Identifying Potential Health Risks in the 2015 NBA Draft

The 2015 NBA draft is days away and teams are starting to narrow down their list of realistic options. After a season that saw a substantial number of lottery picks succumb to injury, a player’s health could ultimately serve as the deciding factor in where a player is taken in the draft. Let’s take a look at several prospects that have their fair share of injury risk.

Willie Cauley-Stein, Center, University of Kentucky

The concerns surrounding Cauley-Stein’s left ankle are well-documented. He sprained the ankle during the 2014 NCAA tournament and ultimately needed surgery to address a fracture in the area. The surgery involved the insertion of surgical hardware, including a pin that may have been inserted at a less than ideal angle. To compound the issue, it isn’t even the first area on the leg that the 7-footer has had surgically addressed. Cauley-Stein underwent knee surgery on his left knee for a bone chip of his patella during hist freshman season. Two weak spots on a kinetic chain can prove to have damaging long-term effects on an individual, especially big men.

The final red flag on Cauley-Stein’s injury report is centered around his comments in December of 2013 when he revealed he is a sickle cell trait (SCT) carrier. A SCT diagnosis means an individual inherited an isolated sickle cell gene from one parent and a normal gene from the other. Sickle cell disease (SCD) is a genetic condition that affects the red blood cells’ ability to carry oxygen. While not as severe as SCD, people with SCT can still experience episodes of pain and can be vulnerable to health issues in areas of low oxygen or high elevation. Former NFL safety Ryan Clark had SCT and was not able to play when his team traveled to Denver following a scary incident in which he was forced to have both his spleen and gall bladder removed. Cayley-Stein’s SCT appears to be well managed but it’s another significant factor that could effect his draft stock.

RJ Hunter, Guard, Georgia State University

While Hunter is perceived as a potential sleeper on draft night, he does have an injury history that could cause teams to pause. The risk is not associated with the reportedly minor shoulder injury Hunter suffered while working out for the Hornets but instead his left foot. Hunter developed a stress fracture in the foot as a junior at Pike High School. The injury resurfaced during his freshman season at Georgia State. While he has managed to avoid surgery so far, stress fractures in the foot can be very problematic. Given the recent problems players like Joel Embiid and Kevin Durant have had with stress-related injuries of the foot, insuring Hunter is not a risk for an additional injury is worth investing for any team interested in drafting the two-time Sun Belt Player of the Year.

Chris McCullough, Forward, Syracuse University

The 6-10″ freshman took a risk entering the draft after suffering a torn anterior cruciate ligament (ACL) in his right knee in a game against Florida State in January. McCullough underwent surgery in February and has spent the last four months rehabbing. He did not participate in of the drills or scrimmages at the Draft Combine but did sit for interviews.

The fact that so much of McCullough’s game is built around his explosiveness and athleticism, the decision to enter the draft following an injury that often saps those attributes is puzzling. The recent success of Spencer Dinwiddie could have played a factor in the decision but Dinwiddie had a more proven track record before he tore his ACL in college. At this point McCullough appears to be a long-term project for an established team rather than someone that can make an immediate impact.

Rashad Vaughn, Guard, University of Nevada, Las Vegas

Like McCullough, Vaughn opted to enter the draft despite a knee injury that shortened his lone collegiate season. Vaughn suffered a torn meniscus in his left knee in mid-February and missed UNLV’s final nine games. He also missed a game earlier in the season after experiencing back spasms.

The meniscus injury was the second of his career having entered UNLV recovering from a meniscus tear in the opposite knee. The injury prevented him from participating with the U18 National Team last summer.

If two knees with cartilage damage wasn’t enough, Vaughn managed an undisclosed left knee injury that sidelined him for two months while at Findlay Prep. That injury came on the heels of a “bad” ankle sprain suffered at the Kevin Durant Skills Academy. Each of these injuries would be problematic on their own but when amassed together they considerably elevate Vaughn’s inherent injury risk.

Cliff Alexander, Forward, University of Kansas

Alexander endured a bumpy year in Lawrence last year. It started in the summer when he suffered a “severe” ankle sprain during workouts. As the regular season began and progressed, Alexander battled several multiple bumps and bruises including a sternum contusion, a sore right wrist, and lingering back soreness. While he would not miss a game to injury, he was ultimately forced to miss Kansas’ final eight outings while the NCAA investigated his mother’s initiation of pre-NBA draft loan processing.

Alexander’s luck didn’t change much after making himself draft eligible as the 6’8″ Chicago native suffered a “mild” medial collateral ligament (MCL) sprain during a pre-draft workout with the Lakers. Any team considering drafting Alexander will have to determine if he has simply been unlucky up to his point or if he carries elevated injury risk.

Every player comes with their own bit of injury risk but gauging the varying degrees each player carries is crucial to long-term success.  InStreetClothes.com will provide injury information on each prospect pick-by-pick during Thursday night’s draft. Just follow @RotowireATC on Twitter for the live coverage.

