Staying Healthy in the NBA vs NFL

Mark Bartelstein from Priority Sports & Entertainment, Dr. Brian Cole (@BrianColeMD) and Steve Kashul discuss Bartelstein’s client Micheal Porter Jr. and protecting his best interest, his rehab and evaluating his long-term prognosis. Bartelstein discusses the difference between staying healthy in the NBA and the NFL.

PRIORITY SPORTS is a full service management firm, with over 25 years of experience, comprised of honest, ethical, hard-working, passionate and productive professionals who make it a point to build long lasting and meaningful relationships with our athletes.

In the NFL

  • PRIORITY SPORTS has been named one of the top football agencies by ESPN in each of their last five rankings.
  • PRIORITY SPORTS has the experience of representing more than 30 First Round Draft Picks.

In the NBA

  • PRIORITY SPORTS has the experience of representing more than 20 First Round Draft Picks.
  • PRIORITY SPORTS has negotiated over a BILLION dollars in contracts in the last 3 years alone.

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Jamari’s Story

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Jamari’s diagnosis

Jamari Sanders’ mother, Sharenne Shumate, didn’t worry when Jamari returned with complaints of leg pain after a day of playing basketball at his uncle’s house. The eight-year-old said he had fallen, but Sharenne didn’t see any bones that appeared to be broken. Just to be sure, she took him to the nearest emergency room where doctors confirmed no broken bones, tendon or ligament tears. But two days later, when Jamari woke in the middle of the night in tears and complaining of pain, his mom knew something was very wrong.

After returning to a local doctor for more tests, Jamari was diagnosed with osteosarcoma of the right femur, or cancer in his right thigh bone. This is the most common form of bone cancer in children. Worried about Jamari’s spirits, Sharenne focused on finding a doctor who could both heal her son and continue to treat him like the strong, outgoing, and active little boy he is.

Finding a care team

Sharenne immediately contacted experts at Midwest Orthopaedics at Rushbecause she was familiar with Rush University Medical Center’s reputation. After a long visit, the family chose the team of Dr. Matthew Colman, orthopedic oncologist; Dr. Monica Kogan, pediatric orthopedic surgeon; Patti Piasecki, N.P., and Dr. Paul Kent, pediatric hemotology-oncology specialist at Rush University Medical Center. With the medical team decision made, Jamari and his family relocated from Wisconsin to Chicago to be closer to his care team.

As part of a carefully constructed treatment plan, Jamari began chemotherapy right away at Rush University Medical Center. Within a month, his tumor had shrunk by 95%, but Drs. Colman and Kogan discussed the importance of surgery to ensure that his cancer wouldn’t return. They approached Jamari’s family with two surgical options.

The first option was a series of several surgeries to remove the tumor and parts of the surrounding bone, then replacing that section with an implant. The procedure would mean lots of time in and out of the operating room and the possibility that the implant could break as he continued to grow. The second option was a rotationplasty, a procedure in which the knee joint is removed along with the tumor from the mid-thigh. Then, the lower leg, ankle joint, and foot – all unaffected by the tumor – are reattached backwards onto the remaining thigh bone. This allows the ankle bone, now rotated, to serve as the “new” knee joint and the foot to serve as an attachment point for a prosthetic lower leg.

Rotationplasty procedures are extremely unusual, with fewer than ten performed in the U.S. each year. This is because the diseases which make rotationplasty an option are rare and the nature of the procedure is unconventional. The procedure is typically the best option for very young children who still have significant growth remaining. This is not only because their bodies are more adaptable and resilient, but because the other main option, a metallic knee replacement prosthesis, is commonly associated with multiple complications and re-operations in this age group. Rotationplasty is complex and Drs. Colman and Kogan are among a short list of surgeons with the required skills to perform a successful rotationplasty.

Jamari’s medical and surgical team provided his family with research, websites, and videos which explained both procedures in layman’s terms. They even connected Jamari and his family with other patients who had had the procedure in the past. The family took a leap of faith and decided on the rotationplasty procedure.

