Dime Q&A: Expert Surgeon Talks Zach Randolph & Knee Injuries

Already this season, we’ve seen star players go down, and a part of me wants to say it’s the shortened season. But face the facts: Injuries happen every year. Ask Steve Nash. He’s been dealing with a back injury for 10 years. Then there’s Zach Randolph, fresh off a breakout season and playoff run last year, and yet hurt his knee and now may be out for the season. You can go down the line – Al Horford, Rajon Rondo, Chris Paul – they’ve all tasted the injury bug this year.

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. Yesterday in part one of this conversation, we chatted on Chris Paul‘s hammy problem and Manu Ginobili‘s broken hand.

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 more injuries. Nash got his back problems under control a long time ago, but it’s something he has to deal with every day. And Randolph? No one really knows if he’s coming back this year or not. The initial prognosis assumed he would, but I’ve heard reports out of Memphis saying they’re not sure. Injuries are always unpredictable.

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Dime: Steve Nash has had a back problem for a long time. With the back, is there any way to reverse the symptoms? Once you have a bad back, are you always going to have a bad back?
Dr. Bal Raj: That’s the problem. Once you have a bad back, the likelihood is you have irreversible damage. It could be a disc bulging. It could be arthritic segments in your back. That causes a cascade of inflammation where your muscles go into a spasm. These issues become more and more troubling. As we age, we load these areas even more. Someone like Steve Nash, who is a top player but is slightly older, there’s more of a likelihood that he’ll be off more because of his back issue.

Dime: Is there anything you can do to limit back pain?
DBR: The best thing you can do is better posture. If you’re someone who slouches around a lot, you’re putting a lot of excessive force on your back. Number two, strengthen your core, especially your abdominal muscles because it will force a normal extension of your back, a normal curve. Number three would be stretching your back muscles. Keeping yourself nimble and stronger is the best thing you can do. And number four, reduce your weight if you have a weight issue, which typically isn’t a problem with NBA players.

Dime: A lot of people assume not being able to jump as you get older is because of knees. But doesn’t the back have a lot to do with it?
DBR: What people don’t realize is your back, like your knees and your hips and your ankles, is a weight-bearing joint. A strong core with a flexible back will definitely allow you to jump higher.

Dime: Zach Randolph had a partial MCL tear. Can you describe what that is?
DBR: Yes, the MCL is the ligament on the inner part of the knee. Basically, it’s a ligament that prevents your knee from opening up.

When it’s a partial tear, what it normally means is that obviously you didn’t fully tear it but its definitely stretched. It’s susceptible to fully tearing it. It usually happens probably from when someone jumps up, landed on a knee and it opens up and stretched or partially tore the ligament. That type of injury is usually non-surgical where you immobilize your knee in a brace to allow this to heal. These types of injuries usually heal in about six weeks.

Dime: When it’s immobilized, they can’t walk or bend it at all?
DBR: By immobilizing it, you’re just immobilizing the ligament that opens up the knee, so you basically wear a brace where you can bend and strengthen the knee but it prevents the knee from going outward. You can still function, but it may limit your jumping ability because of the brace.

What do you think is harder to deal with: a back injury or a knee injury?

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