Earth2Ted wrote:Blazers edge has a phenomenal breakdown of patellar injuries
(LINK HERE)Among the names of interest are old friends Jarvis Hayes (misdiagnosed as tendinitis, rediagnosed as patellar fracture, multiple surgeries, ..., bust), Randy Foye (stress reaction, missed 43 games, returned next year 100%). Blake Griffin also had a stress fractured patella which was surgically repaired. I think most of us would agree that he was able to get most of his hops back.
From what I'm seeing, I am optimistic that Wall is going to come back 100% from this, though it may take time. Part of my optimism is that this was diagnosed by David Altchek (see Washington Examiner), who is one of the big time ortho guys in NY, and more importantly, NOT part of the Wizards vaunted medical team.
But as for how many games he will actually play this year, who the hell knows....
Fantastic article. Truly a must-read for anyone who wants any context on Wall's injury. With that said, I don't feel very hopeful after reading it.
It's tough to classify which category Wall's injury places him in, because the Wizards described the injury in a fashion that hasn't really been used in the past. Hopefully we get some additional insight on the details of the injury in the coming days for clarification. But for now, the Wizards described Wall's injury as in the "early stage of a stress injury to his left patella (kneecap)", and that it "could have turned into a stress fracture".
So here's what we can gather from the few quotes we've got from Grunfeld, Wittman, Wall, and a few others:
1. Wall has not suffered a stress fracture
2. Wall has not torn or partially torn his patellar tendon
So which categories from that article does that leave us with?
1. Broken and/or dislocated patella
2. Bruised patella
3. Injuries to the patellar tendon (strained patellar tendon or patellar tendinitis)
Thoughts on those three categories:
1. Broken and/or dislocated patellaWe already established that he does not have a "stress fracture", which I take to mean as that he has not broken his patella (I'm no medical expert though, or even close, so that could be incorrect). The reason this section was included was because it is possible that Wall has a dislocated patella. However, I think this is pretty doubtful, because if we knew it was dislocated, our description of him having "the early stage of a stress injury" would be fairly misleading. If the "stress injury" was the dislocated patella, then what could possibly be the "early stage" of a dislocation? From my understanding of dislocated anythings, it's not a gradual progression, it just happens at an individual moment. Now, if the "stress injury" that Wall is in the "early stage" of is an actual stress fracture (which is probably a fair assumption, seeing as we also said this current injury could have turned into a stress fracture if we didn't catch it now), then that would mean that in order for Wall to fall under this 1st category from the article, that a dislocated patella is considered the early stage of a stress fracture. Again, I'm no doctor, but I don't believe that a dislocated patella eventually develops into a stress fracture. So I feel fairly confident that Wall's current injury does not fall under this first category.
2. Bruised patellaThe article describes this injury as "a much milder form with no (severe) breaks". No severe breaks definitely fits the description we've been given. As far as it being a "much milder form", well, that's harder to confirm. However, I feel like given the information we have, it seems as though the Wizards are treating this injury as something that's likely a "much milder form" of a dislocated or broken patella. The "early stage of a stress injury" to the patella is probably a "much milder form" of a dislocated or broken patella. This category seems like a pretty good fit with what we've been told by the front office.
3. Injuries to the patellar tendon (strained patellar tendon or patellar tendinitis)From what we've been told so far, there hasn't been any indication that this is an issue with the patellar tendon. We've been lead to believe that it could have lead to a stress fracture, which is different than a torn patellar tendon (although it's possible that they go hand in hand). While this category is different than torn or partially torn patellar tendons, it's of the same basic family of injuries. So unless we have been grossly mislead by the front office and Wall himself, then this is not his current injury.
Note that in his rookie season, Wall missed 12 games early on in the year with what was initially reported as tendinitis in his right knee (current injury is left knee), and later clarified to be a bone bruise below the knee (and not tendinitis, apparently). So unless the front office's statements on the nature of Wall's current injury were incredibly inaccurate, we can probably safely assume that he did not break or dislocate his patella, and he did not tear or partially tear his patellar tendon. Of the categories used in the article, the best match (and really the only one that fits at all) would be the bruised patella category.
