Greg Oden to play in 2012-13 NBA season? It is possible! Heres how…

What a crazy last 12  months in the NBA.  Brandon Roy is coming back! When I wrote about Brandon Roy coming back from retirement in April,  some readers responded in disbelief.  “He’s got bone on bone,” they said.  “I must have been on drugs”, one commenter said.  “No credibility”, and so on.   Well this is not an I told you so follow up, but more about how Greg Oden can get there too.  (Blog coming soon about Brandon Roy’s chances of staying healthy: stay tuned).

After a whirlwind last 6 months or so, Greg Oden was released and gave a lengthy interview discussing his career and life with Mark Titus of Grantland.  According to published reports, Greg also began a rigorous rehab and conditioning program to help get his body right.  In addition, Greg also reportedly underwent a surgical procedure to help reduce pain in his knee.

The reason you’re here is to find out if and how it might be possible for Greg Oden to make a return as well.  I am a fan of Greg as a person and want to see him on the court and achieve his basketball dreams.

My biggest motivation for writing about Greg Oden and other athletes issues is to bring light to the fact that proper treatment of the ‘root cause of any injury is an  essential component to helping prevent athletes and anyone from suffering from an injury long term’.   What traditionally has been referred to as proper treatment has had only short term benefits to the patient.  Traditionally, professionals in the industry treat the symptom.  If you treat the symptom (pain or injury), yes you can get back in the game quickly.  But the long term affects can be devastating and cut short any athlete’s career.

Recently, someone asked what I thought would have happened had Michael Jordan been drafted in Portland instead of Sam Bowie (whose career was hampered by chronic foot injuries)?  The answer is who knows and who really cares.

The bigger question is what would we be saying about Michael Jordan if he had not recovered from injuries suffered to his feet early in his career.  Three games into the 1985-86 season, Jordan went down with a broken bone in his left foot and was sidelined for 64 games before returning in mid-March.

The answer is that Air Jordan might have been reduced to a fraction of what he is today.  According to his teammates and those who played against him, Michael Jordan (whom I first met in 1994) worked harder than any other player in the game on and off the court.  In many ways, his work ethic overshadowed any treatments or training programs prescribed for him  As a result, any trainer who worked with Jordan would have become a name in the industry because he was Michael Jordan. Had that same trainer worked with Sam Bowie, we have no idea how Bowie ‘s body would have responded.  It is impossible to treat the two players with similar injuries with the same treatment because their body types and injury/training histories are different.

Oh by the way, many people forget or don’t know that Sam Bowie played in the NBA until 1995, he just didn’t play the way he was expected to based upon being drafted Number 1 overall ahead of the greatest player of all time.

Now back to Greg Oden so I can tie this all together.  A proven surgical procedure undergone by hardworking Kobe Bryant (who works as hard as Jordan on his fitness level) to eliminate pain only fixes part of the problem: the pain goes away. That is a good thing because the pain prevented Greg from being able to workout efficiently.   Additional benefits to the procedure Greg underwent earlier this year include reduced inflammation and possibly accelerated healing in the areas of his body affected by all of his surgical procedures.  Based upon the sheer number of surgeries Greg has undergone, his body has probably built up a considerable amount of scar tissue and some nerve damage may have occurred as well.  The procedure could potentially help with both.  This is very positive for Greg’s comeback.  But it is still not enough.

I hope Greg’s rehab and training program has focused on his weaknesses.  As I’ve stated previously, Greg moves inefficiently because of weaknesses in his body that have caused injuries.  Here are a few areas that were weak on Greg in 2008 and as evidenced by the repeated procedures in 2009, 2010, 2011, and 2012, possibly still affecting him today: glutes, hamstrings, quads, hip flexors, hip extensors, hip rotators (internal and external), peroneals, gastrocs, soleus, abs,anterior and posterior tibialis, and more–mostly on the right side.  The left side indicated signs of significant fatigue and overuse.  So Greg’s left side needed then and probably still does need a break, relaxation.

The Number One area Greg Oden needs to improve….his feet!!!

Greg Oden laces up the shoes on his size 18 shoes into a rigid botttom, Nike shoe. Oden’s shoes also contain at least a heel lift, which also places stress on the front of his right knee. The lift could contribute significantly to meniscus injuries. immobile feet and a heel lift. No wonder Oden has meniscus and patella issues.