Understanding Jason Day’s Vertigo

With the US Open championship on the line, Australian golfer Jason Day is fighting a case of benign paroxysmal positional vertigo (BPPV). After battling the condition off and on over the past year, it resurfaced throughout Day’s second round, including a scary incident on his final hole when he collapsed to the ground. He was tended to on the course and treated for BBPV Friday night. Still reeling from the effects, Day impressively shot a 2 under 68 on Saturday to move into contention entering the tournament’s final round.

Vertigo is a medical condition that can effect multiple areas of nervous system. BBPV effects the vestibular system, a sensory system located in the inner ear. The vestibular system provides an individual with their sense of balance when standing and moving. It helps the brain process various amounts of information in order to complete both voluntary and involuntary motions when performing complex tasks like swinging a golf club.

An individual affected by vertigo often reports feeling extremely dizzy and a feeling of an uncontrollable spinning motion. Vertigo can be brought on by multiple causes including a head injury like a concussion or, like in Day’s case, BBPV. BPPV is the most common cause of vertigo and is the result of a buildup within the inner ear. BBPV is treatable, but each form of treatment generally takes a considerable amount of time to complete. The medication used to treat BBPV can leave the individual weak and bogged down, a fact echoed by reports that Day completed his third round despite feeling “groggy.”

Day isn’t the first professional athlete to suffer from vertigo. A quick look through the InStreetClothes.com database reveals several cases of NBA players affected by vertigo including Spanish forward Pau Gasol. Gasol missed 12 of his final 13 games with the Lakers during the 2013-14 season. Those games came over a three week stretch for Gasol in which the five-time All-Star spent multiple hours in rehab attempting to move past his vertigo. Other sports stars to suffer from vertigo include former Red Sox outfielder JD Drew and Pro Bowl guard Evan Mathis.

For Day to compress his activities into four consecutive days of golf with the side effects lingering is impressive. To overcome the condition and position himself atop the leaderboard is down right stunning. The Aussie will rest Saturday night and likely undergo another round of medication before teeing off on Sunday. If Day can pull of the stunner and win his first major championship while battling vertigo, his competitor will be the one’s left reeling.

Understanding Kyrie Irving’s Patella Fracture

The NBA Finals was dramatically altered Friday when it was announced All-Star guard Kyrie Irving will miss the remainder of the series after a MRI revealed a fractured patella (kneecap). Irving is slated to undergo surgery in the coming days and becomes the second of Cleveland’s talented trio to suffer a season ending injury in the postseason. Teammate Kevin Love suffered a dislocated shoulder and torn labrum in the team’s first round sweep of the Celtics.

With Irving ruled out for the Finals, the focus instantly shifts to his long-term health. The patella is a sesamoid bone meaning it “floats” the tendon of the quadriceps muscles. As a result of this position, the knee cap is able to move and create a longer moment arm for the tendon. This in turn enhances the torque and improves the range of motion of the knee. The tendon that houses the kneecap is the same tendon involved with Irving’s previous battles with tendinitis.

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However the tendinitis is an afterthought with the kneecap fracture. The type of fracture has not yet been revealed but the kneecap is vulnerable to both stress fractures and breaks following trauma. A stress injury would help explain why Irving was experiencing inflammation in the area in the first place but without confirmation from Cleveland that’s simply speculation. It’s also hard to imagine the team opting to play their All-Star guard with a significant injury like a stress reaction or fracture.

UPDATE: The Cavaliers maintain Irving’s fracture was the result of a collision with Golden State’s Klay Thompson and not the result of a stress reaction or stress-induced trauma.

What is known is that surgery will be necessary to repair the damage. This is a good indicator that the pieces of the bone displaced. Surgical wire and pins will be inserted to realign these fragments and create an environment conducive to healing. However even with surgery, the recovery process for this type of injury can be complicated due to the previously mentioned biomechanics of the joint.

As the knee is bent (flexed) or straightened (extended), the patella moves to alter the mechanics of the quadriceps muscle. In the process, the patella comes in contact with multiples aspects of the leg bones, particularly the femur. This repetitive contact and stress can prolong the healing process as special care must be given to avoid stress to the bone but maintain range of motion at the knee.

Previous NBA All-Stars, including Clippers forward Blake Griffin and Washington guard John Wall, have endured fractured knee caps. Both of these players’ injuries were stress induced though Wall did not require surgery. Griffin missed his entire rookie season recovering from surgery on his patella. Fortunately neither player has reported lingering problems from their respective injuries, providing hope for Irving’s future. Still, determining a specific recovery time for Irving remains complicated even if history shows that players that require surgery need additional time to heal. The Cavaliers have estimated he will miss three to four months recovering but expect those numbers to be fluid.

