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.

Golden State Warriors: Truly Strength In Numbers

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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.”

Muay Thai Champion Returns to the Ring

He’s Baaaaack!! Elite Sports Physical Therapy (ESPT) is thrilled to see Muay Thai Champion Kevin Ross return to the sport he loves. Kevin recently signed a contract with Lion Fight Promotions and is scheduled to return to the ring on January 25, 2013 for “Lion Fight 8” from inside the Joint at the Hard Rock Hotel & Casino in Las Vegas.

Kevin Ross (aka The Soul Assassin) is an icon for Muay Thai in the U.S. and is recovering from ACL surgery. He is currently ranked 10th in the world by the WBC for Muay Thai in the Super Light Weight Division.

“It gives us great pleasure to we working with individuals of world-class caliber like Kevin,” says Jacon C. Chun, MPT, SCS, ATC, CSCS, ESPT’s Director, and one of the few Board Certified Sports Clinical Specialists in the Bay Area. “But ESPT is not just reserved for these top-notch athletes. Anybody can come receive our first-class service.”

“Kevin’s dedication and commitment to rehabilitation was remarkable. He did everything we asked and more,” raves Chun. “He’s a dream patient to work with because of his dedication to his health and his sport.”

Lion Fight 8 will be broadcast on AXS TV on january 25, 2013. For exact time, please check local listings or visit www.lionfightpromotions.com.

Come see for yourself what sets ESPT apart from the competition. Check us out at www.espt-ca.com. We don’t just make you feel better, we help you get better!

Congratulations Miriam – WMC World Champ!

In her first fight in over a year, Miriam Nakamoto captured the WMC World Title over Sandra Bastian this past weekend at the Legends Muay Thai Championship in San Francisco. She’s a testament to the dedication her sports requires with her work ethic and her drive. 

Congratulations Miriam! Great job!!

You can find out more about Miriam’s goals in 2012 by checking out her video interview at Front Row Fights here.

World Champion Fighter Chooses ESPT

Another elite athlete has chosen ESPT as their physical therapy provider. World Champion Muay Thai fighter Miriam Nakamoto is coming to Elite Sports Physical Therapy for her rehab needs.

Considered one of the top female strikers in the world, Miriam is versatile in both Muay Thai kickboxing and traditional boxing. She has been involved in the striking arts for over 11 years, and became a professional in 2005. She has a Muay Thai record of 13-0.

Miriam has a host of fighting awards, accolades, and honors to her name. A testament to her skill and her coaching, since she has bested fellow competitors with much more experience. The most recent title she captured was the the coveted WBC World Title on August 21, 2010 in Haikou City, Hainan Island, China. She scored a vicious first round KO over Luxemburg’s Claire High. Haigh was ranked 3rd in the world at the time.

Miriam currently trains out of Combat Sports Academy in Dublin, CA under the tutelage of Coach Kirian Fitzgibbons, head coach of the US National Muay Thai team.

“It’s a great honor and privilege that athletes of Miriam’s caliber choose ESPT,” says Director of Physical Therapy, Jacon C. Chun, MPT, SCS, ATC, CSCS. “I think that speaks volumes about the level of service we provide and how we can meet the needs and expectations of these special patients.”

With one of the only Board Certified Sports Clinical Specialists in the East Bay leading the team, ESPT has facilities in Dublin and Fremont to serve everybody’s physical therapy needs. Whether you’re a world-class competitor or a weekend warrior, if you want quality sports and orthopedic physical therapy in the San Francisco East Bay, there’s only one choice- Elite Sports Physical Therapy.

For more information, feel free to visit our website at www.espt-ca.com.

ESPT Supports Olympic Hopefuls!

At Elite Sports Physical Therapy, we pride ourselves in providing the highest level of sports and orthopedic rehabilitation. And we could receive no greater compliment, than to have people recognize us for the quality of our work. So it gives us great pleasure, to be able to sponsor Sho Nakamori in his quest for London 2012. You can check out his website here.

Few physical therapy clinics in the Fremont or Dublin areas could probably claim they serve this caliber of athlete. This a true testament to ESPT’s commitment to providing the best physical therapy care possible. Nobody combines clinical excellence, first-class customer service, and cutting-edge technology like ESPT.

“I’m very fortunate to have Jacon on my side as I continue about this journey of mine!,” says Sho on his website. And we are very honored to be working with Sho at ESPT.

With one of the few Board Certified Sports Clinical Specialists in the Bay Area available to the public, ESPT should be your #1 choice for sports and orthopedic rehabilitation. “We see patients from as far north as Sacramento and as far south as Carmel. It’s thrilling to have people seek you out because they believe you can help them out,” says Jacon C. Chun, MPT, SCS, ATC, CSCS, ESPT’s Director of Physical Therapy.

