Welcome to

In Street Clothes

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

Understanding Jrue Holiday’s Stress Reaction

The Pelicans announced guard Jrue Holiday has been diagnosed with a stress reaction in right lower leg late Wednesday evening. Holiday had been a spectator for four consecutive games before the diagnosis and is expected to miss at least the next two week resting the area.

Bone injuries are common in the NBA and can occur in a variety of ways. Fracture can be traumatic as was the case for Indiana’ Paul George or occur gradually over time in areas of high stress.

Nearly every bone of the human skeleton endures some sort of stress during everyday movement. The amount of force applied to the bones increases with strenuous or repetitive activity. To keep up with these high-energy or constant demands, the stressed area of bony tissue is continually remodeled. In the process, new bone tissue is created and used to fill any developing gaps while damaged and worn out bone is absorbed and broken down. However occasionally the body’s natural remodeling process is unable to keep up with the demands placed on the area and a stress injury develops.

A stress reaction is the precursor to a true stress fracture. Stress reactions are often accompanied by localized pain and swelling. When this type of injury is diagnosed the affected individual will be allotted a specific amount of time to rest in hopes that the remodeling process can catch back up and the bone can return to full strength. However should the injury go undetected or the problematic motion resumed too early, a stress reaction can easily develop into a true stress fracture. These injuries require longer periods of rest and, in some cases, surgical intervention.

Stress reactions and fractures are a common occurrence in the NBA as the players endure a strenuous schedule that often leaves little time for rest. The most frequently involved areas include the bones of the foot, the back, and the lower leg bones, the tibia and fibula. The tibia is the bone most likely to experience a stress fracture, due to the fact that it bears a higher percentage of the body’s weight during activity.


Unfortunately this isn’t the first time Holiday has suffered a stress injury in his right tibia. Last season Holiday was diagnosed with a stress fracture in his tibia that prematurely ended his season and ultimately required surgery. Now almost one year to the day, the problem has resurfaced.

Reoccurrence of a stress fracture in a one of the lower leg bones is relatively higher than most injuries, though Coach Monty Williams insists the two injuries are not linked. However a quick look at other lower leg stress injuries in the NBA reveals the likelihood of a future problem is noticeably higher in individuals who underwent surgery to treat a previous stress-related injury. The most recent example is Denver big man JaVale McGee who has missed 29 games this year with lingering soreness in his surgically repaired tibia.

Early detection by the Pelicans medical team should give Holiday a legitimate chance to return this season, something that may not have been possible if the injury has progressed to a full fracture. Still the team is preparing to be without his services for at least two weeks and it wouldn’t be surprising to see Holiday require the full four weeks with a return after the All-Star break a realistic possibility.

Screen Shot 2015-01-21 at 10.19.15 PM

2 thoughts on “Understanding Jrue Holiday’s Stress Reaction”
  1. […] InStreetClothes.com recently addressed stress reaction in a piece on Pelicans guard Jrue Holiday, but let’s review. […]

  2. Today's Best NBA Reporting and Analysis February 18, 2015 on 3:00 pm

    […] – Jrue Holiday:  http://www.nba.com/pelicans/news/jrue-holiday-injury-update-1  and  http://instreetclothes.com/2015/01/21/understanding-jrue-holidays-stress-reaction/ […]

Comments are closed.