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What’s It Like to Return from a Major Injury?

Alex Kennedy talked to players about the physical and mental stress of returning from a significant injury.

Alex Kennedy

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Entering the 2016-17 NBA campaign, a number of notable players are returning to the court after suffering a significant injury last season. This includes big-name stars such as Anthony Davis (left knee), Blake Griffin (left quad), Chris Paul (right hand), John Wall (both knees) and Marc Gasol (right foot).

Every step of an injury is difficult on a player, and their eventual return is no exception. While it’s the culmination of a ton of hard work and they’re thrilled to return to the game that they love, there’s always the possibility that the individual will be limited (physically and/or mentally) at least initially.

When a player goes through an intense rehab regimen, it can drastically change their body. This forces them to make adjustments once they’re healthy enough to play again. Dan Barto, who has trained over 100 NBA players as the Head Skills Trainer at the famed IMG Academy in Florida, has seen this happen many times as a player makes a comeback.

“Any time an athlete misses an extended period of time, they typically come back and work extremely hard, but they’re working with a new body and an old mind,” Barto explained to Basketball Insiders. “When they get back on the court, these ultra-athletic guys have a bunch of very strong muscles from the rehab they’ve done, so their old movement patterns and old reactionary on-court moves put pressure on different areas that their body isn’t used to. Sometimes they try to avoid the pain by moving too hard to one side. Sometimes their muscles are so strong, but their body and joints aren’t ready for the hard cutting and reactionary movements they’re doing. This can lead to an overuse injury or a tear because you’re basically putting a different engine into a car. In some cases, a player has to change the way that they play or work out after an injury to avoid wearing that area of their body out.”

Barto stressed that the key for a player to return to full strength is taking the rehab process slowly. Many NBA players are extremely hard workers who want to be in the gym as much as possible and push to return earlier than expected. While the player thinks they’re doing what’s best for themselves and their team, that kind of mentality can cause problems.

“I think sometimes a player will be cleared and then they think, ‘I’m ready to do everything again,’ but they need to ease back,” Barto said. “In baseball, you have minor league rehab assignments and simulated games for players to test themselves. But in basketball, you hardly see that method used. Rarely do teams send a guy to the D-League for a rehab assignment, but that could help ease them back.”

Jodie Meeks appeared in just three games for the Detroit Pistons last season due to a non-displaced fracture of the fifth metatarsal in his right foot. The veteran shooting guard was traded to the Orlando Magic this summer, but was recently ruled out indefinitely due to another surgery to stabilize the same metatarsal.

“You want to get back as soon as possible, while not rushing it,” Meeks told Basketball Insiders. “It’s real tough to balance those things.”

Barto has a strict order he follows as he eases a player back from an injury.

“What we do when a player is cleared – and I’ve even done this for players who are overweight and trying to get back into shape – is we do a lot of shooting first,” Barto said. “Then, we do jogging. Then, we add some ball-handling and moves. Then, we add jumping and, finally, some contact. If a doctor says you’re going to be out eight months due to an ACL injury, I’ve always said, ‘You need to take nine or 10 months before returning.’ You need time for athletic foundation build-up and then planned contact followed by actual reactive basketball simulation. The best order when a player is coming back is shooting and conditioning, then cutting and moving with the ball, then planned contact and basketball simulation.”

It’s also important to note that every injury is different, which is something Barto was quick to point out.

“Shoulder and ACL injuries are tough to rush back from,” Barto said. “And with ACL injuries, the player needs to slowly get back onto the court and build back up their athletic foundation or they’ll be more at risk for re-injury.”

Then, there’s the mental side of recovering from a serious injury. Not every player can be like Adrian Peterson or Paul George, putting their serious injury behind them and having an amazing bounce-back season right away. Some players struggle with the fear of re-injury. Others are hesitant to duplicate their pre-injury style of play (consciously or not). Mental hurdles are extremely common for a player who is trying to return to form.

BillupsInsideInjury1In fact, when talking to current and former NBA players, the majority said that recovering mentally was the toughest part of their comeback.

