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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



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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Middleton, Bucks Aiming To ‘Lock In’ As Season Comes To Close

Spencer Davies catches up with Milwaukee Bucks swingman Khris Middleton in a Basketball Insiders exclusive.

Spencer Davies



Basketball Insiders had the chance to chat with Khris Middleton about the direction of the Milwaukee Bucks as the season comes to a close.

You guys won three out of four before you came into Cleveland. What was working during that stretch?

Just being us. Doing it with our defense, playing fast-paced offense. Just trying to keep teams off the three-point line. We haven’t done that. We didn’t do that [Monday] or two games ago, but it’s something we’ve just gotta get back to.

With the offense—it seems like it’s inconsistent. What do you think that’s got to do with mostly?

Just trying to do it by ourselves sometimes. Standing, keeping the ball on one side of the floor. We’re a better team when we play in a fast pace. And then also in the half court, when we move the ball from side-to-side it just opens the paint for everybody and there’s a lot more space.

For you, on both ends you’ve been ultra-aggressive here in the last couple weeks or so, does that have to do with you feeling better or is it just a mindset?

I’ve been healthy all year. Right now, it’s the end of the season. Gotta make a push. Everybody’s gotta lock in. Have to be confident, have to be aggressive. Have to do my job and that’s to shoot the ball well and to defend.

Have you changed anything with your jumper? Looking at the past couple months back-to-back, your perimeter shooting was below 32 percent. In March it’s above 45 percent.

I feel like I got a lot of great looks earlier this year. They just weren’t falling. Right now, they’re falling for me, so I have the same mindset that I had when I was missing and that’s to keep on shooting. At some point, they’re gonna go down for me.

Is knowing that every game at this point means more an extra motivator for you guys?

Definitely. We’re basically in the playoffs right now. We’re in a playoff series right now where we have to win games, we have to close out games, in order to get the seeding and to stay in the playoffs. Each game and each possession means something to us right now.

Is it disappointing to be in the position the team is in right now, or are you looking at it as, ‘If we get there, we’re going to be alright’?

I mean, we wish we were in a better position. But where we’re at right now, we’re fine with it. We want to make that last push to get higher in the seeding.

Lots of changes have gone on here. Eric Bledsoe came in two weeks into the season. You had the coaching change and lineup changes. Jabari Parker’s been getting situated before the postseason. How difficult does that make it for you guys to build consistency?

Yeah, it was tough at first. But I think early on we had to adjust on the fly. We didn’t have too many practices. There was a stretch where we were able to get in the film room, get on the court, and practice with each other more.

Now it’s just at a point where we’re adding a lot of new guys off the bench where we have to do the same things—learn on the fly, watch film. We’re not on the court as much now, but we just have to do a great job of buying in to our system, try to get to know each other.

Does this team feel like it has unfinished business based on what happened last year?

Definitely. Last year, we felt like we let one go. Toronto’s a great team. They’re having a hell of a season this year, but I feel like we let one go. This year’s a new year—a little add of extra motivation. We’ve been in the playoff position before, so hopefully, we learn from it when we go into it this year.

Would you welcome that rematch?

I mean, we welcome anybody man. We showed that we compete with any team out here. We can’t worry about other teams as much. We just have to be focused on us.

What has to happen for you guys to achieve your full potential?

Lock in. Just play as hard as we can, play unselfish, and do our job out there night-in, night-out.

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NBA Daily: Raptors Look To Fine-Tune The Defense

The Toronto Raptors’ defense had a letdown against the Cavaliers, but has been outstanding overall.

Buddy Grizzard



The Cleveland Cavaliers and Toronto Raptors engaged in an offensive shootout on Wednesday that could be a playoff preview. The Cavs protected home court with a single-possession, 132-129 victory. Afterward, the Raptors spoke about the types of defensive adjustments the team needs to make as the postseason rapidly approaches.

“That’s how a playoff game would be,” said DeMar DeRozan, who missed a three at the buzzer that could have forced overtime. “This is a team we’ve been playing against the last two years in the postseason. Understanding how we can tighten up things defensively, how to make things tougher for them [is key].

“[It’s] little small things that go a long way, and not just with them … with every team.”

Raptors coach Dwane Casey concurred with DeRozan that fine-tuning of the defense is needed. He also pointed out that, with young contributors such as center Jakob Poeltl and power forward Pascal Siakam on the roster, defensive experience against the league’s best player, LeBron James, is something they will have to gain on the fly.

“I don’t think Jakob Poeltl played against him that much, and Siakam,” said Casey. “This is their first time seeing it. I thought Jak and Pascal did an excellent job, but there are certain situations where they’ve got to read and understand what the other team is trying to do to them.”

Poeltl was outstanding, leading the bench with 17 points and tying for the team lead in rebounds with eight. Casey praised the diversity of his contributions.

“I thought he did an excellent job of rolling, finishing, finding people,” said Casey. “I thought defensively, he did a good job of protecting the paint, going vertical. So I liked what he was giving us, especially his defense against Kevin Love.”

Basketball Insiders previously noted how the Raptors have performed vastly better as a team this season when starting point guard Kyle Lowry is out of the game. Much of that is due to Fred VanVleet’s emergence as one of the NBA’s best reserve point guards. VanVleet scored 16 points with five assists and no turnovers against Cleveland. It’s also a reflection of how good Toronto’s perimeter defense has been up and down the roster.

According to ESPN’s defensive Real Plus-Minus statistic, three of the NBA’s top 15 defensive point guards play for the Raptors. VanVleet ranks seventh while Lowry is 12th and Delon Wright is 14th. Starting small forward OG Anunoby ranks 16th at his position.

