NBA and Its Players Take Steps To Improve Overall Health

July 8th was a big day in the NBA but not for the reason everyone will remember. Lost in the endless stream of emojis, hostage negotiations, and all the other shenanigans associated with the DeAndre Jordan saga, were several announcements that have the potential to improve the overall health of the NBA player and reduce the high number of NBA games lost to injury.

First the league’s announced that it has partnered with GE Healthcare in an effort to promote medical research intended to protect and progress the health of its players.

In the press release, the NBA announced Dr. John DiFiori will chair the new panel. Dr. DiFiori is currently the NBA director of sports medicine and a former president of the American Medical Society for Sports Medicine. Led by Dr. Difori and five other doctors affiliated with NBA organizations, the committee hopes to improve player health by pinpointing risk factors and developing subsequent preventive plan options.

Additionally the announcement stats there will be a collaborative research effort with adidas, Nike, and Under Armour. Partnership amongst these three sports apparel giants is particularly important. According to the InStreetClothes.com injury database, 92% of the games lost to injury during the 2014-15 season occurred when players were wearing shoes produced by one of the three aforementioned companies and their subsidiaries.

As ESPN’s Tom Haberstroh and Yahoo Sports’ Eric Freeman pointed out, this isn’t the first time the NBA has formed a committee to look into player safety. The league has formed committees intended to examine concussions and other significant health concerns. However time and patience is essential for these types of moves to be effective and it would be unwise to expect any immediate schedule modifications or potential changes in protocol. 

On the heels of the league’s announcement, Zach Lowe of Grantland.com revealed the NBA Player’s Union independently hired former Houston Rockets and Orlando Magic strength and conditioning coach Joe Rogowski as the director of physiology and research. Rogowski’s role remains unclear but he is a prominent player in sports medical research, particularly in athlete cardiac physiology. 

So what does it all mean?

It implies the NBA and its players know the best way to run a successful business is to have the best product on the floor. The NBA product suffers when Kevin Durant is sidelined with a Jones fracture or Kyrie Irving and Kevin Love miss the Finals with injuries of their own. The only way to do that is to insure the information provided by emerging technologies in sports medicine and bio-analytics is thoroughly and adequately examined and researched. As ESPN’s Baxter Holmes recently pointed out, the amount of risk associated with NBA players, particularly younger players, is also evolving and determining steps to reduce these new factors is a must. The odds of finding a way to do so significant increase with both the league front office and the players working toward improving the safety and overall wellness of the involved individuals.

Reviewing the Injury Totals for the 2014-15 NBA Season

On the precipice of NBA free agency, it’s important to take one more look at the 2014-15 season. Expect instead of focusing on Golden State’s historical run to the title or LeBron James’ first year back in a Cavaliers jersey, let’s take a look at the injuries that helped shape the season.

As a whole, 4,665 man games were lost to injury or illness. While the number may appear staggering, it’s actually 324 games less than the previous season and just the 4th highest total since the league adopted the game-to-game inactive list prior to the start of the 2005-06 season. However the impact of these injuries may have been higher when the amount of money tied to the lost games is weighed. The 4000+ games lost to injury or illness came with a $344 million price tag, a shade lower than the 2013-14 sum of $358 million. That’s an astronomical $11.5 million lost per team.

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Some teams were hit harder than others, in particular the Los Angeles Lakers. The team finished with 338 games and $28 million lost to injury, the second highest totals in the league for both categories. The problems started before the season began when Steve Nash was ruled out for the season due to reoccurring back problems including a spondylolisthesis and spinal stenosis. Nash would miss 73 games before being waived. Things would only get worse as Julius Randle went down with a fractured tibia on opening night and missed the next 81 games, a total only bested by Philadelphia rookie Joel Embiid. Season-ending injuries to Kobe Bryant, Nick Young, Ronnie Price, and Xavier Henry would follow. In the end the Lakers would lose over 300 games to injury for the second consecutive season, an unprecedented feat over the last 10 seasons.

 

On the opposite end, the Phoenix Suns reclaimed their spot atop the league with just 59 games lost. The team edged out the Toronto Raptors, the team that previously recorded the fewest games lost for the 2013-14. The 59 games marked the sixth time in the past 10 years that the Suns medical team has managed to lose less than 100 games to injury and illness. Phoenix lost the least amount of salary dollars to injury, finishing with just $3.4 million lost.

The biggest injury setback came in the postseason. 196 man games lost to injury or illness were sacrificed during this year’s 81 playoffs games. That total represented the most games lost since the 2008-09 playoffs when 199 games were lost over an 85 game span. Cleveland, the Finals runner up, was hit particularly hard by injuries losing 43 total games to injury including 16 games by Kevin Love and seven games by Kyrie Irving.

The NBA has promised to tackle the injury concerns with Commissioner Adam Silver admitting to USA Today’s Sam Amick that reducing the injury rate will be a focus of the offseason. With an increase in biotracking and wearables and additional funds being diverted to sleep studies, dietary focus, and even team psychology, it’s realistic to think that teams can help improve their player’s heaths and prolong their careers. However a proactive approach must be adopted on a league level if the NBA is to make strides in protecting its players for the 2015-16 season and beyond.

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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.