With the 2014 NBA Draft just a week away, who will go number one overall remains unclear. Injury concerns about his back had already hurt Joel Embiid’s chances but those odds took another significant hit when it was revealed he will need surgery to repair a fracture in his right foot.
Specifically, Embiid suffered a stress fracture in his right navicular bone. The navicular is one of the tiny tarsal bones located in the mid-foot and is essential in proper weight transfer and force absorption generated during ground impact. It also serves as an attachment site for a muscle and a stabilizing ligament of the foot. Unlike some of the bones located in the area, the ends of the navicular have a relatively healthy supply of blood. An ample amount of blood creates an environment more conducive to healing. Generally this means that a small fracture can be treated conservatively or non-surgically. However if the extent of the fracture extends into the body or middle one-third of the bone, surgery is considered the best course of action. This appears to be the case for Embiid.
In the short-term this is a considerable set back for Embiid. Navicular fractures have been costly in the NBA where the averaged missed time sits at 59 games, suggesting his recovery will carry over into the upcoming season. The list of injured players to suffer navicular fractures includes Michael Jordan, Yao Ming, Zydrunas Ilgauskas, and Brendan Haywood, who missed all of the 2013-14 season with the injury. Ming’s career was abruptly ended due to his reoccurring foot problems but Yao was taller and 60 pounds heavier than Embiid. Ilgauskas may be a better comparison but that isn’t necessarily reassuring.
From 1998 to 2001, Ilgauskas missed 202 games and underwent three surgeries on his fractured navicular. The final surgery included a bone graft and a reshaping of his calcaneus and first metatarsal to alleviate the stress placed on the area. Only then was the Big Z able to continue what would become a 15-year career.
The long-term effects are less clear. Refractures can occur if the athlete rushes back and some studies show that pain can linger in the foot for as long as two years following surgery. On the plus side, non-unions and hardware failure in navicular repairs are both relatively low.
Embiid will have his foot immobilized and will likely not be allowed to put weight on his foot for at least six weeks. Recovery will then gradually progress over the next few months but insuring the bone is completely healed will remain the focus. Any team willing to draft Embbid should also identify any potential biomechanical issues contributing to the problem to avoid reinjury. Furthermore additional research should be done to determine if there is a reason for Embiid’s propensity to stress fractures.
Embiid could very well go on to have a productive career in the NBA but his multiple red flags make him a risky pick at the top of the board. His latest setback could easily cost him games during the 2014-15 and, after watching Nerlens Noel sit for an entire season, the precedent for conservatively handling rookies has been established. Just what team will be forced to make that decison is anybody’s guess.