Hansbrough – For Your Own Good, Play or Get Out

Posted by rtmsf on December 2nd, 2008

John Stevens is a featured columnist for RTC.  His columns will appear on Tuesdays throughout the season.

Fine.  If it has to be me, then it has to be me.  I don’t mind, I’ll take the heat.  I’ll be the one to bring up the subject that nobody else wants or has the stones to bring up.

I’m calling him out.

I don’t know what Tyler Hansbrough’s plans are for this Wednesday, but they had better involve showing up at Ford Field in Detroit at around 9pm.  In uniform.  Ankles taped.  Ready to play, a self-proclaimed 100% healthy.


Or, they better involve not just a DNP, but a long-term hiatus from basketball.

Now, I know that, in college basketball circles, saying anything negative about Tyler Hansbrough is just the worst thing you can do.  To know that he has an injury but still demand that he get out onto the floor and actually play basketball paints me as unfeeling, a heathen — possibly even a heretic, given the public perception of Hansbrough, his head coach Roy Williams, and the entire UNC basketball program which has gotten to the point to where the image surrounding all of them can only be described as, well…almost HOLY, for some reason.  I might as well go tell a bunch of little kids that I hate puppies or a roomful of girls that I can’t stand weddings.

I don’t care.  I’ll be the one to suggest that there’s an ugly truth behind the false beauty.  I’m going to point at the emperor and call him naked.  Someone has to say it, and I’m volunteering, because it’s best for college basketball – and for Tyler Hansbrough – that he and his handlers make a decision on his status once and for all.

I say “he” because that’s who the play-versus-sit decision evidently falls to before every game.  Since the season began, we’ve heard that Hansbrough is the one who determines whether he’s well enough to go or not.  We’ve heard nothing about team physicians or their opinions.  We’ve seen Ol’ Roy (expectedly so, since it’s what you’re supposed to do) talk about how Tyler’s just rip-roarin’ to play and how they basically need to use chains to keep the guy on the bench…but the decision to play or not has still been Hansbrough’s.  The only thing close to an exception has been their last game against UNC-Asheville where we were told that Hansbrough was “held out,” though it wasn’t specifically stated who did the holding.

Acceptable Reasons to Sit Out

Acceptable Reason to Sit Out

That in mind, let’s look at Tyler’s season so far.

The DNP against Penn wasn’t surprising.  The “stress reaction” was relatively new and, with all due respect to the Ivy League, it was the first game and it was against Penn.  Enough said. 

Then came the game against Kentucky, the headline event (which turned out to be a snooze) on ESPN’s 24-hour de-facto opening night marathon of college hoops, a game that was hyped as much as any Final Four match-up in recent years.  I thought Hansbrough would play in this one, since in last year’s UK-UNC game (which also featured a #1-ranked Tarheel team against an unranked Ketnucky), in his sixth game as a collegian, Kentucky’s Patrick Patterson largely outplayed Hansbrough and I thought the reigning POY would want to exact revenge in such a high-profile game.  When Hansbrough sat out, I began wondering if this shin injury was worse than we were being led to believe.

But then, the puzzler.  Three days later against Cal-Santa Barbara…Hansbrough started and played 25 minutes.  So let me get this straight – you DON’T play in a hugely-hyped game in prime time against one of your arch-rivals in Kentucky because of this injury, but you DO play three days later against UCSB?  Could those three days have made that much difference for the stress reaction?  If what we hear about Hansbrough’s desire to play is true, that they basically have to tranquilize him and put him in a cage to keep him from playing, it seems to me that the game he’d WANT to play in is the Kentucky game, since he’d be the headline player on the headline team in the headline game in that situation, and it would have afforded him the chance to go up against Patterson again.  Any highly-confident, top-flight athlete would LOVE that stage on which to perform.  I can’t buy that the three days between the games made that much difference to this nebulous, ill-defined injury – at least not a Kentucky-to-UCSB difference.  Then the thought, sinister as it is, crept into my head – maybe Hansbrough didn’t want to run into Patrick Patterson again, especially on prime-time TV (and right there in front of Erin Andrews, and all).

