Stars, highlights and stats make us dream every day in the NBA. But if all these athletes perform every evening on the courts, it is also because their exceptional bodies are constantly monitored, massaged and examined. Thus, Dr. Q, a medical student by day and NBA supporter by night, has set up his office at TrashTalk to decipher and analyze all the sores of our orange ball stars. Sprain, tear, fracture, dislocation… the medical examination will allow us to understand all the injuries of the Great League. Today, it is Chet Holmgren who passes on the table of the doc, for a sprain of Lisfranc with rupture of the ligament in the right foot.
- Professor-student in fifth year of medicine, Dr. Q is a great enthusiast of the human body, who himself was able to test many injuries by being the victim of what is called bad luck in sports. Fascinated by anatomy and determined to excel as a future sports doctor, he has already participated in demonstrations in hospitals at the age of 10 and observed in the operating room from the age of 13. Dr. Q shares his knowledge and research on TrashTalk, to learn more about injuries in the world of basketball.
While the luckiest among us were quietly on a deckchair with a cocktail in hand, Jamal Crawford organized a match for his summer league, the CrawsOver Pro-AM, on August 20, with distinguished guests. Although LeBron James and Jayson Tatum were the two biggest attractions of this meeting, the arrival of Chet Holmgren was also to offer us a new insight into his game. The match finally lasted only 20 minutes (the condensation of the room having made the floor slippery), but that was enough to see Chet… leave on injury following contact with the King, the n°2 of the last draft being visibly touched in the foot. It was last Wednesday that the horizon darkened for good for the future Thunder player, with the announcement of a possible ligament rupture in the foot. Thursday, the news was confirmed: Chet Holmgren is out for the 2022/2023 season, following a sprain from Lisfranc with a total rupture of a ligament in the right foot.
Before going any further, a reminder of the anatomy of the foot and what the Lisfranc joint is. The foot is made up, like the hand, of several bones linked together and is divided into 3 parts: hindfoot (ankle-foot junction and heel), midfoot (5 bones forming 2 rows) and forefoot ( the metatarsals). The Lisfranc is thus a complex joint between 4 of the midfoot bones (the navicular and the 3 cuboids) and the metatarsals. It has a major role in maintaining the stability of the foot, ensured by the shape of the bones and numerous ligaments, the most important of which is the Lisfranc ligament, which connects the base of the second metatarsal to the first cuneiform bone.
Anatomy of the Lisfranc joint
What is a Lisfranc sprain and by what mechanisms is it caused? It is a lesion of one or more ligaments of the joint, generally the Lisfranc ligament, which can range from simple elongation to total rupture, possibly accompanied by other lesions: dislocation, fracture, lesion of other ligaments. In the case of Chet, it is the main ligament, the Lisfranc ligament, which is completely broken. It can be accompanied by a displacement of the bones (dislocation) or a fracture, which is fortunately not the case here. The foot is swollen, support on the ground almost impossible and it becomes totally unstable without suitable support. Uncommon in basketball, this injury is found more regularly in American football, mainly in two situations: during a tackle from behind, when the player is on tiptoe, heel above the ground or when the twist the foot with the toes planted in the ground.
Lisfranc sprain
What is the treatment for this injury? A few years ago, this injury most of the time marked the end of a career, but medicine has progressed well and it is now quite possible to return to the field. Surgery is mandatory in the case of a total rupture: the bones and ligament fragments are correctly repositioned and fixed with screws or a screw/plate combination. The foot is then immobilized for 6 weeks (generally thanks to a cast) with total absence of support, before starting a long rehabilitation for several months. It is indeed necessary to give back to the foot its basic flexibility and to carry out a muscular reinforcement: a stiffening is possible and the systematic muscular wasting during the immobilization.
Example of surgery
Although rarer in the NBA, a few examples exist among players who have recovered from this injury. Udonis Haslem was injured in November 2010 and had surgery before returning to the second round of the 2011 Playoffs. Gerald Green knows this injury later in his career, in 2019 and does not return to the NBA courts, retiring after being traded. However, we could see him in good shape, during a move to the G League in January 2022 with the Vipers. Furkan Korkmaz suffered a different injury, with a fracture without ligament rupture and not requiring surgery, allowing him to return after 3 short months.
Chet Holmgren: a physical unicorn who must worry about the future? The talent of the second choice of the draft is no longer to be proven but it is normal to say that a player measuring 2m13 for barely 88 kilos can have trouble cashing in the contacts of the big league and quickly get into the box. “injury-prone”. Although it will be necessary for him to add muscle to win in the NBA, this injury seems to have no connection with his particular physique. Also, the only real medical issues Holmgren has had are tendinitis in his knees, brought on by a too-rapid growth spurt but which was well taken care of and is behind him now.
1 year to heal and continue his preparation before starting on the grounds of the Great League: can we trust Chet Holmgren? The news fell this week and it is certainly one of the only current certainties concerning Chet: he will spend his 2022/2023 season in the infirmary, between operation, rehabilitation and physical preparation. Indeed, this year off the pitch should allow, apart from recovery from his injury, to set up a complete muscle preparation protocol, with the aim of adding pounds to the unicorn without causing him to lose the size-coordination combination that makes it so exceptional. In addition, we know that Chet knows how to surround himself with the best for his preparation: he had thus joined the P3 (Peak Performance Project) before the Draft, a training and research center located in Santa Barbara which analyzes via sensors and videos thousands of physical data related to the game which allow in particular to target weaknesses and carry out appropriate reinforcement.
In conclusion, although the news is terrible, especially for OKC fans, the concern for the future can be measured. First, medicine has made enormous progress in the management of this injury and the lack of stability and other complications and sequelae are much rarer. In addition, Chet has shown that he knows how to trust specialists when it comes to the analysis and management of his body. Finally, Sam Presti said that Holmgren would be accompanied all year by Nick Collison, now a member of the organization, who had also missed his entire rookie season.
