With players able to enter the NBA at age 19, it should be no surprise that the league boasts the youngest average age — 25 — of the four major sports.
Think of it: you hit age 26 on the hardwood and it hits back. You are over the hill. Best, then, to avoid suffering a major, time-consuming injury.
The ACL tear comes immediately to mind. Epidemic among women collegiate and high school basketball players, it occurs often enough among men, also.
One would think however, that the other dreaded injury, a tendon tear, would be extremely rare among NBA players precisely because of their young age. Ruptured tendons historically have victimized pros in their late 30s.
On consecutive days, as January ended, New Orleans All-Star center DeMarcus Cousins, 27, tore his left Achilles tendon and Oklahoma City defensive specialist Andres Roberson, 26, tore his left patellar tendon. Done for the year, they must be wondering whether or not they will ever come back, but also why the injuries happened at all.
“These guys are playing and training all year round,” said orthopaedic surgeon Michael Knesek, MD, with whom I talked days after Cousins’ and Roberson’s mishaps.
Roberson had missed eight games with left patellar tendinitis from late December to mid-January. With clear-cut symptoms, was he brought back too soon, doing too much? A study published in the American Journal of Sports Medicine in 2011 found that nearly half of NFL players who suffered a patellar tendon tear had pre-existing pain.
Knesek, who works with Bone and Joint Specialists in Merrillville and Munster and Community Care Network in Valparaiso and Portage, explained warning signs are less common in the Achilles tendon.
“Only one in three will complain of pain before,” he said.
Still, most cases of sports-related tendon tears are caused by overuse rather than trauma.
“A lot of (orthopaedic surgeons) similarly think the ACL is a fatigue injury,” he continued, almost prophetically.
Two days after my conversation with Knesek, New York All-Star forward Kristaps Porzingis, 22, tore his left ACL when he landed on an opponent’s foot. A video review shows Porzingis’ ankle turning before his knee buckled.
So when will they be back?
Given his age and injury, Porzingis has the best chance of making a complete recovery. Expect to see him this time next year. A study published in the medical journal Sports Health in 2013 showed 98 percent of NBA players returned from ACL tears but played significantly fewer games per season and minutes per game thereafter.
Perhaps confirming Knesek’s fear that ACL tears are fatigue-related is that this same study found 40 percent of ACL tears occurred in the fourth quarter. Yet what is it" athlete fatigue/tiredness, tissue fatigue/overuse or both?
For Cousins and Roberson, the numbers are not as encouraging.
Another 2013 study, this one published in AJSM, reviewed 18 NBA players who tore their Achilles from 1988-2011. Only 11 ever returned and three of them lasted just one season.
Another AJSM study, published in 2016, revealed that a mere 50 percent of NFL players who suffered patellar tendon tears ever returned to play. and those who did experienced significantly decreased playing time.
The NBA should expect other stars to suffer circumstances similar to Cousins’ and Roberson’s as long as there are too many games and too many minutes with too few players.