- Guy Lake
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I have received several e-mails asking why players receive X-rays for injuries such as sprained ankles and knees. Why not just go straight to an MRI? The reasoning is if the injury is a sprain (ligament damage) or a strain (muscle or tendon damage), how could an X-ray provide any useful information? X-rays, after all, are not able to reveal damage to soft tissues like tendons or ligaments like MRIs. Hence, the oft-repeated phrase of trainers seen in newspapers every day: "X-rays came back negative." So why are the X-rays performed at all?
Luckily for you, though less so for me, I have recent, personal experience with both X-rays and MRIs. Back in August I felt a "tweak" in my right knee while playing pickup hoops in Oakland. I stayed off it for a while, then started playing again in late November. I felt pain in the knee again, so I scheduled an appointment with an orthopedist. I had pre-diagnosed myself with a lateral meniscus tear due the pain being located on the outside of the knee. I figured an MRI would quickly reveal what was going on. The doc scheduled me for both X-rays and an MRI and, thinking of the e-mails, I asked why she wanted an X-ray. The doctor told me she won't order an MRI without an X-ray. Further, while it is true that X-rays do not show soft tissue injuries, they are very good at identifying chronic conditions such as arthritis. And any time there is an injury to a joint where there is swelling, X-rays must be used to eliminate (or confirm) a fracture. Using one type of image without the other creates an incomplete picture of a joint injury.
In my case, I was wrong about the meniscal tear but the MRIs did reveal a small loose piece of cartilage in the knee. I was told that the injury was an issue of pain management. There was no risk of further injury as the cartilage was already loose. No procedures needed to be done unless my knee locked or became very uncomfortable. Well, I am seven days into a ski vacation in Utah and have had no issues. I may be back on the hardwood soon. But enough about me, let's take a look at the injuries in the NBA this week. Luckily for everyone, it has been a light week on the bumps and bruises front.
Tracy McGrady, SG/SF, Rockets: T-Mac is sitting once again. He has not been able to shake his left knee soreness, and the Houston Chronicle reported on Thursday that McGrady thinks he will be sitting for a week. The official diagnosis is an inflamed tendon in McGrady's left knee. Rockets trainer Keith Jones told the Chronicle, "There was some inflammation in the tendon by the kneecap where the tendon starts. That's really it." This description makes it sound as though it is the patellar tendon that is affected. Despite Keith Jones' reluctance to put any kind of timetable on McGrady's return, based on T-Mac's own words, we can count on him missing both games of the back-to-back set and Monday's game against Golden State. This means McGrady is questionable for the game at Boston on Wednesday, Jan. 2. With a four-game week for the Rockets in Week 10 and T-Mac all but guaranteed to miss one of the four, I am recommending that owners in weekly roster leagues bench him and look for someone more reliable. Those of you in need of 3-pointers should look no further than Luther Head, who has averaged 2.2 3-pointers in 38 career starts.
Vince Carter, SG/SF, Nets: The news reported about Vince Carter's ankle by the Newark Star-Ledger this past Sunday is the worst kind for fantasy owners (and injury writers). No, it's not that his foot has snapped off at the joint. With that kind of news we could at least be warmed by the fires of certainty. In this case we have the opposite. The paper has said, "there are frequent whispers around the organization that he may be dealing with his ankle problem all season." Carter initially sprained his right ankle on Nov. 10 and hasn't been right since. That actually isn't wholly accurate. On some nights he is more than right (such as Dec. 14 when he lit up the Cavs for 32 points, 7 rebounds and 6 dimes) but the problem is that Carter himself has no idea when he will be feeling good. He told the Star-Ledger, "It's funny, usually my gauge was in the morning, I knew how it was going to feel in the evenings. But now sometimes I'm great in the morning, and then I was having some rough evenings. So now I don't know. I just wait until game time to decide." For Carter owners, this just means you have to roll him out there and hope for the best. It doesn't appear there will be any advance warning about his condition.
Manu Ginobili, SG, Spurs: He talked his way back into the lineup last time, but that outcome appears unlikely now. Ginobili first sprained his left index finger on Dec. 2 and initially played well; back-to-back 37-point efforts attest to that. However, Ginobili reinjured the digit this past Saturday and this time, according to the San Antonio Express-News, coach Gregg Popovich will be more cautious. The paper reported that there was no tearing of ligaments, which indicates a minor sprain. Still, rest is the best cure for sprains and Ginobili is going to get some whether he wants it or not. I don't think this will be a long absence. He missed Wednesday's game and, using Tony Parker's three-day sabbatical with a sprained ankle as an indication, I think one or two sounds about right. Ordinarily Brent Barry would absorb a lot of Ginobili's minutes but he will miss the next two weeks with a torn calf muscle. Look for Michael Finley and Ime Udoka to fill for the next few games.
Tim Thomas, SF/PF, Clippers: It's day-to-day for Tim Thomas and this is good news. The team and coaching staff were expecting worse news after he left this past Saturday's game holding his left knee. This week's MRI, however, revealed "no structural damage" according to the L.A. Times. This is code for no injuries to any ligaments, tendons or the menisci. Coach Mike Dunleavy told the paper, "It's really a matter of pain tolerance to see where it is." Sound similar to the report on a slightly less famous baller from the Bay Area? Indeed it does. Thomas missed Thursday night's game and should miss Friday's game as well. As far as Week 10 goes, depending on the depth of your bench, I would consider benching Thomas. Al Thornton will start in Thomas' place and is a nice short-term add.
Jason Williams, PG, Heat: Another MRI, another negative result. We mean "negative" in the most positive sense, of course. Jason Williams was sidelined on Wednesday with left knee tendinitis but the results of Thursday's MRI showed no soft tissue damage, according to the Sun-Sentinel newspaper. Williams could be back in time for Friday's game against Orlando. If he can't go, Dwyane Wade will be the prime distributor for the Heat. Chris Quinn (sprained left ankle) has had the walking boot removed but does not look ready to play today.
On the Comeback Trail
Mike Bibby, PG, Kings: The Sacramento Bee is reporting that Mike Bibby should make his return to the court on Jan. 15. He is cleared to begin practicing with the team after the new year and will use that time to work on conditioning. If he responds well, don't be shocked to see him return a little sooner.
Antonio Daniels, PG/SG, Wizards: When Antonio Daniels announced that he would be coming back on the early side of his 2-4 week diagnosis with a sprained MCL, I admit I was skeptical. The Washington Post is reporting that Daniels is practicing with the team and could be back as soon as Friday's game. It appears safe to have him in your lineups next week.
Guy Lake is a fantasy basketball analyst for ESPN.com. He can be reached at GuyLake@TalentedMrRoto.com
Guy Lake discusses the latest injuries affecting the fantasy NBA world.