The news that Joel Embiid was diagnosed with a stress fracture in his right foot is troubling, but it isn't a career death sentence for the Kansas center.
Indeed, the history of big men with foot problems is somewhat foreboding, as Kevin Pelton indicates, but I believe Embiid still will be able to a fruitful NBA career after undergoing surgery on Friday.
Having served as one of the Houston Rockets' team physicians from 2006-10, I am very familiar with this injury. During that time, Rockets All-Star center Yao Ming was plagued by fractures of his left foot's navicular bone. So I saw firsthand the problems that can arise from this injury. Embiid's news certainly conjures visions of a hobbled big man such as Yao, but Yao's fate isn't necessarily what awaits Embiid.
Yao's troubles
In December of the 2005-06 season, Yao developed osteomyelitis (a bone infection) of his left big toe. He returned after missing 21 games and played well but later developed his first navicular stress fracture in April 2006. The navicular bone resides on the inside of the foot, above the big toe at the level of the arch of the foot.
This first navicular fracture was treated by placing him on crutches and in a cast, and he required six months to heal. Yao returned without incident and played well enough during the 2006-07 season to be named second-team All-NBA. But the next season, Yao would miss the remainder of 2007-08 with another stress fracture of his navicular bone. This second injury to the navicular bone was treated by placing screws into the bone to facilitate healing and was performed by world renowned foot and ankle specialist Dr. Thomas Clanton.
Yao healed well and quickly and was able to compete in the Olympics for the Chinese national team in August 2008. The 2008-09 season saw Yao play the entire season without incident, but he reinjured his left foot's navicular bone in the second-round playoff series against the Los Angeles Lakers. Yao had a second surgery and missed the entire 2009-10 season. Upon his return, he developed a left-ankle stress fracture, which eventually led to his retirement.
So what can be expected for Embiid and his NBA career? Although there are similarities between Yao and Embiid, there are also a number of key differences.
First, Embiid is 6 inches shorter and about 70 pounds lighter than Yao, placing markedly reduced forces on his feet. He is also six years younger than Yao was when his foot-injury odyssey began.
Another key difference is mileage. Yao had played eight pro seasons prior to his injuries, five in China and three in the NBA. Yao also played extensively for the Chinese national team. Embiid does not have near the wear and tear on his body and, at 20 years old, should be able to heal this fracture uneventfully.
Finally, Yao had extremely high arches in his feet, which, when placed under stress, compressed his navicular bone like a nutcracker. While I have neither examined nor seen the X-rays of Embiid, it is highly unlikely that he has similar anatomy as Yao.
A number of studies have shown successful returns to sport after a navicular fracture. The average return is four months whether surgery is performed or the bone is allowed to heal in a cast with the athlete placed on crutches. Given Yao's troubles, it does not surprise me that Embiid's team has decided to choose surgery in an effort to reassure NBA executives that he will be ready to play by the start of the 2014-15 season.
Although it is a worrisome injury to be sure, given Embiid's age, body type and lack of mileage, I fully expect him to heal well and have a solid NBA career.