The Boston Celtics and Isaiah Thomas better watch for the hook

April 27, 2016

masslive.com
masslive.com

The hook here is not the Atlanta Hawks closing out the series against the Boston Celtics. The hook I am referring to is the one that may be coming for Isaiah Thomas after the 2 jabs he has taken with ankle sprains in consecutive games. With game 4 and game 5 concluding with Thomas experiencing a “tweak” to his left ankle, you can almost feel the knock out blow coming.

I love boxing and I love boxing analogies. I am currently reading Gary Vee’s book jab, jab, jab, right hook; I hit the heavy bag 2 or 3 times per week; and look forward to boxing matches more than almost any sport aside from football. The beauty of boxing is that once you really understand it, you can predict what is coming. For me, injuries are very similar. When I see a good boxer working their jab all fight; I know a straight right is coming. Once the straight right starts landing, you can expect the left hook. It’s a natural progression in the combination.

With Isaiah Thomas who seems to have a weak left ankle, there is also a natural progression. An ankle that proves to be weak will ask for help. This help may come in the form of taping or bracing; it may come in the form of asking his other joints to chip in a do a little more work. Either scenario will eventually end poorly. A joint that is helped too much causes an overall disruption in the chain of joints and heightens the chance of injury. A joint that is injured and not supported enough to protect it from further injury will eventually suffer a more serious injury. This means that Thomas is likely headed for a more serious ankle sprain or possibly a knee or foot injury on that left side. His probability of this happening will continue to progress if the Boston Celtics season can be extended and Brad Stevens continues his trend of playing his guards for huge minutes.

If you are investing in Thomas for fantasy basketball or picking the Celtics to tie this series up; I would at least consider that Isaiah Thomas is approaching red flag territory with his injury probability; and without him the Celtics do not have much of a chance.

Remember that Injury Science is real and these injuries are not just bad luck or random. While I may not have a hard data print out to show you Isaiah Thomas’ exact risk for injury (yet), you can trust that all the warning signs are there. The best thing for Thomas’ ankle will be a long rest. So while his mind will be pushing for game 7, his body may be shutting down for the off-season.

Can Le’Veon Answer The Bell With A Hyperextended Knee

January 2, 2015

Le’Veon Bell suffered a hyperextended knee this past Sunday night and is questionable for the Pittsburgh Steelers matchup vs. the Baltimore Ravens.  I will break down whether he will play and how effective he can be with this type of injury. (During editing of this post, Le’Veon Bell has been officially ruled out)

leveon-bell-reggie-nelson-hit
Close your eyes Steelers fans!

The Science

A hyperextended knee is not all that uncommon among athletes that play contact sports, but the average person has likely never experienced a hyperextended knee and especially not the traumatic type like Le’Veon Bell suffered.  In medical terms hyper means over or beyond and extension means to straighten.  Therefore hyperextension refers to the act of the knee straightening beyond its normal position.  In essence the knee bends backward either due to trauma or in some cases due to a force or momentum that is put on the knee by intrinsic or extrinsic forces.

Most of us don’t experience this type of injury because we are never exposed to such forces and furthermore when we are exposed to force that would bend our knee in the wrong direction, there are a few barriers that stop hyperextension from occurring.  The first line of defense being your hamstring musculature.  The hamstrings are the primary muscle group that bend the knee in the correct direction, but they also resist the knee being bent in the wrong direction.  Additionally the ligaments of the knee act as another line of defense to prevent the knee from going beyond its normal limits.  The Posterior Cruciate Ligament (PCL) would be the primary limiter against hyperextension.  While these ligaments and musculature help prevent hyperextension, they are also at risk for injury during this act of protecting the knee.

hyperextended knee
This persons left knee is hyperextended. As you can see, some people have this range of motion naturally while for most this would be painful.

