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Offering some clarity

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SlimJim
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Offering some clarity 

Post#1 » by SlimJim » Wed May 2, 2012 1:44 pm

Hey guys, I'm a diehard Bulls fan and I've been reading these forums for a while. Been avoiding registering for a while, but I figured it was time to bite the bullet.

I am in the Athletic Training Education Program at one of the top colleges in the country for such things. (Not to brag, just establishing credibility :wink: ) So I thought I could provide some insight and answer any questions you guys might have.

First, I'll start with some anatomy. The Anterior Cruciate Ligament is one of four ligaments in the knee (MCL, LCL, PCL). It is located at the front of the knee and connects the femur (thigh bone) to the tibia (lower leg bone). It's main function is to prevent anterior displacement of the tibia (meaning without it, the lower leg will literally slide forward like an opening drawer). If you watch the video of the injury closely, you can actually see this in action. The doctors are able to slide Derrick's lower leg back and forth. This is called a Lachman's Test (aka Anterior Drawer Test). This is likely how that Miami news source was able to report the ACL injury before the MRI ever took place.

ACL tears are usually caused by a rotational force while the foot is firmly planted to the ground. This is exactly what happened in Derrick's case. It is in most cases a non-contact injury and is actually much more common than you'd expect in Basketball. It is actually a defense mechanism by the body. The ligaments are strong enough to support the body, but just weak enough that they can tear under extreme circumstances to preserve the integrity of the rest of the joint.

What Derrick suffered was a Grade 3 tear, meaning the ACL is completely torn and non-functional. On the positive side, there is very little persistent pain after about 20 minutes or so, and one can usually go back to routine daily activities about a day or 2 after the injury. On the downside, the ligament is no longer able to heal itself and surgery is required.

New medicine and technology has greatly increased the success rate of ACL treatment. In fact, we can see recovery times as short as 5 months in some cases. We usually try to get the athlete to about 80% of their athletic ability BEFORE the actual surgery takes place using stair climbers and eliptical machines. Most athletes are even able to run in a straight line. I'm not sure if this is how they'll handle Derrick's injury, as they will most likely want to stretch his career as opposed to getting him on the court as soon as possible (Which sucks in the short term as a fan, but long-term is the best thing for Derrick). We are most likely looking at an 8-9 month recovery/rehab time, and even longer after that to get into playing shape and adjust to the NBA game again.

I have seen some of you questioning whether we will ever see the same Derrick again. I have some good news: ACL tears are nowhere near the death sentence they were even 10 years ago. Technology now allows us to reconstruct the knee to be just as strong as it was before the injury. The real hurdle will be Derrick's mind. Think about it: he has spent all of his 23 years with the exact same knee. Now he has one that feels slightly different, but it is enough to make him question it. The hardest part for the athlete is trusting that the knee is strong enough to do what his old one did. It may be years before this happens, or it may not happen at all. Every athlete reacts differently. But keep this in mind: he is one of the hardest working kids in the league and will adjust his game if needed. While we might not see the unicorn we all know and love, he is still more than talented enough to remain a top 5 player in this league.

That's all I have for you guys for now. If you have any questions relating to sports medicine, please don't hesitate to ask. I would love to help you guys out. Look forward to being a part of this great community!
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Re: Offering some clarity 

Post#2 » by blumeany » Wed May 2, 2012 1:53 pm

Realistically, I expect nothing out of Derrick until the 2013/2014 season. That will give him part of the regular season, maybe a short playoff run, and a full off-season to train and gain that trust in his body back. Honestly, in the end, it's a curse and a blessing. A curse that this season and next are pretty much toss-ups, a blessing in that all of Derrick's nagging injuries will be fully healed by the time he hits the court again and he will have had a lot of time to work on other aspects of his game as well as meditate about how he can avoid such issues in the future by expanding his game.