“Physically it’s hard, but through rehab you regain the strength and stability that was lost; however, the biggest obstacles are mental,” NBA champion Chauncey Billups told Basketball Insiders. “You have to rebuild your confidence. You not only have to prove to the team and the fans that you’re back but, more importantly, you have to prove it to yourself. Being injured has a way of chipping away at one’s confidence. When you cross that bridge [and regain your confidence], you’re back.”

“You have to get over the mental aspect, the thought of re-injuring yourself, and just trust your hard work and dedication to get back,” Meeks said. “You have to focus on what you can control – things like your effort and mental focus.”

“Coming back from my season-ending back surgery in 2014 was one of the toughest things I have dealt with in my life,” Phoenix Suns guard John Jenkins told Basketball Insiders. “Mentally and physically, I was drained for the first two-to-three months. You hate not playing the game you love for that long, but you learn to embrace the challenge and attack your rehab the same way you would attack a game or practice. Getting back on the court felt different and it takes a while to get back in playing shape. I would say that the hardest part for me was getting my conditioning where I wanted it and getting back into playing rhythm. I missed almost seven months. But after a good two to three weeks on the court, I started to see positives and regain confidence in my back and my game.”

“I was worried about whether I was going to be the same player after the injury,” said forward Adonis Thomas, who suffered a season-ending wrist injury in December. “After returning, I didn’t do anything to change my game though; I played with confidence immediately. But I was worried at first. [My goal became] to be better than I was before being injured. And I wanted to be in the best possible shape, that way I could prevent any other injuries in the future.”

When it comes to helping players with the mental aspects of their recovery, Barto has several methods that he uses.

“I think visualization is important,” Barto said. “You can’t go back and watch highlights of your old self. Using someone like Derrick Rose as an example, I wouldn’t advise him to watch his old film. I’d tell him to close his eyes and imagine himself playing in a Knicks uniform as opposed to dwelling on the past. And, ideally, you want everyone around the organization helping him with this and being on-board with this approach.”

The ease-back strategy also helps the player mentally, since it gradually increases their confidence and they start to feel like themselves again as they go through the progressions.

“In addition to visualization, a player should have a four-to-six week window once they’re cleared where they’re psychologically advancing,” Barto said. “They’re thinking, ‘Okay, I can make some shots now. Next, I can do sprints. Okay, my handle feels sharp and back up to speed. Okay, now they’re leaning on me, but I know they’re going to lean on me and play dummy defense.’ Then, with the simulated basketball, you’re being defended at 75 percent. It’s basically AAA level. By easing them back this way, they advancing physically and mentally.”

As the players quoted above pointed out, getting the body and mind right are equally important.

Returning from an injury is one of those things that players typically do behind the scenes. Outsiders rarely get to see the hard work that an individual is putting in or hear what issues they are dealing as they go through the process. Instead, very little information is disseminated between the point the injury occurs and the eventual comeback. Hopefully, pulling back the curtain on this process gives everyone a better idea of what a player may be feeling and thinking during that important recovery period.

Alex Kennedy is the Managing Editor of Basketball Insiders and this is his 10th season covering the NBA. He is a member of the Professional Basketball Writers Association.

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NBA Daily: Kevin Knox and Kristaps Porzingis Already Have One Thing In Common

Kevin Knox’s experience on draft night was eerily similar to that of Kristaps Porzingis.

Moke Hamilton

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Michael Porter, Jr. might be the next Kevin Durant, but he could just as easily be the next Greg Oden.

And if you’re searching for comfort in the wake of the decision of the Knicks to pass on the opportunity to draft the young man who was widely regarded as being the top prospect in the class of 2018, it is pretty easy to find in the fact that of all people, Jerry West decided that Porter wasn’t worth the risk, either.

While Porter might end up being a Hall of Famer, when it comes to drafting prospects, we might as well be shooting in the dark. We all knew that Markelle Fultz was the best option for the Sixers in last year’s draft, and 12 other teams clearly had no idea what Donovan Mitchell had in store for the league.

Heck, two years ago, as I was recently reminded by someone on Twitter, I predicted that the Knicks would select Emmanuel Mudiay with their fourth pick. Instead, they walked away with Kristaps Porzingis.