Understanding the NBA Concussion Policy

Concussions

The Golden State Warriors have blazed through the Western Conference playoffs and will face off against the Cleveland Cavaliers in the team’s first NBA Finals appearance since 1975. However the availability of guard Klay Thompson is in doubt after he was sustained in a concussion in the team’s series clinching win over the Rockets.

The injury occurred when the knee of Houston forward Trevor Ariza struck Thompson on the right side of his head while attempting to block a shot. Thompson crumbled to the floor and was removed from the game with what was initially described as an ear laceration. After briefly heading to the locker room, Thompson was cleared to return to action only to leave once again as blood continued to trickle out of his ear. According to reports, the laceration was then stitched closed and Thompson returned to be with his teammates. The All-Star guard never checked back into the game but was on the court to celebrate the team’s Western Conference title and participate in the trophy presentation. Unfortunately as the night progressed, Thompson’s symptoms began to worsen and he began to experience dizziness before vomiting on his ride home. Further examinations, including additional tests performed by a neurologist, confirmed the rising suspicions that Thompson did indeed suffer a concussion. The Warriors have ruled him out indefinitely and placed him into the league’s mandated concussion protocol.

The team’s handling of the incident, as well as Steph Curry’s head injury in the previous game, has brought the NBA’s concussion protocol under scrutiny. However pointing fingers and hurling accusations with only part of the facts made public is unwise and the focus should instead be put on insuring Thompson gets the necessary rest and treatment to properly be cleared for the Finals.

Concussions are the hot topic in sports medicine as details regarding the danger in both the short and long term are continually being discovered. These studies have forced professional sports league’s to adopt strategic protocols on how to handle a player’s removal from a game as well as when they can be allowed to play. The NFL, rightfully so, has been one of the more active leagues to regards to concussion policies and prevention. Since 2007, the NFL has adopted and altered their concussion guidelines multiple times to make them more and more rigorous. Rule changes have implemented and the policy continues to evolve. The policy has been altered as recently as March with the addition of Resolution G-2 or “the Julian Edelman Rule.” The new rule provides the concussion spotter in the press box additional power to stop game play in order to insure a player suspected of a head injury is properly evaluated.

The occurrence rate of concussions in the NBA is significantly smaller. Since the 2005-06 season there have been a total of 159 reported concussions, including Thompson’s recent diagnosis. For comparison sake, the NFL reported 123 concussions in the 2014 season alone. However the NBA still proactively adopted a concussion policy prior to the 2011-12 season. The policy details the evaluation, management, and return to play guidelines for any player suspected of a concussion.

The first step to returning to action states the player must first be symptom-free at rest. Once the symptoms dissipate, the injured player can than sit for a neurocognitive test, most likely the ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) test. Due to the variability amongst concussed athletes, the ImPACT testing allows for each individual to be properly screened.

The test is conducted on a computer and analyzes the individual’s status through neuropsychological tests that include memory recall, immediate shape and color recognition and matching. The results are compared to a set of baseline information gathered on each athlete prior to the start of the season. Before an athlete can progress to the next step in the recovery process, their IMPACT scores must return to their initial baseline numbers. From there an athlete must remain symptom free following a progressive increase of activity, starting with riding a stationary bike and concluding with non-contact team drills.

Once the player has completed these steps, Dr. Jeffrey Kutcher, the Director of the NBA’s Concussion Program, will be contacted to discuss the final clearance for return to play. The time needed to complete the process varies from player to player and predicting how Thompson will react is difficult.

This season the averaged missed time for a concussion was 8.9 days and that doesn’t include the days missed by Minnesota’s Gorgui Dieng or Sacramento’s Rudy Gay who did not return to play before the conclusion of the season. The median for days missed was five. These numbers suggest Thompson should be available for Game 1. However as previously mentioned, each athlete responds differently following a head injury and it’s far from a guarantee that Thompson will be play.

The NBA Finals is slated to start on June 4, eight days after Thompson’s injury. He will spend his time resting and allowing his brain to heal. While he is a key component of Golden State’s success, title aspirations shouldn’t outweigh Thompson’s long-term health. Completion of the NBA’s concussion policy will help guide his return to play and insure Thompson is physically ready to compete for a championship.

Understanding Kyle Korver’s Injury: A Complete Primer to Ankle Injuries

ACL tears are devastating and concussions are the rightful hot topic in sports. However neither injury has dominated the NBA like the ankle sprain. Nearly every player from every era has felt the pain of a turn, tweak, or twist of the joint. An ankle sprain was one of the few injuries to sideline Michael Jordan for a game during his run with the Bulls and was the culprit behind LeBron James’ first missed games as a professional. No other injury lights up the InStreetClothes.com database with over 1,800 ankle sprains recorded. The injury reared its ugly head again last night when Hawks’ forward Kyle Korver had his right ankle roll inward following a collison with Cleveland’s Matthew Dellavedova.

Sadly the injury will end Korver’s 2014-15 season and surgery is currently being considered. Understanding ankle injuries can be difficult but here is the InStreetClothes.com ankle injury primer.

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