on December 23, 2006 and did not play for 10 weeks returning on March 5, 2007 after a 32 game absence. The size of Ming and Wright likely contributed to their extended recovery window but six weeks is clearly a best-case scenario.
Other factors to consider are the numerous setbacks and complications that can arise. Compartment syndrome and nerve entrapment can occur and arthritis is often a resulting complication. These kinds of things can be problematic for a player who has logged as many minutes as Bryant.
With the latest injury occurring on the same leg as his Achilles injury, people are bound to wonder if the two are linked. The answer is maybe. As previously mentioned tibial plateau fractures are rare and Kobe’s break could easily be seen as a freak injury. However pictures of Kobe since his return do seem to show noticeable atrophy in his left calf muscle complex. If his calf was not a full strength, it may have played a role in the fracture.
During motion, eccentric contractions of the gastrocnemius slow the tibia down, moving the knee into extension. As a result the risk of hyperextension at the knee increases, as the calf muscle complex is unable to adequately and smoothly decelerate the knee. If the break occurred when Bryant’s knee hyperextended, then his weakened calf may have been unable to stop the motion and prevent the fracture from happening. It’s hard to pin the injury on that sole reason but it’s reasonable to believe it played a role.
Bryant is a polarizing figure in the NBA and his absence leaves a void difficult to fill. He will attack rehab just as aggressively as he did his previous injury with his mental toughness providing an edge most others do not have.