When is Steph ready?
Huge decision
The Warriors were a dynasty. After trading for Jimmy Butler at the trade deadline, perhaps they’re still the ghost of one.
By and large, when your stars are old, your salary’s insane, and you barely make the playoffs, you should make the hard choice, trade away the big names, hoard draft picks, and commence the rebuild.
But the Warriors did the opposite this year. They traded for another old star. The only possible reason for that is an ardent belief that there just might be a way to nab 37-year-old Stephen Curry one more title as a Warrior.
Hail Mary plays are rational when there’s no rational path to victory. This was always a riverboat gamble. It’s against-all-odds just to continue to exist in the NBA at 37. To be not only healthy, but an elite contributor is, historically speaking, a damn miracle.
But when the Warriors had, by some measures, the NBA’s best defense, a lead in the second-round, and a reinvigorated offense swirling around Steph, Jimmy Butler, and the fiery fingertips of Buddy Hield … the whole thing seemed interesting. If you’ve seen the NBA ever, or the Courts of Gold docuseries, you know how tough it is to bet against Stephen Curry.
A few days ago, Vegas gave the Warriors about a five percent chance of winning this year’s title, which in a 30-team league is not bad. Daryl Morey has said in the past that’s his threshold to go all in.
Then Steph grabbed for his left hamstring and left the game. Other than “not immediately” no one knows when he’ll return. (As of yesterday, he had yet to return to standing still and shooting.) The Wolves tied the series Vegas slashed the Warriors’ chances to about half what they were. Every other team still in the playoffs has way better odds.
A bouncy Steph back in uniform, though, would change everything.
Which means that right now the Warriors training, medical, and performance staff is standing around, sifting through limited insight, and noodling with a return-to-play decision that will do a lot to decide whether or not the greatest Warrior of all time gets another crack at a title.
Play it too conservatively, hold him out an extra few days, and you might be keeping Steph from ever playing in another conference finals.
Bring him back too soon, though, and wow. He really might incur the injury that defines the latter stage of his career. It’s already certain he will stop being elite some year soon. That’s how age works. A compounding set of hamstring strains could carry ominous implications; two hamstring injuries generally have much worse outcomes than one. The hamstring is a wonderful rubber band when it’s healthy. Strains can leave scar tissue, scar tissue is much more brittle. It calls on the adjacent tissue to stretch even more.
And if the same injury’s happening again and again, there might be an unaddressed biomechanical oddity upstream. Stephen Curry is decades into stabbing his left leg far out from his body without straining anything. What’s different now? Landing safely is a story of many muscles coordinating smoothly. Ankles, knees, and hips ideally bend synchronously to share the load. If one joint underperforms in attenuating that force, the math is that the other two take on extra load. Sometimes it’s too much. Did something get weak or tight in Steph’s ankle, knee, or hip that makes this once-routine movement hard on his hammie? Is that fixed?
Bet that the Warriors are hyper-attuned to the potential for re-injury. They’ve been here before. They still have most of the same staff they had from Kevin Durant’s return-to-play hellscape.
In case you have forgotten: Durant strained his right calf in a scary way early in the 2019 playoffs. The Warriors were super banged up. Kevon Looney’s shoulder, Klay Thompson’s hamstring … Kevin Durant watched in street clothes as Steve Kerr and the gang somehow patched together a path to the Finals.
When the Warriors struggled against the Raptors, the team’s loudest voices--Curry, Kerr, Draymond and others--started dropping public hints urging Durant back to the court. (Their savior was right there, if only he’d play through pain like Klay.)
What happened next proved perfectly that the NBA is terrible at preventing injury. LeBron didn’t make the Finals after suffering an MCL sprain in his left knee. Kawhi Leonard starred in the Finals after making news all season pissing people off for sitting out so many games to keep healthy.
With the Warriors on the ropes and on the road, down 3-1 to the Raptors in the 2019 Finals, Durant did what every pundit seemed to demand: he started Game 5. 12 minutes in, he tore the Achilles which is contiguous to the very calf he had been nursing. (The pundits grew quiet.) The next game, the very tough Klay Thompson tore his ACL, and then even played a little more on that leg. The Raptors won the title.
