While recovering from foot surgery and a back injury, Joel Embiid was chosen No. 3 overall by the Phildelphia 76ers in the NBA Draft last month. A week before the draft, Dr. Richard Frenkel inserted two screws into Embiid's navicular bone in his foot. The one-year wonder from the University of Kansas is now out for an undetermined amount of time.
Drafting an injured player is not new for the Sixers. Last year they drafted Nerlens Noel after ACL surgery. He is scheduled to be ready to play at the beginning of the 2014-15 season.
The plan for Embiid is unclear. Last February, he suffered a lumbar stress fracture known as spondylolysis. As a stand-alone injury, once it is healed and an athlete is pain-free, it is no longer a concern. But a second stress fracture, especially in the foot of a young athlete who has recently started to play more minutes on the hard wood, making the transition from volleyball in his native Cameroon, could be problematic.
What is a Stress Fracture?
A stress fracture is a broken bone that has not snapped in two. The repetitive pounding of running and jumping begins to crack a weak spot in the bone. As this continues, the crack spreads or deepens to the point where it causes pain and instability in the bone. With Embiid, the fracture became large enough to require surgery to stabilize the bone.
Who Is At Risk?
Most stress fractures occur in women and novice runners who quickly ramp up their mileage before their bodies are physically prepared. For Embiid as a 7-footer, the stress fracture in his foot is more of a cause for concern than the one in his back ever was. In very tall people, long limbs and feet can put excess stress on the bones, and the weak spots will show up with these types of injuries in weight-bearing bones.
According to the American Journal of Sports Medicine, stress fractures primarily occur in the lower legs of athletes. Athletes who run a lot—like basketball players—are at greater risk. Another study in the same journal said predicting the injury in men is difficult, but foot arch shape (a very high arch), certain foot positions while standing (such as varus foot, more commonly known as flat feet), leg length differences, and changes in general bone density can all have an effect.
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The most significant combination of factors seems to be a high level of activity with low bone density. Vitamin D helps the body absorb calcium. Athletes with Vitamin D deficiencies do not hold onto the calcium they ingest and are more prone to bone weakness and fracture.
What Does Recovery Involve?
According to a study in the journal Foot Ankle International, stress fractures to the navicular, whether repaired surgically or not, take at least four months for recovery. In this particular study, 15 of 16 competitive athletes were able to resume full athletic competition after recovery.
Because the navicular has few attachments to muscles, once his fracture is healed sufficiently and any concerns about re-fracture are gone, Embiid should be able to work hard to restore his lower-body strength and get back in shape. With his recent injury history of stress fractures and the amount of stress an NBA center's body takes playing basketball, it may be best to return at a slower pace and perhaps not at all this season. He is 20 years old, and his bones are still maturing.
Barefoot strength training may be an option for Embiid because it increases muscularity. Performing Squats, Deadlifts and Lunges without shoes can help strengthen the intrinsic muscles of the foot and thus protect the bones.
The hope is that Embiid will not have the same fate as Houston Rockets star Yao Ming, who missed 180 games during his eight seasons in the NBA. Ming's injuries included multiple stress fractures to the foot and low leg, similar to Embiid's injuries.
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