The Washington Wizards’ roster has suffered setbacks beyond a ten-game losing. Two players: Delon Wright and Rui Hachimura have been out for weeks due to a hamstring and ankle injury, respectively.
In Wright’s case, he first injured his right hamstring in late October. The timetable for his return would be about 6-8 weeks for a Grade 2 stra, and we are now toward the higher end of that estimate. And in Hachimura’s, he suffered a bone bruise in his right ankle after a game in late November. Hachimura has done workouts with the team but there is no timetable set for his return.
To help us understand why hamstring and ankle sprains can take so long to recover from, we spoke with Dr. Matthew J. Levine of the Centers for Advanced Orthopaedics. Dr. Levine is an orthopaedic surgeon who specializes in sports medicine and works with high school and college athletes in the D.C. area. He also serves as the lead physician at Tuscarora High School* in Frederick, Md. He has also worked on medical staff teams for the Penn Relays (track) and the World Figure Skating Championships. Dr. Levine’s practice is located in Frederick and Urbana, Md.
As a disclaimer, the answers Dr. Levine gave should be considered as general trends among people in a similar situation as Wright and Hachimura. They are not to be taken as medical advice. The information below is also not an indication of what Williams has experienced or is experiencing. Please consult your doctor for your specific situation.
In this part, we asked Dr. Levine about Wright’s injury specifically. Tomorrow, we will share our questions on Hachimura. And now, the questions!
Bullets Forever: Dr. Levine, thank you for taking the time to speak with us today. First, we want to ask about Delon Wright and his hamstring injury. Could you tell us what the hamstring does for the leg?
Dr. Levine: The hamstring muscles are a series of muscles that cross from the pelvic bone across the hip joint. They go down the length of the back of the leg, and then they cross the knee joint in the back. They serve a couple of different functions, both knee flexion, meaning bending your knee and hip extension, meaning, pulling your hip backward.
BF: How do athletes suffer hamstring injuries?
Dr. Levine: These injuries typically happen when someone uses his or her legs for sudden starts and stops. In basketball, players often move from side to side on offense or defense. Or they may dive for loose balls.
BF: Wright, a guard, came to the Wizards to boost their perimeter defense. Do guards tend to suffer more hamstring injuries than post players?
Dr. Levine: I don’t have data to say that guards are more prone to hamstring injuries than post players. But anecdotally, they are more susceptible to these injuries because they have to rely on sudden bursts of speed and movement more than posts do. It’s also important to note that post players could still play through some discomfort in their hamstrings than guards because they probably because of that.
BF: Wright’s hamstring injury is a Grade 2 strain which is not a mild strain, but not quite as serious as a Grade 3. How these grades determined?
Dr. Levine: The way I think about a hamstring strain, I would say there’s different locations on the hamstring where you can have these injuries. The most common is that the muscle tendon junction on the upper half of the hamstring. So you get these muscle fibers that will get some partial tearing. You can have some very high proximal or very distal avulsion type or tenderness injuries, which are different than the most common muscle strain that we’re talking about.
If you have a Grade 1 strain, it would be micro tearing. Symptom-wise, you will get tightness and some discomfort. You probably don’t have any noticeable bruising. The hamstring will be sore when you walk and it’ll be stiff, but you don’t really have any loss of strength. If you do an ultrasound or an MRI, which are rarely needed in most people (but is typically done for professional athletes), you might see some very mild edema or inflammation in the muscle belly, or the middle of the muscle. So on a grade one strain, you may or may not see any damage.
On a Grade 2 strain which Wright has, there is a little more tearing of the muscle fibers themselves. But there is no disruption of the continuity of the fibers. Ifyou suffer a Grade 2, you will have more pain, and there is likely bruising and some inflammation in the area of the tear. There may be some loss of strength at the onset of the injury.
Finally, Grade 3 strains happen when there is a complete tear of the muscle. Now that can be through part of the muscle, through some of the muscle. The muscle tends to be very vascular. So in those, you almost always have a good bit of hemorrhage and bleeding. And there is usually a palpable defect. If you have a Grade 3 strain, you can feel where this tear is. It becomes very hard to walk and those injuries take longer to heal.
BF: Wright is toward the end of a 6-8 week timetable for his hamstring strain. Is this typical for a recovery?
Dr. Levine: Timetables can be unpredictable. For Grade 2 strains, players can walk under their own power and can often look like they are just fine during regular activity, like walking on the street. However, a 6-8 week recovery timetable isn’t outside the norm.
To recover from this kind of strain, the first and most important part is to get past the initial inflammation. As the hamstring begins to heal, if it begins to inflame again, that can set athletes back. If an athlete takes an abnormally long time to recover from a hamstring, it is often because that athlete is pushing themselves too hard during the rehab process.
I can’t say about Wright’s specific case since I don’t work for the Wizards. But athletes generally don’t return to play until they are pain-free and have their range of motion back. Regular activity doesn’t force athletes to use their bodies at their full capacity as sports does.
Thanks again to Dr. Levine for his answers. We will share the portion of our conversation regarding Hachimura tomorrow!
*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.