Three days after playing against UCSB, Hansbrough logs another DNP against Chaminade in the Maui, but then plays on consecutive nights against Oregon (19 minutes) and Notre Dame (a 30-minute, 34-point performance).  His appearance in the Notre Dame game had me rethinking the issue until I learned that Luke Harangody HAD FREAKING PNEUMONIA which certainly made Hansbrough’s night relatively easier (even though Harangody, after receiving a day’s worth of IV fluids, did put up 13 points and 7 rebounds in 27 minutes against him).  At this point, with UNC having claimed the Maui in most impressive fashion, everyone assumed Hansbrough was healthy and that the issue was settled. 

Four days later he DNPs in that pantsing of UNC-Asheville and now we hear that he’s a game-time decision for the chance to play in front of a leviathan crowd at Ford Field tomorrow against the highest-ranked team they’ve faced so far this season.

Unacceptable Reason to Sit Out

Unacceptable Reason to Sit Out

College basketball fans, and especially UNC fans, should be getting sick of this.  I began thinking Hansbrough was ducking certain teams/players or sitting out of “meaningless” games, or maybe that his coaches were really keeping him out of games where he might not be truly needed.  This would be especially alarming, because…well, you have to play them all, or at least make it apparent to the rest of the team that the guy is at least willing and able to go.  You can’t play the guy in some games and sit him in others because, despite Hansbrough’s valuable future, that’s even more insulting to your opponents and the game overall than a 70-point bitch-slapping.  Either be a college basketball player, or don’t, you know? 

But rather than fall victim to this negativity, I felt that I should go learn more about this injury.  Now, what I’m about to describe is not the result of a double-blinded, well-powered, randomized controlled trial.  It’s the result of me talking to a couple of orthopedic surgeon and radiologist friends and some internet searching, so take it however you want.  There are probably orthopods and radiologists out there who can explain it better than me.    But here’s what I found as far as how this works…

An athlete – say, a college basketball player – notices some pain somewhere in his lower leg after practices/games and decides to go to his coaches and/or team trainer/physician about it because it’s not going away.  It’s not bad, but it’s annoying enough for the player to seek advice about it.  The team physician will probably ask very specific questions about this pain (sharp or dull?  Constant or intermittent?  What makes it better or worse?) and do a complete physical exam. 

As helpful as all of that is, the doctor will probably send this athlete for some kind of imaging of this leg – like (in usual ascending order of image quality) an X-ray, and/or maybe a CT scan, bone scan, or an MRI.  Based on what is found on those images, the treatment plan is determined.  In fact, it’s just flowchart thinking at that point.  You see this on your imaging?  Well, here’s your treatment plan.  It’s already been determined by decades of medical practice.


So let’s say our athlete has some imaging done and his doctor tells him hat he has a “stress reaction,” implying that it is NOT an actual stress fracture, but rather a condition of  “pre-fracture.”  There’s no guarantee that the injury will develop into a fracture with continued use, but there’s medical evidence that says it’s certainly more LIKELY to happen in that area.  And with continued pounding and loading of that bone (like with continued running, jumping, etc.), it sure as hell ain’t gonna get any better.  How did the doctor come to this diagnosis?  From the way the specific area appeared on the imaging, or combination of various imaging studies like X-ray or MRI.  You can see what the bone is doing on these pictures.  Is it building itself up or is it breaking down?  Is there a fracture or just some irritation or swelling?   Most likely in a stress reaction, the doctor will not see an actual fracture line, but rather a change in color or density in that part of the image taken.  As noted above, based on that appearance, the treatment plan is pre-determined.