“I would do it all again with the same team of doctors, nurses, and social workers,” Sharenne explained. “They gave us all the resources we needed to make the best decision.”

Sharenne was confident that the doctors, her son’s strength of spirit, and the support of her family would result in a successful outcome. “Rush really accommodated Jamari and our family,” Sharenne explained. “They made sure that we had a room big enough for all of us to be together on the day of the surgery. They gave us an update through every step of the procedure. Dr. Colman spoke with us immediately after the surgery to tell us that things went well. That meant the world to us.”

Wearing a cast to stabilize his new knee joint, Jamari underwent one more round of chemotherapy and then began physical therapy to build up his strength and get accustomed to walking with his new joint and prosthetic leg.

Reflecting on Jamari’s journey

“He’s been much stronger than we have,“ Sharenne says. “He has stayed positive and worked very hard to turn a tough situation into the best possible outcome.”

When she reflects on her family’s journey, Sharenne is almost at a loss for words when she talks about the Midwest Orthopaedics at Rush medical team. “They’re just amazing. I am in awe. This whole experience made us appreciate life and the little things. It is clear to us that God touched the doctors’ hands to do such an awesome thing for Jamari.”

While he’ll need to be watched regularly for the next five years, Jamari, who’s now 10, is excited to join his friends back at school this fall and to continue being the bright, active boy that he has always been.

For more information on rotationplasty or treating bone tumors, contact Dr. Colman’s office at 877-MD-BONES.

The Real Reason LeBron James Seems to Be Immune From Injuries

Cavaliers forward LeBron James

Dr. Cole and Steve discuss the injuries that have occurred in the NBA from nearly all of its top stars suffer from one injury or another over the past several except for LeBron James. According to his business partner Maverick Carter, anyone can maintain this level of health for 15 years as long as they are willing to spend $1.5 million a year on their body like James does.

In this segment his use of cryotherapy, hyperbaric chambers, and NormaTec leg boots are explained. Related Article>>>

The NBA May Be Pushing its Tallest Players to the Point of Injury

A doctor’s theory about this season’s injury epidemic

These days, the NBA and its faithful fans are searching for unicorns. I’m talking about a virtually mythical combination of physical attributes in one person for the purpose of pure full-court magic.

Once upon a time, players were assigned roles and positions based on their heights. Shorter people were supposed to shoot, pass, and dribble while those more vertically gifted were expected to lumber around the basket. This was all basketball 101.

Somewhere in recent years though, unicorns emerged and the dogma was upended. Since the advent of the NBA, the average height of players has increased from 6’3” to what it is today: 6’7”. As height as increased, the league’s skill and athleticism has also ballooned. And so, tall players (power forwards and centers) are no longer gangly giants dependent entirely on their inches to make an impact. Now, they’re expected to be sublime and omnipotent too. But while they’re tasked to bring their A-game to the court for every game, the anatomical confines of their knees may really not be about that life.

For a piece in the New Yorker, Vinson Cunningham described the preternatural brilliance of the Milwaukee Bucks’ Giannis Antetokounmpo, who’s the archetype of the NBA’s unicorn. “All game, he did things that—given his almost seven-foot frame and long, stretchy limbs—he shouldn’t, by rights, be able to do, but which have become staples of the diet he offers to fans: deceptive hesitations before journeys into the paint; flicked fifteen-foot turn-around jumpers; easy sprints to regain a position on defense that seemed hopelessly lost.”

Here’s where it gets dangerous: when coaches realize these men aren’t mythical beings but instead real people with real body limitations. This season, DeMarcus Cousins of the Pelicans ruptured his left Achilles tendon and Kristaps Porzingis of the Knicks tore his left ACL. Both injuries ended their seasons.