Can't remember who it was (maybe KC) that noted on the radio that Rose had indeed been focusing during the offseason on different things like his post-up, but that due to the extreme scheduling this season (and his recurring injuries) he was never able to really work those things into his game via practices and things like that. So I think we can fully expect to see a 'different' Derrick Rose when he comes back. Bigger, Stronger, Smarter, but probably not faster.
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Re: Offering some clarity 

Post#3 » by organix85 » Wed May 2, 2012 2:17 pm

I'm with blumeany. If he can make a return next season, I will consider it his time to get back into the game. If he exceeds those expectations, great. I'm willing to accept next season won't be his greatest though and wait until the 13-14 season.

Btw, welcome SlimJim. Awesome first post...
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Re: Offering some clarity 

Post#4 » by ChicagoChris » Wed May 2, 2012 2:32 pm

Slim, thanks for the info. I just got done reading this http://sciencelife.uchospitals.edu/2012 ... -injuries/ which is also pretty informative.

the one thing that struck me was that fatigue likely played a roll in the injury. Is that your take as well?
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Re: Offering some clarity 

Post#5 » by JackFinn » Wed May 2, 2012 2:43 pm

Good read. Thanks SlimJim.
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Re: Offering some clarity 

Post#6 » by Ice Man » Wed May 2, 2012 2:47 pm

Thanks.

The plan for Rose should be a 17-month recovery period, at which time (October 2013) he is 100% of his previous self, or at least as close as is physically possible. Rose cannot contribute to the 2012-2013 regular season, and to rush his return and throw him into the playoffs would seem reckless indeed. If he can contribute to the 2013 playoffs as part of his recovery process, OK. But achieving full recovery is the top goal, not getting him on the court next year.

That means find a good 1-year PG solution. But only for 1 year.
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Re: Offering some clarity 

Post#7 » by transplant » Wed May 2, 2012 2:49 pm

Just might be the best first post I've ever seen. Welcome, SlimJim.
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Re: Offering some clarity 

Post#8 » by Force-X45 » Wed May 2, 2012 2:50 pm

Thanks for the info, good first post, and welcome to the board! :D
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Re: Offering some clarity 

Post#9 » by myboyz33 » Wed May 2, 2012 2:59 pm

great explanation. thank you!! i wish doctors know how to explain things like that lol. well as much as it sucks, i hope they let him take the time he needs to let it heal properly. so when he does come back, he is as great as he was before the injury or better!
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Re: Offering some clarity 

Post#10 » by SlimJim » Wed May 2, 2012 3:27 pm

Thanks for the love guys!

ChicagoChris wrote:Slim, thanks for the info. I just got done reading this http://sciencelife.uchospitals.edu/2012 ... -injuries/ which is also pretty informative.

the one thing that struck me was that fatigue likely played a roll in the injury. Is that your take as well?


Yeah, fatigue could have definitely played a role. I think the bigger issue is all of the smaller injuries he had beforehand. One of the things the Phoenix medical staff does really well is finding the root causes of injuries before the injuries actually happen. For example, a person could have a muscle imbalance in their hip or pelvis, but it causes problems in other places like the lower back or knee. What the Suns do is screen the players for things like that and then make exercises to treat them.

Every part of your body affects every other part of your body. if you have to walk/run differently to avoid pain in your toe, the muscles that allow you to do that are going to hurt (lower back/groin). Then you have to compensate for that pain, and you might hurt your ankle. See the pattern? I think he just didn't have enough time to recover from all the little injuries because of the schedule and lack of practice time.
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Re: Offering some clarity 

Post#11 » by JDRochholz » Wed May 2, 2012 3:42 pm

Terrific first post, Slim. Thanks for the info. And welcome to the board! oh, and do us all a favor and STAY ACTIVE here. Judging by your first post, we could use your insight.
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Re: Offering some clarity 

Post#12 » by NBAwesome » Wed May 2, 2012 3:54 pm

SlimJim wrote:Thanks for the love guys!

