Dwight Howard sat out last night’s game against the Minnesota Timberwolves after having a benign cyst drained and removed from his left ankle. Howard has been dealing with an ankle sprain in that same joint but it is unclear if the two are related. He is expected to be back on the court for the Houston Rockets on Saturday against the Cleveland Cavaliers.
Ganglion cysts are benign balls of fluid that usually develop in the membrane that cover tendons and joints. They are most commonly seen in wrists and ankles but usually don’t cause any discomfort unless they are near a nerve, causing pressure and interference. The cause of these cysts are not well established but it is thought that they might be a blister response by the body to trauma or injury.
Up to half of all ganglion cysts disappear on their own but sometimes invasive procedures are warranted such as aspiration (draining of liquid from the cyst) or surgery. Home remedies that are not recommended include hitting the cyst with a heavy object or popping it with a something sharp.
Cleveland Cavaliers point guard Kyrie Irving left yesterday’s game against the Clippers in the first quarter after colliding with Blake Griffin. Irving clutched his left upper arm after the incident and was ruled out of the game with a left bicep injury. Cavs.com updated the situation with the following statement today:
“Irving traveled back to Cleveland with the team and was examined at Cleveland Clinic Sports Health this afternoon by Cavaliers Head Team Physician Dr. Richard Parker. Imaging revealed a strain in the long head tendon of his left biceps. Irving will now undergo a period of inactivity for his left biceps and be re-evaluated in two weeks.”
Losing their leading scorer (21.2 PPG) and playmaker (6.2 AST) virtually eliminates any chance of the Cavs making the playoffs as they are 4.5 games back of Atlanta for the final spot. Irving’s had a history of injuries even in the short time he’s been in the league. Hopefully he will bounce back quickly from this latest setback.
The bicep muscle attaches to the shoulder with two tendons, the long head and short head. The former connects to the top of the shoulder socket at the glenoid while the latter joins to a bony protrusion on the scapula called the coracoid process. Strains can occur in these tendons from repetitive motions and stresses or in Irving’s case, a sudden impact to the area.
With most fantasy leagues entering round one of the playoffs, owners of Irving now have to look elsewhere for production. A good place to start is on the Cavaliers with point guard Jarrett Jack, who is likely to take over the bulk of Irving’s minutes. Jack has been inconsistent in his last 10 games with highs of 21 PTS and lows of 5 PTS on 22% shooting. But with more consistent minutes and playing with the first unit from the outset of the game should help Jack’s value in the coming weeks.
Other point guards to consider if they are still available include Jordan Farmar of the Lakers, Brian Roberts of the Pelicans, Jeremy Lin and Patrick Beverely of the Rockets, and Reggie Jackson the Thunder.
Patrick Patterson of the Toronto Raptors has been diagnosed with a sprained right ulnar collateral ligament and will be out for 7-10 days, pending another evaluation. He actually sustained the injury a couple of weeks ago but exacerbated it this past Friday. Patterson has been the first big man off the bench for the team and is averaging 9.7 PPG and 5.2 RPG while shooting almost 50% from the field.
The ulnar collateral ligament is located on the medial aspect of the elbow and connects the upper arm bone (humerus) to the inside lower arm bone (ulna). This ligament provides valgus support to the elbow, limiting the amount of lateral bending the elbow can perform. Like all sprains, there are three grades depending on the trauma sustained by the ligament. Grade 1 involves very little stretching and no tearing to the ligament, whereas Grades 2 and 3 are where stretching and tearing are present respectively.
The majority of ulnar collateral ligament sprains are usually seen in baseball players due to the repetitive stress of throwing . Frequently, more severe ligament damage requires invasive procedures such as Tommy John Surgery to reconstruct the ligament. A tendon is taken from the patient’s forearm (palmaris tendon), below the kneecap (patella tendon), or from a cadaver to replace the original injured ligament. The most common side effect from this surgery is damage to the ulnar nerve which travels nearby. Typical recovery from Tommy John surgery takes anywhere from one to two years.
Even with Patterson, the Raptors’ big man bench squad wasn’t producing much value fantasy-wise with the likes of Tyler Hansbrough and Chuck Hayes. Amir Johnson (who starts at PF) seems be the prime beneficiary if Patterson is out for an extended period of time. He played well on Sunday, scoring 15 PTS on 7-9 shooting and 2 BLK. He’s currently owned in 76% of Yahoo leagues and should be picked up if he is still available in yours.