And this, my friends, is the compelling part of this whole situation to me.  I don’t know whether Hansbrough’s leg has been put in the X-ray machine or the MRI scanner or whatever (I’d assume it has, since he’s a big-time athlete at a big-time program), but once something – ANYTHING – is found on any imaging study, the decision to play or not play is no longer Hansbrough’s to make.  Not if his best interest is being considered.  The ONLY way that Tyler Hansbrough should be asked “Can you play tonight or not?” should be if his doctor’s examination and the imaging studies showed a TOTALLY NORMAL leg.  The results of the imaging studies are graded on severity and that is what determines the treatment plan.  The MINIMUM – and here is where I did indeed find some ranging of opinions – rest period (since rest is the only real treatment for a stress reaction) based on imaging is THREE WEEKS of consecutive rest.  Has Hansbrough had this?  And since the injury hasn’t improved clinically, should he even be trying to play or practice?  If there’s even a hint of a fracture line on those imaging studies, some people say that a minimum of 6 to 16 weeks (!!) of rest is warranted. 

This leads me to believe that one of two things is happening, here.  We have to assume that Hansbrough and his coaches are aware of what was found on the imaging studies, assuming they were done (there’s really no doubt they were done).  If Hansbrough is allowed to practice or play on his injury, either his imaging showed nothing and his leg is totally normal except for an unexplained pain, OR his coaches are ALLOWING him to play on an injury they know should be rested longer, most likely because of Hansbrough’s intense desire to play that we keep hearing about, and the program’s desire to win.

A Typical Stress Reaction

A Typical Stress Reaction

If it’s the first, and Hansbrough has a totally normal leg after his doctor’s physical exam and by the imaging, then the guy’s got no excuse to be missing a second of practice or game action.  Basically, he’d just need to suck it up and get out there in the assumption that nothing’s wrong with his leg.  It would definitely warrant a downgrading of his nickname from Psycho T (majorly depressed T?  seasonal affective disorder T?).  But if it’s the second of those possibilities, other questions have to be raised.  I’m a big admirer of players who  play through pain to help their team.  I’m all for putting team first and self second.  But in this case, where the athlete in question has millions of dollars waiting on him that are dependent on his health, if there was something on that imaging (and, I’m assuming, multiple re-imaging to assess progress), if I were a coach or a team physician I’d be putting Hansbrough on the pine if I was really worried about his best interests.  Plus, it’s not like this UNC team needs him.  The way they’ve looked this year so far, with those basically un-guardable guards and the play of Deon Thompson and Danny Green, UNC’s just fine without him for a while.  Plus, a full 20% of the regular season schedule is over.  Can Hansbrough really do anything to improve his draft status at this point?  Or can he do more to hurt it?

I’m not going to sit here and try to figure it out or place blame on either Tyler Hansbrough or the coaches/physicians.  As far as I know, nobody knows what his imaging studies have shown or how this is being handled behind the scenes.  I’ll leave that to the readers of this column, and I’d love to hear what you think.  I’ve got to tell you, because I’ve even slightly implied something negative about the UNC basketball program, I feel like Winston Smith in Orwell’s 1984.  I’m convinced that I’m going to be followed, my house will be bugged and my phones tapped.  I’m convinced that I’ll walk out to my car tomorrow and find at least one flat tire.  Hell, I’m even afraid to start the thing.  Before you go climbing telephone poles and putting steak knives in my Goodyears because I’m questioning something about Carolina basketball, all I ask is that you consider the question.  A diagnosis of a stress reaction mandates a certain treatment — and it seems that if the injury is persistent, even more caution is warranted.  Has he received even the minimum time-off for the injury?  Maybe so.  But it isn’t any better.  Logically, either the leg is fine and Hansbrough needs to suck it up and play ALL the time, or he’s being allowed to continue to practice and sometimes play on a leg that is apparently begging for rest.  It’s not my job to lay blame or tell these people what to do, because they know better than me.  But whatever’s being done for Mr. Hansbrough, let’s hope the insiders and decision-makers in this situation have done a true, honest risk-versus-reward analysis and figured out what’s best for this guy and his future.

rtmsf (3954 Posts)

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16 responses to “Hansbrough – For Your Own Good, Play or Get Out”

  1. The Last Unitard says:

    I can tell you as a Chapel Hill resident and a UNC basketball fan that we’re not too worried about this. The fact is, we’d be the consensus #1 team in the country even if Tyler had gone to the NBA after last season. The young guys need some playing time against these inferior opponents. When the games get serious, Tyler will be there.