In particular, Greg needs to improve  his right “foot flexion” strength.  Can Greg grip things with his feet?  As crazy as it may sound to the novice reader, it is a necessary part of efficient biomechanics and Kinesiology.  As you’re reading this, take off your shoe and you’ll see what I mean.  Place a towel flat on the floor and grip or pick it up with your foot (one foot at a time for 50 reps- hold each rep for 2 seconds).  Try it and see how your foot feels.  Some of you won’t make it to 25 before your foot cramps.  If you’re right handed do the exercise with your right foot. Lefty’s just the opposite.

The feet are the single most neglected part of any training program.  Less than one percent (1%) of all trainers or physical therapist include true foot exercises in the daily or even weekly training programs for their athletes.  Now big manly types will say working out your feet is not important. Give them big strong massive biceps and they’ll take that guy. But let’s get real, we are seeing more injuries to knees, achilles, and other parts of the body related to weak feet.

We assume that because we are on our feet that they are functioning correctly, but that is not true. And no all of you you barefoot running enthusiasts, that is not enough either. Barefoot running only affects where the impact occurs not function of the feet. That’s a whole blog series I have set for October.

Here’s an indicator of whether or not you need to train your foot flexion or gripping:  Do you wear flip flops? If so, you are overworking the top of your foot and ankle (dorsiflexion and toe extension). In my research for this post, I watched a youtube video promoting toe extension exercises for dancers. It is honestly the worst and most unnecessary exercise ever, unless you’ve suffered an injury that keeps you from wearing flip flops.  Don’t get me wrong, some people will need it but 9 out of 10 would be negatively impacted by it.

Greg Oden and just about every other basketball player in the world needs the opposite.   These athletes need to work on gripping things with their feet. Why do I say this? It’s because the shoes worn by basketball players prevents their foot and ankle from functioning properly.  The solid rigid surface, the ankle taping…this prevents the ankle and foot from doing what it does naturally.  So yes, Greg Oden has a weak right foot.  In addition, he has a weak right lower leg complex: gastrocs/soleus.

This weak right foot contributes to his weak right lower leg, which contributes to his weaker right hamstrings, glutes, quadriceps, and other areas of his right leg.  These weaknesses cause Greg to over use his left side which is what contributed to Greg Oden’s left patella injury in 2009.  So if Greg Oden wants to come back in 2012-13, he’ll need to work hard, but he’ll also need to work on the right areas of his body.   Most importantly, Greg should absolutely under no conditions perform the same number of sets and reps or stretches on his right side in comparison to his left.  Greg’s injury history alone is an indicator that one side was damaged more than the other, so why do the same things on both? And yes, all of this was a part of the “controversial report” given to the Portland Trailblazers in 2008 and again in 2009 when contacted for a copy by Tom Penn.  Emotionally, another major injury would probably end his career. I would hate to see this because I had a chance to have an impact on his career longevity.

I guess we can say that two chronically, injured players for one team might be playing in the NBA for other teams after being let go due to those alleged career ending injuries.   And isn’t it amazing that one of them could win a championship (if he ends up in Miami and they win again). Shocking!  I’m just saying… somebody other than me thinks these two guys are still worth it and can be fixed.

The bottom line is just because you read it on the internet or someone makes a statement about it does not mean that it’s true.  Apparently one shoe has already dropped as Brandon Roy has signed with a new NBA team.  Another shoe will drop when Greg Oden is signed before the start of the season and returns to the NBA.  I’m pretty sure someone will sign Greg  next season.  And at worst, Greg can hang on for another 5 years or so going from team to team and make millions.  I hope he works hard on the root cause of his injuries and not just the injury itself.  Ask the question of your therapists, Greg.  And make sure you get a real answer not just one to pacify you.

The only other question left for me to answer here is, “What’s my motivation?”

Well, it is truly to see Greg Oden and many other injured athletes back on the court or in the game.  If Greg’s serious about a return, he should have a copy of his old report if he does not already have one.  But also, he should get a new one. Oh and if he does call to request one, no one will never hear about it from me until long after he returned to the court.   After all, you didn’t know about his previous tests as I kept that confidential not because I had to but because I wanted to keep it quiet.  At anytime, I could have promoted my relationship with the Blazers or any athlete or team as many others in the field do.  Having a famous clientele doesn’t make you an expert.   Actually having a positive impact on them or sharing valuable information for their benefit is what makes me and others in the profession feel great about waking up every day to go to work.

