New story for @TheAthleticNBA: I spoke with Dr. Rajpal Brar, DPT (@3cbPerformance) last night about Anthony Davis’ Achilles strain, why the injury might not be tendonosis, why he was cleared to play and what a potential timetable looks like.https://t.co/WdNh1K2FZM
— Jovan Buha (@jovanbuha) February 15, 2021
To better understand Davis’ injury, The Athletic reached out to Dr. Rajpal Brar, DPT, a physical therapist, sports scientist and data analyst from 3CB Performance. Brar specializes in lower body treatment, particularly dealing with the foot and ankle areas.
Based on Davis’ comments from last week about his injury not being to his Achilles tendon but rather the surrounding area, and his relatively quick return, Brar speculates that Davis could have tenosynovitis, which is inflammation of the sheath surrounding the tendon.
“That’s a lot easier to handle because it’s just trying to manage the inflammation and irritation in that area,” Brar told The Athletic. “Whereas if there’s actual tendonosis, and breakdown of the tendon, then it can be a little bit more sensitive, and you’re worried about the actual structure of the tendon.”
Brar is familiar with the type of testing that Davis would have had to have passed to be cleared to play. With Davis passing all of the checks and saying he felt good, Brar reasons that the Lakers made the right decision to allow Davis to play.
“Based off those indicators, and they probably looked at how he’s moving before the game as well, I mean, you have to go off that,” Brar said. “Sometimes just resting to rest, when there’s no indication for it, also isn’t the best move either. …
“The outcome isn’t always what you want, but that’s medicine. There’s always a gray area.”
The MRI results will dictate the next steps of Davis’ rehab. The term “strain” is more of a catch-all phrase than a diagnosis, Brar says.
“There’s no way for them to actually know that until they do imaging,” Brar said. “Yes, they would know if it’s a complete rupture. There’s a test called the Thompson test. But strain, again, sounds very much just like a general term they’re using.”
Davis said he plans on being “smarter” with his recovery, including potentially upping his treatment from three times a day to five times a day.
He iced his leg after the game, and put heel lifts in his shoe to take the stress off of the Achilles area. He played with extra padding in his shoes against the Grizzlies and Nuggets. At night, he’s been sleeping with a sleeve that helps keep his Achilles flexed so it doesn’t shorten.
Additionally, Davis admitted that, in these scenarios, he puts pressure on himself to play through injuries because of his injury-prone label and his competitive desire to help the Lakers win.
“It’s something I’ve kind of been dealing with my whole career, just having that injury bug,” Davis said. “And I overcame it last year, even my last couple years in New Orleans, just playing through injuries and knowing what my body can take, knowing what it can handle and if it’s something minor, I’ll go out there and play. And I even felt like I was fine enough to go out there and play the other day against Memphis with this same injury.
“But this injury is a little different. Because it is an Achilles and you definitely want to make sure it doesn’t lead to anything worse. But I do put a lot of pressure on myself to go out there and play. If I feel I can go out there and play, I will. Just for the simple fact that I want to be able to help my team. And I can help my team from the sidelines, but I think I’m more effective when I’m on the floor. And they pay me to play. I go out there and try to compete at the highest level and do what I can to help this team. And so, if that means me going out there and playing through some minor bumps and bruises, then that’s what it is.
“But this one is a little different that I definitely have to be smart with. I don’t want to go out there and try to play and risk it for the long term. So, all that is inclusive of what the MRI shows tomorrow. Knock on wood, it’s great information and I’ll be out there sooner than later.”
As for Davis’ timetable to return after his re-aggravation, Brar thinks the Lakers will factor in how easily Davis tweaked the injury in-game and be more careful.
“That can indicate that even though he’s having these positive checks, he is more irritable, more sensitive than you might have thought, which, then, of course, gives you a little bit of pause and you have a more cautious approach this time,” Brar said. “And so I think it’s gonna be multiple weeks.”
Multiple weeks would keep Davis out through at least the All-Star break, which ends March 10. The Lakers have nine games between now and when their first half of the season ends on March 3. As long as the MRI doesn’t reveal more serious damage, Brar estimates that a post-All-Star break return would be an adequate recovery for Davis’ potential tenosynovitis.
“It might make sense, I know it’s kind of arbitrary, but giving him that time off until after that break,” Brar said. “So he does have that downtime as well. That would make sense to me if they’re taking that especially cautious approach.”
If Davis misses an extended period of time, the Lakers will collectively try to make up for his offensive production, with the increased burden falling on James, Dennis Schröder, Montrezl Harrell, Kyle Kuzma and Talen Horton-Tucker. Kuzma started in Davis’ place in the second half on Sunday, and finished with 19 points and eight rebounds in 26 minutes.
“Kuz was great tonight,” Vogel said. “He stepped in, obviously, and made shots when guys were struggling to make shots. Always plays extremely hard, with great energy. … But we got a lot of guys that will step up if AD misses some time. The guys will step up. It’s not going to fall on any one person. We got a lot of firepower and a lot of resources.”
Here is the Lakers’ upcoming nine-game schedule before the 2021 All-Star break.
Minnesota Timberwolves, Away, Feb. 16
Brooklyn Net, Home, Feb. 18
Miami Heat. Home, Feb. 20
Washington Wizards, Home, Feb. 22
Utah Jazz, Away, Feb. 24
Portland Trail Blazers, Home, Feb. 26
Golden State Warriors, Home, Feb. 28
Phoenix Suns, Home, Mar. 2
Sacramento Kings, Away, Mar. 3
It’s a difficult slate, with especially tough matchups against several solid playoff teams (Trail Blazers, Warriors and Suns) and contenders (Nets and Jazz). The stretch even includes a Finals rematch with the feisty but hobbled Heat.
But the Lakers’ priority is Davis’ long-term health. Los Angeles’ seeding won’t matter if Davis isn’t available or is physically compromised by the start of the playoffs in late May. And as we’ve seen throughout NBA history, Achilles tears and ruptures are typically career-altering injuries.
The Lakers need to take the long view. They recently re-signed Davis to a five-year max deal. He’s the foundation of the franchise post-LeBron. They theoretically can’t be cautious enough with his health and this particular injury.
In the short term, the Lakers are optimistic they can use a next-man-up mentality to continue to win games at a high level, maintaining their spot in the standings.
“We’ve played games without him and we’ve won games without him,” Vogel said. “If he’s going to miss time, which we don’t know yet, we’ve got plenty of firepower to win games.”
He’s out 2-3 weeks, likely until after the break. ESPN has it.
Good article and great inside info from Raj on his injury.