  2. jstevrtc says:


    You’re certainly correct — the current UNC squad without Hansbrough (for whatever reason…NBA defection or injury) is still the best team in the country, and the polls would have reflected that, for what that’s worth.

    My question was more about Hansbrough, himself. Since UNC is the consensus #1, everyone is an inferior opponent…but I think I know what you mean…you’re talking about the Chaminades, UNC-A’s etc. But I wouldn’t lump #6 Michigan State (UNCs toughest test yet, though I think it won’t be that close) in with that group, and evidently TH is unlikely to play. Kentucky isn’t what they once were right now, but I wouldn’t lump Patrick Patterson in as an inferior opponent since in their only prior meeting, PP got the better of him. But TH didn’t play in that one, either. So quality of opponent hasn’t really shown to be a determiner of TH’s playing status. TH isn’t just missing the non-“intense” games.

    A diagnosis of Stress Reaction has to be based on something. Most likely it’s on the imaging of TH’s leg. If they saw something on the imaging, the guy shouldn’t be putting much weight on the leg at all, let alone practicing and playing at full speed, lest the ‘reaction’ actually evolve into a fracture (then we’re talking MONTHS of rest, casting, maybe even surgery). He should have an extended period of rest. That might not be what UNC fans, coaches, and players want to hear — that TH might be better served if his college career were truncated or even over, since you don’t want to do permanent damage that would hinder his making millions in the NBA — but it might be an unfortunate truth.

    The other possibility is that nothing was seen on the imaging, the term ‘stress reaction’ was thrown out there as an intentionally vague diagnosis, and there’s little that should be keeping TH off the floor. If that’s the case, he needs to quit being flaky, suck it up, and get out there and play like a regular teammate. But I don’t think that’s the case here.

    So I agree with your statement re: the quality success of the UNC side. Even without TH, they’re great. The ACC and NCAA tournaments will probably bear that out. The issue I’ll take is with the last sentence. Maybe in the more “intense” games, if it’s better for his long-term health and his pro basketball career, maybe in those later-season games, maybe he SHOULDN’T be there.

    Thanks VERY much for the comment, and by all means keep them coming. I/we like hearing what you folks have to say.

    John S.

  3. Psycho J says:

    You moron. Do you really want him to exacerbate a stress reaction into a stress fracture so he can play meaningful minutes vs UNC Asheville? UC Santa Barbabra? Chaminade? Penn? Oral Roberts? Valpo? Hell you could start for Carolina vs those guys and he Heels would still win. As opposed for letting him rest him for the grueling ACC schedule, ACC tourney, and NCAA tourney? UNC is looking at playing the most games of any team in the NCAA this season. Especially when Deon Thompson and Ed Davis are crushing opponents’ front-courts without him in the lineup…
    I guess you didn’t see Tyler destroy Luke Harangody, another media darling and pre-season all-america in the maui shoot-out. You wanna call tyler out for being overexposed? Being the most hyped guy since GayGay Redick? Fine. You wanna call him out for not banging Erin Andrews on the half-court circle when she called the Kentucky game? Fine. Do you even watch college hoops, or do you just watch the highlights on PTI and rely on Kornheiser to keep you current? You are a fucking dope.

  4. jstevrtc says:

    Psycho J:

    Read the piece again. You’re helping me prove my point.

    From what I can tell, you’re saying TH should be careful. That he should be resting the leg so the stress reaction doesn’t become a fracture. That very sentiment is present throughout what I wrote, both in the original article and the response to TLU’s comment above.

    You seem to want him to be careful — that is, until later in the year when you might need him more, meaning when conference play begins and the tournaments arrive. So, I’ll ask you…what if he still has a stress reaction at that time? What if it’s not healed, then? Do you still want him to be careful, or would you want him to play anyway?