According to this article (at least when it was published in December 2009), there have been only 2 NBA players in the last 10 years to suffer bruised patellas. A 22-year-old Quentin Richardson in 2003, and a 29-year-old Caron Butler in 2009 (bringing back some good memories yet?). Richardson missed about the last 2 weeks of the season, and returned the next season, playing 79 games at the same performance level (according to the basic stats) that he did before the injury. Butler bruised his patella at the end of October, and only missed 1 game as a result. The other few players who suffered this injury in the past missed anywhere between only 1 game to a month at the most. It definitely is not a severe injury, both in the short- and long-term.
So this is good news for Wall (and us), right? Well, maybe.
If Wall's current injury is, in fact, a bruised patella, then history bodes well for his speedy return and recovery, with no long-term effects. However, something doesn't add up with all of this. If bruised patellas in the past have caused players to miss anywhere from only 1 day to 1 whole month with no lasting harmful effects, why are the Wizards announcing that Wall will be sidelined for approximately 8 weeks? Doesn't setting his timetable for return at 2 months, when the most anyone suffering a similar injury had to sit out in the past was only 1 month (and frequently much less)?
You could take this discrepancy to mean any number of different things.
Are the Wizards being extra cautious with Wall from the get-go because he is our franchise player (similar to the Strasburg situation)? Do we know that he probably only needs to sit out 1 month at the most to recover from this injury, but we'd rather play it safe and let him sit out 2 months, just to make sure that he's truly 100% healed and ready to go? Perhaps we're scared after mismanaging so many injuries (specifically knee ones) in the last few years that we can't fathom doing it again, and would take extra precautions, above and beyond what is actually necessary, just to avoid a similar result.
Or perhaps we're simply setting the timetable for Wall's return at the absolute maximum amount, so that for once, one of our players will return from an injury BEFORE he was initially expected to. After numerous players in our franchise's recent history have been sidelined well beyond their initially expected return date, having a player come back early for once would be a nice breath of fresh air, and it could possibly make fans more pleased with our medical staff's performance.
Or maybe the Wizards haven't been entirely forthcoming about Wall's current injury. What if our front office left out some key details in their comments yesterday that would have lead us to believe that the injury falls into a different category from that article? What if we know that his injury is more severe than a simple bruised patella, but we don't want all hope to be lost for our team and fan base just yet? 8 weeks gives us plenty of time to hope for a miraculous recovery by Wall, simply by resting, and the more severe problem could go away. Or if it hasn't gotten any better after 8 weeks, then we know we tried all we could, but it's definitely going to require season-ending surgery. Delaying the inevitable. Making sure the team and the fans don't completely give up on the season before it even begins. Crossing our fingers and praying that somehow by simply resting, Wall is able to fully recover in 2 months time, and we can avoid surgery.
I think there's a good chance that there's some truth in all of those explanations. Only time will tell which is the real reason. But there's something strange going on here, and it's not fooling me.
If Wall's injury was as minor as they've described it so far, then there would be no need for us to announce that he's expected to miss approximately 8 weeks. Announcing that he, at the very least, won't participate in any preseason games would have given him an entire month of rest, and most likely he would have been ready to go for the start of the season. And if he somehow hadn't healed by then (making him the owner of the slowest healing bruised patella in the history of the NBA), then at the time we could have held him out for more regular season games as needed. I believe that we might just be being overly cautious, similar to the Strasburg situation, and arguably rightfully so, considering how important Wall is to this franchise's long-term success. But this is simply above and beyond what would be necessary, even if we're taking a cautious approach. This injury simply has to be more than a bruised patella. I'm sure you can diagnose the severity of bruised patellas, and maybe the one Caron Butler suffered a few years ago was very very minor, whereas the one Wall is currently suffering from is undoubtedly more severe. But even if that's the case, 2 months?! It's overkill. In my opinion, it's most likely an indication that we know this injury is much more severe than a simple bruised patella, but we don't want to come out and say it yet. We're delaying the inevitable.
I'm not a betting man, but after reading that article and thinking it all through, I think we are being mislead by the front office on this injury, and I sadly now expect Wall to end up having season-ending surgery sometime in December. Hopefully in a month or two I can come back to this thread and laugh about how paranoid and wrong I was, but I don't expect that to be the case.
Here we go again...
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