Embiid Update II – Exit Surgery Enter Sports Science

Oct 8, 2014; Philadelphia, PA, USA; Philadelphia 76ers center

(center) wearing plain clothes and a boot congratulates teammates as they walk to the bench on a timeout during the second half of a game against the Charlotte Hornets at the Wells Fargo Center. The 76ers defeated the Hornets 106-92. Mandatory Credit: Bill Streicher-USA TODAY Sports

Embiid Update II – Exit Surgery Enter Sports Science

Joel Embiid is fine now.  He had successful surgery on his foot and tweeted afterwards that everything went very well.  Now that he’s on the road to recovery, it’s an excellent opportunity to discuss the history of Joel Embiid’s injury.

I’m not a medical doctor.  I’m not even a physical therapist.  But I’m familiar enough with some health care terminology to take a stab at laying out what lays ahead for our beloved Joel Embiid.

More from The Sixer Sense

• 3 Sixers players who could help Team USA Basketball
• 76ers 2k24 ratings: 3 most underrated players on Philadelphia roster
• 76ers head coach Nick Nurse bares lofty plans for Paul Reed this season
• Grade the Trade: 76ers swap Tobias Harris for superstar PG in mock deal
• Sixers Podcast: Danny Green returns + James Harden bombshell

One week before the 2014 draft, our Cameroonian center suffered a stress fracture in the navicular bone in his right foot — a tiny bone in the middle of the foot that’s essential in proper weight transfer and force absorption during ground impact.  This is an injury that is quite similar to the multiple injuries suffered by former NBA

which eventually forced him to retire.  It’s also similar to that of

, who endured three separate surgeries before healing enough to play the strenuous game of NBA basketball for ten years. The initial surgery happened just before the 2014 NBA draft, and even forearmed with that knowledge Embiid became the selection of the Philadelphia 76ers at three.  General manager Sam Hinkie had no hesitation selecting Embiid, stashing him for a year, and bringing him in to play in the 2015 season, just as he had stashed

the previous year.  But plans go astray, even though the team had treated Embiid gingerly.  He was not asked to join the team throughout the year and was virtually pain free and mobile for weeks prior to the summer league.  But something was amiss. When asked, Bob Cooney who reports for the Philadelphia Daily News admitted:

"“From what the sources told me, it’s broken again. Absolutely, you have to be nervous about it. Then this next surgery will be very interesting, find out exactly what they’ll go in and do. Hopefully the Sixers will come out and speak of it after it is done.”"

But as has been the case concerning Joel Embiid, not all the information seems to be forthcoming.

Next: Sam Hinkie Speaks

Sep 29, 2014; Philadelphia, PA, USA; Philadelphia 76ers general manager Sam Hinkie talks with reporters during media day at the Wells Fargo Center. Mandatory Credit: Bill Streicher-USA TODAY Sports

Sam Hinkie Speaks The official Philadelphia press statement is quite verbose, but I will present the July 11, 2015 statement of Sam Hinkie here in its entirety:

"“As we previously communicated, we have spent the last several weeks working closely with Joel and his representatives to further evaluate Joel’s foot following the results of the most recent CT scan. This included conference calls and in-person visits with renowned foot and ankle specialists from the United States (New York, North Carolina, Colorado, California and Pennsylvania) and internationally (Australia, the Netherlands and Qatar).  This group of experts unanimously agreed that the routine CT scan in June did reveal less healing than anticipated, an unexpected result since Joel was not experiencing any foot pain. We have been consistent in our philosophy that our focus will be Joel’s long-term health and wellness to ensure he will have a long and impactful career in the NBA. After receiving the input of the aforementioned medical experts, as well as conversations with Joel and his representatives, there was careful consideration given to a number of options related to this particular situation. A collective decision has been made that the best approach to promote full healing would be to proceed with a bone graft of the fracture site. We anticipate the procedure will take place in the next 7-10 days and result in Joel missing the upcoming season. “We are still in the process of determining the doctor who will perform the procedure, which should be finalized in the coming days. Sixers Director of Performance Research and Development Dr. David T. Martin will outline and lead Joel’s rehab and recovery plan, in collaboration with a worldwide network of experts and specialists.” And so the wait for the surgery, and some sort of update began. Next: Modern Miracle Medicine"

November 16, 2014; Los Angeles, CA, USA; Los Angeles Lakers trainer Gary Vitti treats guard

(24) for an injury suffered against the Golden State Warriors during the first half at Staples Center. Mandatory Credit: Gary A. Vasquez-USA TODAY Sports

Modern Miracle Medicine

Fortunately for Joel Embiid, the science of treating Naviscular stress fractures had advanced many times over.