Until Greg was let go, I was a background guy.  That means when an athlete or team came to me, I stayed in the background. This is not about attention for me, it’s about bringing light to a dark situation. I want Greg Oden’s flame to shine.  Let the candle burn Greg.   Next week, I’ll detail Greg’s number 2-5  most important exercises to guarantee his long term health. Oh by the way, NBA teams, a guy with a tight back (back problems) can be fixed and is still worth a top draft pick. hint hint.

Zig Ziegler, The Sports Kinesiologist can be followed on Twitter @zigsports.

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Derrick Rose Update: Career in Jeopardy…Why Rose will never be the same!

To keep up with the latest from Zig Ziegler, follow Zig on twitter @zig_ziegler.

While Derrick Rose was tearing his ACL, I spent the morning conducting a 3D-Biomechanics Assessment on future projected Top Five NBA draft pick Shabazz Muhammad.  While there are no guarantees the UCLA bound senior at Las Vegas’s Bishop Gorman High School will escape future knee injuries, the move will provide Muhammad with exercises targeting any weaknesses or imbalances in his body. The results are in the hands of Muhammad along with his current and future trainers at UCLA.

I appreciate the your coming out to do the tests on me,” said Shabazz.  “I will do what I can to improve.”  In addition, to the biomechanics assessment to identify his risk of injury, Shabazz, also was able to benefit from a fine tuning of his pelvis position during shooting free throws. Already with a free throw shooting percentage around 85%, after the adjustment to his pelvis, Shabazz stated, “I already feel myself shooting straighter.”

The subtle techniques changes will become permanent as Shabazz follows the strength and conditioning exercises and stretches recommended specifically for his body.  But most importantly, Shabazz and other young players can significantly reduce the risk of overuse and compensatory injuries related to muscle imbalances.

For Derrick Rose, it’s not too late to help improve his ability to recover from his recent ACL tear.  His recent injuries (prior to the ACL tear) were warning signs that something was about to go dreadfully wrong.  It’s like ignoring the check engine or oil light in the car.  Sure we can keep driving; check the oil and probably notice that we are low on oil (adding more), but eventually the symptom turns into a major problem.  The light was an indicator that maybe we had an oil leak?  I’m just guessing here but I’ve seen enough simple symptoms turn into major problems.

As for Rose, Oden, and others, to help us all understand the risks of rehab and recovery, let’s first gain a better understanding of the injury itself.

A tear to the anterior cruciate ligament (ACL) in the knee usually occurs in one of two ways: 1) hyperextension of the knee 2) rotation of the knee.  Both causes contribute to ACL tears while bearing more weight on the knee than supporting muscles can bear. If either motion is too great, an ACL tear or meniscus tear (at a minimum) can occur. This type of non-contact injury usually occurs while the athlete is attempting to change directions.  (There are other ways for injuries to occur but these are the two most common methods for non-contact related ACL/Meniscus tears).

Rose suffered a torn ACL while landing and attempting to RE-accelerate or change directions during his trademark “jump stop” power move.  In my opinion, the injury occurred during the transition phase of the move where Rose was in between stopping and starting (changing directions). At the point in the game when the injury occurred, Rose’s body (which had spent the past two months compensating for injuries below the knee) was experiencing in-game fatigue.  His ACL tear could have happened in the first minute or the last minute, however, because of his history.

Rose is and has always been a player who relies on his explosive leaping ability, quickness, and all around athletic ability. He has been labeled a fearless player who plays with reckless abandon.  That all changed with a little over one minute to play in game one of the 2012 playoffs against the Philadelphia 76ers.

How will this affect Rose going forward?

In the future, when Rose moves to his right, he will be able to play aggressively. However, stopping or changing directions while moving to the right will be extremely challenging.  As Rose attempts to change directions while moving to the right, the inside of the left knee must assist in deceleration.  If the left leg does not absorb its appropriate share of the workload during this deceleration, one of two things is bound to happen: 1) re-injury to the left knee or 2) new injury to the right knee.

As Rose attempts to move to the left, the outside of the left knee absorbs the majority of the workload while moving in that direction. This creates less of a challenge for Rose in the future because of the nature of the injury.  Stopping or changing directions for Rose when moving left should be considerably easier for Rose to do as the inside of his right knee will bear the majority of the load in deceleration.  The act of actually pushing off is primarily the responsibility of the outside of his left leg.  As a result, Rose will be able to change directions when moving left, but may subconsciously rely more on his right leg.

