Wall out 8 weeks with injury to patella

[gesa2]

I doubt that the Synvisc injection would do much at all for the stress fracture, btw. And the injury still leaves lots of question about the Wizard's medical and training staff. But it's probably not osteoarthritis yet. That'll come after a few more years of poorly supervised training and bad advice.

[Earth2Ted]

From David Aldridge's latest column

There will come a time, and soon, when John Wall examines his options, and remembers all the things that could have or should have been done, but weren't, or were done, and shouldn't have been. And then he will make up his mind whether or not he wants to stay in D.C. Your only saving grace is that the Bobcats, the team closest to his family in Raleigh, have been even worse than you've been the last couple of years. But that's a thin stock of soup on which to base a franchise's future.

I still remember DA shaking his head at how good John Wall was the first time he played for the Wizards, and how surreal it was that we had a player like him. You could see him thinking- man, maybe the Wiz are going to screw this up, but I'm not even sure how that would be possible... Well, now we know- it be more than possible.

John Wall means a lot to me as a Bullets-Wizards fan- he played his first game in DC the night my daughter was born. He dropped 29, 13, and 9 steals on Philly and carried us to victory the way RG3 is doing it for the Skins. How much does it hurt to be where we are two years later, with the team 3 and frickin 18, with Wall's knee unplayable bone on bone at age 22?

How hard has management sucked to put us in this position? Could it have been any worse if Ted and Ernie shat in John's gatorade and went after his knees with Alex Ovechkin's stick collection on a daily basis?

Good lord, man... Someone needs to talk David Stern into amnestying Ted out of ownership.

[dangermouse]

Wall: Well I don't really eat too much anyway. I just like chips. I like crab legs and seafood, so that's really what I'm eating. Unless my mom comes to town [then it's] whatever she cooks, Southern food

Holy f*** will management PLEASE get this guy a nutritionist? Half the reason Nash has played for so long is because of his diet.

Crabs legs are good. He can keep eating those. But if all he is eating any other time is f***ing chips and his mom's fried comfort food no wonder he is having injury problems and is starting to look a bit doughy while he sits out.

"I just like chips" sounds REALLY bad, like he can't stick to a diet because he has been raised with a limited palette. Try a salad with some chicken breast or baked white fish and some nuts once in a while John.

[hands11]

Still not over concerned that he won't return, but there does seem to be some mixed perception of what happened going on. So the team say one thing and what is reported seems mixed. Seems to be some difference in the quote regarding what he "thinks" and "feels" but from Johns take, it seems clear he thinks it was a stress fracture. Maybe even the doctors were not entirely clear.

What is clear is that Wall felt like he wanted to talk about what was taking so long.

Now things still seem to be a little touch and go but this is a good sign.

http://www.washingtonpost.com/blogs/wiz ... gh-for-me/

John Wall was back laughing, talking smack and having fun with his teammates at the end of Monday’s practice on the Verizon Center main court.

But this stuff is clearly concerning.

Though Wall repeatedly referred to his injury as a “stress fracture” but the Wizards are adamant that he neither had a stress fracture nor stress reaction, but rather a non-traumatic stress injury.

Wall....

My fracture is already healed. It’s just the cartilage part that is left that I’m trying to get clear. I feel like the eight weeks I took was the time for my stress fracture to heal.”

http://www.bulletsforever.com/2012/12/1 ... -and-rehab

He broke his kneecap. I think mine was just a stress fracture where I was in the beginning stages of breaking my kneecap.

.....since it started off with a stress fracture.

Reporter: The important thing is to let this rest as much as it can, so that the fracture heals?

Wall: Well, my fracture is already healed. I just feel like it's the cartilage part left that I'm trying to get cleared. The 8 weeks I took off was the time I was supposed to take off for the stress fracture to heal.

Then the good news.

Wall: Yeah, it's healing in the right way. Everything else around my knee is in the right order it's supposed to be. There's just this one problem I'm trying to get over... which is the cartridge.

----

Well at least now we know more.. kind of. Seems there is no time table because they are unclear on how the cartridge situation will hamper him. Guess we will know more shortly. Seems to me, its either going to heal up and he will start working out more, or there will be a set back and he will need to have the cartridge cleaned up.

I imagine now that this has happened, that doctor will be checking his knees regularly. My question is ... if this happened once, how do you stop it from happening again ? I guess he was over training.

[dangermouse]

Its his left knee, right?

He takes off on almost all of his one-footed jumps with his right leg, so its not that.

He is a confusing player. Shoots right handed, but jumps mostly off his "wrong" foot and dunks quite a lot with his left.

I think the fact that this leg isnt his dominant leg will work out for us better.

[hands11]

Its his left knee, right?

He takes off on almost all of his one-footed jumps with his right leg, so its not that.

He is a confusing player. Shoots right handed, but jumps mostly off his "wrong" foot and dunks quite a lot with his left.

I think the fact that this leg isnt his dominant leg will work out for us better.

Might you have stumbled into something here.

Maybe he has been jumping off the other leg because he has had discomfort in the left leg

He did have knee problems in year one as well. I wonder how long this problem may have been lingering in the background. Maybe he just adapted because the other leg felt stronger to him.

Then again, maybe not. He seems to be dunking a lot left handed even in HS.

https://www.youtube.com/watch?v=-4_dnb3S8q4

[hands11]

http://www.nba.com/wizards/video/2012/1 ... mv-2328987

Well its been a little while since I have seen a Wall interview.

