Ray of hope on Marcus Smart's prognosis, rehab and return to action


I often tell my Personal Training clients, "You are not a test tube", and neither is Marcus Smart. Marcus, like every other human being, is distinct and different. Giving someone a diet and exercise program is not like pouring certain chemicals into a test tube and knowing exactly what will happen. But here is more information about Smart's injury - his return to the game after it occurred - and the rehab and timeline he may be facing.



Brad Stevens has taken some heat about allowing Marcus to re-enter the Orlando game after experiencing abdominal pain following an on-court collision. Apparently, Marcus and Brad felt the injury was minor, and Smart could play through some pain without significant risk. He quickly found he could not - the pain was too severe. In hindsight, had the true injury been known at the time, Marcus never would have gone back into the game. I see no blame on anyone's part here, and it is very doubtful that the injury was aggravated by Marcus returning to play.

And now, an MRI has revealed an evulsion of the left oblique muscle at the iliac crest. At least one study showed the tearing at the iliac crest to be a rare occurrence.

Tears of the abdominal obliques have previously been reported in the vicinity of the lower ribs but they have not been reported in the vicinity of the iliac crest.

This same study, by Myles Murphy et al, chronicled the rehab and return-to-action (only 35 days) of an Australian football player with a similar injury:

A 21-year-old male Australian football player experienced acute right-sided abdominal pain during a game while performing a commonly executed rotation skill. He was assessed clinically before being further examined with ultrasound and magnetic resonance imaging which revealed a rupture of the abdominal oblique wall at its insertion onto the iliac crest. The player then underwent a structured and graduated rehabilitation program with clear key performance indicators to optimize return to play and prevent recurrence.

Outcomes
The player was able to return to play at 35 days post injury and had no recurrence or complications at 12 month follow up post injury.

The 21-year-old player began a progressive rehab program two days following the injury. It is important to note that there is no assurance that this rehab program would work for a pro basketball player - or Marcus Smart specifically. The study only focused on one individual.

But there was nothing magical about the rehab program. The four phases progressed from pain relief (1), muscle endurance (2), muscle strength (3) to muscle power (4). The player's 35-day return to action is a ray of hope for the Celtics in their playpff run. Hopefully, that happens and Smart returns sooner than previously-reported with minimal risk of further injury. But then again, when you play ball like the Tasmanian Devil, injury risk always lurks nearby.

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Photo via Brian Babineau/NBAE via Getty Images

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