Marcus Smart – Left Oblique Strain

The Celtics guard sustained a “left oblique strain” during the loss to Orlando on Sunday night. Coach Brad Stevens has reported there is currently no timeline for his return (ESPN, Boston Globe). According to the head coach, Smart may be ready to return to practice later in the week and it appears to sound like a short-term issue. This means he could possibly return for the Celtic’s first-round NBA Playoffs matchup against the Indiana Pacers.

Smart suffered his injury after a seemingly innocuous bump with Orlando center Nikola Vucevic. After the collision, Smart fell to the ground clutching at his left side of his body around the hip area but then limped as he got up and attempted to resume playing during the defensive possession. In the very next play, Smart was again on the ground clutching at the same left hip and side area before hobbling to the locker room with help from the Celtics’ trainers (see video below)

Post-game, the former 2016 lottery pick was diagnosed with a ‘left oblique strain’. The obliques (internal and external) are part of the four main abdominal muscles that help protect the abdominal organs and allow various movements of the spine. Injury to the oblique abdominal muscles are more common in sports which require rapid trunk side bending or rotation movements such as cricket or baseball. However, it is reported that the mechanism of oblique strain injuries can often be unclear and difficult to establish – such as in Smart’s case. Side strain injuries more commonly involve the internal obliques, but without confirmation from the Celtics medical team, it’s unclear what structure Smart has injured.

A left oblique or side strain is typically detected in MRI or ultrasound studies as a tear of the internal oblique muscle from its rib attachment, causing acute swelling and haemorrhage (blood escaped from injured blood vessels). Athletes typically feel pain and tenderness on the lateral trunk and can have trouble with breathing deeply, coughing and rolling over in bed.

For treatment of an oblique strain, athletes need to rest until the pain has resolved during breathing. After this phase, restoring strength and trunk mobility is essential before a graduated return to sports-specific activities. For serious strains in cricket and baseball players, times of four to ten weeks have been required before returning to play. Timelines have been reported to be variable between different sports.

It’s currently unclear when Smart will return. The most recent player to sustain a similar injury was J.J. Barea who suffered an oblique strain last season for the lottery-bound Dallas Mavericks. His return-to-play timeline is unclear as he was cautiously shut down with 9 days left in the regular season to allow the injury to rest. If Smart’s injury is of a similar nature, we will hopefully be able to see him in the Playoffs.

Brukner & Khan, 2017. Clinical Sports Medicine 5th ed

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