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Greg Oden, Joel Przybilla, and a tale of tendinitis

Disclaimer: I am not a medical expert, I don't know all the facts, and I don't have a perfect memory.  There's probably something inaccurate in here somewhere.  However, with that said, this post is primarily about the facts that we do have, not about speculation.


On December 5th, 2009, Greg Oden went down with a fractured patella.  The next day, he had surgery.  Speaking to the media, GM Kevin Pritchard said that the bone should be healed in two months, but that after a long period of inactivity, the muscles would take two months further to heal.  There was no ligament damage.  The only injury was to the bone.  The surgeon who operated said that Greg had very thick, very strong bones [Edit: I misremembered.  It was not the surgeon, it was Jay Jensen.  See my comment down below for the quote].  

 17 days later, Joel Przybilla ruptured a tendon in his patella.  He also underwent successful surgery.  The team announced that he would be out for the rest of the season, but then was expected to be back for training camp.  But then, early in March, he slipped in the shower, re-tore the tendon, and needed surgery again.  At the time, there seemed to be a general feeling that his career was likely over.  So why is he now back, practicing, and expecting to be playing in just a few weeks, and we still have no timetable for Greg Oden?

I believe that there are a number of reasons for this, but I think that the key one is that Greg was working too hard.  (And everybody shakes their heads, and calls me crazy.  You might be right,  but hear me out first.)  What do we know about his rehab?  Very little, actually.  We know he was targeting the playoffs for his return.  Yet here is it, more than halfway through October, and he still isn't ready to play.  Why not? 

The answer?  Greg has tendinitis. But what is tendinitis, anyway?

According to MedlinePlus:

Tendinitis means inflammation of a tendon.

Nice and simple, isn't it?  However, it doesn't stop there.

Injuries and overuse are common causes of tendinitis. Cross-training, stretching and decreasing your intensity when you exercise might help prevent tendinitis. Certain diseases, such as rheumatoid arthritis, also can cause it. You can usually treat tendinitis with rest, ice and medicine to relieve pain and decrease swelling. Other treatments include ultrasound, physical therapy, steroid injections and surgery.

Injuries and overuse.  We don't know which it is for Greg Oden.  It's probably safe to say that he would not have tendinitis if he had not been injured.  The most likely explanation is some combination of the two.

From WebMD:

To avoid tendinitis, try these tips when performing activities:

  • Take it slow at first. Gradually build up your activity level.
  • Use limited force and limited repetitions.
  • Stop if unusual pain occurs. Do something else. Try again later and if pain recurs, stop that activity for the day.

I'd like to repeat that:  "Take it slow."

Under treatment:

Surgery. This is only rarely needed for severe problems not responding to other treatments.

That probably hurt to read.  Yes, this could potentially mean another surgery is necessary.  I don't know how severe Greg's tendinitis is, but I'm willing to guess it isn't bad enough to need surgery.

Here's another site:

Tendinitis can cause permanent damage to the tendons. The natural tendency to favor the painful area also can lead to stiffness. A vague discomfort at the age of 30, if overuse is continued for years, this can lead to a loss of flexibility due to scarring of the tissues.

Sometimes the discomfort of tendinitis disappears within a matter of weeks, especially if you rest the affected area. In elderly people and those who continued to use the affected area, tendinitis often heals more slowly and usually progresses to a chronic condition.

...

Rest allows the tissues to heal. Returning to activity too soon may cause the symptoms to reoccur.

...

The most common causes of tendinitis are injury, overuse, infection of the tendon sheath or disease (tendinitis is evident in rheumatoid arthritis, gout and psoriatic arthritis). More often than not, the cause of tendinitis is unknown.

Once again, that's pretty scary stuff to Blazer fans.  There could be permanent damage if he ignores the symptoms.  Coming back too soon could result in a re-occurence.  Tendinitis can last for months or become permanent if not allowed to heal fully. 

Don't panic yet, though.  That's the worst case scenario.  On the other side:

With treatment and if you follow your doctor's instructions, pain and swelling should go away after a few days without further problems.

Recurrences can occur if there is continued overuse, but use of splints, proper technique during exercise, and muscle strengthening exercises can usually help.

Yes, it's not all bad.

Symptoms improve with treatment and rest. If the injury is caused by overuse, a change in work habits may be indicated to prevent recurrence of the problem.

So what's the point of giving you all this information?  Partly, it's so people realize just what Greg is dealing with.  The best case scenario is resting his knee as much as possible until the inflammation dies down.  A recurrence would mean starting the whole process over again.  I believe that this is why there is no timeline for his return. Tendinitis is not something that can be predicted with certainty.  By far the best thing to do at this point is to rest his knee and let it heal.  It could be a few days or weeks, it could be a few months.  The most likely time frame, from what we have heard from the Blazers, is a few weeks.  However, because of the potential consquences of a recurrence (missing significant time once again), I would expect Greg to play very limited minutes until they are confident that the tendinitis is completely gone.  If I'm right, don't yell at Nate McMillan too much, there's a good chance he has instructions from the training staff.

While some of the information up above sounds depressing, don't panic yet.  That is worst case scenario, as in "Joel tears the tendon in his other knee, Roy breaks his kneecap, Nico fractures his collarbone, and Rudy breaks his back" type of worst case scenario.  I would be VERY surprised if there is any kind of permanent damage.  The most likely outcome is that Greg rests the knee for a few weeks, goes out and plays, and doesn't have any more trouble.  The main reason I put all the scary stuff in is for those who think that Greg isn't doing enough.  The reason he has the problem now is most likely because he was doing too much too soon, before his injured knee was ready for it.  Taking it easy is the right thing for him to do.

And finally, Greg Oden is NOT a bust.  If I could emphasize that "not" any more, I would.  If you were shaking your head at me earlier, you are probably now screaming at me through your computer monitor.  Sadly, however, I can't hear you.  You'll need to just vent in the comments.

Anyway, I said it.  He's not a bust.  Take a look at his injuries.  Every single one of them has been a freak injury.  He had a broken hand.  There has been no more trouble with his hands since.  He had microfracture in one knee, and then played most of a season on it.  That knee has had no problem since.  Earlier, I emphasized some comments about this injury.  There was no ligament damage.  Bones heal.  Bones heal more than 100%.  They heal to be thicker and stronger than they were before.  The surgeon [edit: it was Jay Jensen, I misremembered] who operated on him said that his bones were already very thick, and very strong.  Yes, you can say that Oden has an injury history, but it's not the sort of history that is expected to repeat itself.

Joel Przybilla is a tough guy.  It's hardly a surprise that he has returned from his injury, and it's hardly a surprise that he has returned early.  He deserves credit for that, as do the training staff.  However, comparing him to Greg is unfair to both of them.  People are different.  The injuries were different.  Trying to compare them is like comparing apples and oranges.  Give Przy credit for his hard work, but give Greg support every step of the way.  He's working too, and with a lot less thanks.  And so I'll say it, and I hope you join me.  Thank you Greg.  You've had a tough time, but you're going to pull through it and prove the doubters wrong.  I can't wait to hear the O-den chants ring out around the Rose Garden when you come back.  See you soon.

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