Could Love return before playoffs are over? It's possible, says doc
http://www.cbssports.com/nba/writer...e-the-playoffs-are-over-its-possible-says-doc
LOS ANGELES -- With the news Monday that Cavaliers forward Kevin Love is out for at least the entire Eastern Conference semifinals because of an acute left shoulder dislocation, the obvious question is this: If the Cavs advance, what are the chances Love could return for the conference finals or NBA Finals?
For an answer -- or, rather, an educated guess -- we turn to Dr. Kelly Starrett, a physical therapist and best-selling author who has worked with professional athletes from the New Orleans Saints to Major League Baseball players to rugby players and competitive CrossFitters.
Point No. 1: Love's shoulder needs time for the swelling and soft-tissue damage to calm down before anyone, including doctors who are treating him, will know the true prognosis. The soft-tissue damage that occurs when the shoulder is dislocated, Starrett said, is a 4-6 week injury by itself -- and that's if it's just a sprain and not a full-blown tear.
"You really can't tell what's going on because there's so much pain, it's such an acute injury and there's so much swelling in the joint," Starrett said. "There's a lot of soft tissue that gets moved out of the way when it happens."
Point No. 2: Surgery is inevitable as a long-term outcome of this injury for a professional athlete whose job is to run, jump, reach overhead and shoot a basketball.
"If he were a middle-aged so-and-so who worked in an office and wanted to do the elliptical machine," Starrett said, "maybe not."
But after intense treatment during the acute phase of the injury -- stim and compression, 24-7, Starrett said -- it's possible that Love could attempt to play in a limited fashion prior to having surgery. He would have to be willing to play with limited range of motion and accept a certain amount of pain from the speed and violent nature the sport -- as well as the risk of another dislocation.
"The No. 1 predictor of dislocation is a previous issue of dislocation," Starrett said.
How effective Love would be as essentially a one-armed basketball player, however, is another matter. The Cavs, their medical staff, Love and his representatives have to weigh those issues and risks before determining whether he sees the floor again this season.
"The problem is, he's banging around already angry tissue," Starrett said. "It's his guide hand and it's not going to feel great. ... But if they can get ahead of the swelling -- aspirate it, really pump the crap out of it and load him up with lidocaine -- if he plays, he'll play with no pain. It really comes down to, can he move as fast? The game is so fast and so physical and so violent, and speed is a game-changer."
Love suffered the injury -- which the Cavs described as "an acute anterior inferior glenohumeral dislocation with the corresponding ligament/labrum tearing and humeral head bone bruising" -- in their series-clinching game against Boston on Sunday. The Celtics' Kelly Olynyk grabbed Love's arm as they tangled for a loose ball, and all of that medical jargon above means that Love's shoulder joint is a hot mess.
"A bone bruise is super burly; he's got a lot going on that, unfortunately for him, is a bad deal," Starrett said. "When he gets into those ranges, the nervous system will try to take over. If you don't have the labrum intact, you have primary instability in the joint capsule -- it's stretched, torn, there's more laxity, less range of motion, less control -- and the body will protect itself by shutting that joint down."
For the Cavs, it's a round-the-clock effort now to decide whether the injury will shut Love down for the season.
"My best experience is, there's no chance he can make it worse," Starrett said. "And if he wants to play, I wouldn't take that away from an athlete."
Despite the headline, I read this as saying that there is basically no chance he will be back this year, and if he does try to come back for say the finals he will be a much reduced player. He says the soft tissue damage alone is a 4-6 week injury and there is no question surgery will be necessary.