Dr. Congeni offers insight behind Serge Ibaka's amazing turnaround from "tennis leg"

2014-11-28 12:05:08 by Dr. Joe Congeni - Director of Sports Medicine, as posted on the inside.akronchildrens.org blog.

Oklahoma City Thunder player Serge Ibaka's miraculous recovery from a recent "tennis leg" injury has people scratching their heads. First, we heard he was out for the rest of the play-offs. One week later, he was back on the court and the series is now tied 2-2.

Today, I had the chance to offer WAKR morning show host Ray Horner my insight on this injury and aggressive sports therapy treatment. Hats off to the amazing team of PTs and athletic trainers for getting him back on the court and affecting this series.

Below is an audio file and transcript of our discussion. Originally aired on 1590 WAKR-AM on May 28, 2014.

Horner: 1590 WAKR. Good morning to you. Dr. Joe Congeni, Sports Medicine Center at Akron Children's Hospital, with us. Joe, good morning. You want to go to these NBA play-offs and talk about a big turnaround by one of those (Oklahoma City) Thunder players.

Dr. Congeni: Yeah, Ray, you know, you've got to give some credit when the medical team may be actually affecting a series of this magnitude. They're down to the final four, the semi-finals, and they're talking about the miracle recovery of Serge Ibaka.

I have to admit there are a lot of questions surrounding what actually went on with Serge Ibaka. It's kind of interesting. You know, even my son was home from medical school for the Memorial weekend and he said, "What is this plantaris rupture stuff?" And I just wanted to explain a little bit from my insight today.

This injury occurred around 5-15, the 15th of May, and they came out the very next day and said, Serge Ibaka was out for the remainder of the play-offs. The Thunder would have to play without him.

Dr. Joe Congeni Dr. Joe Congeni

One week later on 5-22, they said he was day to day now and could possibly play. And, on 5-25 and 5-27, he's played in two games in Oklahoma City and all of a sudden, the series is all turned around.

He's played pretty well for a guy that wasn't going to play at all and a big swollen calf. It has people scratching their heads. They've won two games. It's a 2-2 series now and seems to have a big affect on things. So, it's really interesting.

Initially, the diagnosis was a plantaris rupture, and that's what had medical people really scratching their heads. The plantaris, Ray, is a muscle you don't hear about a lot. It's in the calf, but it's under the two big, strong muscles of the calf. So, if you have real damage to the calf, it's usually the gastrocnemius. It's the big muscle on top. You can see the outline of the two-headed muscle if you watch people tiptoe or walk from behind.

The gastroc, then the soleus is a big muscle. Underneath them is a pencil-thin muscle that has very little function, very thin, called the plantaris. It does rupture occasionally, but it doesn't usually swell much. Fifteen percent of people don't even have this muscle. And with things like an MRI, they would know if it was a plantaris rupture and know that it's not really a big deal.

So, a lot of other people were calling it tennis leg. Now, tennis leg sounds more like what I think was going on. That is where there is some tearing of the inside head of the gastrocnemius muscle and you'll actually see a lot of swelling, and people have trouble pushing off.

They said it was two to three times . So, in the first few days he could barely push off and, apparently, they made the recommendation he wasn't going to play in the play-offs.

Then what they did was they turned over and started aggressive sports medicine treatment. This is really, most importantly, you can see a tribute to the treatment. They started ice and massage and all these new combinations, stim units.

You know, stim -- we talk about here occasionally -- is where you can control the contraction and relaxation of the muscle and push that fluid out of there. They did a good job stimming 'em 24 hours a day over that week period.

He went in those fancy new ice-therapy chambers from what I understand. And, so, he had all kinds of treatment from physical therapy and athletic trainers.

Now, the one thing that's been questioned is the meds. Would he have used anabolic steroids? Never in a situation would anabolic steroids in a week help at all. So, that's out the window. No way.

Would he use corticosteroids, injections? No way because that could weaken the muscle and the tendon.

Would he be using pain killers 'cause it's a painful injury? Pain killers make your athletes slow their reaction time on the court. I very much doubt he's using pain killers either, probably just some anti-inflammatory medicine.

But, the key is the aggressive treatment daily. You know they're talking about 12-hour-a-day, 14-hour-a-day treatments they did that week. So, the tribute is the hats are off to the PTs and trainers who really maybe affected this series by getting the swelling out of that calf and getting Serge Ibaka back to play.

Horner: Alright. Good stuff, Joe. Good talking with you again. We'll catch up with you next week.

Dr. Congeni: Okay. Next week in studio?

Horner: You got it.

Dr. Congeni: Okay. Sounds good. Thanks, Ray.

Horner: Uh huh. Dr. Joe Congeni, Sports Medicine Center at Akron Children's Hospital.

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