The anatomy of this injury is hopefully fairly simple to understand.  However, the recovery from this injury and whether Bell can play this weekend is a little more complicated.  An injury like this has layers that go beyond simple concerns like pain tolerance and getting the knee strong enough to play.  Le’Veon Bell and the Steelers will need to be attentive to whether Bell can play this week as their primary concern, but with this being the playoffs they will need to look at making sure they don’t lose him for the rest of the playoffs.  While this injury does not typically include any long-term fears for the health of Bell’s knee, there are some short-term issues that make this a situation that needs to be managed just right.

To explain more clearly I will use an injury that is more common; the ankle sprain.  Many more non athletes or recreational athletes have suffered an ankle sprain.  For many, the first ankle sprain leads to a second ankle sprain and for some who are less fortunate it leads to ongoing ankle sprains.  Even for those who don’t sprain the ankle again after the first injury, you can appreciate the instability following and ankle sprain when placing that foot on the ground or a surface like grass or gravel.  An ankle sprain is not all that different from a hyperextended knee as it is still simply a joint that is enduring more motion than it should in a particular direction.  With a sprained ankle, we are many times over stretching our ankle everters (muscles) and our anterior talofibular ligament; while with a hyperextended knee we are over stretching our hamstrings (muscles) and our Posterior Cruciate Ligament (PCL).  In fact, a hyperextended knee is really just a sprained knee; just like you would say a sprained ankle.  The sprained ankle is notorious for its recurrence, and this is not due to plain old bad luck.  There is a scientific reasoning for why people re-sprain the same ankle and this same rationale is essential to the plan for Le’Veon Bell’s return.

In my opinion the three most important words for the Pittsburgh Steelers this week are Somatosensory, Proprioception, and Mechanoreceptors.  These are not the common words that you will hear on all the ESPN and NFL network updates, but trust that Bell’s return should be centered around these words.  These words are all related and based in neuroscience.  In a way they are just three big fancy words that you can use to sound smart that all lead to a similar place of reasoning.

Somatosensory refers to the Somatosensory system.  This is the system that informs us of our external environment, our body positioning, and other stimuli.  Your Somatosensory system processes just about everything ranging from telling your brain that the water on your hands is too hot to telling your hamstrings to contract because your knee is being bent too far backward.  You use this system all the time unconsciously and without it we would all be in a world of trouble.

Proprioception can grossly be viewed as a child of your Somatosensory System.  Proprioception is more specific to muscles, joints, and extremities and is a big part of how we know where our body parts are without looking at them.  I do a lot of work with the geriatric population and much of the reason seniors are falling at an alarming rate is that many are not utilizing proprioception, and are completely depending on their vision for walking.  When you walk, proprioception is what tells you that you are putting your right foot in front of your left ; or allows you to adapt to walking on grass without losing your balance.  In the absence of proprioception, we would all be walking and looking at our feet to make sure they went where we intended and when walking on grass we would be intently watching every step to analyze the change in surface.

Mechanoreceptors are the sensory receptors or data collectors for proprioception.  Your muscles and tissues have these sensory receptors in them to collect the information of how they are being distorted, or how they are receiving pressure and this information translates into the proprioceptive abilities I described above.

All of this neuroscience talk is a big deal for Le’Veon Bell and any one else recovering from a sprained knee or ankle.  During the process of injury, the muscles and ligament are obviously stretched.  The less obvious observation is that the mechanoreceptors in the area also suffer injury.  This mechanoreceptor injury has a domino effect.   Without functioning mechanoreceptors, Bell will have some proprioceptive deficits which means that his knee may not be as precise with knowing when its extended to 0 degrees or when it is moving into hyperextension.  Similarly to with the common sprained ankle, the ankle and foot may not be precise with knowing whether the foot is completely flat or slightly turned in.  When this occurs with the ankle, you may put your foot down while its turned in and just like that you have re-sprained your ankle.  For Le’Veon Bell’s knee, he may plant his leg thinking his knee is bent 5 degrees when in fact it is extended beyond 0 degrees and just like that he will hyperextend it again.

