Jeff Stotts runs InStreetClothes.com, focusing on sports injuries. He will provide short- and long-term updates on various injuries around the league. As Week 10 of the Fantasy season comes to a close, he takes an in-depth look at key injuries around the league.
James Harden
The Rockets have been one of the most Fantasy friendly teams in the NBA. Unfortunately, they will be forced to navigate the next few weeks without the top-ranked player in Fantasy basketball after Harden suffered a hamstring injury in an overtime win over the Lakers on New Year's Eve. A complete examination following the game revealed a moderate strain of Harden's left hamstring.
Muscles and ligaments are commonly injured when their components are pushed beyond a characteristic known as a yield point. When this occurs, a muscle is strained and a ligament is sprained. Both injuries are medically assigned grades based on the severity of the damage. A Grade 1 injury is often considered minor. In these injuries, the microfibers that make up the muscle or ligament are damaged though the injured individual often reports discomfort with little to no loss of function.
A more significant, Grade 2 injury is considered moderate and is marked by damage to actual ligament or muscle fibers. Grade 2 injuries are often referred to as partial tears. Anything given a Grade 3 or higher ranking is considered severe and is often accompanied by a rupture or complete tear of the involved structure. Grade 3 injuries usually involve a loss of both stability and function and in some cases require surgery to mend.
Harden's hamstring injury has been assigned a Grade 2 classification. The Rockets plan on re-evaluating the All-Star's health status in two weeks, but there is no guarantee he will be back in action at that time. Hamstring injuries are tricky injuries to manage, specifically due to their complex healing process.
The body's natural healing response occurs in multiple stages initiated by the inflammatory phase. During this preliminary step, the injury site begins to swell and the clotting reaction begins. While the inflammatory phase is ongoing, the second phase of healing -- the proliferative phase -- begins. The proliferative phase is the start of the body's actual repair work. At this time, scar tissue comprised of protein fibers, like collagen and elastin, are laid down at the injury site to repair the gaps.
Unfortunately for players like Harden, the proliferative phase requires a significant amount of time and must be finished before the final phase can begin. The last step, the remodeling phase, varies in length based on the location of the injury and the amount of sustained damage. At this point, collagen fibers within the freshly developed scar tissue are continually broken down and reformed. This tedious process gradually increases the strength of the scar tissue allowing it to better resemble healthy muscle tissue. However, the body often does this in a random fashion, an approach that can have a negative impact on the athlete's recovery. To combat this haphazard process, a skilled medical professional can load the injured muscle in a very specific way during rehabilitation.
Determining when the process is complete is difficult, especially because the athlete can feel healthy even while the remodeling phase is ongoing. As a result, the risk of re-injury is high, especially with a dynamic muscle like the hamstring muscle complex. A healthy hamstring is vital for a player with Harden's start-and-stop style of play. If he returns too early and disrupts the recently formed scar tissue, The Beard will be forced to restart the entire healing process.
As a result, Harden owners should anticipate this injury taking longer than two weeks. Houston has a top-notch medical team, but it will likely take a conservative approach with his recovery. The void left by Harden's absence will be difficult for one player to fill. Chris Paul's usage will likely increase with Harden sidelined and players like Gerald Green and Eric Gordon should also see extra playing time. Green has thrived in the two games since Harden went down, averaging 28.0 points and 7.5 made three-pointers.
Fast Breaks
- Lonzo Ball: The Lakers' rookie is nearing a return after missing time with a sprained shoulder. Originally diagnosed as a contusion, a further exam revealed the ligamentous injury. Ball has missed six consecutive games heading into Friday's contest against the Hornets. He is currently listed as questionable but has been an active participant in practice. His already low shooting percentage is likely to dip a bit, but his peripheral statistics shouldn't suffer.
- Joel Embiid: The oft-injured big man has added a new injury to his laundry list of ailments. While his foot and back have been the historically problematic areas, Embiid is currently nursing a sprained hand. He played through the injury earlier in the week and appears set to continue this approach. Fantasy owners should continue to utilize Embiid as they normally would but scale back their expectations for the immediate future. On the plus side, the Sixers have five consecutive days off following Friday's matchup with the Pistons before they face off against the Celtics in London on Jan. 11.
- Rudy Gobert: Utah will be without Gobert for another two weeks as he continues to work his way back from a posterior cruciate ligament (PCL) sprain. The PCL serves as the axis for rotation at the knee and it is critical for Gobert's long-term health that he returns only at 100 percent. Derrick Favors will continue to benefit from Gobert's absence.
- Rudy Gay: The Spurs lost Gay just as the team began working Kawhi Leonard back into the rotation. Gay was diagnosed with retrocalcaneal bursitis, meaning the bursa sac located between his heel bone and his Achilles has become inflamed. These fluid-filled sacs act as ball-bearings within joints, reducing friction. Gay has dealt with lingering soreness in the area throughout the season but has now been ruled out two weeks. However, it wouldn't be surprising to see that timeline extended based on the lingering nature of the problem. On a more positive note, the current issue is opposite his surgically-repaired Achilles.
- Reggie Jackson: The Pistons' point guard suffered a Grade 3 ankle sprain just days after Christmas and is expected to be sidelined until the All-Star break. As previously discussed, a Grade 3 sprain usually indicates a complete tear of a ligament or ligaments, meaning Jackson's facing a lengthy recovery. Ish Smith has played well as the starting point guard and is worth a waiver wire addition for Fantasy teams in need of the typical guard-related statistics.