In my description above, Rose will be forced to overuse his right leg considerably, resulting in a higher risk of injury to the right leg from foot to hip.  We may see Rose tear his right ACL or retear his left, develop Patella tendonitis in the right knee, or suffer an injury to the right hip,or foot (which was supported by muscles already weaker than those in his left leg).

The biggest concern for Rose is the fact that Rose’s injury is an injury related to rotational stability of his left knee.  The ACL attaches to the inside of the lateral aspect of his femur (thigh bone) and the lateral aspect of the medial portion of the tibia (lower leg).  In stabilizing the knee, the ACL resists rotation. In Rose’s case, his lower leg internally rotated and could not stabilize before his femur began to externally rotate.  The rotated out of sequence and in opposite directions.

The most neglected part of ACL surgery and rehab is the rotational stability of the knee.  During surgery, the bones of the upper and lower leg are not typically rotated back into their normal position prior to the injury.  The new ACL is attached typically with the two segments in the posture they moved to when the injury occurred.

As for rehab, we constantly hear “experts” in the field of medicine and rehab referring to the quadriceps and hamstring muscles as the most important to ACL recovery. But we are rehabbing only part of the knee’s stabilizing muscle groups.

Why is it that no one discusses the extremely important segment of the body below the knee with muscles that cross the knee and assist in the stability of the knee?  It’s because the protocols have become watered down and we only look at the primary muscles that flex or extend the knee.  Apparently, experts in the field of rehab and medicine have forgotten that the lower leg muscles assist in stabilizing and supporting healthy knee function. Yes, I’m referring the entire muscle group of the lower leg.

The Gastrocnemius/Soleus complex (typically referred to as the calf muscles) is the single most important muscle group to target when recovering from ACL surgery, the quads and hamstrings are important but no more important than the lower leg muscle group.  Yet, only a minimal portion rehab is dedicated to targeting the lower leg.  The Anterior and Posterior Tibialis, and mobility of the peroneals are extremely important to complete recovery.

In addressing this area to aid in recovery, Rose’s therapist must pay attention to the rotation of the knee, by manually assisting the repositioning the tibia/femur posture. In doing so, they can return his knee to its pre-injury “joint posture”. If this happens, Rose can return quickly and achieve near pre-injury levels, reducing his risk of re-occurrence.

If you ask anyone who has ever undergone ACL or meniscus rehab (Greg Oden, Brandon Roy, Terrell Owens, myself (8 times), and the list goes on and on) no one will say that they spent a good deal of rehab time working on developing the lower leg muscles. For Derrick Rose and others to recover completely from ACL or other knee injuries, more emphasis must be placed on the lower leg.  If not, Rose will become an out of control player (unable to stop to change directions) or suffer repeated injuries to his knees and be out of the game before he’s 26 years old.  Keep in mind that rehab type exercises for Rose will need to become a part of his regular training program to ensure that his “fixes” are permanent and to keep him from suffering chronic knee, hip, foot, and other injuries.  As a Bulls fan, I’m pulling hard for Derrick Rose, but I have my concerns.

As a Sports Kinesiologist specializing in human movement, I’m pulling for experts in our field to open their eyes and close their protocols. Address every athlete individually, not the injury.  The injury is just a symptom that something went wrong.  And in the case of Derrick Rose, Greg Oden, Brandon Roy and others, something went wrong repeatedly and will continue to do so, unless the root cause of the injury is address. Let’s hope Shabazz Muhammad and other young players bound for the NBA can benefit from the changes in the sports, fitness, and medical injury early enough to stop the trend in accepting injuries as part of the game.  Many injuries can be prevented but we have to take steps to make this a reality.

Zig Ziegler, The Sports Kinesiologist, provides feedback on injuries to A-List athletes in an effort to help educate athletes and parents on the prevention of injuries.  Be sure to check out other stories here about Greg Oden, Brandon Roy, Mark Sanchez, Tiger Woods, and more.  Follow Zig on twitter @zig_ziegler.

Derrick Rose: Career in Jeopardy! Why he may never be the same.

To keep up with the latest from Zig Ziegler, follow Zig on twitter @zig_ziegler.