With his mechanoreceptors and proprioception operating at a deficit, we can conclude that his Somatosensory system is also working at a deficit.  For a running back this is bad news as his activity during a game is unpredictable and he has to depend on his body and his neurological systems to react and keep up with his moves.  Many other football positions have more routine and will not challenge the Somatosensory system as much; such as quarterback, who if protected will make his drop and throw, or turn and hand off;  or a wide receiver who knows exactly where to go before they do it. As a running back, Bell has to react all game and if his Somatosensory system is not on point, there is a good chance he hyperextends that knee again.

With all that said there are some remedies that can protect Bell from re-injury.  The most straight forward remedy is a knee brace with a dial lock that would not allow his knee to extend beyond 0 degrees which would protect him from hyperextension.  That may seem like a no-brainer to some but for a dynamic back like Bell, this would likely feel like a hinderance to his agility.  Taping is another option.  Taping is a way to give increased support to a particular area that may not be at full strength.  In this case we can assume that Bell suffered some excess stretching to his distal hamstring fibers, and re-enforcing that area may give him more stability if his knee tries to hyperextend.

knee brace
You may see Le’Veon Bell later in the playoffs with a brace that looks something like this. Expect his to be less bulky and as light as possible. The dial that you see right at the knee would be locked at 0 degrees to avoid re-injury.

What you need to know

First and foremost what you need to know is that these athletes and these medical teams in the NFL are special.  DeMarco Murray completely proved me wrong to the 4th power and to some extent his situation humbled me to respect how continuous the progressions in healthcare are, despite the fact that I am a part of it.  I would estimate that the NFL is 5 to10 years ahead of the most progressive parts of our country in regards to medicine.

As I am editing this post, I hear that Bell has been officially ruled out.  Now to be truthful, I was going to write that I thought that he would play and that he would wear a brace.  Ultimately I was projecting him to be more of a decoy and expected a somewhat poor performance and possible re-injury.  I agree with this decision by the Steelers to hold him out.  The Steelers are likely smart to do this, as if they are to move on in the playoffs, which is quite possible considering the injuries the Ravens have in the secondary, they will need Bell in the line-up.  This injury should likely be a 2-3 week recovery process and with the playoffs accelerating the healing time, I think there is a good chance that Bell will be available for whoever the Steelers get after the Ravens.

For those playing daily fantasy, the play is definitely to start Big Ben and Antonio Brown as the Ravens are poor vs. the pass and very good vs. the run.  With Bell out, this game is almost exclusively in Big Ben’s hands.  I think we will all keep an eye on Bell’s recovery if the Steelers advance, but I would expect him to play if they do; maybe with a brace or maybe without.

Good Luck!

FANTASY FOOTBALL PLAYOFFS!

December 4, 2014

With most either getting ready or already in playoff mode, I thought I would cover some of the injuries that may literally make or break your season.  Here are some of the key injuries to take note of, as well as what you can expect:

rashad jennings

Rashad Jennings is suffering from an ankle injury from this past weeks loss vs. the Jacksonville Jaguars.  This is one of the biggest injuries for league play and one day players as Jennings was in line to face the awful run defense of the Tennessee Titans. The Titans have been a running backs dream this season and I think that Jennings will unfortunately miss out.  Initially the injury was said to not be serious but Jennings was quoted as not being able to put enough weight on his foot when it first happen.  These details likely suggest that he is dealing with a simple grade 1 or 2 low ankle sprain.  Although this may not be a serious injury, it will still need to go through the phases of healing.  Like most ankle injuries, this will limit Jennings ability to cut and plant on that foot and should take 1-3 weeks of rest and treatment to heal.  My guess is that Jennings is currently dealing with a swollen ankle that gives him pain if not supported significantly.  The training staff should be focused on getting the swelling and pain under control and we may see him give it a go with a heavy tape job, but I would need to see him practice at least on Friday to have any faith.  If you are in a league, a Friday practice and good reports may allow you to start him, but for one day fantasy it would be impossible to pay that premium price for damaged goods (wish they would adjust the prices mid-week). Unfortunately those who were licking their chops for this matchup will either have to trust Andre Williams,  his back up, to still light up this poor run defense or look elsewhere for a quality running back.  I would give Jennings until week 15 if it were my line up; after all it’s not like the Giants are in the playoff hunt and that he will pull out all the stops to get on the field.  For league players, I would just pick up Williams.  For one day players, there are other backs to consider near his price point (Eddie Lacy and Joique Bell are my picks for now).