Injuries and injury scares have also punctuated the careers of other uncanny talents: Joel Embiid, Ben Simmons, Kevin Durant, and Anthony Davis. A 2014 tally by FiveThirtyEight found that taller players have missed a larger percentage of games than their shorter counterparts, with those 7’0” or taller being absent for 24 percent of their games. Cousins’ and Porzingis’ injuries have occurred in a season already teeming with hurt players. A recent count found that 3,798 games had been missed due injuries, up 42 percent from the same point last season.

There are theories about this year’s injury epidemic, which is perplexing at a time of unprecedented advances in medicine and science. Some have noted that the rise is merely part of a random year-to-year fluctuation, devoid of any meaningful explanation. Others are suspicious of the NBA’s adoption of a more frenetic style of play, which increases the probability for injury because of all the additional movement up and down the court. There have also been rumblings from executives and coaches about this year’s shortened preseason and the suboptimal conditioning and regular season preparation that resulted.

In recent seasons, coaches have not been passive about their lengthened injured lists and have implemented their own remedy to prevent injury: the Did Not Play-rest (DNP-rest). Though a study has discerned no effect of this on playoff injury risk or performance, players are simply held out of entire regular season games and instructed to sit on the sidelines and rest. While new league rules have caused a dip in the practice, it still persists.

Any temptation to blame the schedule is unfounded. Playing back-to-back games or playing four games in five days alone has not been associated with a heightened injury risk. Game injuries do occur more often in away games, which may be attributed to NBA travel schedules that affect sleep patterns and thus reaction times.

According to Dr. Brian Cole, an orthopedic surgeon at Rush University and team physician for the Chicago Bulls, this season is no different from others. “Game schedule density, back-to-backs, things of that nature have not really been shown to make a difference,” he says. “Other than a statistical anomaly, we have no data that it is otherwise. This population of players is likely no different than the year before.”

Dr. Cole notes that the NBA is still not good at injury prediction models and assimilating all the independent variables that go in it. Assessing the risk for any player, let alone these unprecedented unicorns, thus remains an unknown. He adds, “I have this intuitive feeling that as they get bigger, stronger, faster, and taller, I think the body can only do so much and that may be a factor.”

In the end, the principles of human anatomy, physics, and physiology may prove to be nonnegotiable. In his forthcoming book Human Errors, scientist Nathan Lents writes about our imperfect evolution to bipedalism and the anatomy that was left most vulnerable. “The anatomical adaptation to upright walking never quite finished in humans. We have several defects that are the result of this failure to complete the process.

Lents comments specifically on two overburdened parts: the anterior cruciate ligament (ACL), which connects the femur (thighbone) to the tibia (shinbone) and resides in the middle of the knee, and the Achilles tendon, which attaches the calf muscle to the heel of the foot. Because of our evolutionary straight-leg arrangement, “the Achilles tendon has become the Achilles’ heel” of the entire ankle joint and the ACL endures “much more strain than it is designed to.”

Stressed to their unnatural max by the sudden changes in speed, momentum, and direction of today’s larger players, the ACL and Achilles tendon capitulate—and this is what might have happened when Porzingis and Cousins were felled to the ground earlier this season.

In a running sport that involves acceleration and deceleration and a high degree of unpredictability, the risk is perpetual. One study found that even asymptomatic NBA players carry one or more abnormalities within the knee on MRI. As renowned trainer Tim Grover wrote in Sports Illustrated, “The same muscles, ligaments, tendons, and joints are used over and over again, in the same direction, the same angles, the same motions…At some point the human body just says, ‘Enough.’”

As we wander further into this new frontier on basketball in which players like Antetokounmpo do the outrageous with facility, there will be more work for NBA officials, doctors, trainers, and support staff to do. While injury prediction models still lag behind and bad luck will intermittently reign, league schedulers should redouble their efforts to assess risk and interventions should be deployed to encourage more multi-sport athletes at the high school level. And given the unremitting demands of a 82-game schedule, fatigue management, recovery, and sleep have to be optimized. At this moment of unknowns, this is all we have in order to ensure that we’re not destroying the unicorns for the sake of a little magic.

By Jalal Baig, MD  for TONIC