Forget Russell, Oden will have to emulate Stoudemire

The biggest inspiration for Greg Oden is Amare Stoudemire, who averaged 20.4 points and 9.6 rebounds a season after undergoing microfracture surgery on his knee. AP

The comparisons have shifted dramatically for Greg Oden. No longer will the 19-year-old center be hailed as the Bill Russell of his generation. Now that Oden has undergone microfracture surgery to repair his right knee, the Portland Trail Blazers will be hoping that Oden can turn into the second coming of Amare Stoudemire.

Stoudemire is the strongest proof that players can recover from this relatively new surgery. The explosive 6-foot-10 center missed all but three games in 2005-06 following his preseason operation, but last year Stoudemire recovered to play all 82 for Phoenix while averaging 20.4 points and 9.6 rebounds. Based on his improvement throughout the year, those numbers should continue to rise this season.

While Stoudemire, Jason Kidd and former Blazer forward Zach Randolph have survived similar knee injuries, there is still reason to fear for Oden's future. Chris Webber and Kenyon Martin are among those who have failed to recover from microfracture surgery.

"It's like the ACL was back in the day: It's a mystery,'' says Dr. Micheal Clark, who has overseen Stoudemire's rehab in Phoenix with Suns athletic trainer Aaron Nelson. "Surgically, they're getting significantly better -- less invasive, less intrusive with the surgery itself ... but then the rehab comes and nobody knows what the hell to do. Everybody is afraid of it. It's swollen up: Do I bend it or do I not bend it? Do I load it or do I not load it?''

Clark and Nelson applied a logical and science-based approach to Stoudemire's rehab. They focused on improving other areas of his body besides his knee.

The Suns tried to understand what caused the injury, so that they could fix the problem. They wanted to apprehend the criminal element in Stoudemire's body so that it could cause no further harm.

"Why is it one knee [that was injured] and not the other?'' says Clark. "Something is going on in his body that's causing him to compensate, so we have to find out what's tight and what's weak and then we have to address that. What we found is that there's tightness in areas and weaknesses in areas that we had to fix that takes stress off the knee to allow him to come back and play.''

"We look at his whole body,'' says Nelson. "We're not positive what caused it, but basically we're looking everywhere from foot to head. At the same time that we're rehabbing the microfracture surgery, we're also addressing these other issues. So it's a whole-body approach and correcting these dysfunctions and getting him stronger. It was basically his ass, his legs, his arms, his back -- all that stuff.''

The surgeries for both Stoudemire and Oden became necessary when each suffered a loss of cartilage in the knee, exposing the bone and causing pain. "They poke tiny holes into the bone,'' explains Nelson of the resulting microfracture surgery. "They have to be careful that the holes don't go too deep into the bone because then you get necrosis, which is the dying of the area.

"But if they're poked at just the right depth and they're spaced perfectly apart," says Nelson, "they'll fill in with fibro-cartilage produced through blood: poke the bone, it bleeds out, forms a scab and the cartilage is formed in that area. But the new cartilage is not quite as strong as your initial area was before the injury.''

Oden's recovery will be extended, as was Stoudemire's, because he must keep his knee quiet in order to allow the new cartilage to grow. But that doesn't mean he can't spend time strengthening the other areas of his body that led to the injury. In Stoudemire's case, he worked on improving the muscle groups that affect his feet, ankles and hips.

Clark is a doctor of physical therapy who has created a system he calls Optimum Performance Training, which is based on a scientific understanding of how different parts of the body help or hinder each other. The National Academy of Sports Medicine, which Clark serves as president and CEO, recently became the official provider of sports education for the NBA athletic trainers organization.

"With Amare, a lot of it was hip muscles, stomach muscles,'' says Clark. "So even though he looked shredded -- you look at him and he had the six-pack -- he still needed to work on the deep muscles that control the spine. A lot of athletes don't have that mechanism. They're very strong but they're not very stable. They have big engines but they don't have good brakes.''

The problem with the new era of bulked-up NBA players is their failure to create balance between their muscle groups. "Typically in our line of business, people keep building bigger engines, but they don't really work on the brakes,'' insists Clark. The key for Oden will be to improve the muscular areas that created the microfracture of his knee. By fixing those problems, he'll take pressure off his injured knee and enhance his comeback.

"Other areas [of the body] are potentially causing the injury,'' says Clark. "You can do all of the leg work you want and the leg can get strong, but if you don't fix the other areas [the injury] may come back.''

"If a guy comes in and tells me his knee's sore, we're immediately checking out everything else -- we're not just looking at the knee,'' says Nelson. "If you don't correct the issue? You may make them feel better, but as soon as they go back out the body is going to compensate and they're going to do the exact same thing again. So then they might break down again, or they might have gotten the knee strong enough so that the problem is going to go to the next weakest link -- maybe it's the back.''

An hour-long conversation with Clark and Nelson not only provides insight to what lies ahead for Oden. It also brings newfound respect for Steve Nash -- and concern for LeBron James.

Clark and Nelson say that Nash suffers from spinal olisthesis, or a slipping of the vertebra in his lower back. "It's where your back is basically broken in the little joints where they connect,'' says Clark. "It's a pretty serious injury. Twenty-five percent of NFL players have it. The No. 1 group [of athletes to sustain the injury] is NFL offensive linemen, No. 2 is pole vaulters, No. 3 is pitchers. So it's not all that common in basketball to get it.''

Clark believes Nash suffered the injury nine years ago because of an imbalance in his muscles. "The deep muscles that support your spine get weak, and then you start using one of your hip flexors, which is pulling pulling your hip up,'' says Clark. "The bone breaks and then it heals back with fibro-cartilage, and when it bends too much all of these muscles around the spine act like brakes and they go into spasm. You feel like you're constantly in spasm because you can't move. The only thing that moves is your hamstring, so the hamstring gets overstretched.''

Nash came to the Suns amid concerns that he was too frail to endure a full season. Instead he has missed an average of five games annually for Phoenix while winning two MVPs before finishing as runnerup as a 33-year-old last year. Part of the reason for his endurance has been his devotion to conditioning to deal with his spinal injury.

Based on Clark's and Nelson's experiences with Stoudemire and other athletes, there is reason to fear for the longterm future of James because of his peculiar gait. By running with his feet splayed out, James is putting inordinate pressure on his patellar tendon while preventing his knee from bending properly. The ultimate worry is that he may suffer cartilage damage, ankle problems and especially lower-back issues if he fails to alter his running style. In addition to rehabbing from knee surgery, Stoudemire has worked hard to alleviate a similar duck-walk in recent years.

"People say, `That's the way I walk, I can't change it.' Well, they don't want to change it,'' says Nelson. "Over the years we've dealt with it, dealt with it, dealt with it with Amare, and now he walks pretty normal.''

There are two morals to this story. The first is that Oden can recover from his injury. The second is that Stoudemire, now 24, proved during his rehab to be a more mature and disciplined athlete than his reputation would suggest. It's going to require a monotonous daily regimen that will stretch on for a year or more, but if Oden applies the same persistence as Stoudemire, with similar progressive advice from his therapists and athletic trainers, he may yet come through this episode with a stronger, healthier body than before.

(Ian Thomsen can be reached at siwriters@simail.com)