Alshon Jeffrey’s injured hamstring is likely on many people’s minds.  If I had to pick my least favorite injury for one of my fantasy players to have it would be either a groin strain or a hamstring strain.  I despise these injuries mostly because they are the lingering type.  In many cases with a hamstring strain, a player will seem to come along well, may be practicing again, and be generally pointing in the right direction; and with one simple stride that player will do what all fantasy owners dread seeing–abruptly slow up and grab the back of their leg in pain.  Many of the other injuries are easy to predict, but a hamstring strain can feel like rolling the dice.  The good news is that Jeffrey appears to have been struggling with hamstring issues as early as week 3 of the season and has now been dealing with it for the past 2-3 weeks, and during that time his production has been good.

The infamous hamstring pull or strain is generally a result of one or more of the hamstring muscles stretching to forcefully or quickly.  This can happen for a number of reasons, but I believe that in many cases these athletes are simply too fast for their own bodies.  This may be the case for Jeffries as he clocks in at a 4.48 with his 40 yard dash; and for a receiver standing 6’3″ and 216lbs that may almost slot him in the “Freaky Talented” column (although my verdict is still out on that).  During the process of running, these athletes can sometimes just simply be thrusting their legs into extension (a straight knee position) too fast, and when this is combined with any contraction of the hamstring; the athlete will typically experience a strain or even a tear of the muscle fibers.

Additionally, some individuals simply suffer from muscle imbalances.  Despite state of the art facilities and the top strength and conditioning professionals in the country, some athletes are still disproportioned.  With respect to hamstring injuries, the culprit would be extremely strong quadriceps (thigh muscles on the front) combined with slightly less strong hamstring muscles (thigh muscles on the back).  While in full speed action, if both sides are acting at their max capacities, the quadriceps can over power the hamstrings and in the process injure the hamstrings.

These are all things Alshon Jeffrey and his team should examine in the offseason to reduce his chances of repetitive hamstring issues next year, but for now I would expect Jeffries to play.  Despite him playing, I would not play him on my fantasy team regardless of the upside he may possess .  As I stated before, you are one stride away from that moment of him grabbing the back of his leg and ending your fantasy season.  Combine that with the fact that he has to share with Brandon Marshall and the fact that Jay Cutler can not be trusted and I would simply look elsewhere for nearly all formats.

T.Y. Hilton was also limited on Wednesday with a reported hamstring injury.  The timing of this being a Wednesday injury is the most troublesome factor to me as a T.Y. Hilton owner.  Hamstring strain recovery feeds off of time to recover, and with a mid-week starting point, Hilton may be feeling some restrictions on Sunday.  Additionally, Hilton is definitely in the “Freaky Talented” column based off his 4.34 speed alone.  With his game being primarily based on his speed, a hamstring injury may bump Hilton’s stock down significantly.  The Indianapolis Colts also have to leave the comfort of their temperature and surface controlled dome to go to Cleveland.  As hard as it may be for a league player (I know as I own T.Y. in my league), this is a week I would have already considered sitting Hilton but any signs of a hamstring issue beyond Thursday would reserve a spot on the bench for T.Y. Hilton on my team.  The good news is that wide receiver would have to be the deepest position in fantasy right now and you should be able to find a good matchup this week for league play (I have the luxury of Randall Cobb, Odell Beckham Jr. and Mike Evans as my other wideouts…..ha ha).  One day players should not even consider Hilton an option.

