Greg Oden has been cut by the Portland Trailblazers due to chronic knee problems. Brandon Roy announced his retirement in 2011 prior to the start of the season, citing “degenerative knees” as the major contributing factor in his decision. Something is going dreadfully wrong in the Northwest! And it’s not the athletes’ fault.
In the August of 2008, I received a call from then Portland Trailblazer’s assistant General Manager Tom Penn. “I heard about your services and want to know if you have an interest in conducting your biomechanics assessment on Greg Oden?” was how he started the conversation. I replied, “Of course, what did you have in mind?”
According to Tom, they had just been given the ok for Greg to start practicing basketball. After about an hour of conversation about what types of tests I would perform, Tom and I decided now would be as good a time as any. Well, it turns out Greg Oden was in LA filming an episode of a television show and if I could get there before he left it would be an ideal time to test Greg. So I packed up my biomechanics equipment and headed for LA.
When I arrived at the Mondrian Hotel in Beverly Hills, the hotel staff directed me to their exercise facility where I began to set up my equipment. Greg arrived shortly after I did and we immediately got started on the first of six (6) motion analysis-based biomechanics assessments I would conduct on him that day. At the time, we called the assessment motion DNA testing. The concept is based on the idea that no two people move the same way. Every person’s motion is as unique to them as their fingerprint or DNA. What affects the efficiency of their motion DNA is their physical strengths, weakness, injuries, habits, limitations, and more…regardless of whether their physical history is positive or negative. It all affects how each person moves.
In Greg’s case, his history was affected by his height and injury history, as well as the training and rehab he’d undergone since his first day of playing sports. At the time of his assessment, Greg was coming off micro-fracture surgery to repair torn cartilage in his right knee which cut his rookie season short before it started. The procedure and coinciding rehabilitation program forced Greg to miss his entire rookie season. According to team physicians and the medical staff, Greg was recovered and approved to return to the court for practices and “game like” situations. Greg’s biomechanics assessment told a different story.
Test 1- I hooked up 2 inertia-based motion tracking sensors just above Greg’s knees. The assessment was designed to measure the symmetry of motion between Greg’s left and right legs to determine any differences which might lead to setbacks unless targeted with deficiency specific exercises. The sensors measure the rotation, adduction/abduction, and flexion/extension of each leg above and below the knee. In addition to the crucial range of motion-related data, the sensor also allowed me to look at the timing, tempo, and coordination of each leg during normal straight ahead walking and running.
Greg was given two walking tests at 3mph with a 5% incline and 4 running tests at other varying speeds of 6 mph, 7 mph, and 8 mph . Greg’s results showed an alarming disparity in the range of motion (ROM) between his legs with his right leg showing significant weaknesses above and below the knee. Greg’s left knee showed increasingly large signs of fatigue and overuse resulting from compensations for the weaknesses and physical limitations of his right leg.
For biomechanics testing #2, I placed 8 motion tracking sensors all over Greg’s legs, arms, hips and torso. Each of these sensors would be give us valuable information about how Greg’s entire body responded to stresses and muscle imbalances. Greg was asked to do simple moves including a functional movement screen referred to as an Overhead Squat (body weight only) and a single and triple vertical leap test. The 3D-Motion Capture assessment confirmed the imbalances identified by his gait analysis and then some.
The following is an excerpt from his report delivered to and reviewed with the Portland Trailblazers medical staff.
From Greg Oden’s Report of Findings August 25, 2008:
Oden’s Right knee appears to have recovered from the surgery. Data indicates the ability to bear weight almost normally in the right leg’s Quadriceps and Hamstring muscles. However, a deeper look at the data indicates that Oden’s normal gait patterns have altered to compensate for weaknesses in his right lower leg. And as a result, does not distribute weight appropriately throughout the entire right leg. To compensate for the original injury and lower leg weaknesses, Oden has started to bear at times as much as 144% of his weight on the left leg (Ex.: during running trial at 7.0mph for 15 seconds, ROM 10.8 degrees extension L compared to 4.4 degrees of extension R). To compensate, Oden’s right leg excessively internally rotates during extension (push off) at lower speeds. While at higher rates of speed excessively abducts and externally rotates indicating circumduction of the right leg. This action can lead to hip pain on the right side, lower back pain/injury and opposite side knee pain as rotational forces cause the opposite knee to twist and as a result may cause the quadriceps muscles to overload to resist the rotation. This could be the cause of the left leg Patella Tendonitis.
When asked to jump, Oden proceeded to bear more weight evenly during take off, but landed with over 30% more weight on his left leg, demonstrating a conscious or subconscious lack of use of the right knee. The overloaded landing can cause significant stress and fatigue to the left quadriceps/patella tendon.
After reviewing the report with the Trailblazers medical staff, I came to several conclusions. The problem might not be Greg. I learned from the medical staff that they were already working on some of the exercises and drills which I was recommending for Greg. My response was simple…Greg’s ability to do any of the exercises correctly without hands on assistance was hampered by his own weaknesses. Greg needed (as do many people undergoing rehab) one-on-one attention to detail as he performed each exercise. For example: If the goal is to increase the strength in the weakest parts of Greg’s right leg, the more complex the exercise, the more he was able to compensate and work around actually isolating the weak muscles. Greg needed someone to watch over each rep and exercise carefully to make sure he was doing each exercise correctly until all of the muscles being targeted were able to contract on autopilot. Surgery causes damage to nerves which take time to regenerate, affecting the way a person performs an exercise. This is nearly impossible in a team setting and requires private one-on-one therapy with a therapist who understands how each segment of the body is supposed to move.