With a rash of MCL injuries occurring in the NBA recently (Iman Shumpert and Nene Hilario), I thought it would be appropriate to showcase a couple of kinesiotaping techniques for inner knee pain. In addition to knee ligament issues, medial knee pain can also be caused by inflammation of the tendons from leg muscles that attach in the area such as the sartorious, gracilis, and semitendinosis.
KT Tape provides a way to tape the inner knee using two small strips and one larger strip of tape.
Rocktape on the other hand provides support in the region using a regular strip and a half strip of tape.
Shaun Livingston suffered an injury to his tailbone on Saturday and was diagnosed with a bruised tailbone after x-rays came back negative. He missed Sunday’s game and is listed as day-to-day. The Brooklyn Nets don’t play again until Wednesday and have three games remaining this week.
A tailbone bruise refers to an injury to five small bones at the end of the sacrum called the coccyx. Typical methods of trauma include falling back and landing on the area or a direct blow. Bruising, fractures, and dislocations are common results of injury to the tailbone. Full recovery can take anywhere from 4 to 8 weeks depending on severity and if there is a fracture. A doughnut cushion may be used for long periods of sitting to help alleviate pressure on the coccyx.
Newly acquired Marcus Thornton from Sacramento should put up solid numbers once he plays his first game for the Nets. He has been out with food poisoning but will provide scoring punch off the bench as evidenced by a 42 PTS outburst on January 24.
Denver Nuggets starting point guard Ty Lawson missed his third game in a row last night with a fractured left rib. He suffered the injury during the February 8th game against the Detroit Pistons and was formally diagnosed with an x-ray. No timetable has been set for his return and should be out for at least a couple more games.
Rib fractures usually occur with direct trauma such as in contact sports or motor vehicle accidents. Because ribs are involved with expansion and contraction of the thorax, common symptoms include pain with breathing and coughing. Tenderness to palpation of the injured area and pain with general motion are also likely. Pain relief is the main goal during recovery as most rib fractures will heal on its own within a couple of weeks.
Randy Foye has been starting in place of Lawson but has not been consistently putting up big numbers. Foye only registered 8 PTS and 5 REB in 40 minutes of action last night. He has struggled with his shot the past 3 games, all under 30% from the field. Foye did have a productive line during the game Lawson exited early from (25 PTS with 5 3PT made) so he will most likely get hot again. Evan Fournier is starting at shooting guard and has doubled his scoring output in the last 4 games (7.2 PPG to 14.5 PPG) and can help out any owners in need of some scoring and three point makes.
Milwaukee Bucks big man Larry Sanders will be out until at least after the All-star break after suffering a fractured right orbital bone. The injury came early in Saturday night’s game against the Houston Rockets after Sanders caught an inadvertent elbow from James Harden to his right eye area. Sanders left the game and did not return.
Orbital fractures occur when trauma, from a car accident or a blunt object, is exerted on the bone of the eye socket. There are three main classifications of orbital fractures:
Orbital Rim Fractures: affects the outer edges of the eye socket, which is the thickest area and therefore requires a great deal of force to fracture (such as motor vehicle accidents)
Blowout Fractures: rim stays unaffected but the thinner floor of the eye socket sustains a fracture and restricts the mobility and anatomy of the eye
Direct Orbital Floor Fractures: rim fractures that also affect the floor
Common symptoms include edema (swelling), bruising, visual deficiencies (blurry, double vision), limited range of motion of the affected eye, and numbness around the area of injury. Typical recovery for orbital fractures range from one to six weeks depending on the severity of the injury. Surgical options may be necessary if there are issues with eye movement but conservative treatments will usually suffice.
Fantasy Impact With coach Larry Drew’s inconsistent rotations, it is hard to pinpoint a player who will definitely benefit while Sanders is out. The most likely candidate appears to be Zaza Pachulia who got the start at center Monday night against the Boston Celtics and contributed 8 PTS, 8 REB, 4 AST, and 2 STL in 32 minutes of action. Pachulia also put up a double-double after Sanders left the Houston game so there is some upside. Just don’t be surprised if he concedes his minutes to someone else in the next game.
Already without their starting center until after the All-Star break, injury woes are starting to pile up for the Minnesota Timberwolves. Starting shooting guard Kevin Martin has been diagnosed with a non-displaced left thumb fracture of the distal phalanx and will be out indefinitely. He injured it late in Friday night’s game against the New Orleans Pelicans. The team is 6 games out of the last playoff spot and will now have to contend without the services of their second leading scorer and best threat from downtown.
