What’s wrong with Derrick Rose?

A city in shock

The Chicago sports world has a Derrick Rose hangover. There’s nothing quite like letting your hopes and expectations rise only to have them excised with a scalpel twice in 19 months. Derrick is currently recovering from his 2nd knee surgery, and he will be back with two structurally healthy knees next season. Unfortunately, the cause of his knee injuries hasn’t been fixed, which means that when he returns he does so with a high risk of re-injury. Sorry, sports fans. As it stands Derrick Rose is in real trouble.

The complete history 

Derrick’s problems didn’t begin with his left ACL tear. He’s had a string of injuries dating back to January 2012. This history shows us that there is more to Derrick’s problems than a meniscus repair can fix. Something’s wrong here:

The lingering problem

A few joints in your body are more critical than others. Amongst the most important is your big toe joint. Yes—your big toe. While it may seem trivial, it’s absolutely crucial for high-level movements. When you run and jump there’s a point in time when your entire body weight is supported solely by your big toe. Forces up to 3 times your body weight transfer directly through your toe during explosive movements (upwards of 600 lbs for Rose). If your big toe is dysfunctional or painful in any way, it causes immediate adaptations; first in your foot, but then very quickly in your hip, knee, and spine. Like a droplet of water landing in a lake, the ripple effect can be extremely far reaching. The initial big toe injury sent a shockwave of adaptation throughout Rose’s body and, in an instant, he fundamentally changed the way he moved his entire body. With that change came a new distribution of the stress he absorbs during an NBA game.

If you don’t believe me or if you’d like to feel this for yourself, I’d encourage you to immobilize your big toe with a splint or heavy taping job, and then go out and play a few games of 5-on-5. You won’t believe the extra stress that it puts on your body. Now multiply that by ten (to account for the fact that Derrick moves faster than everyone else on the planet), and do that over and over again every day. Do you see how this would be a recipe for injury?

 

The tweet

It’s not unreasonable to think that, over the course of 22 months, Derrick’s toe might’ve actually healed; that it’s an old injury and there’s no longer any reason for concern. That would be entirely reasonable, except for this prophetic tweet sent out by Bulls beat reporter Nick Friedell,

“Rose says he is still dealing with turf toe. He’s dealt with it twice already in his career…”

Friedell confirmed that Derrick’s toe injury was still actively painful just one day before Rose tore the meniscus in his right knee.

 

But I had that once…

There’s one more important concept that needs to be touched on here, and that’s the difference between Derrick and everyone else. Derrick Rose, you see, is a Ferrari.  You and I, we’re a bunch of VW Beatles. Derrick Rose’s performance, explosiveness, and acceleration are in another stratosphere.  When he moves, he does it better, faster, and more effectively than everyone else.  When we move, we’re fairly adequate at moving casually around town. If our mechanics wear down, our decreased performance is hardly noticed because it just wasn’t elite to begin with. However, when Derrick’s mechanics are altered in just the slightest, his performance goes through a massive transformation. Because of his physical capabilities, his system is exponentially more sensitive to changes.

The reports were that Derrick came back with more quickness and an even higher vertical leap. This was fantastic news. The Ferrari came back with even more horsepower. And it would’ve been great news, but it wasn’t the whole story because his toe injury and movement pattern had never been fixed. Instead, his compensation pattern (think, “shockwave”) remained active. The Ferrari came in with a mechanical problem, and instead of fixing it they gave it more horsepower. More power with the same bad mechanics is a recipe for a crash.

 

Now what?

Derrick Rose has two options: either he learns to play a different way or he fixes his toe.

If his toe isn’t fixed, his shockwave of adaptation will remain and he’ll be risking further injury. If this is the route he goes with, he’ll absolutely need to throttle down the Ferrari in certain ways. No longer will be able to cut and explode so wildly on the court. He’ll need to play within the limits of his new adaptations. At 25 years old, his body will be different and his style of play will have to match.

Truth be known, I would prefer if his big toe was fixed.  Every possible treatment should be considered. Joint manipulation, intrinsic foot muscle activation, sock and shoe choice, hot/cold therapy, exploratory arthroscopic surgery, acupuncture, cold laser, and anti-inflammatory measures should all be on the list.

Of course rest is always helpful in healing up toe injuries as well. Fortunately for Derrick, he has about 9 months of free time on his hands. Let’s hope he and his team use that time to once and for all fix this problem and wipe out the shockwave of adaptation that has been tearing through his body over the past 22 months. Let’s hope, Chicago sports fans, that the Ferrari gets the tune up it really needs.