For those of you that can translate Walleneese, here it is.

Good thing they had a transcript of most of this.

Good news is the bone part of the injury seems healed and he says he feels better. The cartilage part is still a concern which we need to learn more about to understand the longer term impact. Sounds like progress has been made and this last shot should help his make another step toward his recovery. He seems focused on returning this year. I hope things work out for the young man and the team. I watch some youtube highlight reels. If you need a lift, I suggest you do the same. The kid did have an impact on the court.

[dangermouse]

Well yeah, because he dunks left handed, on the gather he sets up to jump off his right foot. If you look at left-handed dunkers, they start their gather on their left and jump off their right foot. I think it just feels natural to him because he likes to throw it down with the left.

Its so odd though. Ive mentioned in the Wall thread a while back now that maybe he should try out shooting with this left hand. Someone then mentioned that he writes with his right hand, but he has said that he can also write pretty well with his left.

I guess he is ambidextrous. But it is strange that half his game is right handed and the other half left handed.

I do hope that because it isnt the knee he takes off with, that he recovers quicker.

Edit to add: Just thinking about shooting again, I am beginning to think that he should definitely move to trying to shoot with his left. Its all about body control. Even if you are jumping off both feet, you still subconciously favour one leg over the other to get your power and rhythm going. Maybe this is why Wall prefers to shoot those flat, stand-still jumpers, because what he is doing doesn't feel quite right? Maybe to you or me or someone who has a dominant hand it would feel more awkward and we would adjust, but to someone ambisextrous like Wall the awkwardness is more subtle, so he changes the rest of his shot to avoid it?

I dont know if that makes any sense and i fear im rambling a bit. But I may have a point.

[dangermouse]

I just realised i wrote ambisextrous.

I'm sure Wall isnt ambisextrous, he seems to love the ladies only.

[Wizardspride]

You guys all know that microfracture surgery is coming next, right?

Next we'll hear that the cartiliage in his knee isn't regenerating etc.

You know it's coming......

[nate33]

You guys all know that microfracture surgery is coming next, right?

Next we'll hear that the cartiliage in his knee isn't regenerating etc.

You know it's coming......

Yup. Microfracture surgery followed by about 12-18 months of rehab. He'll miss all of this season and most of next season. His rookie contract will expire without us knowing how much he is worth. He'll refuse any extension that isn't a max extension so we'll either give him the max (and end up drastically overpaying) or he'll take the qualifying offer. He'll play one more year under the qualifying offer and then bolt as a free agent.

[Halcyon]

Well...maybe we can luck into Wiggins?

[Zonkerbl]

Yeah... if wall is out for 18 months then we will have one top five pick in the next draft and probably another top ten pick in the next.

Now if we could just get lucky in the draft for once. Seraphin is a good pickup for the #17. Booker is a good pickup for #23. Singleton is looking ok, although not what we expected. Where we've struck out is in the top ten. Ves' ceiling gets lower every month. Wall looks like the next Arenas.

[Nivek]

I think you're right about chondromalacia, gesa. Which, by the way, I have in my other knee.

Wizards should be well experienced in dealing with chondromalacia -- they misdiagnosed it in Stackhouse's knee for a full season and an offseason before finally figuring out what was wrong with his knee and getting him the surgery he needed to return to action.

[gesa2]

It would make sense for chondromalacia to come as a consequence to his stress fracture. One cause of chondromalacia is a relatively weak quadriceps, leading to excess mobility of the patella over the groove it sits on, leading to wearing ofthe cartilage under the patella incontact with the groove. They probably had Wall doing little to no quad strengthening exercises early in his rehab for fear of pulling the bone apart at the stress injury site.

[cwb3]

We have all seen this movie before. I am resigned to fate of Wall being out for the season.

[gesa2]

After some review of sports medicine articles on this, and with the caveat that we don't have any idea how bad Wall's injury was at the start, the risk for a lost season seems pretty high. The chance of stress fractures propagating to a full transverse patellar fracture is much higher than in the more commonly seen stress fractures in the forefoot, or shin splints which are stress fractures of the anterior tibia. And the chances are higher still with activities required in basketball - jumping and sudden stops. A couple of links and comments --

http://bjsm.bmj.com/content/39/2/e6.full
(case report of a 35 year old recreational athlete with stress fracture, so hopefully not fully applicable here. Nice pics of an MRI with a stress fracture though)

http://www.jaaos.org/content/8/6/344.full.pdf+html
This is a pretty technical article aimed at orthopedic surgeons, some of it over my head as a family doc, and lots of it don't apply to Wall. The most relevant quote is this:

Nonoperative treatment with careful observation is recommended for the patient who does not require an immediate return to activity. For high-demand athletes and those with displaced fractures and nonunions, ORIF is appropriate. A standard tension-band wiring technique with Kirschner wires or cannulated compression screws provides excellent fixation

ORIF = open reduction and internal fixation.

[montestewart]

Thanks for the info gesa2. Maybe everyone but me already knows this, but you sure sound like a doctor. You should be a dedicated mod for all the health issues.

[Nivek]

In my case, the chondromalacia was the result of a dislocated patella followed by what was likely inadequate rehab. Kinda funny, though that the knee I dislocated -- the one with the chondromalacia -- that's actually my good knee.

Neither as good as my ASS, though.

[gesa2]

Yep, I'm a family practice doc. I know some sports medicine but I'm far from an expert. A lot of times the evaluation and treatment of upper level athletes is very different than what I do with high school athletes and seekend warriors.