Derrick Rose, then of the Chicago Bulls, was part of a wave of serious ACL injuries in the NBA in ... [+]
In December of 2011, when ACL expert Dr. Tim Hewett was director of the Ohio State Sports Health & Performance Institute, he had a dire warning for NBA teams. Hewett had studied the impact that the NFL’s offseason lockout that year was having on injuries in the league and, with the NBA rushing back to action faster than the NFL after its lockout dragged into Thanksgiving weekend, he predicted ligament troubles ahead.
“I could see in the NBA in the range of 2, 3, 4 times higher rates of injury,” Hewett said at the time. “This could be a historic event.”
He was right. In the season-and-a-half that followed, the NBA saw 11 players go down with serious knee ligament injuries. The league had never experienced a two-year span that difficult for ACL injuries—in the previous year, the total number of ACL injuries was three.
Nine years later, the NBA is in a similar situation, rushing back to action in the so-called bubble atmosphere in Orlando at the end of next month. There will be 22 teams returning to finish the season and more than 300 players, all putting their bodies through an unfamiliar grind after three months away from organized NBA training.
Hewett, who was brought in as a consultant by the NBA after the league suffered its post-lockout spike in ACL injuries (he is no longer in that role), has another warning for the players and teams involved in the reset closing of the 2019-20 season.
“I don’t think it’s so different,” Hewett told me. “It’s going to depend—maybe players, maybe teams, maybe agents, there are different groups that prepare players year-round, maybe they have changed approaches. But I would say even though we are nine years later, I doubt it has changed so much that we’re going to see something different. That means an uptick in serious ligament and maybe tendon injuries. It’s likely we will see it.”
‘We Better Watch Out’ For NBA ACL Injuries
Dr. Tim Hewett, expert on ACL injuries.
Among the many concerns that have been driving players to reconsider going to Orlando to help their teams in the reboot of this season, injury is one that has been largely overlooked. Some players have cited family concerns, like the Blazers’ Trevor Ariza and the Lakers’ Avery Bradley. More recently, Brooklyn center DeAndre Jordan bowed out because he tested positive for COVID-19 and it is possible teammate Spencer Dinwiddie will do the same.
But Davis Bertans, one of the big breakout stories of the season for his 15.4 points per game scoring average and his 42.4% 3-point shooting, will not join the Wizards in Orlando largely because he is hitting the free agent market and does not want to risk a serious injury like an ACL. Bradley and Ariza, too, are potentially free agents this summer. Dodging injury could have played a part of the reasoning for pushing Ariza and Bradley to sit out the season restart.
That might be wise. In the coming weeks, players must get up to game speed. They might be tempted to push their conditioning to meet that goal, but that is part of the problem. Hewett compared what NBA players will be doing to driving a car at high speeds vs. driving it at high acceleration. A driver is much more likely to suffer an accident and serious injury because of acceleration, not because of speed.
Similarly, players are accustomed to game-level conditioning, which means playing fast. They’re not accustomed to getting to that level after four months off and in the dead of summer with limited time.
“The data would say to us, yes, we better watch out,” Hewett said. “What it also tells us is that gradual increases in volume and load make a lot of sense. But situations like this don’t necessarily foster an approach like that. It is going to vary a lot, the amount of offseason conditioning and preparation these player keep themselves in. Some will keep themselves in good shape and others won’t. The assumption is that those that don’t will be at greater risk and the data would support that concept.”
Hewett pointed out that in the first weekend of the return of the Bundesliga—German soccer’s top league—in May, there were 12 major injuries among the first tier of teams. That ranks as an abnormally high slate. There is some difference in that the big concern among NBA teams is the ACLs, but in soccer, it is the hamstrings.
The comparison, then, is not perfect.
“It is difficult to look at it statistically,” Hewett said, “and determine a magnitude of significance but a warning for teams, coaches and player and agents to get ready and get ready now, preparing these players and exposing them to load gradually rather than going from 0-100 as fast as possible. It is not a good idea.”
An ACL injury is never a good idea. But Hewett saw a rash of injuries coming once before. Don’t be surprised, he said, to see more of them in the near future.