In the past, it was simply considered a simple “car repair” and they bolted bones together as best as they could and sent the athlete back out to smash the bone once more. Now the treatment has improved greatly. What have doctors learned about the injury?Well, breaking down the components, there are three areas to be addressed in the injury.

The first is the diagnosis. Due to the area, and the complexity, of the injury, the imaging of the injury requires more detailed process. A simple XRay may appear completely normal. A true diagnosis can optimally be made with an MRI, a CT scan, or a bone scan. An MRI or a CT scan will allow the fracture orientation to be identified. In addition, those studies will allow determination of whether the fracture is complete or incomplete.

MORE ON SIXERS SENSE: Hollis Thompson, What Can He Do Next Season?

The second is the injury itself. Due to the location, size, and load bearing features of the foot skeleton, the slightest misalignment of any bone or bones in repair can be devastating. The injury is either “undisplaced” or “displaced”. In an undisplaced injury, the fracture occurs without reorienting the alignment of the bones. Simply casting the foot and staying off that injured foot for the first six weeks can achieve a 90% rate of fully healing after a four month process. Sometimes in an undisplaced injury, surgery is still the best option. This assures the bones remain in alignment throughout the time required to heal the fracture.
In a displaced injury, surgery is required.  The surgeon must now reduce the fracture (set it into exact position), hold it in place with screws, and introduce a bone graft to promote healing of the bone back to full strength.

The third is the vascular system – the blood flow system. The foot is not a well nourished area of the human body in terms of the blood supply it receives. It is at the farthest point from the life giving lungs and blood pumping heart, so it tends to be the least satisfied when the body is subject to any stress.  If you’ve stood outside in the winter for long, you may have experienced a pins and needles feeling in your foot.  That’s just the body cutting blood off to the feet so that more vital organs remain warm and nourished. But that blood is imperative to heal a fractured bone.   So what is there to do…. um…

CALLING DOCTOR DAVID T MARTIN!

Next: Dr Martin Earns His Title

Apr 15, 2015; Philadelphia, PA, USA; General view of the exterior of the Wells Fargo Center as seen through a gate before a game between the Philadelphia 76ers and the Miami Heat. Mandatory Credit: Bill Streicher-USA TODAY Sports

Dr Martin Earns His Title

Remember when Sam Hinkie indicated “Sixers Director of Performance Research and Development Dr. David T. Martin will outline and lead Joel’s rehab and recovery plan, in collaboration with a worldwide network of experts and specialists.” Now as to why the delay in having the surgery performed?

There was good reason for that. First the matter of the surgery. It was performed on August 18, 2015 and the surgeons were identified later in the evening:

And the hospital of the surgery is:

The hospital stay should be short in duration.  Essentially enough time to ensure all systems are proceding well and then a discharge plan expected to have extensive post-surgical instructions for Embiid to adhere to.  From the moment of discharge, Joel Embiid will benefit from the services of Dr. David T. Martin.  

(Did somebody just roll their eyes? Stop that!)

The struggle to heal this injury is to ensure that good nutrition races to the injury site, while ensuring that toxins are eliminated.   That’s sports medicine.  That’s sports science.  That’s the brainchild of Dr. David T. Martin.

So what?  Well, research on slow healing bone fractures have shown remarkable improvement with a strict regiment of diet, fluid, supplements, and where appropriate, exercise.   Diet ensures a good healthy and stress free body.  Fluids ensure good blood flow and effective kidney functions.  Supplements ensure the injured area is getting a supercharged blood stream loaded with the building blocks needed to repair the  fracture quickly.  And finally appropriate exercise ensures that the blood is flowing to nourish the site.

The challenge with an injury of this type is the length of time required to heal the site before the success of the procedure can be fully validated.   At a minimum, Embiid’s surgery will require a minimum of six weeks with no weight placed onto the foot whatsoever.

After an initial healing phase of some three weeks, the cast will be removed and the site will be examined for alignment.  Embiid will be asked if he has stayed off his foot as well.  If all is going as planned, a second cast will be placed for another three weeks.  Following the full six week period, the site will be examined again for signs of healing.  Gradually, Joel will be given a weight bearing cast with crutches.  Signs of pain could indicate a need to refrain from weight.  Eventually, pain free ambulation will occur, and then it will be a slow process to increase the exercise to confirm the injured site is fully healed.

This is step one folks.  We’ve got a year of healing to go – if everything goes well.