NBA Injury Analysis: Beal Out Again

Bradley Beal
Beal has been diagnosed with the fourth stress-related injury to his right fibula in the past four seasons. He suffered the initial injury during the final month of his rookie season and sat out Washington's last eight games. It was diagnosed as a stress reaction in the distal portion of the fibula near the ankle. The time off proved beneficial and Beal was back in action the following season. His return was cut short after he developed a second stress reaction in the same fibula, this time in the proximal portion of the leg closer to the knee. He missed nine games but finished the season without any reported issues. Again, he improved in the offseason and reported healthy to training camp for the 2014-15 season. However, the cycle continued as Beal once again developed a stress reaction in the distal portion of his problematic right fibula. He sat out six games and was able to play out the remainder of the year. Now the Wizards will again play without Beal for an extended period as yet another stress reaction has developed in the distal portion of his right fibula.

Before examining the underlying issue with Beal it's important to understand how these types of injuries occur. A majority of our bones are subjected to some type of stress during the activities that we perform on a daily basis. The sheer amount of stress placed on and through these bones escalates during high-load activities like running or jumping. As a result, bone tissue in the areas of high stress continually remodels themselves to keep up with these high demands. However, in incidences in which the stress is continuous or simply too high for the remodeling process to stay ahead of the demands, a stress injury can develop.

Stress injuries often start as a stress reaction that is accompanied by localized pain and, in some cases, swelling and inflammation. If detected early and activity is reduced or stopped, the remodeling process is allowed to catch up and complete its normal duties. If activity goes uninterrupted or is resumed prematurely, a stress reaction generally progresses into a more problematic stress fracture in which the bone tissue in the affected area breaks. Stress fractures require a longer amount of rest or, in some extreme cases, surgery.

Stress fractures in the lower leg are common though the larger tibia is more vulnerable as it bears a larger amount of weight. Tibial stress fractures have gained notoriety in recent seasons, sending Jrue Holiday and JaVale McGee under the knife. However, the fibula can also fail when subjected to high degrees of stress, as evidenced by Beal's reoccurring problem.
 
The Wizards have stated that Beal will be removed from basketball activities for the next two weeks, allowing for ample healing time. Beal's familiarity with the process does play in his favor, though it seems likely the threat of re-injury will loom unless an underlying biomechanical factor or any other contributing factor is addressed. A stern minutes restriction could be in order as the number of minutes played in the games leading up to each of Beal's four injuries is over 38 per game.

In the meantime, Garrett Temple joins the starting unit in Washington with Gary Neal and Ramon Sessions playing roles off the bench. Otto Porter Jr. will also be leaned on a bit more, and he scored a career-best 28 points Saturday in a win over the Mavericks.

DeMarre Carroll
The Raptors will proceed without their biggest offseason acquisition after Carroll suffered a right knee contusion. The fact that the team ruled him out indefinitely suggests the injury is more than just a simple soft tissue bruise. Instead, Carroll is likely managing a bone contusion, a more serious injury that takes longer to heal. As mentioned with Beal, remodeling is necessary for injuries to bone tissue, and the biomechanics of the knee often stunt this process. Shelve Carroll for the time being. Terrence Ross, the player who replaced Carroll in the starting lineup, has struggled after a 22-point performance against the Lakers.

Fast Breaks

Rondae Hollis-Jefferson
Outside of Brook Lopez and Thaddeus Young, Brooklyn hasn't provided many reliable fantasy options during the first quarter of the season. Sadly, a significant injury to Hollis-Jefferson only weakens their talent pool as the rookie swingman is expected to miss eight-to-10 weeks with a fractured ankle. The injury occurred in practice when Hollis-Jefferson rolled his ankle, fracturing the posterior aspect of his talus bone. Foot injuries are often difficult to manage, so expect his recovery to end on the latter end of the estimated timeline.

Kyrie Irving
Irving has increased his participation in practice and has not experienced any reoccurring symptoms in his surgically-repaired kneecap. However, the Cavaliers continue to treat him conservatively, though he is expected to return this week. He has already been ruled out for Tuesday's outing, which means Irving will play twice this week, at most. Keep him on the bench for one more week, particularly in weekly formats.

Emmanuel Mudiay
The Denver rookie will not play Monday after aggravating a previously sprained ankle over the weekend. The team also plays Tuesday as part of a back-to-back but Mudiay should be considered doubtful at best. Veteran point guard Jameer Nelson should start in his place and could be a nice value play in DFS.

Nerlens Noel
The Sixers big man was limited to 18 minutes Sunday after suffering an injury to his left eye. He was taken to a nearby hospital where he was diagnosed with an abrasion of his cornea. The cornea is the outermost layer of the eyeball whose primary function is protection. It also helps focus the amount of available light into the eye. Superficial abrasions or scratches to the cornea generally heal quickly and smoothly, though deeper cuts can effect vision and take a longer amount of time to repair. Noel's availability for Monday's game remains unknown, though an extended absence is not expected.