Red Circle Denotes Distal Phalanx
Distal phalanx fractures account for the majority (approximately 50%) of hand fractures. The most common digit affected is the middle finger, followed by the thumb and occurs from trauma and crush injuries. A non-displaced fracture refers to one where the bones affected are still in alignment. Thus, typical treatment is more conservative, focusing on stabilizing the bones and soft tissue to allow the body to heal.
Fantasy Impact Chase Budinger slides into the starting lineup and his owners can expect increased production across the board with this opportunity. He’s averaging 19 min/game this year but played 29 minutes yesterday with 19 PTS, 3 3PT, and 5 REB. Corey Brewer also figures to get more offensive touches and he responded with 26 PTS on 23 shots during Saturday’s game. Granted, Kevin Love was a late scratch with a bruised left quad, but Brewer will still be looked upon to step up even when Love returns.
Pau Gasol of the Los Angeles Lakers underwent an MRI on Saturday and was diagnosed with a strained right groin. He had been playing with pain in the area for the past week and now will be out for at least a week following the diagnosis. Gasol had been playing well, notching 7 double-doubles in his last 10 games. This mini-break might be good for him as there are rumors the Phoenix Suns are trying to trade Emeka Okafor’s expiring contract for Gasol.
Groin strains affect the adductor muscle group that attaches from the pubic bone to the femur. The six muscles that allow the leg to move towards the midline of the body (adduct) are adductor brevis, adductor longus, adductor magnus, adductor minimus, pectineus, and gracilis.
There are three grades of strains in the groin:
Grade 1: mild pain but no loss of function or mobility
Grade 2: moderate pain with limitations on running and jumping
Grade 3: Pain with mild activity such as walking and often muscles are torn
Usual time frame for recovery is 1 week for grade 1, 2-3 weeks for grade 2, and 6-8 weeks for grade 3. Initial therapy includes rest, icing the area of discomfort, and wrapping the thigh with tape. Stretching and strengthening exercises can be added as pain dissipates and range of motion returns.
With Gasol out, Jordan Hill and Chris Kaman will see the biggest bumps in minutes and production. After a hot start to the season, Hill has scored in double digits only once in his last ten games, bottoming out with a 3 REB and 0 PTS in 12 minutes of action on Friday. If Gasol misses an extended period of time or gets traded, Hill might be able to re-capture the output at the beginning of the season. Kaman has been cleared to play after an MRI on his knee came back negative and will probably get the start at center. He hasn’t played in 2 weeks but should contribute if healthy.
Minnesota Timberwolves big-man Nikola Pekovic left in the first quarter on Monday night against the Chicago Bulls with a right ankle injury. An MRI performed on Tuesday showed bursitis of the ankle and the team announced he will be sidelined for 7-10 days. This means Pekovic will miss at least the next 4 games and maybe even up to 7.
The Timberwolves are 3 games out of the last playoff spot as we come to the midpoint of the season and losing him is a big blow since he is third on the team in scoring and second in rebounds and field goal percentage. The team lacks depth at the center position and will look to Ronny Turiaf to start at center. Besides Kevin Love and Turiaf, the only other player above 6’10” on the roster is Gorgui Dieng, who has appeared in 25 of the 44 games this season and averages 5.4 minutes per game.
No specific bursa was named in Pekovic’s injury but there are three common areas where ankle bursitis can occur, as represented by green in the picture above. Going from left to right in the picture, there is the subcutaneous calcaneal bursa, the retrocalcaneal bursa, and the subcutaneous bursa of medial malleolus.
The first often becomes inflamed when there is an injury to the Achilles tendon or with tight fitting shoes. The second bursa can develop inflammation with overuse of the ligaments, tendons, and ligaments around it especially in sports such as soccer and basketball. The last bursa listed is often injured with trauma or contact sports, causing severe pain with dorsi and plantar flexion of the foot.
Typical treatment consists of rest, ice, and shoe inserts to help cushion and stabilize the ankle. Corticosteroid injection into the bursa can help decrease inflammation. Surgery is usually not required.
Ronny Turiaf will start at center while Pekovic is out. Turiaf finished the game against the Bulls on Monday night with 14 PTS, 7 REB, and 3 BLK on 6-7 shooting in 32 minutes. He had been averaging 15.6 minutes per game in his last 10 games so more playing time will boost his value in most standard leagues. Kevin Love might see a spike in points and rebounds as he becomes the lone threat in the low post for the T-wolves.