    The point of my article was that if he’s got a stress reaction, he should be sitting, at the VERY LEAST for the early part of the season, and, if it’s best for his basketball future, maybe the whole thing. IF he really DOESN’T have a stress reaction (because if he does, he shouldn’t even by TRYING to play or practice on it, esp. if it STILL HURTS, which it obviously does), then he should be out there with his teammates praticing and playing. In other words, if he’s really healthy in the opinion of his coaches/doctors but is just having an unexplained pain, and a diagnosis of ‘stress reaction’ was just given to the media as a reason for his sitting out, then he needs to get out there and play. But again, that’s only if there’s NOTHING that they’re basing that diagnosis on. That’s if he really DOES NOT have any bony changes on exam and/or the imaging studies. And again, I DON’T THINK that’s the case, here. We have to take the UNC coaches and docs at face value and assume they’re telling the truth when they say TH has a diagnosis of a stress reaction.

    It looks like we’re agreeing more than we’re disagreeing. And yet you’re calling me a moron. I suggest you reread the article.

    So do us both a favor, and try to make your points like an adult. I admire the passion and love you have for your team, and I’ll talk basketball with anyone, so let’s do that, OK? It’s an open forum and you can say whatever you want, but come on, man. You’re better than that. Represent your fan base like a real man.

    John S.

  5. Ringo says:

    Wow, harsh reaction Psycho J. I think you were reinforcing his point there. Way to call a guy out on not actually watching hoops when it sounds like you didn’t actually read his post.

  6. Chris says:

    If you had read anything in the past week or so on this, you would know that what is keeping Hansbrough out of the lineup is not his stress reacted shin, it’s his “tweaked” ankle.

    It was the ankle that stiffened up on the flight back from Maui that kept him out of the UNC-Asheville game (and too bad, UNC could have used him, I mean they only won by 68 points).

    And by Roy’s own comments from yesterday and Monday, it will be how his ankle reacts that allows him to play tonight or not.

    So your whole diatribe here is not based in facts and/or reality. Hansbrough has had 2 different injuries — the stress reaction in his shin for which he sat out 3 straight weeks of practice and missed a few games, and now his “tweaked” ankle.

    The shin has healed, the ankle is the problem now.

  7. rtmsf says:

    @ Chris – From today’s Detroit News:

    It’s unclear if North Carolina’s Tyler Hansbrough, last season’s national Player of the Year, will play Wednesday against Michigan State because of a lingering problem in his right shin.

    “I don’t know,” Tar Heels coach Roy Williams said Tuesday in a teleconference.

  8. jstevrtc says:


    I understand about the ankle injury, but ESPN.com has reported in two different places in the last 48 hours that the shin (the stress reaction) is still a problem. I’ve put two links below. The first is a report that specifically says the shin/stress reaction is what kept him out of the UNC-A game, not the ankle. The second link also cites the shin as a reason that he might sit out tonight against MSU, but does indeed mention the ankle, as well:



    If these Associated Press and ESPN News reports are erroneous, and the stress reaction is truly healed, then I say good for TH. Hopefully he won’t have to worry about it any more, and hopefully this ankle will be a minor problem that he’s already over.

    Thanks, and keep the comments coming. Discussion is always a good thing.

    John S.

  9. jrhyne says:

    Don’t go by anything ESPN says…..they (esp Andy Katz) just don’t know.

    Roy has said in more than one press conference, and on his radio show, that Tyler’s ankle is the problem right now, not his shin.

  10. Ed says:

    Maybe the injury to Tyler Zeller has something to do with it. Zeller went down really late in the UK game, and they were ahead to the point that they could win the game without him. Since then, Hansbrough has played in games against legit opponents. It seems as if even if the stress “reaction” isn’t completely healed, he is getting closer to 100% and UNC is using him against real teams to try and get him worked into the flow of everything (although it is debatable as to whether or not UCSB is a dangerous opponent). We’ll see if he plays tonight at all, although Suton being out means he probably wont have to play too long tonight. I understand your argument about his knee being an all or nothing proposition, but ultimately the choice to play is his, and I see no problem with simply playing as neccessary against better opponents.