If I were the man making the call back then, with the information I had, I certainly would have drafted Mudiay. And you know what? That decision probably would have gotten me fired, and rightfully so.

The true moral of the story is that we simply can’t see into the future and all the analytics in the world won’t able to measure things like guts and heart. So as the Knicks pin their hopes on Kevin Knox, it truly will be interesting to see how the career arcs of he and Porter compare.

As for why we would single out the Knicks and make the franchise’s decision to draft Knox over him a personal one, quite a few people in the know relayed the same information on the Knicks and Porter going back to their date at the NBA Draft Combine in Chicago in May—they loved each other.

Thereafter, there were reports that the Knicks were looking to move up in the draft, and Porter was on their minds. On Thursday night in Barclays Center, with the Knicks on the clock, their fans in attendance cheered for Porter, as they were hopeful that he would be selected to be the franchise’s next stud.

They were disappointed, and now, they’ll hope that Scott Perry’s decision to go with Knox ends up being the right one. It might be, just like Porzingis was the right pick over Mudiay, and it might not be, just like selecting Frank Ntilikina over Mitchell wasn’t.

Like it or not, though, the two young men will forever be linked, both in my mind and in the minds of plenty of other Knicks fans.

“That’s just motivation,” Knox said of the Knicks fans in attendance chanting Porter’s name.

“A lot of people want him to get to the Knicks, but I mean, it’s all good with me. I’m ready to get to work. I’m ready to get to work and ready to prove people in Summer League and prove people in the NBA.”

Knox’s experience on draft night was remarkably similar to that of Porzingis, and now, if you even so much as suggest trading the Latvian unicorn for a player such as Kyrie Irving, Knicks fans just might call for your head.

It’s strange how quickly things can change for you in New York City. At the end of the day, it comes down to working hard and earning the adoration of the faithful in Gotham City. Porzingis succeeded there, and there’s every reason to believe that Knox will, as well.

“They booed Porzingis (on draft night) and look where he is now,” the rookie remarked.

“They can chant Michael Porter all they want, but they got Kevin Knox, and I’m willing to work and I’m willing to get better.”

When asked, Knox would tell you that he and Jayson Tatum happen to have something in common. According to him, neither of the two really got an opportunity to show what they could do at the collegiate level.

With more opportunities and more repetitions, the sky truly is the limit for the 18-year-old.

“I think I can pretty much play all around the floor,” Knox said.

“I can handle the ball, pick-and-roll situations, make plays, make passes. I can stretch the floor, shoot the ball, get rebounds, push it coast to coast. So I think that versatility in the league is something that a lot of teams really need, and I think that’s something I can bring to the Knicks right now.”

Privately, to members of the Knicks organization, Knox has spoken highly of the spotlight that he’s bound to face in New York and believes that playing at Kentucky helped to prepare him for the type of demanding environment that he’ll be introduced to once the season gets underway in New York. And even without a bad back, the crushing expectations and heavy burden could cause a weaker minded player to crumble.

A FaceTime call with Porzingis on draft night went a long way toward giving the rookie the confidence that he’ll need to thrive in New York.

That the franchise’s pride and joy immediately reached out to his new running mate to congratulate him, welcome him to the team and give him some insight is a good sign. At the very least, it shows that Porzingis takes his responsibility as being the team’s lead man seriously.

At most, it could signal K.P.’s being pleased with the selection.

We’re about to embark upon the story of Kevin Knox. We’ve only seen the preamble.

You can’t judge a book by its cover, and you certainly can’t know how the final chapter will end based on what you’ve read in the first chapter. So no, the Knicks fans that wanted Michael Porter on their squad didn’t get their wish, but in the long run, they may end up being better for it.

Just like Kristaps Porzingis, Knox wasn’t received warmly by Knicks fans on draft night.

Hopefully, for the rookie, it’s not the last thing he and the beloved Porzingis will have in common.

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NBA Daily: Lessons From The 2018 NBA Draft

After a wild 2018 NBA Draft, here are four lessons and storylines worth watching over the next few years.

