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.

 

Prevent Pediatric Sports Injuries With ESPT

As summer ends and we get ready to embark on another school year, that means student-athletes will be starting practice with competitions soon to follow. Depending on off-season conditioning, the coach’s awareness of injury prevention, and the athlete’s own physical development, some of these students will end up with aches and pains, while others will be able to avoid them altogether.

“What’s most disappointing is the majority of these injuries are totally preventable,” says Jacon C. Chun, MPT, SCS, ATC, CSCS, Director of Physical Therapy at Elite Sports Physical Therapy (ESPT). “Simple preventative measures such as adequate rest, hydration, flexibility, strength, and support, could mean the difference between sitting on the bench to recover or staying healthy and playing regularly in competitions.”

ESPT is better equipped than any other clinic in Fremont to address the issues these young athletes face. With the only Board Certified Sports Clinical Specialist in the city leading the clinical team, you can be sure that each treatment program will be individualized for the injured athlete’s particular sport and needs.

One key in treating young athletes is to remember that children are not little adults. Things that you can use in designing programs for grown-ups, need to be modified when you are dealing with an immature musculoskeletal system. “The last thing we want to do is cause more harm, when we are trying to do good,” say Chun.

Another reason ESPT is more appropriately suited for these young athletes, is the fact that they can offer the most 1-on-1 Physical Therapist time in Fremont. With children, we can’t expect them to have the same attention span as adults. So most children cannot be left alone to perform exercises. They need proper supervision and instruction at all times. This will allow for greater adherence to to proper technique and successful completion of each and every treatment session. This practice model is why we will afford the greatest opportunity for success when working with young athletes.

Combine our clinical expertise and first-class service with some of the newest, cutting-edge equipment and it’s not hard to see why ESPT should be your first choice for an Outpatient Physical Therapy clinic in Fremont. Not just for young athletes, but for patients of all ages.

For more information about our services and how we can help you get rid of pain and get back in the game, contact us at 510.656.3777 or check us out at www.espt-ca.com.

Pediatric Overuse Injuries Part 2- Let The Kid Be A Kid

As I mentioned in my previous post, overuse injuries in athletic children are increasing at an alarming rate. Most of this is due to lack of cross-training/multi-sport participation and is the result of sport specialization at a younger age. The consequence of this specialization is undue stress to an immature musculoskeletal system, resulting in overuse injuries.

So, other than having children play 2,3, or 4 different sports, how do we prevent these types of injuries? The first step is recognition. As mentioned in the last post, if your child or a child you coach is having pain in one of the following areas, they may benefit from a visit with an orthopedist: heels, shins, knees, hips, back, elbows, or shoulders. (Feel free to contact us at ESPT if you would like a referral to a local orthopedic physician).

Once you have identified a painful area that is not resolving, you can follow the RICES principle:

Rest- In children, most of their painful areas will resolve with appropriate rest. Since most of the symptoms in children are the result of stress to immature bones (growth planes), appropriate time for these areas to mature will often alleviate the pain. There are also taping techniques and assistive devices that can be used to take stress of these painful sites. A sports physical therapist with experience treating athletes can help you find the right equipment for your child.

Ice – Try icing the painful area for 15 minutes with an ice pack. You can use a ziploc bag with ice and a little water or a commercial gel pack. Be sure to place a wet towel between the ice and skin to prevent any irritation to underlying tissue. This can be repeated several times a day to minimize swelling and symptoms at the painful site.

Compression – As mentioned earlier, compression garments and equipment like braces/straps/tape can be used to help decrease symptoms. Check with you physical therapist or doctor for more details.

Elevation – Try to elevate the painful site above the heart to assist with carrying swelling away from that area.

Stretch – Release tension and muscle imbalances that could be putting stress to the immature bony sites and causing pain. A physical therapist that understands the sport requirements for your young athlete and the biomechanics of the specific recreational activity involved, will be able to design a program tailored to each individual’s needs. No one is more qualified to do this than our therapists at ESPT. With experience treating athletes in 34 sports from lacrosse to water polo, synchronized swimming to football, no other clinic in Fremont can provide you a more complete sports and orthopedic evaluation to allow your child to return to the activities they love.

If your child’s symptoms are not relieved with the RICES principles, it is highly recommended that you follow-up with your pediatrician or with an orthopedist for further medical evaluation. Early detection can help address issues while they are still manageable and help prevent progression to a condition that would require mandatory rest.

The bottom line is that it’s important to keep kids healthy, to allow them to have positive developmental associations and pleasure with sports. This will allow kids to stay active and maintain a healthy lifestyle. It will allow kids to just be kids. And it may even allow some kids to emerge into the stars of tomorrow.

Pediatric Overuse Injuries- Too Much Of A Good Thing?

I remember in high school when we voted someone most athletic, they usually were good at more than one sport. It may have been a guy that played football, then basketball, then baseball. Or a girl that played soccer, then ran track. That, however, is becoming less common today and specialization is becoming the norm.

Kids are becoming dedicated to a particular sport at a younger age. They focus themselves year-round on trying to be the best. They go from their high school team to the club team. They hope for a possible college scholarship and perhaps a professional career.

Along with year-round preparation and practice though, there are consequences- an alarming increase in overuse injuries. In the 2005-2006 school year, more than 1.4 million injuries were sustained by high school athletes. Most of these, could have been prevented with proper education and timely treatment.

The important thing to realize is that children are not little adults. Coaches need to be educated in the effects of overtraining on an immature musculoskeletal system. What worked for them and what is tradition, is not always in the best interest of the young athlete. With the evolution of science and medicine, training methods also need to evolve.

If you bend a piece of metal repetitively, it will eventually break at its weakest link. And that is what happens with an immature musculoskeletal system. Where adults can get tendinitis, strains, or ruptures at their weakest links, children can get traction apophysitis injuries. These are irritations to the growth plates because children have bones that are not completely fused. Injuries at these vulnerable sites produce inflammation, pain, and can stimulate bone growth.

Common sites for these types of injuries are: heels, shins, knees, hips, elbows, and shoulders. If your athletic child is experiencing pain in any of these areas, the best thing to do is set up an appointment with your physician to have them evaluated, so the proper course of treatment can be recommended. (I’ll talk a little more about treatments in my next blog). And remember, just because a physical therapist says they treat sports injuries, doesn’t mean they have direct experience in a sports setting. At ESPT, our director is the only Board Certified Sports Clinical Specialist in the area. (Check us out at Elite Sports Physical Therapy).

The bottom line is that kids aren’t immune to injuries and they are in fact becoming more common. Increased awareness by the athletes, parents, and coaches can aid with earlier detection and prevention. And this in turn will allow kids to continue playing the sports they love and to continue just being kids.