Kawhi had looked so bad to so many by playing only 69 of his team’s two seasons prior. But Durant played just 35 of his team’s next 164 games. Klay didn’t play a single game for two years and has been a little worse ever since. Prevention is valuable.
So the more-than-a-million-dollar question today is: how will we know when it’s safe for Stephen Curry to return to the court?
Now we’re entering the province of the book, BALLISTIC, that I have been working on for the last few years. There’s an epochal shift lurking behind the book. Mark my words: MRIs and scans will soon stop being the dominant dataset in these conversations. They’ll be supplanted by granular movement data, and the world will be far better for it.
Ballistic traces the life mission of Marcus Elliott M.D. as he searched voraciously through disciplines--biochemistry, physiology, neurology, athletic training, more--looking for the signals that are upstream of the injuries that ruin sports.
What Marcus and his team at the Peak Performance Project (P3) learned is that non-contact injuries are by and large caused by the massive forces of landing, and dangerous landings are best assessed with force plates in the floor and a ring of infrared cameras in the ceiling. P3 collects nearly a million data points per athlete assessment, and can easily see not only risks to superstar hamstrings, but other risks that might follow. For instance, it would be absolutely common for Steph, after this injury to his left leg, to land extra hard on the right for a while, which could inspire other injuries.
The question of return-to-play has lurked over sports forever. Past injury remains a leading predictor of future injury, which tells us our existing systems leave a lot to be desired. In some cases, the team at P3 feels it’s easy to see the shortcomings of the existing protocols. For example, surgeons often clear players to return from ACL surgery when the affected leg is 90 percent as strong as the other leg. But when they’re assessing that, Marcus notes, the other leg is profoundly detrained from all the time off. (And even at 100 percent, it clearly wasn’t teflon.)
More importantly, such a simple assessment denies the complex symphony of full-tile NBA basketball. Safe landings are a story of dozens of muscles working with brilliant precision timing.
What P3 would recommend, with a bit of urgency, is that a player like Steph would have rigorous baseline assessments on the servers, taken every few months for years. If those assessments are on P3’s servers, they could compare Steph’s movement to a thousand other NBA players, or hundreds of other guards, and know how his lateral slides, jab steps, and braking ability compare right now to the very players he’ll be guarding when he’s back on the court. If those assessments are only on the Warriors servers, though, the team could at the very least follow P3’s tip-top recommendation: return Steph to play when Steph moves like Steph. When he landed well, his left ankle moved in a certain range of motion, and absorbed a certain number of Newtons of force. Can he still do that? And so on, up through his body.
There’s a story in Ballistic about when Derrick Rose returned from ACL tear. The breathless media reports hyped all the muscle he had added, and how much higher he was jumping. In Marcus’s view, those were unimportant measures. Instead, the key was to see if he had developed risky new compensation patterns. Ten games into his return, Rose tore the meniscus in his other knee, which ultimately proved to be more troublesome. He was never an MVP candidate again. These sports tragedies keep Marcus up at night.
A few years later, another Bulls guard coming off an ACL surgery, Zach LaVine, was also said to be jumping five inches higher. Overwhelmed by the nature of history repeating itself, Marcus called the Bulls who were receptive. LaVine returned to Santa Barbara, went through a full assessment, and emerged as an amazing mover with a ton of new injury risks to his uninjured leg.
P3 recommended a delay in LaVine’s return to play, as he took on new kinds of workouts. LaVine did ankle hops, pogos, and skaters to retrain LaVine’s ground-foot interactions; calf raises and isometric calf holds to increase ankle stiffness; and an array of posterior chain work to encourage LaVine’s hips to absorb the force of landing. It took several weeks, but LaVine’s P3 assessment numbers improved dramatically, and he returned to the court and played several years without a meaningful injury.
The new NBA collective bargaining agreement includes granular movement assessments for every player four times a year. The league is on board with the P3 approach. But it’s just getting off the ground; the facilities are being installed, and the systems calibrated. Everyone knows what the future of return-to-play decisions will be like. The question for Steph and the Warriors, though, is how do they handle this in the present?
Thank you for reading TrueHoop! Learn more about Ballistic here.
terrific article. Thanks.