Ben Nadeau

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Now that the dust has settled on an unpredictable NBA Draft — what exactly have we learned? In amongst the unrelenting rumors, refused workouts and surprise reaches, there are a few key takeaways from Brooklyn. Of course, some of these are one-off instances, but others are definitely part of modern-day draft patterns. While draft night may sometimes seem like complete chaos or chance, each scenario on this rundown has been boiling over for weeks. Between passing on a talented prospect to letting an injured one slide, here are four important lessons from the 2018 NBA Draft.

Luka Dončić… Not The No. 1?

For months and months, it appeared as if Luka Dončić was poised to become the No. 1 overall pick in this draft. Even today, it’s hard to believe that somebody with Dončić’s age and resume wasn’t the top selection. In 2017-18 alone, the Slovenian took home EuroLeague MVP and Finals MVP plus ACB MVP, with championships in both leagues to boot — but here we are. Dončić averaged 14.1 points, 5.3 rebounds, 4.5 assists and 1.1 steals over just 25 minutes per game, quickly transforming into the most well-rounded overseas prospect of all-time. But as impressive as Dončić was throughout the spring, the potential ceilings of both DeAndre Ayton and Marvin Bagley III eventually won out.

At 7-foot-1, Ayton’s 20.1 points, 11.6 rebounds and 1.9 blocks per game were undeniably worthy of a top selection too, pairing well alongside Devin Booker and Josh Jackson for the foreseeable future. While the jury is still out on Bagley III — his defense needs some major fine-tuning — he won’t take key touches away from De’Aaron Fox either. More or less, nobody wants to be the organization to miss on such a franchise-altering pick. The Suns, Kings and even the Hawks may eventually regret passing on Dončić, but when general managers’ entire careers can depend on making the right choice at the right time, it’s not difficult to understand why the top of the draft unfolded as it did.

Playing Hard To Get Doesn’t Always Work Out…

As draft boards began to take shape, there was one particularly interesting situation sitting at No. 4 overall. Jaren Jackson Jr., solidly leading the second tier of prospects, was looking like a lock at the Memphis Grizzlies’ pick — but with one major caveat: Jackson Jr. reportedly didn’t work out or give his medical information to the franchise. After he was drafted, Jackson Jr. called those rumors “a tad out of context” — but, obviously, those are some massive red flags. Either way, Memphis went with their gut and selected the talented forward anyway.

But beyond all that, Memphis absolutely made the right move by sticking to their guns. Putting a modern three-point shooting, defensive-minded athlete next to Marc Gasol should prove to be an absolute nightmare for years to come. Naturally, Jackson Jr. will get plenty of easy looks from the stellar Mike Conley Jr. too — so if the draftee was once apprehensive, surely that will pass soon. Still, it reflects on a larger NBA pattern, wherein which prospective athletes sensibly look to mold their own path out of college. With players trying to control their draft narratives more than ever, it’s reassuring to see that some franchises will take their target first and then figure out the rest.

We may never know Jackson Jr.’s full thought process behind not working out for the Grizzlies, but there’s a great chance that the former Spartan was made for Memphis’ tough brand of basketball — and we should all be glad we’ll get to see it.

…But Injuries Will Lead To A Slide

Michael Porter Jr. — what a year for him, huh?

After missing out on much of his only collegiate season due to back surgery, Porter Jr. promised that he was feeling better than ever. But over the last month, scouts and front offices were treated to canceled workouts and hazy uncertainty. And, at the end of the day, it probably scared a handful of franchises away from the talented scorer. Just this week, the Kings heavily considered Porter Jr. at No. 2 overall — but even with that sudden unlikelihood passing by, few thought he’d drop out of the top ten altogether. Outside of the guaranteed money that Porter Jr. will miss out on, redshirting his rookie year may also be on the table as well.

The inherent upside with Porter Jr. is obvious, but — similarly to the Dončić issue — it’s tough to ask franchise officials to stake their livelihood on the prospect’s health. If Porter Jr.’s lingering issues stay with him and he never reaches his mountain of potential, that’s a tough pill to swallow. The 19-year-old would fall all the way down to No. 14, where the Denver Nuggets gladly scooped him up. During the combine in May, Porter Jr. called himself the best player in the draft — but it’s now up to him to prove them all wrong.