In this day and age of high flying, fast moving, power displaying NBA players, Derrick Rose was regarded as one of the best! MVP in 2010-11 season; comparisons to Michael Jordan; and numerous championships already planned for Chicago in the minds of fans like me.  The dream of Chicago Bulls fans around the world has now come to a knee buckling jump stop. Hoping for the best for you D. Rose, but I have major concerns. So here we go…

Derrick Rose tore his ACL (anterior cruciate ligament) and MCL (medial collateral ligament) while performing his signature power move: Jump Stop and attack or pass.  Since his rookie season in the NBA, Rose has amazed fans around the world with his athletic ability, conjuring up images of and comparisons to the greatest of all time, Michael Jordan who led the bulls to six (6) NBA championships (All of us Bulls fans know there would have been more banners if not for baseball).

While watching the video, you’ll notice Rose’s body was off balance (if you look closely) as he landed with more weight on his left leg than his right leg. This is a move that is partially learned (NBA players often practice the move landing on the inside leg incorrectly) and in other cases it is done subconsciously, as a compensation for weakness or injury to the other leg. Weight should be more evenly distributed with more weight on the outside leg to actually change directions more effectively.

While moving to his right, Rose should have been preparing his body to land with slightly more weight on his right leg than his left.  To help you understand, when moving to the right, it is the right leg’s job to stop the lateral movement to the right. The left leg acts as a decelerator with weight distribution (40-45% left, 60-55% right). In Rose’s case, his left leg (in hitting the ground with more of Rose bodyweight on it) attempted to stop his motion to the right, with limited weight absorbed on his right leg (based upon an evaluation of Rose’s posture in video footage of the incident).

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In my opinion, Rose was most likely compensating (as many great athletes would do) for the foot injury/soreness he felt less than two weeks ago. Now Rose has been battling injuries all year:

According to Fox Sports these are the injuries reported since January 11, 2012:

1/11/2012 Sprained left big toe. (Catalyst to right leg injuries)

1/16/2012 Sprained left big toe.

2/10/2012 Strained lower back

3/14/2012 Groin

4/10/2012 Sprained Right Ankle (Key injury leading contributor to ACL/MCL tear)

4/16/2012 Soreness Right Foot (Key injury major contributor to ACL/MCL tear)

Other injuries Rose suffered during his brief career include additional injuries to his right ankle and a bruise to his right hip from a collision with Dwight Howard in 2010.

Rose’s injury patterns indicate a clear cut case of compensating injuries shifting back and forth from his right side to his left, and from his feet/a

nkles up to his knees (with the exception of ankle sprains and contact related injuries).  It is blatantly obvious to anyone who understands how the body works that Rose’ left leg should have been experiencing a significant amount of left leg fatigue as a result of the recent right foot and ankle injuries, regardless of what caused them.

In my opinion, this injury would have happened anytime.  And unless Rose and his medical team address the root mean cause of his previou

s

injurie

s and compensations related to them, the ACL injury could not have been prevented.

Now, one thing to keep in mind is that some of Rose’s injuries occur because he plays fearlessly with reckless abandon.  It is that style of play that now w

ith an ACL and MCL injury could lead to more injuries from Rose. In addition to the risk of more injuries (next up is

either a reoccurrence of the left ACL tear or a tear of the right ACL within 12 to 18 months (which is actually pretty common).

I’m thinking a tear of his right ACL happens first but this one is tough to predict because of Rose’s style of play. If I were to complete a 3D Motion Analysis of Rose’s body, I’d be able to provide a more accurate prediction (This is based solely on my opinion and evaluation of his injury history and playing style).

Rose ACL tear is clearly related to his recent injuries.  Many people are asking should Coach Tom Thibodeau have taken Rose out of the game.

Actually, coach has no idea about limits that should have been placed on Rose after his recent string of injuries. However, common sense would tell any medical professional that Rose’s play should have been limited (bring up images of Brandon Roy against Phoenix in 2009 playoffs).

It’s easy to see that Rose was compensating for the soreness in his right foot. This can be done consciously or subconsciously. Only Rose really know

s how

his foot feels when he jumps, changes directions, or lands on it. If Rose was feeling any fatigue at all in his foot, it was up to him to salvage his career. However, because no player wants to be considered soft and take himself out of the game, Rose chose to stay in the game (as would every other athlete who is taught “no pain, no gain”) hopefully sending a message to the Philadelphia 76ers.

