Dime Q&A: Expert Surgeon Talks Manu Ginobili & Hand Injuries

01.30.12 7 years ago 2 Comments
Already this season, we’ve seen star players go down. Zach Randolph is out for a long time. So is Al Horford. No one knows how Manu Ginobili will play when he comes back. And no one really knows how much injuries are affecting Kobe Bryant, Chris Paul and Gerald Wallace. A part of me wants to say it’s the shortened season, but face the facts: Injuries happen every year.

No one is feeling the pain more than the Spurs though. They’re sitting on the edge of the playoffs at 12-9, playing just .500 ball in their last 10. Without the best player in the NBA – he may not be, but he was undoubtedly playing like perhaps the best player before getting hurt – the Spurs go from being a threat to just a bump in the road. But even some of the West’s elite are having trouble. Chris Paul could be dealing with a nagging hamstring injury all season. Over the summer, we caught up with a surgeon, Dr. Bal Raj, to help break down some of the game’s most important injuries. We’ve done it again.

I caught back up with Dr. Raj – who was named one of the “Top Orthopedic Surgeons in Los Angeles and a Leading Physician of the World” by the International Association of Orthopedic Surgeons, and someone who has a lot of experience with high-profile athletes – to talk injuries. Ginobili should be back sometime in March, but hand injuries are different for everyone. And if you think those are unpredictable, just ask someone like CP3 what having a strained hammy is like.

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Dime: We’ve had a lot of finger/hand injuries already this season (Kobe Bryant, Manu Ginobili, Gerald Wallace). But there are a lot of different ways a bone in your finger or hand can break correct?
Dr. Bal Raj: Yeah. You can have dislocations, tendon ruptures. You can have fractures outside of the joint or involving the joint. You also have different joints in your fingers. The question, number one, is is this a stable fracture? And number two is, can you actually play with this?

Dime: What do you mean by a stable fracture?
DBR: You can have fractures that are undisplaced, meaning it is just a hairline crack so that type of fracture, there’s no displacement of the bone. And when there’s no displacement, it’s because generally your ligaments and most of the bone are still intact. That’s considered a stable fracture. What you’ll see is maybe bruising around the finger but you won’t see any deformity.

Dime: What happens if you keep trying to play through that?
DBR: Let’s say you have a hairline fracture and you don’t protect it, number one you’re at a high chance that it, through a simple or minimal mechanism which could be catching a basketball, become a complete fracture and displacing. So it definitely can get worse.

Number two, once you have a fracture, the secret is to mobilize it because what’s happening is your body is bringing in all of its mediators around for inflammation, bone healing and bone repair. If you’re active on that fracture, you will significantly slow that process because you’re causing repeated damage to that area.

Dime: Ginobili had surgery on his fifth metacarpal. Are there any bones in your hand that are more troublesome to hurt?
DBR: The general rule of thumb is anything around the metacarpals involving the joint are usually bad. Whenever anything involves a joint… if you have a fracture that’s outside of a joint, that’s a much better prognosis because fractures are real and if they don’t heal, we can make them heal with plates and screws. But the point is if it’s outside of the joint, it won’t cause any restriction or range of motion or stiffness in the joint or arthritis. The worst type of fractures are ones that involve a joint.

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