This article is part of our NBA Injury Analysis series.
Marvin Williams and Chandler Parsons
Two fantasy friendly forwards are currently sidelined by an injury with a misleading name. The term bruise is most commonly associated with a soft tissue contusion and the black and blue spot that accompanies it. However, both Parsons and Williams are dealing with bone bruises, meaning bone tissue has been damaged and not just muscle or fat.
Bone tissue is comprised of multiple layers that vary in thickness and consistency. The outer layer is the periosteum, a thin layer of bone that surrounds nerves and blood vessels. Below that sits the hard compact bone that comprises the majority of the human skeleton. The next layer of bone is the less dense cancellous or spongy bone. Like its name suggests, spongy bone is porous and often located at the end of long bones like the femur. These layers protect the innermost aspect of the bone, the marrow, which is involved in red blood cell production.
Each of these layers can be damaged when overloaded or stressed, like after a fall or with a direct blow. If every layer of the affected bone is damaged, the bone is considered fractured or broken. However, if the damage is isolated to one specific area, it's considered a bone bruise. A subperiosteal hematoma or periosteal bruise develops when blood builds up under the outer layer of periosteum. An interosseous bone bruise is marked by deeper edema in the medulla of the bone where the bone marrow is contained. The final
Marvin Williams and Chandler Parsons
Two fantasy friendly forwards are currently sidelined by an injury with a misleading name. The term bruise is most commonly associated with a soft tissue contusion and the black and blue spot that accompanies it. However, both Parsons and Williams are dealing with bone bruises, meaning bone tissue has been damaged and not just muscle or fat.
Bone tissue is comprised of multiple layers that vary in thickness and consistency. The outer layer is the periosteum, a thin layer of bone that surrounds nerves and blood vessels. Below that sits the hard compact bone that comprises the majority of the human skeleton. The next layer of bone is the less dense cancellous or spongy bone. Like its name suggests, spongy bone is porous and often located at the end of long bones like the femur. These layers protect the innermost aspect of the bone, the marrow, which is involved in red blood cell production.
Each of these layers can be damaged when overloaded or stressed, like after a fall or with a direct blow. If every layer of the affected bone is damaged, the bone is considered fractured or broken. However, if the damage is isolated to one specific area, it's considered a bone bruise. A subperiosteal hematoma or periosteal bruise develops when blood builds up under the outer layer of periosteum. An interosseous bone bruise is marked by deeper edema in the medulla of the bone where the bone marrow is contained. The final bone bruise classification is a subchondral bruise, which develops between an area of cartilage and the bone tissue below.
An interosseous bone bruise is the most common among professional athletes. Unfortunately for the injured individual, the body does not differentiate between a bone bruise and a fracture; it repairs both injuries in a similar manner. To mend damaged bone, the body produces specialized cells known as osteoblasts that generate and lay down new bony tissue. The task requires time to completely repair the damage, which causes athletes suffering from the injury to miss a longer bit of time. Fortunately, this extra time is worth it, as the newly created bone tissue is capable of returning to its original strength.
Unfortunately, bone bruises at the knee are often more complicated. The recovery process can be prolonged if the damage is to a weight-bearing aspect of the knee like the tibial plateau or one of the femoral condyles. Bone contusions involving the patella (kneecap) are even more complex due to the biomechanics of the kneecap. The kneecap is a sesamoid bone, meaning it sits within the tendon of the quadriceps muscle group. As result, the patella is able to increase the moment arm of the tendon, and increase the moment of torque. Consequently, the knee gains a wider range of motion. Unfortunately during this process, the kneecap comes in contact with various areas of the knee joint, including the femur. This repetitive bone-on-bone contact can make healing difficult and stretch out a player's missed time.
The specific type of bone bruises suffered by both Parsons and Williams was not revealed, though each player's respective team did provide an estimated timeline when revealing the injury.
In Memphis, Parsons was expected to miss at least two weeks after suffering his injury on November 18. He hasn't played in Memphis' last six contests and a recent update hasn't been provided. Look for him to sit out all four of the Grizzlies' games this week.
Charlotte expects Williams to miss about a week recovering, setting him up to miss at least three of the Hornets' next four games. He has an outside shot of returning Saturday against the Timberwolves but shouldn't be used in weekly formats. Frank Kaminsky has joined the starting lineup and is a must-add in all formats.
Fast Breaks
Michael Carter-Williams: The Chicago point guard has already missed 13 games with his own bone bruise in his left knee, though it's a newly discovered injury that is threatening to extend his missed time. When Carter-Williams suffered the knee injury he was also diagnosed with a wrist sprain. However, a CT scan performed last week revealed a bone chip fracture in the wrist, and the former Rookie of the Year is now in a cast instead of a brace. It's not uncommon for wrist fractures to be missed on initial x-rays, and often a CT scan is a better option to visualize the injury. Carter-Williams will be reevaluated in two weeks, which would allow him to return in line with the initial four-to-six week window. However, he may need extra time to get back in rhythm now that his hand is immobilized.
Paul George: The Pacers forward will miss at least one more game as he battles lingering soreness in his left ankle and back. Indiana, along with Portland and Phoenix, have just two games on this week's schedule. As a result, George's value for the next seven days will be minimal.
Draymond Green: The All-Star big man suffered two injuries last week. He first suffered a corneal abrasion on Wednesday against the Lakers but was in action Friday for the rematch. Sadly, Green suffered another injury in that game, turning his ankle after landing on teammate Ian Clark. The injury was later diagnosed as a left ankle contusion. Green did not suit up Saturday against the Timberwolves and is considered questionable for Monday's game versus the Hawks. Golden State has been historically conservative with their players' health, and it wouldn't be surprising to see Green miss another game or two recuperating.
D'Angelo Russell Russell's troublesome knee soreness required a PRP injection, and the Lakers expect the second-year point guard to miss between two to three weeks. A quick look at recent PRP injections show that players who undergo the procedure during the season average over 12 missed games recovering. As result, look for Russell to return on the latter end of the estimated timeline. Veteran point guard Jose Calderon has assumed the starting role and could be worth a speculative add for a team in need of made threes and assists.