From Greg Oden’s Report of Findings September 24, 2008:
Based upon the analysis, our recommendation is the following:
- Increase Overall Hamstring Strength
- Increase R hamstring and Glute Strength
- Improve R leg explosiveness
- Increase L Gastroc, Soleus, Glute, Hamstring and Quad Flexibility
- Consider a more efficient shoe designed to lift the entire foot to improve normal leg stride.
In Greg’s case, every exercise or target area needing improvement on his list required slow, yet focused repetitions. If Greg was asked to walk, run, squat or jump, he placed more of the load on his left leg than his weaker right leg. I informed the medical staff that this overload would put Greg at risk for a major acute injury to his left leg. Greg’s imbalance was so distinct that I even advised that staff that if he didn’t improve the weaknesses in the short-term and continue some of the rehab-like exercises for the entire season, his career could be at risk.
And you can believe it or not, but the medical staff laughed off my recommendations. In fact, we spent nearly two hours at dinner with the medical staff questioning my results and looking for reasons to discredit the results rather than search for solutions to keep the team’s multimillion dollar athlete on the court. At one point, one member of the medical staff informed me that Greg suffered from a true anatomical leg length shortness on the right side. As a result of that diagnosis, Greg had been prescribed, by physicians, to wear a heel lift in his right shoe. Well doc, I hate to be the one to tell you again, but the heel lift actually increases the load and the amount of anterior/posterior shear (forward/backward sliding) on Greg’s right knee, contributing to his need to undergo several micro-fracture surgeries.
The results of Greg’s biomechanics assessments created doubt in my mind about the leg length claims. However, I suggested an alternative to a heel lift if they truly believed that a shorter right leg was a contributing factor to his knee injuries. The solution, for an athlete with Greg’s height and leg length, an entire shoe lift (orthopedic shoe on the right side) would reduce the sheer forces in the joint and keep Greg healthy while he continued the rehab.
You can imagine the laughter that filled the restaurant from the table. “No one wears a shoe lift,” one staffer replied. “That’s crazy. Where would we get one?” To which I replied, “Hey Nike is Greg’s shoe sponsor and they are right down the street. I’m sure they could customize a shoe lift for one of their star athletes if it keeps him healthy.” To my knowledge, no shoe lift was ordered for Greg.
Despite the medical staff’s objections to further testing, Assistant General Manager Tom Penn was sold on the results and wanted the entire team tested. Over the next two weeks, we scheduled a visit to Portland to test the entire team at the start of the preseason. Testing, of those players not in camp or available at the time for biomechanics testing during my visit to Portland, would be completed during a practice session in Los Angeles prior to a preseason game with the Clippers.
After completing testing of the entire team (in Portland and LA) and a retest of Greg Oden in Portland, I was astonished at the results of the athletes on the Trailblazer teams. While some athletes demonstrated more biomechanical efficiency than others. The results of several athletes stood out: Greg Oden, Brandon Roy, and Joel Pryzbilla. Each of their results showed imbalances, which if gone untreated, would lead to long-term, career threatening, chronic knee issues among other random supposedly unrelated injuries.
Well you may not recall but in 2009, Joel Pryzbilla and Greg Oden both suffered patella or patella tendon injuries . The reports submitted to the team and its medical staff both specifically identified significant amounts of stress on each player’s patella tendon and knee joints as a result of compensating for opposite leg weaknesses and physical limitations. From 2008 through 2012, all three players had each undergone at least one surgery each (that we know of). Oden has had at least three major surgeries since 2008, and Brandon Roy is retired after undergoing at least three procedures since 2008.
Neither player consistently contributed significantly to the team as a result of the physical condition of their bodies. Based upon my assessments back in 2008 and the marginal access I have had to follow their histories, each player’s the risk of each injury could have been significantly reduced or prevented all together. So I say this to Greg , Brandon, Joel, and every other professional athlete…get a second opinion outside of the team. Take control of your body and your career. Over the past two years, I have written about the risks of injuries associated with biomechanical deficiencies.
Strong egos and lack of information are catching up to athletes and changing if not ending careers in all sports. Nicolas Batum, Pryzbilla, Travis Outlaw, among other Trailblazers, all missed significant time since their initial biomechanics assessments from 2008-2009 due to injuries which could have been prevented and were pointed out in their reports to the team’s medical staff. Brandon Roy was forced into retirement because he was not given proper care for his injuries. Greg Oden’s career is at risk for the same reasons. Both players could still get back on the court and yes, Brandon Roy’s “degenerative knees” can be healthy and he could play for 5-10 more years with the proper treatment.
The solution: more testing to obtain more objective information is the only way to insure the investment professional teams make in athletes. Tom Penn should be applauded as an assistant general manager for trying to make a positive impact on the health of the team. Instead, shortly after 2008, Tom was not rehired and currently works as an analyst for ESPN. Sure another Greg Oden and maybe even another Brandon Roy will come along for Portland. In the future, athletes like Greg and Brandon will be labeled injury-prone or a bad risk (as they have been since the beginning of sports). The risk is not the investment in the athlete, its the investment in the care they get from the team which drafts or trades for them.
The Sports Kinesiologist’s Advice:
Wake up professional athletes as well as the agents and teams who care for them.
Mr. Paul Allen, this is your team and your investment is at risk! If you continue to do the same thing and get the same results…. I believe it is considered the definition of insanity?
Athletes: Know your body, know yourself, and ask questions (even if if means getting an opinion outside of your team’s medical staff. This is your career!
Want to keep up with the latest in sports and fitness injury prevention plus tips on how to reduce your own personal injury experiences? Follow me on twitter @zigsports!