Why Steph Curry Will Probably Be Back Sooner Rather Than Later

Photo Credit: KNBR

Photo Credit: KNBR

All of DubNation held their collective breath Monday for what probably seemed like an eternity. Awaiting the MRI results on Steph Curry’s knee injury, Warriors fans breathed a sigh of relief with the good news that there was no structural damage and it was just a Grade I MCL Sprain.

But now people want to know- How long will the rehab take? When will Steph be able to get back into the Warriors lineup to lead this team on their march to another NBA Championship?

GM Bob Myers told the media that there are no guarantees (and there aren’t when it comes to rehab because everyone’s different), but expects the timeline to be around 2 weeks. That’s based on typical expectations for a Grade I MCL sprain with a 2-3 week return to activity. It could be longer he said, but I actually think that it will be less than 2 weeks barring any unforeseen circumstances. Let me explain why.

Steph Curry Knee Injury

The Injury

With the replays and pictures of how awkwardly the reigning MVP fell Sunday afternoon at the Toyota Center, I’m sure many were shocked and surprised his injury was not more serious. I saw many a tweet from pundits and professionals alike predicting a more serious MCL sprain or even an ACL tear.

Upon further review of the footage, I noticed two things that helped minimize the stress to Curry’s knee when he fell:

1) His Right Foot Was Not Planted- It actually slipped, just like his left foot did, from the sweat that was on the floor.

2) He Has Good Hip Mobility– His right hip internally rotates when he slips, banging the inside of his right knee into the floor, right where the MCL is.

At first glance, it looks much worse. But because Steph’s hips are mobile, and his right foot is not stuck to the floor, he’s able to preserve the alignment between the right hip/knee/ankle, thus saving his knee.  If either one of those factors were not there, than we may be talking about something else.

LLIstress.jif
The Diagnosis

An MCL (Medial Collateral Ligament) sprain is an injury to the ligament on the inside of the knee that connects the tibia to the femur. With these types of injuries, forces usually come from the outside causing what we call a valgus stress to the knee. This valgus stress causes gapping (or stretching) to the inside of the knee resulting in a sprain. With a sprain, there can be partial tearing (Gr. I) all the way up to a complete rupture (Gr. III) of the MCL. These injuries may result in swelling, pain, and tenderness along the inside of the knee where the ligament runs. Higher grade sprains are also associated with instability in the knee when tested manually by a clinician. Gr. I sprains do not show evidence of instability.

But wait? How can Steph have a Gr. I MCL Sprain (partial tear) if there was no structural damage on the MRI? Does he have a tear or doesn’t he?

As I mentioned earlier, it looks like Curry was saved from more serious injury by the way he fell. I actually did not see any valgus stress to the knee when you look at the slow motion replays. What may look like valgus, I believe, is just the way his knee was flexed as he was getting ready to plant that leg.

Without any visible valgus deviation or movement to his knee, Steph should only have sustained minimal, if any, stress to his MCL. He did, however, bang the inside of his knee quite hard into the floor. (You can see this if you watch the replay in real time). Swelling from that would be in the same area as his MCL.

So in the absence of any positive structural findings on the MRI, the diagnosis of a Gr. I MCL Sprain is basically made because he has swelling and tenderness on the inside of the knee in the area of the MCL. It could just as easily be a bad bruise though. There’s no way to really distinguish between the two, all you would see is swelling and pain on the inside of the knee.

Steph Curry Stretching

The Treatment

In the absence of any structural findings, meaning there is no instability in the knee, it’s just managing pain and swelling from here and getting Curry moving when he’s comfortable. Inflammation typically lasts from 48-72 hours after the initial injury, so they won’t know where exactly Curry will be until probably Tues/Wed. As he feels better and moves more, he should continue to improve.

With a top-notch medical staff that has already garnered recognition from Klay Thompson earlier this year for helping him through a back injury, and cutting-edge equipment at their disposal like the AlterG Anti-Gravity Treadmill, I have no doubt they will get Steph back in action as soon as it’s safe to do so. I wouldn’t be surprised if Steph Curry starts feeling good towards the end of the week. That gives him a few more days to get his legs back under him before he’s released to return to full participation. So my estimate is he’ll probably feel ready to go at around 1.5 weeks (especially knowing that Steph wants to get back on the court with his guys). But as we’ve seen with these playoffs, it will be up to the medical staff and Kerr when he actually gets back on the court.

I’ve been really impressed with how the trainers and therapists have been able to keep guys like Bogut, Iguodala, and Livingston not just healthy, but playing at a very high level. #StrengthInNumbers to me applies to the whole organization. From the fans to the players, coaching staff to the medical team.  That’s why I’m hopeful that Steph will be back sooner rather than later. And that’s why I’m anticipating they’ll make a nice long run this post-season towards another NBA Title.

 

If Your Ankles Are Weak, Then Strengthen Your….Hips?

PJ-BO118_SP_CUR_G_20130506184038

A few years ago Steph Curry was having problems with his ankles. Now the All-Star NBA MVP is having an amazing season having missed only 1 game. The secret? A training and injury prevention program that focuses on his….hips. That’s right, his hips.

