Return to Sport

Hot topic of the day – Kevin Durant’s lower leg injury (suspected R achilles tendon rupture) from last night’s Game 5 of the NBA finals.

Here are some things to know prior to passing judgement and assessment of his injury:

  1. Mechanism of Injury: Usually results from sudden forceful increased stress on the Achilles tendon – in Kevin Durant’s case, he was planting with his R leg as well as making a move to his L, forcing increased dorsiflexion into his ankle (relative forced stretch of the achilles).
  2. He had not played in the 9 games prior to this game due to a R calf strain.

So this begs the question(s): Are his two injures (calf strain and now achilles rupture) related? And, did he return too soon? We’ll take a look at both of these questions.

First – Are his two injuries related. Absolutely. Everything in the body is connected and if you think that anything in the body functions independently of any other part in the body then … you’re wrong. This is an absolute truth and there’s no room for argument. Now, how are his two injuries related? There are a couple of parts we need to examine. It’s easy to see that he had strained his R calf and now he has a ruptured R achilles tendon. Your calf muscle (gastrocnemius and soleus) tendons turn into the achilles tendon and insert onto the back of your calcaneus (heel bone):

Gastrocnemius-Muscle

With the way I practice – utilizing NeuroKinetic Therapy (NKT) – his R calf (gastrocnemius or soleus, medial or lateral) would have been found to be either inhibited or facilitated. It’s important, then, to figure out the other half of that equation – if it’s inhibited, what’s facilitated and inhibiting the muscle? If it’s facilitated, what is it inhibited? This is VERY important to figure out because after an injury (ANY injury), the body will go into a protective state and start to compensate. Compensations are not bad inherently – in fact our bodies constantly will compensate when we start off learning a new movement pattern or if it’s a short term pattern. However, once the compensation has done its job, are our bodies able to let go of that pattern? If not, that’s when – given enough time – the compensation pattern can become a problem.

If his R calf was either facilitated or inhibited – it has become inefficient. Now, with inefficiency the muscle can be either tight or not and either one can lead to this injury we now see that he’s suffered because inefficiency just means that the muscle can’t do it’s job at 100%. I recently read a quote from Perry Nickleston, DC who wrote “we mistake being able to function for healthy”. Kevin Durant may not have had any more pain (or he may still have had discomfort, it is the NBA finals and athletes can be stubborn), or he may have been able to walk/run with no limp, or he may have passed all of his return to sport tests – but our bodies are amazing at compensating and hiding dysfunctions. Professional athletes are EVEN better at it. But just because he was able to pass these tests or run with no visual impairments doesn’t mean he was 100% healthy.

This leads to the second question: Did he return to sport too soon? In my opinion yes. He only practiced once at full speed prior to last night’s game. However, there’s much more to it. Having worked with professional athletes and teams in the past (Boston Blades, professional women’s hockey 2016-2017), something that many in the rehab world fail to understand (unless you’ve worked with athletes of this caliber before) is the athlete’s mentality. With regards to rehabbing an athlete (amateur or professional) I always followed the mantra of “Maintenance during the season, rehab in the off season”. This means that during the season, there’s not much you can do (or should do – a post for another time, but in short there’s always a learning curve with movement patterns and that takes TIME, which athletes in season don’t always have) but to keep them healthy enough to play with any means necessary (usually this means symptom treatment, taping etc…). But the key here is what part of the season are we in? If this were the regular season, I’m sure Kevin Durant would have sat out until he was completely healthy since Golden State was going to the make the playoffs anyway, and there’s more TIME. Post season, it’s do-or-die for the athlete. If this was a first round, though, Golden State may feel confident enough to not play him and still win. However, this is the NBA FINALS. There’s a lot on the line. Him and his team have worked hard all season to get to this point. I’m sure Kevin Durant was willing to do anything if it meant winning last night to keep their season alive (they were down 3-1 in the best of 7 series going into that game).

Kevin Durant left it all out on the court last night – ending his season to help keep his team’s season alive. He did it because he didn’t want to let his team down. Did he know he wasn’t 100% – absolutely. But to him, he wanted to end his contract with GSW on a high note, even though now he is injured and free agency is only days away. That is the mentality of an athlete – to do WHATEVER it takes for your brothers, your team. Not everyone will understand that unless you’ve participated in team sports at a high enough level.

So do I think he returned too early? Yes. Do I understand why he came back early? Yes. And the latter is more important in this case than the logical/obvious answer. Because to him, this was worth it at the time. So before we start to judge Kevin’s decision, or his medical staffs’ abilities, understand that this is the athlete’s mentality in season.

I welcome any comments you may have on this topic.

 

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