Breaking Down The Jrue Holiday Injury

Earlier this morning the Pelicans announced that guard Jrue Holiday will be sidelined indefinitely with a stress fracture in his right tibia. The injury is just another setback for New Orleans who is still without Ryan Anderson, out recovering from a herniated disc in the cervical region of his spine.

Holiday’s injury isn’t uncommon in NBA given the amount of running and jumping the sport of basketball requires. The tibia, or shinbone, is the larger of the two lower leg bones and is the primary weight bearing bone in the body. Despite its importance, the tibia is poorly protected by its surrounding muscle and is susceptible to injury. Tibia fractures usually occur following a direct blow, but that’s not the case for Holiday.

The All-Star guard is suffering from a stress fracture in his tibia. The bones of the body are constantly remodeling themselves to handle the various stresses placed on them through everyday activity. Excessive workloads from constant or repetitive exercise can overwhelm the process and leave the cells responsible for repairing the area unable to maintain pace with the body’s demands. As a result, the effected area can crack, creating a stress-induced fracture in the bone. Tibia stress fractures are the most common of all stress fractures due to the high amounts of strain placed on the tibia during running and jumping. Tibial stress fractures can occur in several locations of the bone each with its own recovery rate.

The location of Holiday’s fracture has not been publically made available but reports of him wearing a protective boot suggest the injury is in the middle to distal portion of the leg near the ankle. On the bright side this means the knee wasn’t involved and the integrity of the meniscus and tibial plateau has not been compromised. However stress fractures in the lower portions of the tibia often taken longer to heal, as this area is responsible for a considerable amount of weight bearing in the ankle joint. The distal end of the tibia, known as the plafond, bears roughly 90% of the load placed on and through the ankle joint.

To address the problem, all weight-bearing activity must be stopped to allow for the healing process to reset and fix the damaged tissue. Holiday will spend the next few weeks performing minimal activity until additional examinations are performed to determine the rate of healing. He can gradually progress his workload, utilizing equipment like an altered-gravity treadmill or underwater treadmill.

Screen shot 2014-01-10 at 11.07.02 AMHowever New Orleans should be prepared to be without Holiday for a substantial amount of time. The last five players to suffer a true stress fracture in their tibia missed an average of 22 games. These numbers do not include Denver’s JaVale McGee who has missed 30 games this season and has yet to be cleared for activity.

Holiday’s absence will move Brian Roberts into the rotation and guard Tyreke Evans and Eric Gordon will see an increase in responsibilities. Gordon has been the subject of trade rumors though this injury could alter those plans.