A great ESPN article came out today to highlight the success Steph has had with this training program. Even though the problem lies all the way down the chain at his ankles, the hip plays a major role in controlling position of the lower body joints. If there is weakness up higher in the chain, the lower joints end up taking more stress. By working on stability at the core, Steph and his trainers have given him a much more stable foundation to move, change direction, accelerate, decelerate, and juke other players out of their shoes.

This is another reason why a good physical therapist, athletic trainer, or doctor doesn’t just focus on the injured area. Remember, the injury is where the athlete broke down, but the cause could be elsewhere. We see that all the time at our clinic. Someone that has plantar fasciitis, ankle sprains, knee tendinitis could have the root of their problem at the hips. So just massaging the injured area, applying ultrasound or ice, and exercising the painful body part will only produce temporary results.

stephen-curry

For truly successful outcomes, you need to treat the whole person. Look at Steph. He was good before and treating his ankles allowed him to play and be an All-Star. Treat the whole person, and he’s the NBA MVP and on the verge of an NBA Championship.

Don’t Chase Pain

Microsoft PowerPoint - Presentation1

If your physical therapist only looks at and treats the area where you have pain…..FIND YOURSELF A NEW PHYSICAL THERAPIST!

A good clinician doesn’t just treat a body part, they treat the WHOLE PERSON. That doesn’t just go for Physical Therapists. That includes Doctors, Chiropractors, and Massage Therapists. Just about anybody who works on your body.

About a month ago, I had a professional athlete come in for an evaluation. The athlete had been having low back pain and had been diagnosed with Left Sacroiliac (SI) issues. The symptoms had been going on for 8-9 months and they were going to chiropractic and even tried flying to LA for an injection to the SI joint. The injection resolved things temporarily, but they were still not able to participate in their sport of choice. They had to know soon if they could perform, because there was a competition coming up.

At the evaluation, we did a thorough screening and I noticed that the Right SI joint might actually be the problem. We did some manual therapy to release the right side and the pain reduced significantly. In fact, the athlete told me that they were able to perform movements after that one visit, they previously could not. ONE VISIT. But the the pain was still present.

healthy-living-woman

One week later at a follow-up visit, we looked at the SI joint again both sides seemed to be moving better. We did a little more manual therapy to target problem areas and they left without any low back or SI symptoms. TWO VISITS and NO LOW BACK PAIN. They were still sore to the back when returning to activities, but the SI symptoms were much less significant now. The athlete eventually was able to compete with their team and achieve their athletic goals.

A female road runner runs down a road at dusk at Independence Pass.

After suffering 8-9 months, the athlete was now able to get back to doing what they love. After only TWO VISITS! The point of this is to help you realize that where the body is hurting or in pain, is not necessarily the source of the problem. It’s just the weakest link in the chain. It’s your body’s way of telling you that a problem may be lying somewhere else. If you address the real problem, then the pain can be reduced and eventually eliminated. If you only deal with the pain, it will likely come back because the problem area is still around.

So the moral of this post is: Don’t Chase Pain. And if you have a clinician that does that, then you should run. Run to one that doesn’t.

Golden State Warriors: Truly Strength In Numbers

goldenstatewarriors

It continues to be an amazing year for the Golden State Warriors. And when I watch them this year, nothing gives me greater joy than seeing Shaun Livingston on the court.

Many of you may not remember, but Shaun suffered a career threatening knee injury back in 2007 when playing for the LA Clippers. He dislocated his patella and pretty much tore every ligament in his knee. The Clippers decided to let him go as an unrestricted free agent after the 2007-2008 season. After being cleared by doctors to resume basketball activities in 2008, Livingston has continued his comeback with multiple teams. He’s even had to make a trip to the NBA D-League trying to secure a contract. After a successful stint with the Brooklyn Nets last year, the Golden State Warriors signed Livingston to a three-year contract this past summer.

Getty-Images-Shaun-Livingston

His comeback seemed to come full circle for me with his amazing performance last night in Game 1 f the Western Conference Finals. Coming off the bench to spark a tremendous 2nd quarter comeback, the Warriors were able to hold off the Houston Rockets and take this 1st Game in the Best-of-Seven series. As a sports medicine professional, every time he makes a play, it gives me goose bumps, knowing how hard Shaun worked to get to where he is today after that knee injury.

One of the key reasons for Shaun’s amazing return is the wonderful medical staff he is surrounded by. Signing with the Warriors reunited Shaun with Head Athletic Trainer JoHan Wang. Entering is 2nd full year as Head Athletic Trainer for Golden State, Wang spent the previous 8 years of his NBA career with the LA Clippers. That included helping Livingston recover from his knee injury from the 2007-2008 season. So you could probably say no one in the NBA knows Shaun Livingston’s medical history better than JoHan. And having JoHan there, must give Shaun a sense of relief and confidence that allows him to perform at such as high level.

To me this signifies how important a good athletic trainer/sports medicine professional is to any athlete. It gives them someone that can track their performance, monitor them to prevent injuries, and evaluate their practice/training programs for potential problems. If Livingston’s performance isn’t enough proof that a top-notch medical team is important, since Wang has been with the Warriors both Curry and Bogut have been able to stay healthier and play longer.

Thanks to Wang and his team, Livingston is able to be a major factor in the Warriors deep run this post-season and we get to fully appreciate the talent that is Steph Curry. With the amazing medical staff to take care of its players and the support of the best fans in the NBA, I can see how the Warriors can say that there truly is “Strength In Numbers.”