The Cavaliers should be thanking the Portland Trail Blazers!

This has “I told you so” all over it, but I can’t help it. After the Golden State Warriors dominated the Houston Rockets, I proposed that Stephen Curry simply sit the 2nd round series out vs. the Portland Trail Blazers and get at least 3 weeks of healing. Instead, the Golden State Warriors rushed Curry back in a little over 2 weeks. Although Curry was not awful for the rest of the playoffs, he definitely was not his MVP self. I blame this solely on the status of his right leg and having to endure two seven game series in a row. The thing about injuries is that re-injury is not always the only risk. Poor performance is just as bad as being unavailable in most cases, and we all saw that Steph played poor in game 7. The insiders for the team admitted to seeing Curry’s knee appearing red and swollen after games as he continuously received treatment throughout the playoffs. Steph himself would not go into detail about his injuries, but his tone said it all.

I know that the Golden State Warriors training staff is very capable, but I hope there is a lesson learned for the future here. Just because a player can take the court, doesn’t mean he should take the court. I believe that the Warriors would have taken care of the Blazers without Stephen Curry in the second round and at the very most Curry should have only played in the case of an elimination game. The extra rest would have allowed his to fully heal and may have made a big difference in the rest of the Warriors playoff run. I guess the Trail Blazers looked alive enough to scare the team into rushing their MVP back on the court and I believe this is at least part of the reason Lebron James and the Cleveland Cavaliers are celebrating right now.

In the end, poor usage of Injury Science may have cost the Golden State Warriors HISTORY.

The NBA Finals MVP NOT named Steph or Lebron!

All eyes will be on Steph Curry and Lebron James on Sunday night but in my opinion, there is someone else that will decide this game 7. If you watch enough basketball, you know that Tristan Thompson’s performance is very unlikely to be repeated on the road, as role players tend to only shine that bright at home. With the Cleveland role players coming back to earth, I think we can expect Lebron and Kyrie Irving to carry the load like they did in game 5. Additionally, we can assume that by returning home that the Warriors role players will step their games up. But there is one person that I bet no one is looking at as having the biggest role for Sunday night’s game….take your guess before you read on.

If you guessed Andre Iguodala you are the close, but not quite. Chelsea Lane is actually my guaranteed MVP for Sunday night. In her case the P stands for PhysioTherapist or as the Warriors label her “head performance therapist”. She is the lady who always has her collar popped on the sidelines. You probably noticed her massaging Andre Iguodala’s back in game 6.

sfcchronicle.com
sfcchronicle.com

When you go back to my theory that the role players for Cleveland will return to their shells, it leads you to the fact that stopping Lebron from scoring will be essential in the Warriors getting this win. No one in the world is better equipped to stop Lebron James than Andre Iguodala, but if his back is not allowing him to move, the Warriors are in big trouble. This leads us back to Chelsea Lane.

The status of Iguodala’s back will be mostly on Lane in preparation for game 7. While the exact diagnosis for Iguodala has not been reported, he appears to have a low back strain/sprain type injury. Generally this is a minor issue that does not take long to manage, however it does typically take more than 2 days. If this were more of a typical rehabilitation for a back injury, the responsibility is more of a shared burden between the player and the rehab staff; but in this case I put the majority of the task on the staff. Andre Iguodala will likely be receiving a regimen that is modality heavy over the 68 hours that separate game 6 and game 7. These modalities will help loosen and relax the injured area, while also helping healthy blood flow to the area to support healing. Additionally, Chelsea Lane is likely to give a good amount of manual therapy to the area to manipulate and mobilize the tissues in his low back.

It is doubtful that Iguodala will have much of an active role with his short-term therapy as this may lead to fatigue in his low back and therefore elevate his risk for recurrence during the game. This puts the ball almost solely in the hands of Lane and her staff to make sure that the reigning Finals MVP can help the Golden State Warriors win a second championship. While Lane will not be playing on Sunday night, she will need to be on her game during the break between games to likely decide the NBA champion. I literally believe the Warriors have no chance if she does not do her job well.

With an abundance of experience with these types of injuries and knowing the pedigree of Chelsea Lane, I am 1000 percent sure that Andre Iguodala will at least take the court on Sunday night. The measure of how well Lane manages this injury will be based on how long he can play. Back injuries are impossible to run from as your back has to be active in nearly every movement you make. For many patients I use back stability braces or other adaptive equipment to protect from re-injury; but with basketball players this is not much of an option due to the flexibility demands on the basketball court. Lane will simply have to hit that perfect balance of helping Iguodala be loose but not too loose, so that he can survive for about 30 minutes on the court. Furthermore, she will have to keep him loose when he is not on the court. I expect moist heat, bike riding, and anything else that will keep his low back warmed up.

In the end I believe the Physical Therapy that Andre Iguodala receives will decide the the NBA championship. With that said, I am betting on therapy and Chelsea Lane to succeed!

