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A glimpse into Amare's recovery and return

4/20/2012

Confirmed: Amare Stoudemire is coming back and starting tonight in Cleveland. He's missed the Knicks' past 13 games (since March 26) with a bulging disk in his lower back.

So now that STAT is ready to return, what has he done to get to this point, and how will the Knicks' training staff monitor and treat his back during games to prevent another bulging disk?

For insights, ESPN New York's Jared Zwerling spoke with renowned pro trainer Ed Downs, who specializes in core development workouts that are designed to strengthen a player's midsection, including the back, for better multi-directional movement throughout his or her body. Downs has worked with current and former stars in the NBA, NFL and MLB, including the Knicks' Baron Davis, LeBron James, Dwyane Wade, Chris Bosh, Carlos Boozer, Alonzo Mourning, Tim Hardaway, Jamal Mashburn, Pittsburgh Steeler LaMarr Woodley and New York Yankee Alex Rodriguez.

Here are the essential things you need to know about Stoudemire's likely recovery and return (in chronological order):

1. The cause of the injury: "He could've taken a fall. Any kind of blow. Usually with an athlete, it's more of a blow than it is degenerative over time, breaking down. [Amare's] too strong for that. That's more of an older person."

2. The rehab: "Electrical stimulation, massages, stretching, core and stabilization exercises. You want that [lower back] area as strong as possible to try to limit that movement in the spine and the disk from slipping out. The muscle that attaches to the vertebrae, you've got to keep it strong and stable. They're probably also doing spinal traction in his rehab, which is a process of opening up and trying to get the disk to slide back in. You're like on a bed and they actually have a weight that pulls your feet away from your upper body, which opens up the spinal column, allowing the disk to slip back in. It sounds kind of barbaric, but it works."

3. The epidural shot: "For the pain, for the inflammation. Forgetting about basketball, it's just to relieve the pain. Basically that disk hit the nerve, swelled it up and caused him pain all up and down his body, literally. And the only way to get rid of it is with an epidural shot, which gets down in there and gets rid of the inflammation that you can't get to through stretching and stuff like that. It's deep down within the spinal column. The epidural shot is painful. I have not heard a person yet say it was pleasant."

4. The mental challenge of returning: "A little, but as athletes, once they're out there, they almost forget about it. They really do. I work with football players all the time and when they get a broken finger, their mind takes over and they don't even think about it. They focus on the game. Usually after their first few contacts and things are okay, boom, they end up mentally okay. But it's ultimately up to Amare."

5. The in-game protection: "Even through rehab, therapy and strength training, they still have to put a brace on his lower back. There's a lot of contact playing ball. Because it happened in his lower back, they'll probably going to wrap that lower back to help stabilize it. The main thing is stabilizing the area."

6. The brace: "A wrap made of a small hard plastic in the lumbar area of his back to help it from going back too far, like a back bend. It will keep it from going back too far. It will keep it more erect. Because let's say he went up for a rebound and he reached back too far, it would compress the lower back, which can squeeze the disk back out and hit a nerve. That's what a weight belt does, like when you do a squat. It helps to keep the spinal column from compressing. In fact, the brace will likely be the same thickness as a weight belt. In addition to the wrap, they may use one of those shirted under-pads, like McDavid, to absorb some blow before it gets to that spinal column."

7. The monitoring: "A lot of it is feedback from Amare. They'll probably stretch him whenever he comes out [of the game], because the more loose he will be, the more nimble he will be and the less compression it will have on that area. The tighter you are, the more compression you have. There will be a lot of stretching and tissue work probably at halftime and on the sidelines when he comes out. If he's on his stomach, they're probably doing tissue work, like massaging type stuff. If he's on his back, they're probably stretching his hamstrings to keep those flexible and stretching his hips -- things that put stress on the lower back."

8. The potential for re-injury: "Oh for sure. It's only been like four weeks, and depending on how bad the bulging disk was, it could happen again. He also has more stress on that [lower back] area anyway because he's tall, compared to someone who's 5-2. The probability is there to re-injure it."

You can follow Jared Zwerling on Twitter.