Understanding Carmelo Anthony’s Back Spasms

The 2014-15 season is off to a rocky start for the New York Knicks with the team currently holding a 4-11 record, good enough for 12th in the Eastern Conference. Injuries have yet again been at the heart of the problem. Forward Andrea Bargnani yet to play this season due to calf and hamstring strains and offseason acquisition Jose Calderon has played just two games after missing the team’s first 13 outings with a calf strain of his own. Now the team enters a tough spot in their schedule without the services of Carmelo Anthony.

Anthony, New York’s leading scorer, made an early exit from Monday’s loss to Houston after experiencing back spasms in the first half. The team is calling him doubtful for Wednesday meeting with the Mavericks but do not expect him to play.

The injury itself is difficult to gauge but very problematic. Back spasms aren’t actually an injury but the symptom of an underlying cause. When an injury to the muscles or other tissues of the back results in pain, the effected individual often enters into a viscous sequence known as the pain-spasm-pain cycle.

The pain associated with the injury causes the surrounding musculature to contract in spasms in an attempt to support the area. However excessive spasms increase pain, which produces tension, which leads to more pain. If prolonged, the cycle perpetuates ischemia, a reduction in blood flow and thus oxygen, in the muscle and surrounding areas. A simple injury suddenly becomes very complicated and often unrelenting.

As a result, interrupting the cycle is the first and necessary step in treatment. Various modalities can be utilized including anti-inflammatory medication, hot or cold therapy, and physical therapy. Once the individual is comfortable, the main goal of the medical staff becomes locating and fixing the primary cause of the injury to prevent the cycle from reoccurring.

It is more than likely Anthony’s problems are muscular in nature though a detailed evaluation is necessary to rule out a more significant injury like an inflamed disc or pinched nerve. Marc Berman of the New York Post reports the team is fully aware of this possibility and is hoping the problem can be controlled before it develops into something more serious.

Head coach Derek Fisher reiterated the importance of remaining patient, stating, “Until you can actually play without being in spasm, there isn’t anything you can really do. Hopefully that will be soon. His back will be the only indicator of how soon that can be. I don’t think there’s anything we can necessarily do to rush that right now.”

Back spasms have always been an issue for NBA players with multiple players enduring the painful cycle. The Brooklyn Nets know the problems this condition can create all too well with Kevin Garnett and Andrei Kirilenko each missing extended stretches of last year due to back spasms. Even worse the reoccurrence rate is relatively high. Of the numerous examples in the InStreetClothes.com database, a player that suffered in-season back spasms dealt with another set of spasms or an additional back injury in the same season 37 percent of the time.

Anthony appears poised to sit for at least a few games as the Knicks medical staff exhausts their options and protects the face of the franchise. The unpredictable yet common problem is just another setback in what has been an already frustrating season for New York.

Predictive Analytics Applications

InStreetClothes.com gets various request for data sets and information. While the injury database is not publicly available, the data presented on the site has been utilized to bolster media stories, compare injury rates, and numerous other applications. Recently, Mason Ginsberg, a writer for BourbonStreetShots.com, used the data in an interesting way.

As part of a presentation on Predictive Analytics in Business, Ginsberg examined the injury rates and dollars lost for NBA teams that utilize GPS tracking monitors by Catapult Sports and plotted them against those that do not use Catapult.

The findings were a small part of the overall presentation but still a fascinating look into how preventive care can help teams in professional sports.

Photo courtesy of Mason Ginsberg:

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Understanding Dwight Howard’s PRP Treatment And Why It’s Not “The Kobe Treatment”

Houston center Dwight Howard recently underwent a procedure that is becoming commonplace in the NBA. Howard received a platelet-rich plasma (PRP) injection into his strained right knee in hopes of accelerating the healing process.

In the traditional PRP treatment, like the one Howard reportedly received, a sample of the injured athlete’s blood is taken and broken down in a machine known as a centrifuge. A protein-concentrated mixture is removed from the sample and injected into the injury site. The PRP mixture is filled with platelets, the primary component of blood responsible for clotting. Increasing the platelet count speeds up the body’s natural healing response and allows it to work more efficiently.

PRP injections are often compared to another type of treatment known as Orthokine or Regenokine. Orthokine, made famous by Lakers guard Kobe Bryant and his multiple trips to Germany, uses similar principles to PRP injections but utilizes a different component of the athlete’s blood. Instead of utilizing platelets, specific anti-inflammatory proteins are extracted and a personalized anti-inflammatory drug is created for the individual. However, the FDA has yet to approve Orthokine for use in the United States due to how the blood specimen is prepared.

While each treatment is designed to speed up the healing process, time is still necessary for a complete recovery. The majority of players who have opted for Orthokine have done so in the offseason with Xavier Henry’s preseason trip to Germany one of the only exceptions. However numerous examples of in-season PRP injections exist with the average number of missed games just above 11 games. It should be noted that the length of time missed is also dependent on the injury itself so determining just how long Howard will be sidelined remains difficult. On the plus side, Portland forward Nicolas Batum recently underwent two rounds of PRP injections for a right knee contusion and was able to return after sitting out just three games.