  11. jbates says:

    This was Roy Williams from the UNC-A postgame. The foot in reference is an ankle injury suffered during the UCSB game. “He felt great against Notre Dame and he played great, and was about as intense as I’ve ever seen him. It’s a hard plane ride back, those seats are so small, and we had some problems that you read about – we were sitting in those seats a long, long time. Came back on Friday and he could barely touch the rim his foot was so stiff.”

    So the injury that may or may not keep Hansbrough out of the MSU game is an ankle, not the stress reaction.

  12. jstevrtc says:


    So it looks like when it came down to Play or Get Out, Hansbrough chose Play, at least for now. And boy did he play, eh? Again, it didn’t look like he was needed against the Spartans but he was out there anyway and he did pretty much whatever he wanted. Despite being a game-time decision, I’d say this proves that TH is completely healthy, and he should stay that way now that he’s got 7-10 days off where he’s been told (acc. to the ESPN broadcast, at least) that he’s to do nothing but shoot FTs. The only way that college hoop/UNC fans should have any further questions about the guy’s fitness (shin, ankle, or whatever) is if he misses games after this rest period. If that happens, I’ll revisit the issue then. As for now, it looks like TH’s health is no longer a problem, and the issue is closed.

  13. jstevrtc says:

    Honestly, I say great for him if the stress reaction is totally healed. The whole point of my column was that TH’s best interest should be the main motivation, especially since it’s obvious that, at least right now, the team doesn’t need his on-court contribution. They’re better with him, but they’re pretty unbelievable without him, too.

    When ESPN started its broadcast, Doris Burke came on and reported the ankle as the more concerning injury, and the fact that THAT itself was a new story — not the ankle injury against UCSB, but the fact that it was more concerning than the shin/stress rxn — even if it wasn’t a totally new bit of info. Even Dan Shulman was talking about how he was unaware of that. I appreciate your reference above, since evidently Roy Williams says it was being “misreported.”

    Anyway…with last night’s performance, we can assume the ankle is fine. As you note above, Roy is saying the shin/stress reaction is also not a concern. He may be under restricted activity by his coaches/docs/trainers over the next 7-10 days (as reported on the broadcast last night), but it sounds like TH is completely healthy. It certainly looks that way too, given his production and the fact that he didn’t seem to be restricted-of-movement at all during the game. If he continues to miss games after this bit of down time, you can best believe I’ll revisit the issue. I think fans of the game and specifically UNC fans would have the right to ask why their reigning POY and an obviously important player is still missing games after it had been made apparent that he was over his injuries. But again, I don’t think we’ll need to worry about that. I/we have no reason to assume that TH will be hindered in any way after the next week or so. We have every indication that his injuries aren’t a story anymore, that he’ll be in the lineup from now on, and should take his place not only on the All-American 1st team, but also what looks like a frankly unbeatable eventual national champion squad.

    I definitely don’t think the column was a waste because it generated discussion, and that’s the point of this whole thing. That’s why we do this. In all seriousness, thanks for reading, thanks for commenting, keep them coming, and enjoy the season!

    John S.

  14. Unfortunately, North Carolina’s world-reknowned sports medicine staff is currently fully staffed with experts (although I’m sure that they will take your advice under consideration due to the depth of your analysis), however, my organization is in need of an expert. If you have any interest please contact me head of sports medicine for the Cleveland Steamers of the MILL.

  15. I used some quotes form this article of your post in my own blog post at http://carveraig.21classes.com/weblogCategory/1r3qhubc2xwy4?slsid=1231357231785&p=1
    and I just wanted to let you know you can check it out and find out all about me as well. When I wrote my blog I did address the author as Rush the Court, because there was no name that I saw. Please read my blog and give me feedback if you wish, because this is my first blog and I want to know your opinion.

  16. I’m sorry that in my reply I didn’t add that I did this article in Early December and I just got it the way I wanted it, but it was posted before.

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