Those of you who follow fantasy sports should already know the name and outstanding work of Stephania Bell. She is a licensed physical therapist who has been helping us to understand and better estimate the injury absences and return prognostications for fantasy players for more than a decade.
On Monday, I was lucky enough to sit down with her to discuss the prognoses of several injured and/or recovering NBA stars as we move into the home stretch after the All-Star break.
Without further ado, let's get right to the action.
@ProfessorDrz hi andre. If they keep delaying paul millsap return is he a hold or a drop without an ir spot? How would you handle this situation if you do if you have paul millsap?
- Omar Kharouba (@OKharouba) February 8, 2018
I get into a lot of Twitter conversations (follow me @ProfessorDrz) about injured players, often with questions such as this one about whether to pick up/drop a given player due to their prognosis.
Millsap was originally diagnosed with injury in late November, and had surgery on his left wrist on November 26 done by Dr. Frank Scott of the University of Colorado. The original estimates said that Millsap would be out for about three months. Just doing the math, many people then started using the All-Star break as the estimated time for his return.
However, on February 7, the Nuggets announced that he was expected to make a return in early/mid-March. This is what Omar meant when he asked about Millsap's return being delayed.
However, Stephania offered a different insight. She pointed out that the initial estimates of three months were general, and there was no word of any setback. The Nuggets simply didn't give any public estimate for his return until February, when they announced the early/mid-March date.
Thus, instead of looking at it as a delay, she suggests that he could very well be returning right on schedule and at a very reasonable pace.
Based on what we know, there's no reason to believe that his return date would be delayed again unless there actually is a setback, which would likely be announced at that time. Thus, for the sake of fantasy, it's reasonable to assume that Millsap could reasonably be back on the court in some fashion by around mid-March, which would give him a reasonable chance to be productive in the fantasy playoffs.
@ProfessorDrz Should I add Millsap or Vuc? Both have been dropped because of multiple injuries on rosters. I'm 1st in the standings and they're both coming back around the same time. Thanks!
- David Rubel (@DavidRubelMusic) January 14, 2018
When I received this question last month from David, both Vucevic and Millsap were expected to return roughly around the All-Star break. At the time, I thought Vucevic was the better bet to return sooner and was having the better season before injury anyway, so I suggested that Vucevic was the one that I'd pick up.
Stephania began by completely schooling me on Vucevic's injury. He had a fracture in his second metacarpal, which she showed me on my hand corresponded to the bone that runs from the knuckle beneath my left pointer finger to my wrist. She also pointed out that the two interior metacarpals (associated with the pointer and middle fingers) move the least when making a fist, compared to the outer bones associated with the thumb or pinky.
This is actually helpful in the healing process for the interior bones. Vucevic had surgery to repair and stabilize that bone on December 26, and the expected recovery time for such a surgery is right around eight weeks. Thus, his announced return date of February 22 sounds very reasonable, and there's no reason (outside of a setback) to expect that Vucevic won't be back and contributing near full capacity by the time the fantasy playoffs begin.
Kevin Love, Cleveland Cavaliers
@ProfessorDrz thinking about offering booker and tyreke for Howard and Jrue Holiday. I lost K Love and Cousins I'm down to 1 center. Your thoughts ?
- Micah Bondon�� (@bondon_world) January 31, 2018
Love suffered a non-displaced fracture of the fifth metacarpal of his left hand, which Stephania showed me to be the bone running from the knuckle beneath the pinky finger to the wrist.
Love has previously suffered broken bones to the fourth metacarpal in 2009, and to the third and fourth in 2012 and 2013, respectively. This time, with the injury being non-displaced and to the bone beneath the pinky, it was decided that Love wouldn't have surgery.
Stephania said that the estimated eight-week return time for such an injury is pretty standard, which would put Love's return around the end of March. That return date is likely already into the fantasy playoffs in most leagues and leaves only a couple of weeks for him to contribute in roto leagues.
I rarely council fantasy managers to cut players outright, but this prognosis makes it unlikely that Love will contribute much during the remainder of this fantasy season. If you have a DL slot or the space to stash him, fine, because he does have upside to potentially provide a nice boost during the championship game, if your team makes it that far, but if you're in a shallower league and need the roster spot to produce ... well, now you've got the prognosis data to decide whether you can afford to keep him.