Please keep in mind it is the medical staff whose job it is to impose limitations on players’ time on the court or in a game when a player returns from

injury.  It is not the responsibility of the coaches at the professional or any level to determine if a player is physically recovered.  Thibodeau’s job is to play the players who are eligible to play, not monitor rehab and fitness levels of players. So let’s give Thibodeau a break. If the injury hadn’t happened, and the Bulls won by 20 with rose on the court, this topic related to the injury would be a non-issue.

When Rose comes back after surgery, his style of play will definitely change. We won’t see the old powerful, explosive Derrick Rose for 2? 3? Ma

ybe 4 years, and that’s only if there are no setbacks over the first year.  His signature “jump stop” power move could be what ends the career of another bright young NBA star.  Keep in mind, an ACL injury is not like a meniscus/cartilage injury.  It can be death to an athlete who relies on explosiveness and changing directions. The ACL and MCL provide stability to the knee, while cartilage essentially acts as a cushion.  Rose needs stability of the knee for his game to be effective. It will be at least one year before Rose’s repaired ACL is healed enough to provide the stability for the types of moves Rose needs to make when playing.  And let’s also not forget about those chronic injuries on his right side.  They could at any time cause an injury to his right knee or re-injury to his left.

Yes. Derrick Rose will play again but it is highly unlikely he be the same high flying Derrick Rose we knew before the fourth quarter was near its end this past Saturday. I’m praying for a safe surgery and really, really, good rehab. And hey Derrick in case you’re listening, objective measurements of how your body is functioning during rehab and identifications of your injury related compensations will be the key to your return to the Derrick Rose glory days. Speaking as a Bulls fan sin

ce the arrival my home states’ Scottie Pippen, I’m pulling for D. Rose.

While I have not worked with Derrick Rose, I write this post at the request of several readers who have posted or emailed with questions about the topic.  My preference is to comment on athletes based on objective information.  This post is merely my opinion based upon a subjective review of Rose’s injury history and video of the actual incident in which Rose tore his ACL.

On Wednesday, I’ll discuss ACL injuries, the surgical procedures and the most common aspect related to the surgery and rehab that could be considered negligent in the areas of orthopedic surgery and rehab.  In this story, I’ll explain why I feel Derrick Rose’ career could be over and what Rose and his therapists and trainers can do to help extend his career and reduce the risk of repeat or compensation injuries related to the ACL/MCL reconstruction he is about to undergo.

Zig Ziegler, The Sports Kinesiologist, provides feedback on injuries to A-List athletes in an effort to help educate athletes and parents on the prevention of injuries.  Be sure to check out other stories here about Greg Oden, Mark Sanchez, Tiger Woods, and more.  Follow on twitter @zig_ziegler

Responses to Comments and Questions on Oden, Roy, and Pryzbilla; Plus Concussions and other injuries

Over the past few days, thousands of people have visited my blog and posted questions or comments. Some of the great questions and comments I have received are from twitter: @zigsports.  All of the comments are appreciated.  Every comment provides me with a learning opportunity.  I am re-posting some of those comments below.

Most of the comments and confusion seems to center around biomechanics or my qualifications to make recommendations.   Please keep in mind that while I use 3D motion capture to conduct a biomechanics assessment, my primary focus is the evaluation of the efficiency of Human Movement or Kinesiology.  The more efficient the movement, the more evenly stress is distributed throughout the body.  As for my experience, a degree in Kinesiology from Western State College of Colorado is the foundation for my methods of working with people. Over the years (18 years of experience working with thousands of “unique” athletes), I have been asked “my opinion” about athlete’s throwing motions, swings, running mechanics, etc..  While on occasion, I have offered my opinion, I prefer to provide my objective interpretation of data rather than offering my subjective opinion.  When I offer an objective interpretation of data, it is much stronger than my opinion.  It’s like asking me to read a tape measure to tell you how far a person traveled versus glancing at the distance and providing a guess.

