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What’s Up, Doc?

Think the latest injury to your favorite athlete sounds as though someone invented it? You may be right.

Author Joe Lemire Illustration Guy Stauber

KDFINALARTWhen reigning NBA MVP Kevin Durant injured his right foot during a mid-October preseason practice, the Oklahoma City Thunder announced that the superstar forward had suffered a Jones fracture, which would require surgery and sideline Durant for six to eight weeks. Sportswriters across the country immediately rushed to place calls to medical experts, and soon stories were popping up like the one written by Anthony Slater, NewsOK.com’s Thunder beat writer: “Kevin Durant Injury: What Is a Jones Fracture?”

As Slater explained, a Jones fracture is a break of the fifth metatarsal—the outermost bone of the foot, which ends at the pinkie toe—near where everyone has a small bump at the foot’s midpoint. An operation to insert a screw is almost always necessary for athletes who suffer the injury, because that area of the foot has low blood flow and thus heals slowly. (The injury was eponymously named back in 1902 by Dr. Robert Jones—who suffered the break while dancing—but remained obscure for more than a century.) Thanks to Durant, who missed 17 games and returned to action on December 2, the general public learned quickly about the injury and its ramifications. Even seasoned athletes were mystified.

“I’m so old that when you got hurt they didn’t have names for it,” says NBA Hall of Famer and TNT analyst Charles Barkley. “They come up with names for injuries now. Back in my day [they’d say], ‘Oh, he broke a foot.’”

Durant’s Jones fracture isn’t the first time the sports media has felt the need for an explanatory article. Back in the mid-’90s , when Cincinnati Reds shortstop and future Hall of Famer Barry Larkin suffered an injury in the groin area that defied any straight-ahead medical vernacular—it was kind of like a hernia, but not quite—reporters hounded the Reds’ medical director and chief orthopedic surgeon, Dr. Timothy Kremchek.

“The newspaper writers—there was no HIPAA back then, nothing—kept asking me about it,” Kremchek says now, “so I said he’s got a sports hernia. I had never even heard of it. I made it up.”

Kremchek is referring to the privacy rule of the Health Insurance Portability and Accountability Act (HIPAA), which Congress passed in 1996 and which forbids public disclosure of medical information without appropriate consent. Before HIPAA, Kremchek got the nickname “Doc Hollywood” because Jim Bowden, the Reds’ general manager at the time, deferred all medical questions his way; the physician ended up regularly speaking in front of television cameras and tape recorders.

HIPAA quieted open discussion of injuries for a time, but that led to uninformed speculation that sometimes painted players in a negative light—and thus gave them incentive to have their medical information released. Now Major League Baseball and the National Football League include HIPAA waivers in their collective bargaining agreements (the waiver excludes medications players take).

“There’s obviously a real thirst for this information among the fans and the public,” says Dr. Struan Coleman, the head physician for the New York Mets. Coleman and his colleagues at the Hospital for Special Surgery have prerecorded short informational videos for the Mets’ TV network in which the physicians explain common injuries, showing magnetic resonance imaging (MRIs) and X-rays and detailing the players’ expected period of absence.

Advances in medical imaging technology have enabled physicians to more accurately diagnose—and discover—injuries. MRIs used to be so costly that they were reserved for serious injuries. “Now everybody gets an MRI,” Coleman says, “so we can tell exactly what the problem is.”

Some of the increased interest from fans can be chalked up to these technological advances. After all, a weekend warrior who suffers a high ankle sprain hiking the Appalachian Trail now has access to an MRI just like Kevin Durant. But there might be a dark side, as well: Coleman wonders how much gamblers and high-stakes fantasy players are driving the demand. That sports leagues even require teams to list injuries is likely implicit acknowledgment of the influence of gambling on fan interest.

No matter the reason for the dissemination of these diagnoses, they spread quickly. Kremchek recalls that a couple of weeks after he invented the sports hernia, the phrase popped up in USA Today describing Larkin’s ailment. In October 1996, the San Francisco Chronicle described 49ers cornerback Eric Wright as having a “sports hernia”—the newspaper put the unfamiliar term in quotes—with the disclaimer that it was something “specialists are just beginning to recognize and treat.”

Today, there’s a world expert in the injury’s repair—Dr. William Meyers, in Philadelphia—and even a popular website called The Sports Hernia Blog. But in 1997, when Barkley suffered from the same nagging injury, it took six months for a physician to identify it. Not that the experience has necessarily convinced Sir Charles of the authenticity of some newer injuries.

“I think now with all the new technology, [doctors] have to make up something so they can charge you more for it,” Barkley says. “With all the new lasers and stuff for injuries, they have to charge you more, so they have to make up names.”

Still, it’s become a common progression in sports: A star player gets injured, fans want to know how long he or she will be out of uniform, and the world is introduced to a new medical diagnosis. No one had heard of plantar fasciitis (inflammation of the tissue in the heel of the foot) before it cost Oakland A’s All-Star Mark McGwire much of the 1993 and 1994 seasons. By 2013, it had become enough of an epidemic in baseball—afflicting Angels star Albert Pujols most prominently—that Dodgers manager and former Yankees great Don Mattingly told USA Today, “You do hear about it more and more. When I was playing, I never really heard about it.”

The easiest way for an injury to embed itself in the public consciousness is for it to take on the name of a famous player. The best example is the ulnar-collateral ligament repair, a surgical technique to heal an elbow injury, which came to be known after its patient zero, Tommy John. Dr. Frank Jobe performed the revolutionary operation on John in 1974, and today there’s not a baseball fan in America who hasn’t seen a pitcher on his favorite team go under the knife for that surgery.

Who knows? If Durant comes back to bring Oklahoma City its first major sports championship, maybe Dr. Jones will be supplanted. Perhaps the injury will become known as a Durant fracture.

Joe Lemire, a writer based in New York City, suffered two Jones fractures before Kevin Durant made them cool.

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