In the dynasty auction league that I play in, I traded for Rivers ($1 keeper) in December when he was playing great. He then got hurt, and the injury lingered for weeks and weeks.
When I asked Stephania about Rivers, he was still sidelined and there wasn't a lot of news on his return. However, before we had a chance to chat, Rivers returned and began playing starter minutes while producing again.
In her words, "It was a heel bruise. He's back now, so it's a non-thing."
Barring a setback, I'm expecting Rivers at full capacity coming out of the break.
Markelle Fultz, Philadelphia 76ers
In that same dynasty auction league, I had spent a few auction dollars to make Fultz my rookie to build around for the next few years. As such, you can imagine the sinking feeling that I've had this season, as Fultz has very publicly gone through injury and recovery issues that had many pundits claiming loudly that there may be some sort of conspiracy and/or incompetence keeping him on the sidelines.
Stephania had a lot to say about Fultz and his injury. She pointed out that the original diagnosis of scapular muscle imbalance (SMI) is actually a very common thing among athletes. She analogized it to runners dealing with hamstring issues, in that both injury types are ubiquitous and broad enough to encompass a wide variety of outcomes. She pointed out that often, injuries that we may be more used to hearing about (e.g. shoulder bursitis) are actually symptoms that were caused by other factors, with SMI as one of the more common causes.
As that relates to Fultz and his potential future fantasy contributions, Stephania pointed out that it was possible for the SMI to be healed enough to allow Fultz to function at a seemingly normal level across many activities but still require re-education of the muscles that could lead to shoulder soreness when introducing higher levels of activity.
As such, Fultz' continued absence is not necessarily related to any of the negative claims that pundits have made, nor even necessarily a setback -- it could very well be that Fultz is progressing reasonably but that the recovery time for full capability was longer than expected.
It is difficult to count on Fultz for much fantasy production this season. However, Stephania doesn't see anything in the published information about Fultz's injury and rehab process to make her worry about his outlook moving into next season. Thus, it's possible that drafting him in my dynasty league could still pay dividends down the road.
D'Angelo Russell, Brooklyn Nets
@ProfessorDrz hi andre. Would you still take a chance on d angelo russell since Spencer d is starting?
- Omar Kharouba (@OKharouba) February 3, 2018
Russell suffered a knee injury on November 11, had arthroscopic surgery on November 17, and didn't return to game action until January 19. Russell has not started a game since his return and has been on a clear minutes restriction. He played 15 minutes or fewer during his first three games back, 16-24 minutes during his next seven games, and 25-32 minutes during his past three contests before the break.
Since the injury was to his lower body, Russell was unable to keep his cardio level up the way that someone with a hand or wrist injury might be able to.
Stephania confirmed that when it comes to injuries like Russell's, this kind of minutes restriction and graded buildup in playing time is both normal and the right thing to do for the best long-term health outcome.
Russell was back near his typical starter minutes before the break, and if he isn't starting and playing full minutes immediately after the break, it's likely that he gets back there very soon.
Kawhi Leonard, San Antonio Spurs
@ProfessorDrz Your advice has not been wrong for me yet. Any (usually higher tier players, minus kawhi) players that value will climb over the second half that I could trade for? Thanks so much
- Ethan Yablon (@YablonEthan) January 13, 2018
Leonard is a huge mystery. The biggest mystery of the players in this list, actually. The Spurs have traditionally been very careful and forward-thinking with their players, moreso than any other NBA organization. Tim Duncan was the first superstar player whom I remember being on any kind of minutes ration, and that was more than a decade ago. Thus, it follows that the Spurs would be cautious and forward-thinking with Leonard through this process as well.
Leonard has quad tendinopathy, which Stephania indicated is the correct term to use and not "tendonitis", the term that we hear more often. Tendinopathy is a disease in the tendon, which causes pain and potential weakness.
Stephania showed me the quad tendon on my leg: It runs down the front of the thigh, narrowing to move through the knee and then, on the other side of the knee, is continuous with the patellar tendon. Thus, quad tendinopathy would very likely cause chronic pain in the upper knee area, which would make it very difficult to play through with any sort of confidence, because any knee soreness is considered dangerous.