The Mysterious Men Nearly Miss Out

Let’s rewind to early April. Villanova had been just crowned NCAA champions for the second time in three years, the NBA playoffs were soundly on the horizon and mock drafts had begun to consistently pour out. Early on, there were two athletic big men that looked like shoo-ins as first-rounders: Robert Williams and Mitchell Robinson. Despite their undercooked skill-sets, both players pulled out of the combine and then waited for the hype to build — except, well, it didn’t. Williams, who was typically projected in the early teens, slipped out of the lottery entirely, only to be rescued by the Boston Celtics at No. 27. Williams is a booming, powerful prospect, but he could’ve really benefited from competing against the other top prospects in May.

Although he’s now landed in an ideal situation with Brad Stevens, Al Horford and a process-driven Celtics squad, Williams likely cost himself a whole load of money over the last 30-plus days as well.

In Robinson’s case, many believed his floor was the Los Angeles Lakers at No. 25 — rumors swirling that the 7-foot-1 center even received a promise from the illustrious franchise. Instead, Robinson dropped to the New York Knicks at No. 36 overall. Robinson had originally committed to Western Kentucky in July of 2017 before dropping out to prepare for the draft. After skipping the combine last month, Robinson indeed exhibited the potential to be both a steady shot-blocker and three-point maker during his individual evaluations. But with little to go off of but high school highlight reels and small session workout tapes, he understandably fell.

Sometimes the hype is impossible to ignore, but not participating in the combine and staying as mysterious as possible hurt these ultra-talented prospects.

While the 2018 NBA Draft wasn’t quite the trade-heavy, drama-laden extravaganza much of the world expected, there are plenty of narratives to reflect upon. At the end of the day, the ink is barely dry on this year’s festivities and it’ll be some time before there’s any indication of these successes or failures. Still, there are lessons to be learned from every draft, workout or injury process and these are four conversations worth considering as the NBA quickly rolls into the summer league season.

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2018 NBA Draft Diary

NBA Daily: The Losers of the NBA Draft

Shane Rhodes breaks down the losers of the 2018 NBA Draft.

Shane Rhodes

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The 2018 NBA Draft season has come to a close. And, while the actual draft wasn’t the fireworks show that it could have been, there was still plenty of surprises, both good and bad.

While Basketball Insiders’ Simon Hannig discussed the winners of the draft, not everyone was so fortunate. And, while the draft can come down to chance, some teams were worse off than others.

Let’s take a look at some of the bigger losers from draft night

Mikal Bridges

Talk about heartbreak.

Mikal Bridges was going home. The Philadelphia 76ers selected the Villanova standout with the No. 10 pick. Bridges did an entire press conference, talking about what it was like to be staying in Philadelphia. His mother, Tyneeha Rivers, is even the Global VP of Human Resources for Harris Blitzer Sports & Entertainment, the company that owns the team. It was perfect.

And then it wasn’t.

It’s hard to not feel bad for Bridges, who was dropped into a dream scenario and then had it all ripped away. Going to the Phoenix Suns, an organization heading in a new direction, to play alongside plenty of young, high upside talent, including No. 1 pick Deandre Ayton as well as former lottery picks Josh Jackson and Devin Booker, isn’t the worst thing in the world for the rookie forward. Bridges could even flourish in Phoenix.

But it certainly won’t compare to playing under the bright lights in Philadelphia alongside Ben Simmons and Joel Embiid come next April and for years to come.

Michael Porter Jr.

One year ago, Michael Porter Jr. was a top three draft prospect projected to go as high as No. 1 overall. However, with rumors of questionable medicals swirling throughout the draft process, he dropped all the way to the Denver Nuggets at No. 14 overall.

While Porter will certainly welcome the chip on his shoulder, the lost earnings will definitely hurt him and his pocket. Porter is missing out on millions on his first NBA contract. Plus, the sheer amount of teams that balked at his medicals doesn’t bode well for his long-term future in the NBA.