ChicagoChris wrote:Slim, thanks for the info. I just got done reading this http://sciencelife.uchospitals.edu/2012 ... -injuries/ which is also pretty informative.

the one thing that struck me was that fatigue likely played a roll in the injury. Is that your take as well?


Yeah, fatigue could have definitely played a role. I think the bigger issue is all of the smaller injuries he had beforehand. One of the things the Phoenix medical staff does really well is finding the root causes of injuries before the injuries actually happen. For example, a person could have a muscle imbalance in their hip or pelvis, but it causes problems in other places like the lower back or knee. What the Suns do is screen the players for things like that and then make exercises to treat them.

Every part of your body affects every other part of your body. if you have to walk/run differently to avoid pain in your toe, the muscles that allow you to do that are going to hurt (lower back/groin). Then you have to compensate for that pain, and you might hurt your ankle. See the pattern? I think he just didn't have enough time to recover from all the little injuries because of the schedule and lack of practice time.


and how about the lack of a good Bulls training/medical staff, could that have something to do with it? Are they worse than the Phoenix staff? Do they operate based on a completely different medical philosophy?
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Re: Offering some clarity 

Post#13 » by heir_jordan22 » Wed May 2, 2012 4:52 pm

:clap: great post!

1 question: Fatigue and prior injuries probably had something to do with this injury. Are knee injuries more likely to occur when you have an injured ankle or restrict its motion?
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Re: Offering some clarity 

Post#14 » by Steve Brule » Wed May 2, 2012 4:53 pm

Thank God for granting me this Moment of Clairty.
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Re: Offering some clarity 

Post#15 » by Rerisen » Wed May 2, 2012 6:16 pm

SlimJim wrote: The hardest part for the athlete is trusting that the knee is strong enough to do what his old one did. It may be years before this happens, or it may not happen at all. Every athlete reacts differently.


Resonates strongly with what Jamal said:

"Then, after surgery, you start rehab and start to see some progressions. You get a little more confident as it goes along. And then the last stage is the mental part: 'Can I still do that move? Can I still do that cut?' The actual leg you injure ends up being stronger than the leg that's not injured. But you don't believe that at first. You're scared. You doubt.

"Tell Derrick I never had any residual effects and don't think about it anymore," Crawford said. "Tell him I'm pulling for him."


Also, welcome to the board.
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Re: Offering some clarity 

Post#16 » by taco_daddy » Wed May 2, 2012 10:51 pm

Awesome first post. This is bar raising.
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Re: Offering some clarity 

Post#17 » by Jo Jo English » Wed May 2, 2012 11:08 pm

I'll join the chorus and say thank you for an excellent post regarding Derrick's health and also welcome to the boards!
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Re: Offering some clarity 

Post#18 » by CjayC » Thu May 3, 2012 12:05 am

Great informative post! :D

Why us though? God I'll never get over it :(
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Re: Offering some clarity 

Post#19 » by chicagoballer » Thu May 3, 2012 1:12 am

Quick OT addition about Dr. Brain Cole. didnt want to make a new thread for this

I know all of his credentials have been posted on the website more than once, and how the bulls medical staff has been bashed to some degree on the board. They have gotten return/expected dates wrong and missed the Deng injury. Deng injury was likely missed by the radiologist, not Dr. Cole specifically.

Now what derrick is getting is surgery (duh, i know) and Dr. Cole is the best of the best for that. Maybe he does not have the exercise kinesiology experience, I dont know, but he knows surgery. My roommate is a future orthopedic surgeon, and I had another well known orthopedic surgeon as a guest in our house the past weekend. Both speak highly of him. In fact, our guest, orthopedic surgeon himself, flew in just to get his own knee evaluated by Dr. Cole which he injured playing soccer and had failed surgery before. so in conclusion, in Dr. Cole, I trust.
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Re: Offering some clarity 

Post#20 » by Bulls69 » Thu May 3, 2012 1:48 am

I can't wait to see Rose back on court this kid is going to give his blood,sweat, and tears just watch.
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