Earlier this year, an associate of mine who is a medical doctor informed me of a study at the University of California-Davis, which has invalidated the use of goniometers in evaluating joint range of motion.  Medical practitioners (physicians, physician assistants, physical therapists, athletic trainers, chiropractors, and nurse practitioners) use a goniometer to document initial and subsequent range of motion in a joint to evaluate progress.   The reason the study invalidated the use of goniometers is because it showed that practitioners rarely achieved the exact same measurement on the same subject as other practitioners.  This means when that using a subjective tool like a goniometer, 10 out of 10 medical professionals will not measure your knee flexion at 90 degrees using the same goniometer.  So your true progress may be in question.

Consider the evaluations I perform on athletes as a way to document progress with more accuracy a repeatable methodology… A computerized goniometer that can measure joint range of motion while performing any activity, which is repeatable. This is unlike a goniometer which only allows for single joint measurement in a fixed position.

In 2010, i was asked to give my opinion on the throwing mechanics of Mark Sanchez of the New York Jet’s.  In a rare occasion, I did so on this blog and the story was retold in an article by the reporter on his BLOG.  What I wrote was my opinion, no matter how accurate it may or may not have been.   It was still just my opinion based on an evaluation of videos of Sanchez’s in game and practice throwing motions. My experience in comparing and reviewing data and watching human movement have given me an edge in evaluating the potential effects of injuries (known and unknown to the casual observer).

With Greg and his teammates, I interpreted data.  Basically, its like putting down a tape measure and asking 10 people to look at a certain spot on the ground and record the number on the tape measure at that spot indicating the distance from the starting point.  The chances of all 10 people recording the same number are a lot higher than if you ask those same 10 people to guess at how far away from them the spot is from the starting point without using a tape measure.  I am the person who prefers to use the tape measure to validate my opinion or what I thought I saw.

Human movement, especially sports skills, happen way to fast for even the trained eye to see all that is happening, even if you know where to start your review.  Depending upon how significant the abnormality in their motion, the more difficult the visual evaluation becomes to the observer.  Manual evaluations are limited as well.  Primarily, in a manual evaluation, the medical practitioner will palpate (feel around) the injured area feeling for abnormalities.  The thorough examiner may also manually take the injured joint or area through passive range of motion testing.  During both manual evaluations by “expert” medical professionals, time is spent asking the injured person how it feels when they “do this” or “do that”  The injured area may be more or less painful to the person at that point in the position, invalidating the manual assessment.

We’ve all been there, when asked how does it feel?  “Feels fine now doc, is our typical response once the healing process has begun around the symptom. “I feel ready to go” is what we might say as the injured area has significantly healed. Then we get up and limp away.  Where is the accuracy in this if it is the standard evaluation (which I too learned during athletic training classes at Western State)?  Unfortunately, I experienced more of these evaluations due to my participation in sports than I would have wanted as an athlete.

Objective information is the key to preventing injuries and improving performance.    This is not a response to comments from the Portland Trailblazers management.  A response to those comments could come next week.   Thanks for reading.  Here are those comments I told you about earlier. Just a few here and as always, more to come…@zigsports

COMMENT from carrite April 13, 2012 >>Brandon Roy’s “degenerative knees” can be healthy and he could play for 5-10 more years with the proper treatment. I’m reminded of Eric Idle in “The Meaning of Life” obliviously asking about his leg that a tiger has bitten off, “So it will just grow back again, will it?” The only way Brandon Roy is gonna play 5 to 10 more years in the NBA is if one believes in the Magical Meniscus Fairy that brings cartilage to good boys and girls who cross their fingers and believes hard enough…

RESPONSE: zigsports April 16, 2012 That fairy you speak of came to visit me personally in 1997 as a part of my 8th knee surgery and delivered healthy cartilage to my knee which remains intact today nearly 15 years later (After suffering 2 two ACL reconstructions within 12 months and six surgical procedures to remove torn cartilage). A meniscus transplant is another option. However, if corrections are not made to the body to reduce the stress, that meniscus will be damaged as well. So be careful what you wish for my friend. We live in an age where science and medicine provide us with many options.   point of Interest: Brandon may have done damage to the lining of the the bones in his knee which may make him ineligible for the procedure (only a surgeon can determine if he is eligible). However, if he is a candidate, he could play again as I previously stated. But if he does not address his body’s issues which cause him to place stress on the interior of the joint, that procedure may fail.

COMMENT: In general do NBA teams embrace your work? Did you say it’s used in Phoenix? Specifically (because it’s a team I am a fan of), what response if any have you gotten from the Dallas Mavericks to this sort of physical evaluation of players?