For more information about how you too can receive the same level of care that professional athletes and olympians receive, check out our website at www.espt-ca.com. With convenient locations in Dublin and Fremont, ESPT is easily accessible for all your sports and orthopedic rehabilitation needs.

ESPT Now For All Ages!

The following is a little more information about physical therapists from the Pediatric Section of the American Physical Therapy Association (APTA):

What Is Pediatric Physical Therapy?

Pediatric physical therapists work to help children reach their maximum potential for functional independence through examination, evaluation, promotion of health and wellness, and implementation of a wide variety of interventions and supports. Pediatric PT’s support children from infancy through adolescence and collaborate with their families and other medical, educational, developmental, and rehabilitation specialists. They promote the participation of children in daily activities and routines in the home, school, and community.

Pediatric physical therapy promotes independence, increases participation, facilitates motor development and function, improves strength, enhances learning opportunities, and eases care giving.

For more details about our clinic, look us up at www.espt-ca.com. For more information about pediatric physical therapy, contact us at (510) 656-3777.

The Back Pain Epidemic

Did you know hat Americans spend at least $50 billion each year on low back pain? Did you know low back pain is the most common cause of job-related disability and a leading contributor to missed work? And the only neurological ailment more common in the United States than low back pain is headache.

Most incidences of low back pain are temporary and the result of trauma to the low back from sports, overuse with housework/yard work, or a motor vehicle accident. This usually results in inflammation and muscle spasm in the low back, creating a problem that is mechanical in nature. There are situations, however, where the source of pain is a damaged structure like a protruding disk, a fractured vertebrae, or a pinched nerve. In these cases, it’s very important that you seek the advice of a physical medicine and rehab physician or a spine specialist for the next step in caring for your back.

Finding The Right Balance

In treating many patients with mechanical low back pain (and even some of those with structural issues), I have found that there is usually an imbalance in hip flexibility, thoracic mobility, and core strength. In other words, most of my patients have tight hip/leg muscles, they are very stiff in the thoracic spine (usually from poor sitting posture), and have weak abdominal and back muscles due to deconditioning. Most of the time, correcting these imbalances will provide a significant reduction in pain and improvement in function.

For example, I had the opportunity to treat a crew athlete that had been diagnosed with several disc protrusions in his low back. One physician told him that he would never be able to row again. Another doctor said, “Who knows how many of these crew athletes have protrusions. They sit in that prolonged position in the boat for practice and competition. If we did an MRI on all the crew athletes, we might find some with the same thing. But how many of them are actually in pain? Go ahead and treat the imbalances first and see what happens.”

Well, that’s what we did. This crew athlete had very poor hamstring flexibility and core strength. We worked very hard on this for 8 weeks and he started to see improvements in both of these areas. Soon after, guess what: His Back Pain Decreased!!! And before he knew it, he was back in the boat with the crew team rowing!!

Treat The Cause, Not The Symptoms

Fortunately for the crew athlete, his second doctor was able to think outside the box, or should I say the back. (A very good doctor might I add. If you would like more information about him, email me at jchun@espt-ca.com). This is something that we are seeing more and more as medicine (and physical therapy) is evolving. Just because someone has back pain, you don’t just keep treating the back. This can provide relief, but without addressing some of the other issues mentioned above, the back pain will likely return.

Most physical therapists use modalities like ultrasound, electrical stimulation, cold lasers, and traction to address low back pain. But that should not be the only thing they do. If it is, you need to find yourself another therapist. Those things will only address your pain. A physical therapist that looks at the whole person and not just the diagnosis, will help patients find the root cause of their back issues. They will help patients find balance in their bodies. Balance between flexibility, mobility, and strength, so that the low back pain is relief is for longer periods and the occurrences are fewer and farther between.

For more information about how physical therapy can help decrease low back pain or for a comprehensive evaluation, contact us at Elite Sports Physical Therapy at (510) 656-3777.

Barefoot Running- Au Naturel or Unnatural?

Today I ran into this article which has an interesting take on running barefoot and the new “minimalist” campaign taken by Nike and some other footwear makers: Should-you-toss-your-running- shoes-and-just-go-barefoot?

Nike has their Nike Free shoes which are supposed to mimic the bare feet and allow the foot to adapt and strengthen as you run. The result is supposedly better biomechanics because one does not need to “rely” on footwear for support. The article even cites some runners that have noticed increased foot/leg pain with their new shoes.

Please check out my two part blog here and here, before jumping to conclusions. There is such a thing as too MUCH support when selecting a running shoe. And there is such a thing as too LITTLE support. Make sure you see a physical therapist or a podiatrist for proper footwear recommendations. I have seen many a running shoe store employee make the wrong recommendation. Only a proper biomechanical foot evaluation can give you a clear picture of the proper type of shoe for your foot.

Feel free to contact us at Elite Sports Physical Therapy at 510.656.3777 if you have any questions. Just ask to speak with a physical therapist and will guide you in the right direction!