Wake-up call: Stress injuries can heal quickly

Wake-up call: Stress injuries can heal quickly
November 29, 2013, 8:15 am
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Bradley Beal being out just two weeks sounds too good to be true, especially considering the latest stress reaction that he has in his right fibula -- the small bone in his lower leg -- is his second since April. 

This reaction, a precursor to a fracture that would require surgery and be season-ending, is in a different spot. It's higher on the non-weight bearing bone. 

According to Dr. Jason De Luigi, director of sports medicine at MedStar Sports National Rehabilitation Hospital, it's reasonable to believe that Beal could return that quickly.

"It's definitely possible to be able to return to play within two weeks, depending on the level of the stress reaction that's occurring on the bone," he told CSN Washington. "They're going to monitor both the symptoms and also the amount of inflammation that's in the area, but its very feasible that he would be back in two weeks."

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When Beal missed the last eight games of his rookie season, he was projected to be cleared for basketball activities by May 20. The Wizards were extra cautious with him as he sat out of the Las Vegas summer league in July and didn't partake in contact drills at USA Basketball's mini-camp. Beal wasn't cleared for full activity until August. 

Playing with stress injuries can be disastrous. In the 1980s, Andrew Toney of the Philadelphia 76ers had them in both feet. They became fractures and ruined an All-Star career. He retired after just eight seasons.

Of course, the ability to diagnose an injury before it happened wasn't as common then. 

Reactions in the fibula are much like shin splints on the tibia, the adjacent, major bone in the leg. Both are caused by stress.

Though unfortunate, Beal getting two stress reactions in such a short time isn't unusual even though he's just 20.

"It's not uncommon to happen in younger individuals. The most common type of stress reaction is actually in military recruits with a high use of running," De Luigi said. "It's very frequent to see stress fractures in 18-to-20 year-olds in the military. They do a number of things to help prevent injuries ... shoe wearing, using Vitamin D and calcium. But for the most part if it's handled appropriately it heals well without any residual effects."

The two muscles on the side that attach to the fibula are the keys to Beal's ability to return. The pulling on the bone is what leads to the stress reaction. That's where he could have soreness.

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"What they do is they take your foot and they turn it up and out. So one of the things it would really affect would be some of his lateral movement," De Luigi said. "So if he's cutting to the left or right or if he's trying to guard somebody he could have a little discomfort with that."

The treatment to get him back is simple.

"First, they're going to focus on symptom control and they're going to be able to decrease the amount of pain that he has and they're going to go through some non-specific sports exercises to see how he's doing. And then they're going through sports-specific," De Luigi said. "So I can imagine him running through cones and doing some drills with dribbling as well as guarding his teammates."