In general there is a fear that if we look closely at athletes true physical attributes under the microscope of motion capture, we may do more harm than good. As a result, the industry chooses to ignore it as a whole. Unfortunately, no, the Mavericks have not been significantly exposed to it.   Teams who have been exposed include the New York Knicks (2008 draft pick Danillo Gallinari and a few other players were tested during the 2008 NBA Summer League. Interestingly enough, two days after we gave the results to the Knicks staff indicating excessive stress in Danillo’s back, he suffered a low back injury which affected him most of the 2008-2009 season. He has not been retested.   Yao Ming is another athlete,  I would love to evaluate.  In my opinion, he too should still be playing professional basketball, but I have no idea the extent of damage to his feet and ankles. But I am pretty sure that it is related to imbalances and improper absorption of his body weight from left to right.

COMMENT: What has Joel Przybilla done correctly to get back on the court?

According to his report, Joel actually suffered an injury to the leg we identified as weaker. So his rehab actually forced him to strengthen the leg I indicated he needed to improve. Unfortunately, it was after the injury and subsequent surgery. As a result, he missed time on the court while doing what I suggested (inadvertently). As a result of that rehab, he has been able to come back and continue to play.

In Greg’s case, his patella injury should be considered an overuse injury to his previously healthy leg. But the root cause of his knee problems are more than likely still present as he awaits being healthy enough to be operated on again.  And unfortunately, if the causes are not addressed, another procedure is likely to be required to his knees, left Achilles tendon, or right hip at some point in the future.

I also received a question about my mantra: 100% of all injuries and sports performances are affected by motion…either too much or not enough.

Tej Sahota@boatical   @ZigSports 100% of all injuries are related to motion is a bogus statement. non articulating bone injury? fractures? dislocations?

RESPONSE:  “NEW”  Hi Tej,  non-articulating joints, fractures and dislocations are conditions or injuries caused in the same way as any other injury.  These conditions become present when caused by some activity which places stress on a part of the body causing function of the affected area to fail.

Even a concussion (which is another condition) is related to motion. A concussion occurs when impact causes forces related to the impact unable to properly absorbed and distributed by the body (not just the head) causing movement inside the head whereby the brain itself is displaced impacting the inside of the head. This impact inside the head damages the brain and interrupts normal brain activity, possibly causing minor to severe bruising.  Now this is not the medical definition of a concussion but its meant for the average person to be able to understand what I’m saying  (sometimes we get too complicated).  A football player can get hit in the chest by another player making a tackle.  If the tackled player fails to absorb the force properly a concussion can occur as the head impacts the ground a greater amount of speed and force in a whipping action.  The injury could have occurred in the neck, back, almost anywhere else in the body depending on the direction of the impact and how the energy traveled along the spine when combined with the persons strength and ability to resist the force.  As energy from the impact is absorbed by the body it has to go somewhere.  The better prepared the body, the better force is dissipated throughout the body. A fracture and non-articulating joint may be similar in cause but not exactly the same as a concussion.  Both are caused by something else.  In the cause of a non-articulating joint, it may also be caused an interruption of nerve function as well.

As for a dislocation, this is an injury purely related to motion, strength, and flexibility.  My first surgery was to repair a shoulder dislocation. As a freshman at Oklahoma State University on full athletic scholarship on the track and field team, I dislocated my shoulder playing intramural football. I fumbled a ball, reached out and grabbed it as others piled on, causing the injury.  The shoulder dislocated  31 additional times from September 1987 until I finally had surgery in August of 1988 (I later transferred and graduated with a degree in Kinesiology from Western State College in Gunnison,Colorado).

Today, my shoulder is strong because of the imbalances I’ve learned about and how they affect my body.  Incidentally, the limited range of motion of my left shoulder contributed to a naturally shortened range of motion in my right leg while running. The two sides have to work together for me to be able to hurdle or run period.  It is believed that an injured left shoulder can contribute to acute leg injures on the right leg.  In addition, it may contribute to overuse injuries on the left leg and right low back.  The body is connected!  A toe injury can cause neck pain, not by the injury itself.  The neck pain could be caused by the way we limp after the toe injury.

Are we going to continue to treat the symptoms?  Most importantly are we going to only evaluate the symptoms?  I say NO!  So the next time you’re at the doctor for back pain or some other muscle/joint related issue. Ask more questions.

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!