Anatomy Of Joel Embiid

Weird Science

Sometimes I get a tad “meditechnical” when facing the issues the team is confronting with Joel Embiid’s condition.  This slide entitled weird science is for those who want to know more about the science of the treatment.   If you are not one of those types, simply hit the “next slide” and you will emerge at more basketball related conversation.

The basic path of Joel Embiid’s treatment is to engage in vigorous exercise, be monitored as to his body’s reaction to elevated exertion, and then acting to eliminate any anomalies.  But to say that the treatment at this point is entirely just made of running, jumping, massaging, and graphing the trends as they devellop is simplistic.  There exists a wide arsenal of treatments to promote more rapid and thorough recovery. Let’s examine a few of the most recent developments such as PEMFs, ESWTs and PRPs.

One such alternative method of treatment is known as Pulsed ElectroMagnetic Fields (PEMFs). They have been shown to promote rapid healing in parts of the body with limited blood flow.  This technology is widely accepted in equestrian care, as it is often used to heal similar injuries in race horses.  In this type of therapy, insulated coils of wire are place on or around the injury site.   When current is turned on, the coils become a low intensity electromagnet, stimulating the injury site.

Extracorporeal Shockwave Therapy (ESWT) is another cutting-edge treatment which shows promise to help improve healing times for stress fractures.   This type of treatment has grown popular with ballet dancers, who often suffer from foot injuries, but cannot risk long rehabiliation periods to recover in a traditional manner.  In this treatment, sound waves or low intensity ultrasound waves are focused upon the injury site.

Another area of interest is the use of Platelet Rich Plasma (PRP).   In this treatment, whole blood is taken directly from the patient where it is processed to concentrate platelets.  This platelet enriched blood is then used directly at the injury site, flooding the area with platelet enhanced blood. Although evidence suggests that PRP is safe and can promote bone formation, the strategy is designed to promote healing of the surrounding connective tissue as well.

But there continue to be pitfalls in care even as technology offers several new and effective options.  That  is why the team has elected a very conservative approach of engaging a fully intensive rehabilitation therapy at this vulnerable stage.

As I was investigating Navicular stress fracture, my research uncovered a similar type ailment to bones of the human foot, and can occur after a bone suffers stress fractures – known as bone marrow edema.  This is a relatively new medical terminology, only made possible with the advent of superior imaging equipment such as the magnetic-resonance imagery (MRI).  In essence, the bone marrow of an injured bone separates from the calcified bony shell, showing up as a white patch on the normally darker imaged bone.  That separation is considered part of a recent terminology “bone bruise” and can result in swelling of tissue inside of the bone.  That swelling appears as a gap between a bone and the bone marrow, and results in pain prolonged pain to the victim.  Since the symptoms are virtually identical to that of a patient recovering from Navicular stress fracture surgery, the only distinction is the use of advanced imagery equipment.

Once diagnosed, the bone marrow Edema can be treated with multiple infusions of 50 µg of iloprost given over six hours on five consecutive days. Iloprost is a drug used to treat the constriction of blood vessels, which prevents blood flow to an injury site.  If caught early, full recovery is expected.  That could explain the nature of the second visit, to eliminate any complications in the rehab process.

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