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.

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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?

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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.

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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.

Tiger Woods’ Knee

On my way to work I usually listen to sports radio and catch the top 6 sports news stories from the day before, just as I walk into the office. Today, the #1 story was Tiger Woods’ season ending knee surgery. As I had a little bit more time to think about and learn what he had been diagnosed with, it brought into perspective just how amazing his win this past weekend was.

So lets summarize some the medical findings that came to light:
1) Tiger Woods will have ACL reconstruction on his left knee and will be out the rest of the season. This is for an ACL tear he say he sustained jogging in July 2007.
2) He had been diagnosed with stress fractures in his left tibia 2 weeks prior to the US Open and his doctors recommended he not compete.

Based on these findings, here are some ponderings I had today on how amazing an athlete Tiger Woods is:

Realization #1: Tiger Woods has been playing with a torn ACL. Specifically a torn ACL in his left knee. And he hasn’t just been playing, he has been winning!!! He won the PGA Championship last year, the BMW championship and a few other tournaments to end 2007, he came in 2nd at the Master’s this year, then won the US Open this past week. ALL ON ONE KNEE!!!!! For those of you who do not know much about the ACL, that is a major stabilizing ligament in the knee. Without it, the knee usually feels unstable and the shear forces and torque produced in the knee are higher than normal. These forces could possibly lead to incr. stress on the cartilage and meniscus. And for a right handed golfer with a swing like Tiger’s, the forces on his left knee are probably ridiculous.

Realization #2: I have read articles where people have been questioning Tiger’s timing in electing an April surgery, but like anybody else, Tiger Woods probably wanted to try all his options before going to the last resort- ACL reconstruction. This explains his decision to have arthroscopic surgery in April. I would assume this was a debridement type surgery where his surgeon would just clean out some of the damaged cartilage, so he would not get as much pain and stiffness. If the strength would return and his knee would feel stable, he could then opt for the ACL reconstruction at a later date. Usual timeline for rehab in this type of surgery is 4-6 weeks. Obviously this was not enough.

Realization #3: Perhaps trying to push his progress after the surgery, the stress to Tiger’s knee after eventually lead to fractures in his tibia. Painful, but with time these will heal. It is amazing though that he walked 7,607 yards x 5 over the weekend with these fractures. All I can say is this guy is a gamer!!!

Realization #4: I am sure that the doctors went over all this with Tiger, and he said himself that he probably should have heeded their advice. Which probably would have meant having that knee surgery last year in July, after a problem with the ACL was discovered. But for an athlete that had yet to win a Major in 2007 and that was probably trying to win the FedEx Cup, staying in the game was the only option. Once again, the competitive nature of these elite athletes is something that is difficult for most of us in the general public to understand.

Having worked with athletes for the majority of my professional career, I understand how special some of these situations/competitions are for them and how special they are. And many times, my job is to help them just be ready and get by. Of course I have opinions about what is medically sound and what is not, but many of the decisions I leave up to the athlete. Because I’ll never be their shoes. I’ll never know what it’s like to compete at the Olympic games or an NCAA championship. I’ll never walk 18 holes in a US Open playoff at Torrey Pines with a chance to cement my place in history as one of the greatest, if not the greatest, golfer of all time. So, all can really do is watch, be amazed, and be ready when these athletes come calling.