It is big news among sports fans that Kansas University star freshman center Joel Embiid is benched for the Big 12 tournament while he recovers from a stress fracture in his back. It’s also of interest that this type of injury is rare among basketball players.
“Basketball players make up only 4 percent of stress fractures diagnoses and even less of lumbar stress fracture diagnoses,” Dr. Barbara Semakula, sports rehabilitation director at The University of Kansas Hospital, Kansas City, Kan. She is also an assistant professor. Stress fractures of the back are more common among athletes who do repetitive hyperextension of the spine such as gymnasts, cheerleaders, and divers. Runners suffer 69 percent of stress fractures.
Diagnosing stress fractures can take time as the fracture needs time to show up on x-rays and MRIs. Two-thirds of initial X-rays are negative. Bone scans are the gold standard in making the proper diagnosis when a stress fracture of the back is involved.
“Lumbar stress fractures can present initially with lumbar spasms,” Dr. Semakula said. “A stress fracture can take up to three weeks to show on an X-ray which can lead doctors to initially diagnose pain as lumbar spasms or lumbar strain.” Even then, doctors must consider the athletes history of injury and training along with medical exams including special maneuvers and radiology testing.
Embiid was seen by the medical staff of the KU basketball program in Lawrence, and subsequently decided to seek a second opinion in California.
No doctor at The University of Kansas Hospital examined Joel Embiid, but Dr. Semakula has experience and knowledge in helping athletes like Embiid recover from stress fractures.
Dr. Semakula said treatment has three phases. Phase one lasts 10 to 14 days and is dedicated to pain control and rest. Some elite athletes are given a bone stimulator to help with bone healing. Phase two can last several weeks. Athletes begin slowly resuming physical activity at a level that is dependent on the severity of the fracture. Phase three the athlete begins preparation for a return to competition. Treatment lasts until the patient is symptom free and cleared for play using a CT scan.
Lumbar stress fractures often present as low back pain that eventually grows worse despite short periods of rest. Dr. Semakula said to help prevent stress fractures athletes should train properly including adequate rest periods and eating right. Stress fractures have been linked to lower caloric and fat intake.
To see a KU Hospital video on the subject, visit https://www.youtube.com/watch?v=rlfa4jePEvg.
- Story from KU Hospital