Plus, Leonard's teammate Tony Parker dealt with a quad tendon rupture just last season, and though he has since returned to game action, it's been at a significant attenuation from what he used to be. This also could play a part in the Spurs' care for Leonard, as well as Leonard's concerns as he tries to return from this injury.
Given all of these factors, and that so much of Leonard's current level of function has not been made public, it is very difficult to estimate with any confidence that Leonard will return in time to contribute to fantasy teams this season.
I have him on a couple of teams, and at this point, I feel somewhat pot committed to him because I've held on for so long, but Leonard's outlook is very guarded for the rest of this season.
Sounds like John Wall is out for the next six weeks due to a knee issue https://t.co/RJSaHNvxSv
- Andre Snellings (@ProfessorDrz) January 30, 2018
Wall had a left knee surgery on January 31 and was scheduled to be out 6-8 weeks. The surgery was arthroscopic, and the exact procedure was unclear, though it was described as a clean-up procedure.
Wall announced this past weekend that he is no longer using crutches but has not started running or taking part in basketball activities yet. He also made a statement about his recovery timetable that, "right now it's between 6-8 weeks".
There is ambiguity in that statement. If he was just saying that he's still on the original timetable, then he could be able to return in mid-to-late March. If, on the other hand, he was resetting the time outlook as of this weekend, it would make his return unlikely before the end of the regular season.
Without knowing the details of the exact surgery that was done, Stephania suggested that the original timetable was likely reasonable and that, unless news of a setback is released, it's reasonable to expect that rough timetable to hold ... for now.
She suggested that seasonal factors could really play a role in his timetable. If the Wizards were to completely fall out of the playoff picture it would make sense to re-evaluate whether his return this season would be warranted. However, the Wizards have played well enough in Wall's absence to actually rise to the fourth seed in the Eastern Conference, with a five-game cushion on the ninth-place Detroit Pistons, so it seems likely that they will continue to factor into the playoffs picture.
As such, given the original prognosis, it is reasonable to think that Wall could be back on the court on some level during the fantasy playoffs. However, like Love, his return is potentially late enough that it is worth wondering whether his potential contributions are worthy of an active spot on rosters in shallow leagues.
Isaiah Thomas, Cleveland Cavaliers
Isaiah Thomas looks like a #FantasyBasketball winner in this trade, because he can be more ball dominant and shoot out of slump on team w/o championship pressure this year...assuming he gets run. Ironic that trade to Lakers means less eyes and pressure on IT @ESPNFantasy
- Andre Snellings (@ProfessorDrz) February 8, 2018
Thomas is a mystery wrapped in an enigma. His poor play after returning from a major hip injury was enough to get him traded from the Cavaliers, and now he's on a Los Angeles Lakers team that could use his scoring ability but that is committed to a rookie point guard in Lonzo Ball who is likely to return from his own injury immediately after the break. So ... what should we expect from Thomas moving forward?
It's unclear. Stephania points out that he had a good game in his first outing for the Lakers, which suggests that the hip isn't precluding him from being able to reach a certain positive level of scoring. However, he had an awful game in his only other full outing in a Lakers' uniform prior to the break.
What isn't clear is how much of his struggles are due to rust or continued struggles in adjusting to the hip, and how much may have been from external issues such as a poor fit in Cleveland and/or questions about his role for the Lakers.
Personally, I think back to Sam Cassell. The veteran point guard injured his groin/hip in the 2004 playoffs, then returned for the 2004-05 season wanting a contract extension from the Minnesota Timberwolves. The Wolves didn't give him one, and he had a horrible season. Then, they traded him for pennies on the dollar the following offseason, and he returned for the Clippers for 2005-06 and had a terrific season.
Outside of the fact that both are dealing with hip injuries, there's nothing to necessarily connect Thomas' prognosis with Cassell's. However, there are enough similarities there that I tend to give Thomas the benefit of the doubt, after his own trade for pennies on the dollar, as he tries to earn himself another contract.
There's no way to know if, or by how much, Thomas will recover after the break. But for me, personally, I'm buying on the Little Giant more than I'm selling. It's speculative on my part, but I figure that his value is low enough now, that if he can be acquired, it's likely at a low enough price that it's worth it (to me) to take the risk on upside.