The Raptors also rank in the top five in offensive efficiency (third) and defensive efficiency (fifth). Having established an identity as a defensive team, especially on the perimeter, it’s perhaps understandable that Lowry was the one player in the visiting locker room who took the sub-standard defensive showing personally.

“It was a disgraceful display of defense by us and we’ve got to be better than that,” said Lowry. “We’ve got to be more physical. They picked us apart and made a lot of threes. We’ve got to find a way to be a better defensive team.”

Lowry continued the theme of fine-tuning as the regular season winds down.

“I think we’ve just got to make adjustments on the fly as a team,” said Lowry. “We can score with the best of them, but they outscored us tonight. We got what we wanted offensively. We’re one of the top teams in scoring in the league, but we’re also a good defensive team.”

Lowry was clearly bothered by Toronto’s defensive showing, but Casey downplayed the importance of a single regular-season game.

“We’ve got to take these games and learn from them, and again learn from the situations where we have to be disciplined,” said Casey. “It’s not a huge thing. It’s situations where we are that we’ve got to learn from and be disciplined and not maybe take this step and over-help here. Because a team like that and a passer like James will make you pay.”

While the Raptors continue to gain experience and dial in the fine defensive details, Casey was insistent that his players should not hang their heads over falling short against Cleveland.

“Hopefully our guys understand that we’re right there,” said Casey.

The Raptors host the Brooklyn Nets tonight to open a three-game home stand that includes visits from the Clippers Sunday and the Nuggets Tuesday. After that, Toronto visits the Celtics March 31 followed by a return to Cleveland April 3 and a home game against Boston the next night. With three games in a row against the other two top-three teams in the East, the schedule presents plenty of opportunities for the Raptors to add defensive polish before the playoffs begin.

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NBA Daily: Jaylen Brown Set To Return For Celtics

The Celtics finally got some good news on Thursday. Jaylen Brown’s return is imminent.

Moke Hamilton



Finally, some good news for the Boston Celtics.

Jaylen Brown is set to return to action.

Brown has been M.I.A. since sustaining a concussion during the team’s 117-109 victory over the Minnesota Timberwolves back on March 8, but has traveled with the team to Portland and is expecting to return to the lineup on Sunday when the Celtics do battle with the Sacramento Kings.

As the Celts gear up for a playoff run, which they hope will result in them ending LeBron James’ reign atop the Eastern Conference, they’ve picked the wrong time to run into injury issues. Along with Brown, both Kyrie Irving and Marcus Smart have each been conspicuous by their absences, and the team could certainly use all of their pieces as they attempt to enter the postseason on a high note.

Fortunately for Boston, with the Toronto Raptors leading them by 4.5 games in the standings and the Celts ahead of the Cleveland Cavaliers by a comfortable six games, Brad Stevens’ team is enjoying the rare situation of having a playoff seed that appears to be somewhat locked in.

Still, with the team only able to go as far as its young rotation will carry it, Brown addressed the media on Thursday.

“I’m feeling a lot better. I’m just trying to hurry up and get back,” Brown said, as quoted by

“I’m tired of not playing.”

Stevens is probably tired of him not playing, too.

As we head into the month of April, playoff-bound teams and conference contenders begin to think about playing into June, while the cellar-dwellers and pretenders begin to look toward the draft lottery and free agency.

What’s funny is that in the midst of the Raptors and their rise out East, the Celtics and their dominance has become a bit of a forgotten storyline. When Gordon Hayward went down on opening night, the neophytes from the Northeast were thought to be a decent team in the making whose ceiling probably wasn’t anywhere near that of the Cavs, the Raptors and perhaps even the Washington Wizards.

Yet through it all, with the impressive growth of Jaylen Brown, impressive rookie Jayson Tatum and the rise of Irving as a franchise’s lynchpin, the Celtics stormed out the games to the tune of a a 17-3 record. What made the strong start even more impressive was the fact that the team won 16 straight games after beginning the season 0-2.

Although they weren’t able to keep up that pace, they began the month of February having gone 37-15 and turned a great many into believers. With their spry legs, team-first playing style and capable leader in Irving, the Celtics, it was thought, were a true contender in the Eastern Conference — if not the favorite.

Since then, and after experiencing injuries to some of its key cogs, the team has gone just 11-8.

In the interim, it seems that many have forgotten about the team that tantalized the Eastern Conference in the early goings of the season.

Brown’s return, in one important respect, will signify a return to Boston’s prior self.

With Marcus Smart having recently undergone surgery to repair a torn tendon in his right thumb, he is expected to be out another five weeks or so, meaning that he’ll likely miss the beginning of the postseason.

As for Irving, although reports say that his ailing knee has no structural damage, everything the Celtics hope to accomplish begins and ends with him. FOX Sports 1’s Chris Broussard believes that it’s no slam dunk that Irving returns to action this season, but he’s in the minority. This team has simply come too far to not give themselves every opportunity to compete at the highest level, so long as doing so doesn’t jeopardize the long term health of any of the franchise’s cornerstones.

Make no mistake about it, the Celtics are far from a finished product. With their nucleus intact and flexibility preserved, they will have another offseason with which to tinker with their rotation pieces and plug away at building a champion.

But here and now, with what they’ve got, the Celtics are much closer than any of us thought they would be at this point.

And on Sunday, when Jaylen Brown rejoins his team in the lineup, to the delight of the Boston faithful, the Celtics will be that much closer.

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