About eight weeks ago, Ryan Anderson underwent a cervical procedure and was expected to return to basketball activities in approximately 4-6 months. On good authority, it is believed he had an anterior cervical discectomy and fusion (best surgical procedure for numbness/weaknesses involving arms), much like what was assumed some time ago. This common surgery has a very high success rate under ordinary circumstances, but as we've learned, playing professional basketball with 250 pound brutes is anything but ordinary.
It's not an open and shut case
From the American Journal of Sports Medicine, the numbers are good, but not perfect regarding athletes and spinal procedures.
Average return to sport is 89 percent after microscopic lumbar discectomy, according to an American Journal of Sports Medicine study published in 2012.
If the season is in-play when the athlete returns, 50 percent return after three months; 72 percent after six months and 77 percent after 12 months. After returning to play, athletes may not return to the same peak level as before surgery. About 13.5 percent of athletes undergoing spine surgery for disc herniation require a revision surgery and 86 percent of those athletes return to play after the revision, according to a 2011 study published in the American Journal of Sports Medicine.
In another recent study, aimed at examining careers, 15 professional football players and wrestlers underwent an ACDF procedure. 13 of them returned to their respected sports, 8 are still actively participating and 5 have gone on to retire, with their careers ranging 1 to 3 years additional years after returning to their sports.
Anderson handled by the best
Fortunately, one of the things going for Anderson is he had the procedure done by Dr. Robert Watkins, one of the most revered physicians within the discipline. He is considered largely responsible for Peyton Manning's remarkable comeback. Dr. Watkins is well-known for having prominent athletes as patients because of his highly successful specific trunk stabilization program:
"The success to returning the athlete to a sport in my opinion depends on controlling and directing the rehabilitation program," says Dr. Watkins. "If you don't understand and can't control the rehabilitation, don't do the surgery."
Dr. Watkins and his team developed a core strengthening and rehabilitation program allowing them to quantify the rehabilitation process and meet key goals before returning to the weight room and then to play. As a result, he is able to monitor and help coordinate rehabilitation for athletes from around the country.
"As the surgeon you need to understand the sport and what people need to do to get back to those kinds of things," says Dr. Watkins.
Getting back into the swing of things
Nearly several weeks ago, Anderson made his first appearance in a gym in approximately 5 months.
Obviously it's good news that there haven't been any reported setbacks, but as Anderson knows, the road to full recovery is still a very long one.
Just reminding myself and all of you that 1. I play basketball and 2. I will be back (God willing)… http://t.co/3rTfIqPPmy— Ryan Anderson (@ryananderson33) June 3, 2014
Will Ryan Anderson be limited in any way this upcoming season? This is the million dollar question. Since crystal balls don't exist, there is no way of absolutely knowing. Perusing through a number of spinal forums, people with the same procedures have endured a wide variety of outcomes. A few return to 100% within a 6 month span, not being restricted any which way. Others, the recovery takes quite a bit longer, often times the mental hurdles being just as large of an obstacle.
One thing that you quickly surmise is the biggest problem to full recoveries are neurological setbacks such as continued weakness or numbness sensations.
Compressed nerves in the cervical spine can then lead to weakness, numbness and pain in the neck, arms or shoulders. Ideally, by removing the offending disc, doctors cut out the root cause of the problem, thereby allowing the damaged nerves to regenerate and regain function.
Notice the above quoted word, ideally. From reading through a number of personal situations, all neurological issues were not resolved by an ACDF procedure. The majority of remaining issues had to do with numbness more than any sort of pain. Why?
Nerve signals cannot properly get through the nervous system in the area where the spine was compressed. Damaged nerves don't always completely regenerate. Consequently, people have to adjust to living with a new normal -- numbness and tingling, although lessened by the spinal procedure, continue to persist in some degree for years or even the rest of one's lifetime.
Ryan Anderson had the surgery done because he was still experiencing these type of sensations. Have they been resolved? If not, how severe do they remain? For a long range shooter who relies on touch as much as the world's finest golfers, it wouldn't take much to upset the feel on his shot. Thankfully, as it was mentioned, Anderson not only had his surgery performed by one of the world's best, but his rehabilitation is being monitored by a cutting-edge program.
Manning returned to the NFL and proved he is still considered one of the league's best. However, even he'd be the first to admit he still isn't back to the form he was before the surgery, now 2+ years removed from it.
"I'm not at a 100 percent compared to what I was before my surgery,'' Manning said during his segment. "But I have made strides each season and this year felt a lot better than I did the year before. These nerves just go at their own pace.''
Manning also referred to his recovery, including the difficulty in dealing with the fact many who had similar surgeries said it would be difficult to predict how quickly or how much the nerve in his arm would regenerate, but that he could simply wake up one day feeling better than ever.
"You talk about waking up every day at 7 a.m. excited and then being pretty depressed by noon every day -- today's not the day,'' Manning said.
Manning also discussed how he tried to regain the feel in his throwing motion and the differences in the player he is now compared to the 13 seasons he spent with the Indianapolis Colts before his surgery.
"I used to sit in the mirror and just sort of go through my throwing motion trying to get the feel back the way I'd always thrown before,'' Manning said. " ... Maybe I can't throw the 100 mile-an-hour fastball any more, but I can still strike you out, picking my spots, working the plate. I don't make the same kind of throws I used to make, I try to use the cerebral part, use my experience.''
Sure sounds like Manning is currently living a new normal. Yet, at least it is still good enough, whereby he is not only participating in his sport, but achieving at a very high level. It is difficult to say how long he'll maintain this level of play. Besides turning 38 years old, he must subject his body to a yearly physical exam. Dr. Watkins and his group must be satisfied him meeting all checkpoints in pain, sensation, strength and stability.
We can only hope Ryan Anderson will go through a similar regiment, as his long-term health and well-being are the most important things at the end of the day. However, once the important benchmarks are met, can the 26-year old Anderson keep withstanding the long NBA schedule, year after year?
With the Pelicans 2013-14 season long in the rearview mirror, there is relatively little news most days as to the roster. Everywhere you turn, there is optimistic talk and projections about the upcoming season. All the ones I've come across, assume Anderson will be back on day one and ready to handle the rigors of 82 games.
I urge caution. Maybe imagine an asterisk beside his name the next time you're pondering the depth chart.
Anderson suffered a spinal damage that can end careers or, more likely, reduce the effectiveness and length of them. Normal individuals have trouble enjoying their lives in the same capacity as pre-injury, but we are assuming Anderson will also be able to perform at the level we're accustomed to against some of the best and strongest athletes in the world.
Considering the evasiveness of the front office (how about the lack of alerting the public to Tyreke Evan's recent surgery until after the fact), I honestly don't expect any negative news for at least several months. Then, during training camp or preseason, it may be announced Anderson's recovery will take longer. (Eric Gordon says hello.) Or maybe, once the games begin, his body takes a hit where those dreaded sensations suddenly return and he is stamped with the 'out indefinitely' tag. Perhaps, he plays uninterrupted but some of his numbers are noticeably down from his career norm.
Like all of you, I'm hoping for the best. But it is conceivable, in just the short term alone, any one of the above hypotheticals come to fruition. Reality, please keep your fingers crossed.