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NBA: Why did Bone Bruise shut down Hachimura for a month?

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Yesterday, we had the first part of our interview with Dr. Matthew J. Levin Advanced orthopedic centers Where we discuss hamstring injuries, like a Washington Wizards guard Dillon Wright suffers. Dr. Levine is an orthopedic surgeon specializing in sports medicine. He also serves as team physician at Tuscarora High School* in Frederick, Maryland.

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In this part, we discussed striker Rui Hachimura’s ankle injury.

As a disclaimer, the answers given by Dr. Levine should be seen as general trends among people in a situation similar to Hachimura’s. It is not to be taken as medical advice. The information below is also not indicative of what Williams has experienced or is testing. Please consult your doctor for your specific situation.

Our questions below.


BULLET FOREVER: Rui Hachimura has missed all Wizards games since November 18 when he suffered an ankle injury that was later determined to be a bone bruise. This sounds a little primitive, but what is the function of the ankle function of the leg and foot?

Dr.. Levine: The ankle is what I would describe as a joint. Allows your foot to flex and extend or point your foot and lift and rotate your toes slightly from side to side. It then connects to some parts of the foot which then allow some other rotational components which allow multiple range of motion throughout the ankle complex.

But basically it is the joint that the ankle is the joint that connects the leg to the foot, these bones are held together by ligaments and then the muscles act on the bones as well. The muscles then control the direction of movement while the ligaments provide these stabilizing forces. When you sprain, roll, or break your ankle, the stability disappears so the muscles can no longer function in their normal way.

BF: How do bone bruises happen?

Dr.. Levine: When the ankle is injured or unstable, the bones in the ankle can impact each other as well. That can be painful. Sometimes you will develop small fractures or small breaks. These small fractures are what we call bone contusions or bone contusions.

BF: What’s the difference between a bruise like someone fell on their buttocks and a bruise in that area and a bone bruise? To the average person, one would probably think of a bruise as something visible rather than something on the bone.

Dr.. Levine: The bruise you are talking about is a tissue bruise. In this case, you have visible bleeding that is generally located within the skin. It’s what we call bruises or bruises that you might see on the skin and say, ‘You have a bruise. “

In the case of bones, there is a very rigid structure that does not allow this blood to circulate and be seen at the level of the skin. But bones are a living thing. If you think about the interior of the bone it resembles the lattice structure of a sugar cube. You can have a little with little cells inside that make bone and wear away. There are osteoblasts and osteoclasts that continually remodel bone. But those tiny structures within the bones can develop small fractures or cracks. Then the bone gets fluids or bleeding and things deep within the bone bring healing responses from the body. These are also bruises, but they are generally not visible because the bleeding remains within the bone.

BF: How long does a bone bruise take to heal?

Dr.. Levin: Since bone bruises are generally contained injuries, they also take longer to recover than tissue bruises. When I have patients with bone bruises, I often tell them that it can be, the recovery can be as short as six weeks. But it can take up to three months. And I’ve had patients with bone bruises for up to six months. The six-month number is on the long end of things.

Most people can return to some light levels of physical activity before the end of these schedules. But that initial level of pain has to go away before they can function well. The athlete’s body is constantly responding to this pain, preventing him from performing at his normal level. Muscles will not work when the body feels pain. It’s called reflex inhibition, and it stops the muscle from doing things that cause pain to itself.

BF: You mentioned that the recovery timeline for this injury can take anywhere from three to six months. Does this apply to the general population or to professional athletes or other serious athletes?

Dr.. Levin: This applies to anyone. Professional athletes vary a bit in terms of treatment, but we don’t usually get repeat MRIs to see if the bone bruise has gone away. We know that over time they tend to recover after clinical treatment and when their pain levels have decreased sufficiently. When the pain someone is feeling is sufficiently gone, they are functionally able to do the things they need to do. This is when they are allowed to play.

BF: How frustrating can bone bruises be for athletes, more than an “average Joe?”

Dr.. Levin: I would say that a bone bruise is a particularly frustrating injury for high level athletes because when they try to push themselves to perform at the level they need to, then they will have recurring pain, which prevents them from performing well.

The recreational league “weekend warrior” or someone who just wants to work toward personal fitness on their own will likely adjust their routine to combat the pain. But for serious, high-level athletes, they have to push their bodies even more to perform.

Bone bruising is also frustrating for athletes (and everyone else) because there aren’t a lot of treatments available to them besides time and rest. On the other hand, a hamstring injury can be treated with anti-inflammatories, massage, etc.

BF: In short, is Hachimura’s recovery for about a month normal so far?

Dr.. Levine: Yeah. He may do some other activities like shooting to keep his skills fresh. But with a bone bruise, Hachimura doesn’t play until the pain goes away and when the bruise goes away on its own.

BF: You mentioned that you’re the team physician at Tuscarora High School in Frederick County, Maryland. **Have you worked or worked with athletes at the college or professional level in the past?

Dr.. Levin: My practice also works with other high schools in Frederick County as well as Hood College, an NCAA Division III school, and Frederick Community College. And we see some people from the University of Mount St.

She also did a sports medicine fellowship at Duke University in Durham, NC. While there, I traveled with the soccer and lacrosse teams. And yes, I’ve also worked with players on both the men’s and women’s basketball teams.

BF: Last question — at the high school level, players often play multiple sports during the school year. But there are students who focus on one sport, and college athletes also generally focus on one sport. Are players who play multiple sports throughout the year more likely to get injured?

Dr.. Levin: On the contrary. High school athletes who perform multiple sports often suffer fewer injuries during the season that “individual athletes” athletes do. One possible reason for this is that different sports require different athletes to use different muscle groups.

There is some research This showed that high school athletes who were multi-sport athletes when they became individual athletes in college were less likely to be injured in their sport in college.

It is also true that the highest performing individual athletes in college sometimes tended to be individual athletes throughout high school. While they may perform at a higher level, they are more susceptible to injury due to overtraining.

Also at the college and high school levels, teams train and lift weights in the off-season to mitigate the risk of overtraining and injury.


Thanks to Dr. Levine and the Centers for Advanced Orthopedic Surgery for helping us learn more about sports injuries. We’ll continue to check in with them if and when players get them from witches and shapeshifters.


* There is also a Tuscarora HS in Leesburg, VA which is about a 30-35 minute drive south of Tuscarora HS in Maryland. Dr. Levine confirmed with us that he works with the Maryland school.

**For those unfamiliar with the geography of the metropolitan area, there is Frederick County, Virginia which is located southwest of Frederick County, Maryland, the county that surrounds Winchester City. Frederick County also happens to be where former site manager Jake Whitacre grew up!

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