DeSean Jackson has a lower leg contusion.  Those who are familiar with me know that a contusion is just a fancy word for a bruise.  Jackson may take a little time to manage any pain or swelling associated with the injury but he should be a full go.  His presence is a domino effect for any offensive Washington player you may have.  He opens up Jordan Reed who should continue to be a PPR monster, he allows Colt McCoy to likely put up 20 + for his 3rd straight time as a starter, and he gives Alfred Morris a chance to run in a box that would not dare stack 8 with Jackson as the deep threat.  I am not sure DeSean would be my guy at receiver but in one-day PPR play, I think Reed and McCoy hold good value due to his presence.  Use the information as you see fit, but expect him to be ready to go.

Dwayne Allen is back after suffering an ankle sprain.  I think he took the perfect amount of time off as an ankle sprain generally is a 1-3 week injury, and he took the 3.  I expect Allen to be effective, and with my expectations for T.Y. Hilton being low, you may find Allen to be a low-cost/high reward option especially in one day play.  Coby Fleener is the obvious buzz kill for those who own Allen in traditional leagues, but simply stated–Dwayne Allen is a better football player than Coby Fleener (for now).  That may be unpopular to the highlight watchers of the recent weeks, but most who really pay attention know this to be true.  So in this spot, I would roll with Allen and expect things to slowly return to normal in which Allen is the obvious TE1 on the Indianapolis Colts.

How about some defense?  They say defense wins championships and this can be true in fantasy football too.  Aqib Talib has the hamstring bug too.  Talib will have about 2 weeks off from game action by the time the Denver Broncos face the Buffalo Bills, but I would watch out for him having some difficulty.  I especially think he will have difficulty if he somehow get matched up with Robert Woods.  If he covers Sammy Watkins as expected, their injuries may cancel each other out as they are both banged up.  Denver got away with missing their #1 corner vs. the Kansas City Chiefs as the Chiefs have no wide receivers, but I am not so sure they will fair as well without Talib against a respectable wide receiver duo.  Owners of the Denver D/ST should pay attention and look for a good matchup this week instead of using a defense that may be without a true #1 cornerback, as I think I have cemented how I feel about depending on players with hamstring strains.

The other cornerback that may cause a fantasy domino effect is Vontae Davis who is coming off a concussion last week.  I will eventually talk about concussion a little more in-depth, but one of my simple rules is to not trust a player to play at their best the week following a concussion.  There is complicated evidence out there that correlates concussions with poor performance, but my stance is more from a common sense point of view.  Concussion cloud the brain and typically take the player out of their normal routine.  I believe that many of the players in positions in which studying the opponent is key, will suffer the most, shortly after a concussion.  I especially worry about defensive players who need to read and react to the offense and as the corner that makes that defense go, Vontae not being at full capacity may spell disaster in Cleveland.  I think the Davis concussion takes the Colts out of the starting D/ST conversation as I believe he is the single most important person on their defense.  I also think his injury bumps Josh Gordon stock up. Gordon already has a QB in Brian Hoyer with something to prove and he gets what may be a shoot out vs. Andrew Luck.  When you add in a recovering Vontae Davis, I think Gordon will be lighting up the scoreboard this week.  If one day players can get lucky enough for Davis to not play, I think Hoyer and Gordon could be the value play of the week.

Quick notes:

Reggie Bush- You can’t trust him.  He’s been out too long with this ankle injury.  Maybe during the regular season you could take a chance but at playoff time he is too much of a gamble.  He made our running backs running out of time earlier this season and is fully living up to the injury prone status that I predicted.

 

bush in new orleansbush in miamibush in detroit

Greg Olsen –The proof is in the pudding.  Make sure he gets back to practice before believing that his swollen knee is not a problem.  With tight end being such a tough position to fill, I think if he practices he should start in all league play.  As a one day option, he would be way down my list.

Larry Fitzgerald- He should be back this week but watch his practice pattern.  If he misses any practices, I would  throw up a red flag for a set back.

Andre Ellington-He needs to rest and heal!  Unfortunately his owners will have to scramble to find a RB1 that can get them through a playoff run.  You better start matchup hunting.

Good Luck!