This article is part of our NBA Injury Analysis series.
The NBA season has officially wrapped up its first quarter, providing a nice sample size of information and statistics for fantasy owners. One noteworthy developing trend is the total number of games lost to injury or illness that is on par with the most injury-riddled seasons of the past. The number of games lost to injury is up 10 percent from last season, with the amount of bone-related issues playing a significant role.
Games lost to bone injuries – including fractures, bone contusions and stress fractures – are twice as high as they were at this point in the 2018-19 season, with players like Stephen Curry, Gordon Hayward, Otto Porter Jr., and Marvin Bagley all contributing to the lofty total. Unfortunately, bone injuries, especially ones to the hand and fingers, are difficult to predict and often the result of an isolated, fluky incident. On the plus side, bone tissue often heals nicely, even if surgery is needed, and players generally return to top form.
Hopefully, some of the following names can return to action soon to help alleviate the rising number of players in street clothes.
Stephen Curry, Warriors
Curry has always carried an elevated level of injury risk due to his balky ankle but no amount of preventative care could have helped when Phoenix's Aron Baynes fell on his left hand back on Oct. 30. The impact left Curry with a fractured second metacarpal that ultimately required surgery to fix.
The metacarpal bones form the bulk of the hand and bridge the carpal bones of the wrist and the long bones of the fingers. The distal ends of the metacarpals form the knuckles of the hand when making a fist. Based on this positioning, the metacarpals are particularly susceptible to breaking especially following a direct blow or an axial load. As a result, a metacarpal fracture is often referred to as a Boxer's fracture.
Metacarpal fractures aren't uncommon in the NBA with players like Russell Westbrook, Kawhi Leonard, and Nikola Vucevic all suffering the injury in recent seasons. However, not all fractures are considered equal and the estimated length of Curry's recovery suggests his break was not a simple, hairline fracture. Curry did have surgical hardware inserted to stabilize the bone, but has since undergone a second procedure to have the pins removed. Still, he isn't expected back until the spring following a scheduled evaluation around the All-Star break. For now, Curry remains a hold for fantasy purposes.
Luka Doncic, Mavericks
Dallas has been one of the early surprises of the season led by the 20-year-old MVP candidate. Doncic has become a fantasy gold mine, contributing across the board and skyrocketing into the elite tier perhaps a year earlier than expected. In his 25 games played, he's averaging 29.3 points, 9.6 rebounds, and 8.9 assists per game. Sadly, a moderately sprained ankle suffered on December 14 has sidelined the Slovenian star.
The term "moderate" is often used to describe a Grade 2 sprain, a designation that indicates noticeable ligament damage. However, there is growing optimism that the injury was not as severe as initially feared and that Doncic could be back by Christmas. The Mavs have indicated that he's responded well to treatment and is progressing nicely though the team's rehab protocol. As long as Doncic avoids any unforeseen setback, fantasy owners should be able to welcome him back before the end of the calendar year.
Kyrie Irving, Nets
The Nets knew when they signed Kevin Durant and Kyrie Irving that Durant's still-healing Achilles would prevent the duo from taking the floor together in the 2019-20 season. What they didn't expect was that Irving would also missed a considerable amount of time with an injury.
The All-Star point guard has missed 16 consecutive games with right shoulder impingement. The ball-and-socket joint of the shoulder is known as the glenohumeral (GH) joint. The GH joint is very mobile by design with the rotator cuff responsible for a large part of the movement here. The rotator cuff is comprised of four muscles, the supraspinatus, infraspinatus, teres minor, and subscapularis. These muscles surround the head of the upper arm bone, the humerus, and help stabilize the shoulder. However, the space in which the tendons of these muscles run is small and narrow. If the tendons become inflamed, whether through an acute episode or repetitive chronic use, the space further narrows and the tendons can become impinged or pinched.
Other factors like unique bony structure or joint laxity can also result in impingement. Impingement often continues until the inflammation subsides but can return if the root of the problem is not addressed. As a result, impingement can be slow to heal.
Irving continues to move slowly in his recovery and has yet to receive clearance to resume contact drills. A return date remains unknown as fantasy owners must simply take a wait-and-see approach with his availability.
Otto Porter Jr., Bulls
The forward never truly looked healthy at any point this season and is slated to miss at least three more weeks due to a lingering foot fracture. Originally diagnosed as a sprain and bone contusion, subsequent images taken on the left foot revealed the underlying fracture. It isn't unheard of for a fracture to be missed on initial imaging. Sometimes, the nature of the break is too small to be seen after it has occurred and will only be detected when visible signs of healing have transpired.
Unfortunately, foot fractures are often very problematic for basketball players given the amount of stress placed on and through the area while playing the game. Furthermore, areas of the foot are often slow to heal due to a limited blood supply. As a result, it wouldn't be shocking to see Porter's return pushed back again. He will remain a risky investment upon his return and it may be time to consider trading Porter or sending him to the waiver wire.
Zion Williamson, Pelicans
As you may have heard, the top overall selection in the 2019 draft has yet to take the floor over suffering a torn meniscus in his knee during the preseason.
The menisci of the knee are comprised of a specialized cartilage known as fibrocartilage that is able to withstand a high degree of stress while maintaining a degree of elasticity. This design allows them to act as shock absorbers for the joint. Each knee has a medial and lateral meniscus with the latter playing a larger role in weight bearing. The lateral meniscus also plays a bigger role in joint motion and fluidity and as a result is designed to be more mobile. This is the area involved in Zion's case.
Treatment for meniscus damage is based on location. If a meniscus injury is small and located within an area of the disc with a regular supply of blood, then a quick recovery is very possible and surgery can be avoided.
However, the majority of meniscus injuries require surgical intervention, including Williamson's injury. Meniscus surgeries can be broken down into two basic types: repairs or removals. A meniscectomy, or removal, is the more common of the two procedures and is often accompanied by a shorter recovery window. Following a meniscectomy, players can often return to activity within six weeks. However, the quick turnaround does elevate the risk of long-term issues like osteoarthritis and other complications like cysts since the cartilage of the area has been removed. Given that the initial estimated timeline of six-to-eight weeks and the term debridement was to describe the surgery, it appears as though Williamson underwent a meniscectomy.
The six-to-eight week window has come and passed without Williamson taking the court. He is reportedly full weight-bearing on the joint but is still "a ways away" from returning. Given New Orleans' place in the standings and the long-term value of Williamson's health to the stability of the franchise, look for the Pelicans to handle his recovery with an extremely conservative approach. He hasn't been lost for the year just yet but his fantasy value is diminishing with each passing day.