Chris Paul had a stellar game in the Clippers Game 7 111-109 victory over the Spurs on Saturday He scored 27 points with two rebounds, six assists, two steals, one block, five 3-pointers and one turnover. However, is was all peachy for CP3 and the Clips. Paul tweaked his hamstring late in the first quarter when he hit a three-pointer. He was subbed out and went to the locker room. Paul returned and tweaked the hamstring again in the third quarter whilst driving into the lane. He had to sit again before returning to close out the victory.
Hamstring injuries are highly prevalent in our game of AFL, but not so commonly seen in the NBA. Muscle tear injuries used to be solely classified on extend of tearing, ranging from a mild Grade 1 injury through to a far more extensive tear being classified as Grade 3. Timeframes of recovery and return to sport were then based around such diagnosis. I’m sure we have all heard of the 21 day hamstring injury.
More recently, the trend in classification has been attributed to the site in the muscle tissue. We now like to diagnose these injuries based on location, where those that are located into tendon tissue, often require a far longer lay off and journey of recovery.
The basic classification exists as:
Epimysial – where there is a tear between separate muscle/fascial compartments
Intramuscular – a tear of the muscle belly tissue
Musculotendinous junction – one of the most common sites for tearing
Tendon involvement – occur generally at the extreme ends of muscles, closer to the joint location
Avulsion – where the tendon and muscle does not tear, but instead the site of attachment pulls away with a small fragment of bone
This is a very simplified version to get your head around, but each description demonstrates how the severity of injury becomes greater as it progresses on the continuum. This is due to blood supply and healing response time, but also the further involvement of additional structures.
Tears also can depend on which belly of the hamstrings the injury occurs on. It may be simplified that tears into the long head of biceps femoris limit rotation and cutting movements whilst short head of biceps femoris often impact on high level sprinting.
The MRI results are apparently negative, indicating no or little damage to tissue. This suggest it may be a ‘back related hamstring’ injury or Sacro-Iliac joint. These pathologies commonly refer pain to the hamstring. He did however appear to clutch high up towards his buttock, on an outside pushing, cutting leg. In our opinion this could indicate mild tendon involvement as the tendon does not bleed as much. He then can function up to 90% maximum as the muscle fibres disperse the forces to the remaining component of where they insert onto the tendon. He may only feel his discomfort when he pushes beyond that 90% capacity on an explosive cutting movement.
All in all, hamstring injuries cannot be treated as a recipe fits all when it comes to rehabilitation. Source an experienced clinician who can guide you safely on your return.
The Clippers will be doing everything in their power to make sure Chris Paul is right to play. Currently he would be considered a day-to-day decision, but it would be likely in our opinion that he rests Game 1 of the Rockets series whilst he gets his body in better condition. You can be sure he’ll be loosening his hip flexors and lumbar spine whilst strengthening up his hamstring and glute musculature! We can’t forget he is now 30 years old, so to suffer a catastrophic muscle tear would take a longer period to heal. To sit one game would be a far more logical risk vs reward decision.
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