A lot of sports fans and sports gamblers held their breath a few weeks ago when the 76ers faced the Washington Wizards. A week prior, Joel Embiid was listed as the favorite to win the MVP this year. That will be more challenging now.
Following a dunk, Embiid landed awkwardly on his left leg. By awkward, I mean he experimented with bending his knee in the opposite direction.
As you can imagine, he did not enjoy the experience.
Embiid immediately fell to the court in severe pain. The first positive sign was his ability to walk of the court on his own power – with a noticeable limp, however. The second positive sign was the MRI result.
Embiid did not suffer any structural damage to his ACL or meniscus – the injuries players, fans, and coaches most feared. He did, however, suffer a “deep” bone bruise.
Many fans were left wondering the prognosis.
How soon will he return to court? Will he be 100%? Will he be at a greater risk for future injury?
Having returned last night – scoring 24 points in 29 minutes of play – we know the answer to the first question. The others still need to be addressed.
Initial reports predicted Embiid would miss two weeks of competition – he ended up missing three weeks and 10 games. There is an important caveat to the prediction and recent return. Returning to the court does not mean he will perform at the same level as pre-injury.
While 24 points in 29 minutes is impressive, it came with four turnovers hitting only six of 14 shots. He has some rust to knock off. This is done both in game and in rehab.
No, his rehab isn’t over. To better understand Embiid’s rehab, we need to understand the injury.
A bone bruise – or contusion – results in swelling in the area. This trapped fluid – also known as edema – can limit muscle activation. The damage to the bone will also be painful, limiting Embiid’s ability to bear significant weight. He can walk, but running and jumping are out of the question for a couple of days.
NBA basketball is one of the most demanding sports in the world. It requires substantial power and endurance, as players must frequently sprint and jump. Any extended time off will lead to deconditioning.
The bone must heal enough to allow for running and jumping. Research suggest most of the healing occurs within the first 2 weeks following an injury, however, full healing will require 6 months-1 year most likely. It’s worth noting that, as a professional athlete, Embiid will have every resource at his disposal to expedite recovery.
The other thing to remember is Embiid does not need to be fully healed to return to the court. This is where art meets science.
This is tough to know.
His minutes were limited in his first game back and that will likely for several games. He needs to build up his endurance to in-season levels. He may be a little less powerful as he will need a few weeks to restore strength and power lost from his brief period on inactivity.
Yes, loss of muscle, strength, and power can happen fast, but they are restored faster after the second time compared to the first. This process is known as the reversibility principle. Just remember, we lose gains faster than we gain them. It will take longer than three weeks for Embiid to return to pre-injury form.
The other consideration is the psychological side of injury. In a recent study in the Journal of Athletic Training, researchers found psychological readiness displayed a predictive ability for return to preinjury level of sports, while conventional return top sport tests did not. Emotions related to returning (eg, fear and frustration), confidence in sports performance, and appraisal of reinjury risk must be considered. Traditional return to sport measures of strength, power, education, range of motion, and functional testing – such as triple hop test, broad jump, and single-leg hop – are not enough.
It may take Embiid time to return to his dominating self as he builds confidence in his leg. There is no precise timeline.
With any injury, athletes need to weigh the risks and rewards. In Embiid’s case, is rushing back to support the first place 76ers putting his long-term health at risk?
I don’t think so.
Yes, his odds of future cartilage degeneration increases – by how much I can’t definitely say – but his size and activity already increase his risk for future degeneration.
On the flip side, he has remarkable cardiorespiratory fitness, substantial muscle, and little fat. He is firmly entrenched in the healthy side of the health scale.
The greater concern is his increased injury risk this year.
Injuries are multifactorial. I have covered many of the issues already. Fatigue, strength, power, anxiety, fear of movement, and previous injuries all contribute to injury risk. If Embiid returns too quickly and is not fully prepared, the risk increases.
There are plenty of examples of athletes making remarkable returns to the field only to suffer a new injury soon after. Tua Tagovailoa and Jerry Rice are the first that come to mind.
There is no way to completely prevent injuries except for avoiding the sport altogether. There is zero chance Embiid retires due to this injury. He and his rehab team will have to design a personalized approach and be willing to call audibles as needed.
He certainly can. Will he? I don’t think so.
The race is very tight. LeBron James and Nikola Jokic were on his heels pre-injury. With LeBron’s recent injury, he is likely out but Harden has joined the race. If Embiid had a substantial lead, perhaps he could have still won. Maybe MVP voters will take the injury into account and still give him the award, provided he returns to MVP form quickly. This will be a challenge.
A championship is more important than an MVP. The 76ers will manage Embiid carefully, ensuring he is 100% for the playoffs.
Embiid should return to 100% at some point this season, but it is likely the injury will limit him enough to stop him from winning the MVP.
The NBA championship is still within reach.
I don’t think Embiid will be too concerned about losing out on the MVP if his team brings home the ultimate prize.
Zach has numerous research publications in peer-reviewed rehabilitation and medical journals. He has developed and taught weekend continuing education courses in the areas of plan of care development, exercise prescription, pain science, and nutrition. He has presented research at numerous national conferences including APTA CSM, APTA NEXT, and the ACRM annual conference.
Zach is an active member of the Orthopedic and Research sections of the American Physical Therapy Association and the Physical Therapy Association of Georgia. He currently serves on the APTA Science and Practice Affairs Committee and the PTAG Barney Poole Leadership Academy.