Houston hopes to have their big man back in the middle soon but have not set a definitive timetable on his return. To minimize the time lost, the team elected to utilize a non-operative PRP treatment that has been mislabeled as “the Kobe treatment.” PRP remains a proactive option but a return to play still depends on why it was needed in the first place. For an injury reported as a minor strain, the Rockets are optimistic this will be sooner rather than later.

Breaking Down Andrea Bargnani’s Calf Injury

New York Knicks forward Andrea Bargnani has yet to play this season after straining his right hamstring during training camp. He had reported progressed through rehab and appeared close to returning. However Bargnani will miss additional time after a MRI revealed a strained calf muscle sustained in Friday’s practice.

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The injury is an unfortunate setback but not overly surprising. Both the hamstring and calf are actually muscle groups made up of multiple muscles.  The beginning point of the calf complex is situated in close proximity to the insertion site of the hamstrings. Additionally both muscle groups work synergistically to bend the knee. Based on their location and co-dependence, it is easy to see how an injury or imbalance in either the calf or hamstring could directly alter and weaken the other.

To better understand this dynamic relationship, consider what sports medicine practitioners call the kinetic chain model. Each joint of the lower extremity is treated as a unit. When one joint, or link in the kinetic chain, is weakened, the entire chain is negatively affected. As a result other area of the leg become susceptible to injury as the body adjusts for the weak link. Though Bargnani’s injuries occurred at different times it is likely the hamstring injury disrupted the kinetic chain of his right leg and contributed to his current calf problem.

There have been multiple examples of players who have endured congruent hamstring and calf strains including Al Horford, Danny Granger, Devin Harris, and Tiago Splitter. A majority of these players also went on to have other issues including ankle and knee problems on the same extremity. As a result, the Knicks will want to tread carefully with Bargnani’s treatment to insure the former number one overall pick does not suffer a more significant injury. Unfortunately that means another extended absence for a player who has been sidelined for more games (53) than he’s played (42) since joining New York last year.

Understanding Kinesio Tape and Its Use In the NBA

During a recent game against the Milwaukee Bucks, Knicks forward Carmelo Anthony left the court limping and headed for the locker room. Anthony’s absence was brief and the Knicks telecast reported the seven-time All-Star simply needed to have his left knee retaped.

The tape job Melo emerged wearing was not a simple athletic tape job, like the kind one would use on an unstable ankle. Instead Anthony was seen wearing a specific type of tape known as elastic therapeutic tape or kinesio tape.

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Kinesio tape has been around for decades but exploded after receiving high profile exposure during the 2008 Summer Olympics in Beijing and again during the 2012 Summer Olympics in London. The bright colors and crazy patterns of the technique have since popped up in every sport imaginable at a variety of levels.

Each application of kinesio tape involves strips comprised of thin, elastic fabric, generally cotton. The elasticity of the tape makes it stretchier than normal athletic tape and allows it to recoil once applied. The thought is that when the tape recoils it lifts the skin below.  As a result, inflammation is believed to decrease as pressure on the area is diminished all while lymphatic draining and circulation increases.

Kinesio tape is also designed to generate neuromuscular feedback and alleviate pain by stimulating the various receptors of the sensory system. It can reportedly help with injuries to multiple types of tissues including muscles, ligaments, and tendons. Furthermore the design of kinesio tape allows the taped individual to maintain range of motion in the affected area.

Studies on the effectiveness of kinesio tape are mixed. Some have shown that kinesio tape may improve functional performance and improve pain levels as advertised. Others report there is little evidence to support the overall effectiveness of kinesio tape.

Whether or not kinesio tape works or its benefits are simply the result of a placebo effect, there is no denying its presence in the NBA. It has been around for several years now but gained notoriety at the beginning of the 2013-14 season. In early November, the league’s front office banned Chicago Bulls guard Derrick Rose from wearing it on his then ailing neck. The league quickly reversed course saying it would allow players to wear kinesio tape on “an experimental basis.” Since then multiple players have been spotted wearing therapeutic tape including Kevin Garnett, Kobe Bryant, and now Anthony.

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Not every team in the NBA utilizes kinesio tape though multiple organizations including the Celtics, Heat, and Pistons employ someone on their medical team that is a Certified Kinesio Taping Practitioner (CKTP). These individuals are trained during a series of courses led by instructors from the Kinesio Taping Association International, a group founded by kinesio tape innovator, Dr. Kenzo Kase.

However, multiple competitors have emerged in the elastic therapeutic tape market including KT Tape and Rock Tape.  These companies promote application of their product freely and provide step-by-step instructions and video tutorials to show how to utilize their tape on an assortment of injuries. Rock Tape does train its own set of practitioners and boasts three different types of certifications including performance movement, fascial movements, and defensive movement taping. Regardless of the brand or method utilized, it is becoming clear kinesio tape has found its place in the NBA.

As its popularity continues to rise, expect more studies to emerge testing the claims of elastic therapeutic tape. However if notable players like Anthony continue to praise its benefits, the kinesio tape phenomenon may be prove to be more than a fad and teams around the NBA can expect more individuals to approach their athletic training staff about possible application.