 

 

Golden State Warrior Stephen Curry’s Leg Is INFESTED!

April 26, 2016

Golden State Warriors fans will be sad to hear this, but it is true. Stephen Curry has an infestation in his right leg that will threaten their historic season. Being from the city of brotherly love, I have often given my patients the analogy of injuries to row houses. For those who are not from the Tri-State area and have been blessed to not know what a row house is; I will explain. Where I grew up the houses on either side of a block were connected. In a row house you literally share a wall with your neighbor. This is similar to how some condos or apartments are built, but with less of a luxury feel. For an example, just go back and look at the Rocky movies…Rocky thought he was the man when he bought that house for Adria in Rocky 1….that is a row house.

South Philly
South Philly

Back to Steph Curry. Imagine Steph’s right leg as the block of row houses. His foot would be a house, his ankle would be a house, his knee another, his hip another, his lumbar spine being 5 houses to represent each lumbar segment, and on and on until you reach his cervical spine/neck area. Each of these areas of the body represents a house that is its own entity, but also very affected by the other homes.

The unfortunate aspect of living in a row house was that you were always at the mercy of your neighbor. With walls that are connected, it was really as if your side of the block was one big house with 30 adjacent rooms. I found this out the hard way when a supermarket at the corner was shut down and the neighborhood became infested with mice. The challenge with this is that no matter how clean you are or how much you do to deter the infestation, the mice simply move up and down the segment of row houses back and forth.

For Stephen Curry, we saw a mini infestation that has been recurrent in his right ankle. He appears to have managed this fairly well in the past and confined the issue to one joint. I am afraid that his quick return without fully healing that right ankle may have allowed his mini infestation in his ankle to spread to his knee. Some may look at his knee injury and call it a “freak injury” and dispel the correlation between the 2 injuries, but this is something I have preached to my patients for a long time–“always watch the neighboring joints”.

That old song about your hip bone is connected to your thigh bone and your thigh bone is connected to your knee bone is somewhat silly but does highlight a good point. It’s all connected. Our bodies work together to achieve almost everything we do and when one link becomes weak, it puts the other links at risk. Most often it is the adjacent or neighboring joint that will experience symptoms first. When one row home gets mice it usually spreads to the neighbors, and eventually it puts all the rest of the block at risk for getting mice…unless that first home gets rid of the mice completely.

The ankle joint is one of the first responders to perturbations or uneven surfaces. If you pay close attention when you walk on uneven grass or a trampoline floor; it is your ankle that is turning in and out or forward and backward to stabilize you. If the surface is even more unsteady, you will sense that your knees will bend and straighten to further stabilize you. As the challenges continue, the amount of joints that work together for stabilization increases. When any of those joints or the muscles around those joints do not do their job, the next joint must act earlier than anticipated and do more work than anticipated. In Steph Curry’s case, his right ankle either did not react fast enough or did not exert enough force to stabilize him before he slipped and his knee attempted to compensate but failed to act in time. This is not only the likely thing that happen with Steph but also is a very common occurrence with people who return a little too soon from a particular injury.

Joints have mechanoreceptors in them that tell you what the joint is doing and what position the joint is in. After injury those mechanoreceptors are often damaged and unable to work as efficiently as they do when they are healthy.  For many who suffer multiple ankle sprains, this is much of the reason. When you step, jump, or even get pushed in a particular direction; your mechanoreceptors in your ankle send signals to your brain that gauge whether your foot is flat and ready to land or turned inward which would cause the ankle to land awkwardly and sprain. In a healthy ankle, this message is sent quickly and the mechanoreceptors allow the foot to get flat and the ankle to get to neutral for safe landing. With an injured ankle, these signals can be slow or they can be wrong. The ankle sprain can be one of the more recurrent injuries because while those mechanoreceptors are injured or in the process of being rehabilitated, they may tell the brain that the foot is flat when it is not, or they may not figure out where the foot is before it hits the ground. Many of these scenarios end with your foot landing in a non flat position, which puts force on structures that are not supposed to have the force. With the multitude of injuries that Stephen Curry has had to that right ankle, I would guess that the mechanoreceptors in that ankle were already at a disadvantage. It is not a coincidence that Steph just happened to have a weird slip on his first game back. Injury Science is real and can explain what most consider to be coincidence or unlucky.

Anyone who is counting on StephenCurry to take the Warriors to another championship better hope they can get through the second round without him. I would even be hoping that the Rockets pushed this series out, if it meant they would buy more time for Steph to heal. I would bring him back in no less than 3 weeks and would squeeze every day of recovery I could out of him. The fact is that his right foot and right hip are at great risk for the infestation to spread. The only remedy is to completely let that ankle and knee heal before allowing him to return to play and soft tissue injuries of this nature are generally going to need at least 3 weeks to heal. If you see Steph or the training staff push for an earlier return and succeed, I think it would be the end of their run as a return in earlier than 3 weeks smells like re-injury to me.