The Spurs and Clippers seven game series was a first-round matchup for the ages that was ultimately decided by Chris Paul hitting an impossible bank shot off of his left leg. What made the shot particularly impressive was Paul elevated off the same leg in which he had sustained a hamstring strain earlier in the game. The All-Star point guard first indicated the muscle was an issue late in the first quarter and eventually went to the locker room to be worked on by the Clippers medical team. He did return and was noticeably limping throughout the contest, including just prior to his decisive game-winner. Now with the Rockets on tap for Monday, the Clippers have to begin wondering about the availability of their floor general.
Hamstring strains are common in the NBA. This season alone over 200 games were lost to hamstring-related problems, the most for any muscle-related injury. InStreetClothes.com previously detailed why these types of injuries are so problematic in the NBA, but let’s once again review.
Whenever a muscle is stressed beyond its yield point, a strain occurs. Strains are graded based on the severity of the accrued damage. A Grade I injury is the least severe strain and is considered minor. In these injuries, microtearing of the tissue occurs though the individual experiences little to no loss of function. A Grade II is considered moderate and involves damage to actual muscle fibers. These injuries are often called partial tears. Anything given a Grade III or higher is considered severe and the tear is complete. Grade III injuries are accompanied by a loss of both stability and function and in some cases require surgery.
Regardless of the severity, the manner in which muscle tissue heals is a detailed process. The healing process occurs in multiple stages that begins with the inflammatory phase and includes the initial swelling and clotting reactions at the injury site. As the inflammatory phase progresses the second phase, the proliferative phase, will start. The proliferative phase is the beginning of the body’s actually repair work of the damaged tissue. Scar tissue is formed at the injury site as specialized cells begin repairing the strain using protein fibers, including collagen and elastin.
The proliferative phase requires a considerable amount of time but must be completed before the final phase, the remodeling phase, can begin. The remodeling phase varies in length and depends on the aforementioned grade assigned. During the remodeling phase, collagen fibers within the newly developed scar tissue are repeatedly broken down and remade. By doing so the strength of the scar tissue progressively improves and will begin to resemble healthy muscle tissue. However the body’s natural way of healing doesn’t normally occur in the appropriate pattern. Instead the protein fibers are aimlessly and unsystematically laid down. This random approach can have a negative impact on the athlete. Fortunately, an athletic trainer or physical therapist can help fight this pattern by loading the injured muscle in a specific way during rehabilitation.
Unfortunately even the best treatment doesn’t guarantee the new tissue will be as strong as the original and the risk of re-injury will loom. A functional muscle doesn’t equate to a healthy muscle. The hamstring muscle complex is a dynamic muscle and must be able to withstand high amounts of force. For this reason, hamstring injuries often require long periods of rest and why these injuries strains are easily aggravated. If aggressive movement disrupts the newly laid down scar tissue, the effected individual must begin the intricate process of tissue repair all over again.
Paul’s been down this road before. Over the course of the last four seasons, Paul has strained his right hamstring twice and left hamstring once. The right hamstring was an issue last year costing him a game early in the regular season and flaring up again in the postseason. His previous left hamstring strain occurred during the lockout-shortened 2011-12 season and sidelined the point guard for five games. While he’s avoided hamstring problems this season, extra care will be needed to insure his current injury doesn’t have a cascade effect on the rest of his left leg. It’s particularly important since this is the same leg that required meniscus surgery back in 2010.
The Clippers will utilize every treatment option at their disposal over the next 48 hours but it’s hard to imagine Paul will be 100 percent entering Game 1 against the Rockets. While he’s proven he’s capable of delivering a monster performance with the injury, Paul’s health will be key if Los Angeles is to advance to the first Western Conference Finals in franchise history.