Welcome to

In Street Clothes

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

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.