Could Ryan Anderson Miss Significant Time?

As of this writing, the latest news surrounding Ryan Anderson's condition is that he remained in Boston Saturday to undergo further testing.

As the Pelicans prepared to play the Indiana Pacers on Saturday night, Anderson remained hospitalized, undergoing a series of tests to determine the severity of Anderson's ailment, which originally was diagnosed as a cervical stinger.

Obviously this type of injury isn't the run-of-the-mill bone bruise or sprained ankle. A standard X-ray and/or MRI may not be enough to gauge severity. Consequently, several electrodiagnostic studies might be taken and likely include an electromyography (EMG) and a nerve conduction study (NCS). In essence, these tests help doctors make a diagnosis by looking for discrepancies of electrical signals of affected nerves and muscles.

What is a Cervical Stinger?

A stinger is a sports related injury to the nerves about the neck or shoulder. It is sometimes called a burner or nerve pinch injury, but the term stinger is most descriptive of the symptoms that the athlete experiences including painful electrical sensations radiating through one of the arms. While the stinger is usually a spine injury, it is never a spinal cord injury.

Okay, so Anderson isn't in danger of any sustained paralysis, but how serious is it? The medical terminology is transient brachial plexopathy or an injury to the brachial plexus and consists of three grades:

- A Grade I injury is called a neuropraxia injury and results in a temporary loss of sensation and/or loss of motor function (ability to use muscles). This is thought to occur due to a localized conduction block in the nerve bundle that prevents the flow of information from the spinal cord to the innervated areas. Because this is only a "block", the symptoms are transient and may only last from several minutes to several days.

- Grade II injuries are more significant injuries because there may be actual damage to the nerves known as axonotmesis. Axonotmesis is defined as damage to the axon of the nerve without severing the nerve.

These types of injuries may produce significant motor and/or sensory deficits that last at least two weeks. Because growth of an injured axon is a very slow process (a rate of 1 to 2 mm per day), it takes several weeks for the regrowth to occur. However, once the regrowth as occurred, full function of the athlete’s motor and sensory functions are restored.

- The most severe plexus injury is a Grade III injury. Athletes with these types of injuries may not have a full recovery and may be considered to have sustained a catastrophic injury because the neurological symptoms may last up to one year.

A Grade III is known as a neurotmesis injury and is defined as a complete severance of the nerve. Athletes who have sustained this type of injury have a poor prognosis and may need surgical intervention.

A pretty wide range there and from the earlier Nola link, the article didn't give us much information as to any particulars involving Anderson. However, in my quick research, regular stingers are very temporary and go away quickly. Normally, tests such as x-rays, MRI's and EMG's are unnecessary. The fact Anderson appears to have undergone extensive testing signals something at least a little more worrisome.

Currently, there is a rumor floating around in a forum of Pelicans Report that Anderson may be suffering from a herniated disc and his recovery time could be measured in months. It is true that occasionally stingers can result from a disc herniation in the neck, but for now, let's avoid going down this unsubstantiated path.

Basically, if Anderson is suffering from a Grade 1 or 2 stinger, his time away from game participation will be dictated by several factors: the length of time his symptoms persist and the amount of rehabilitation he'll require to regain full range of pain-free motion. In addition, stingers have high recurrence rates so expect the medical staff to favor a longer timetable.

In one collegiate football study, players sustaining stingers missed an average of 10.7 practice days. If Anderson's stinger was strictly the result of the Gerald Wallace collision, then the Pelicans will hopefully be looking at a similar time frame. Otherwise...no...let's not even contemplate otherwise.