Philadelphia 76ers’ Zhaire Smith Injury Discussion


And the curse continues. The injury bug bites another top draft pick for the Philadelphia 76ers. It comes in the form of combo guard/forward rookie Zhaire Smith. He was drafted 16th overall in the 2018 NBA Draft out of Texas Tech.

It was later confirmed through multiple outlets that Smith indeed did suffer a fracture in his fifth metatarsal.

If this sounds all too familiar for Sixers’ fans it is because it is. Last year rookie Markelle Fultz had strange and highly criticized rookie season that caused him to miss 68 games and be regulated to a benchwarmer during the postseason. Two years ago, forward Ben Simmons suffered from a Jones’ fracture that forced him to miss his entire rookie year. The year before Simmons, Joel Embiid had missed two seasons due to a navicular fracture in his right foot.


Anatomy Review:


A Jones’ fracture is a fracture of between the base of the 5th Metatarsal and the shaft of the 5th Metatarsal. It is the most common fracture of the metatarsal bones and it can be a long recovery process because of minimal blood supply it receives.

The 5th Metatarsal is the smallest of the metatarsal bones and is located on the lateral side of the foot. It articulates with the Cuboid bone. What is unique about the 5th metatarsal is that the base overhangs which allows for attachment of muscles. It also widens the base of support available. But since there a boney overhang it is susceptible to overuse and overstress.


What is not known about the type of fracture sustained by Zhaire Smith. It hasn’t been disclosed whether the fracture is an avulsion fracture or a shaft fracture. An avulsion fracture when there is a piece of bone that breaks off from the rest of the metatarsal. A shaft fracture is when there is a break through the shaft of the bone itself.

Rehabilitation Outlook:

The rehabilitation for a Jones’ fracture is not fast. Since there is such a low blood supply to the base of the metatarsal the recovery process can be drawn out. After about six weeks of non-weight bearing and imaging shows the healing process is progressing, only then can the patient begin to be weight bearing in a protective boot.

Rehabilitation can then start if all is clear. A common place for rehabilitation to start is to help restore range of motion in the big toe, foot, and ankle because the patient has been in a boot for at least six weeks. When you are in a boot your muscles can begin to atrophy and the muscles can begin to contract and shorten.

Where I come into play is to help restore range of motion. By working on the muscles and ligaments of the foot and ankle, it can start the physical therapy process. Common rolling out techniques can focus on the posterior lower leg and the foot. I don’t recommend rolling out the foot with a lacrosse ball or golf ball right away since the patient is still recovering from a fracture, but manually working on the foot is a common place to start with manual techniques of the foot.

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Through the use of active release techniques, instrument assisted soft tissue mobilization, and joint mobilization it can be part of the medical care that he will receive to get him back to health.

Season Outlook:

In this case, timing is important. If there’s any sort of blessing it is that it happened in the summer as opposed to it happening during training camp or during the season. But with the best case scenario being 3-4 months, assuming there are no complications, and worse case scenario he takes his Philadelphia 76er-obligated medical redshirt year and misses his entire rookie year, it is hard to tell what the next step is. So much will be influenced on how his rehabilitation goes.


If there is any pain late in rehabilitation or a lack of healing, there won’t be any hesitation to shut him down for the entire season. The lack of healing after about 12 weeks could force a second surgery to make sure the healing occurs. There’s a possibility he plays this year for the Sixers but I don’t believe it could be until the start of the 2019 calendar year to give him ample time to rehabilitate and then give him time to work himself into basketball playing shape.

If there’s any sort of consolation prize there have been some current NBA All-Stars and great NBA players who have suffered Jones’ fractures and have continued to have successful careers:

Disclaimer: I don’t own these photos. Credit to photographers, Sports Illustrated, ESPN, FoxSports, USA Today, Getty Images, NBA, and represented NBA teams.

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