It isn’t all bad for Porter; Denver has a young, talented roster and was one win away from a postseason birth last year. They can afford to be patient with Porter’s back, should he need to miss some time, as well. Standing 6-foot-11, 211 pounds and with a smooth jumper, Porter still has a great chance to be a star in this league.

Still, it was an inauspicious beginning to what, hopefully, is a long NBA career.

Sacramento Kings

This could apply to the Sacramento Kings roster as well as their fanbase.

The Kings got “their guy” in No. 2 overall pick Marvin Bagley III. And, while Bagley is still an amazing talent, the pick just seems like more of the same for the Kings, who have a glut of bigs — Willie-Cauley Stein, Harry Giles III, Skal Labissiere, Kostas Koufos — on the roster and a distinct lack of high-quality guard or wing depth.

In steps Luka Dončić, the 19-year-old Slovenian phenom. With the Suns taking Ayton with the top pick, the Kings had their chance to shore up their backcourt for the foreseeable future alongside De’Aaron Fox and move another step closer to relevancy.

And they whiffed.

Dončić could very well end up as the best player in the class. While he isn’t the most athletic, Dončić is exactly where the NBA is going; he is a multipositional defender and playmaker that can shoot the three. Meanwhile, Bagley, who is a questionable fit in the modern game, will be hardpressed to find playing time early on in his Kings tenure. Even worse, with their hearts set on Bagley, the Kings likely could have traded down a la the Atlanta Hawks and picked up another asset for their troubles.

While it’s much too early to call it either way, this is a pick that could come back to haunt Sacramento down the line.

Cleveland Cavaliers

It was not a great night for the Cleveland Cavaliers.

The Cavaliers missed out on one point-guard prospect, Trae Young, and another, Shai Gilgeous-Alexander, flat out said he didn’t want to play for the franchise. And, even though they got a guard they liked in Alabama’s Collin Sexton, the Cavaliers are still in the unenviable position of dealing with LeBron James’ third iteration of The Decision.

Sexton’s selection doesn’t exactly help them retain James’ services either.

Since acquiring the pick from the Boston Celtics in the Kyrie Irving trade last summer, it had been speculated as to whether Cleveland would use the pick or trade it to get James help. With the team opting for the former, it’s difficult to imagine the Cavaliers getting any significant help for James, in free agency or otherwise, which could push him closer to leaving than he already may be. Meanwhile, Sexton, who dominated the ball during his time at Alabama, isn’t exactly the best fit alongside James in the event that he stays.

Either way, there appears to be a bumpy road ahead for the Cavaliers.

Washington Wizards

Troy Brown Jr. is a great pickup for the Washington Wizards. That still doesn’t mean he wasn’t a reach.

Brown is a twitchy wing that can defend multiple positions. But there were multiple wings that Washington could have taken ahead of Brown (e.g., Lonnie Walker II) that would have made this a better pick. Brown struggled as a shooter during his lone season at Oregon — he shot just 29.1 percent from three and has some iffy mechanics — and is a strange fit on the Wizards roster that already has a surplus of wing depth in John Wall, Bradley Beal, Otto Porter Jr. and Kelly Oubre.

With the team looking to move Marcin Gortat, a big would have been a better fit for Washington at 15. Or, if management was deadset on Brown, dropping back a few spots would have made more sense.

Brown certainly has the talent to make an impact, but it’s hard to like a pick that may not crack the rotation in year one, according to the Wizards own General Manager.

Toronto Raptors

The Toronto Raptors took a big step earlier this offseason, moving on from Dwane Casey and placing Nick Nurse at the helm in early June.

But, with zero picks in a loaded draft, the Raptors have to be considered losers.

There were plenty of difference makers available up-and-down the draft board, but the Raptors didn’t end up with any of them. While management could improve the team via trade or free agency come July, they still feature the same roster that got manhandled in the Eastern Conference Semifinals by James and the Cavaliers and that isn’t good.

Not everyone can come out a winner in a crapshoot like the NBA Draft. Still, some teams found themselves worse off than others when all was said and done. Luckily, those teams still have a chance to improve themselves with free agency right around the corner.

 

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