The latest New Orleans Pelicans player to succumb to season-ending surgery is Anthony Davis. However, what set the world ablaze yesterday was the fact that he's been playing with a bum shoulder for years now. Three to be exact. Pretty much every NBA personality jumped to the same conclusion: the Pelicans and their medical staff must be an inept bunch.
I'm here to tell you that their latest perceived mishap just might not be the epically poor decision everyone has made it out to be. The simple reason is that not all shoulder labral tears are best served from undergoing immediate surgery.
Back in 2013, medical experts opined Carmelo Anthony may have correctly chosen to rehab instead of having surgery on his labrum and rotator cuff tear in his left shoulder.
"I think it's perfectly reasonable [to opt for rehab] as long as he's not limited or symptomatic to the degree that he's not able to do what he needs to do on the court," Galano says. "Right now, it seems like he's able to play at the level that he needs to play at and he's not overly symptomatic as a result of it. So I would say right now that it was the right call."
To this day, he has still not undergone any procedure to permanently fix the issue, despite the fact that rehab has not healed the tear in his shoulder.
"A labrum tear doesn't heal itself," Bell says. "Once you have damage, [the shoulder after rehabilitation is] not going to be as good as the original structure. [Anthony] can rehab all he wants and that labrum will [still] have damage to it; that doesn't change. But functionally, he should be fine."
Why postpone surgery? Because small tears do not necessitate they'll automatically grow bigger by nature or even that the said player is performing in pain. Each case is different and this was made clear by Trevor over at Hardwood Paroxysm earlier today.
It is possible that the Pelicans evaluated Davis’s labral tear on MRI and deemed it able to be treated conservatively, and did so. Less extensive labral tears can be asymptomatic, especially in young, athletic patients, so it’s not necessarily a surprise that Davis was able to rehab from the injury and regain normal function of his shoulder, enough that he could play with it. Studies have shown that in the case of atraumatic (non-dislocation related) Bankart lesions, up to 80% can see good recovery with non-operative management, which includes strengthening of surrounding musculature, correction of biomechanical deficiencies, and pain control.
Another reason to avoid surgery is it may lead to complications because new risks are introduced. Mobility can be compromised which could lead to a reduction in the range of motion. This could directly affect a player's shot or dribbling mechanics.
"That little bit of motion that they lose could be the difference in their ability to perform at the level that they're performing," Roth says.
Adds Bell: "You just don't know what the outcome [of surgery] is going to be, there's a lot of uncertainty."
Yes, I'm asking for everyone to give the team's medical staff the benefit of the doubt regarding Anthony Davis. I honestly believe they haven't treated him haphazardly. However (and this is a gigantic but), do not mistaken this with giving the organization a free pass altogether -- they have made plenty of errors along the way.
Before the start of the season, I had declared I was paranoid of the organization for their methods of handling injuries.
Past history mandates to be wary of the New Orleans organization; one that has been constantly plagued more than the majority, has been known to change prognoses midstream (usually for the worse) and is sensitive about the release of information.
A few others have alluded to this: if the Pelicans are concerned about creating a stronger image, they need to start with releasing all pertinent and correct news in a timely manner.
For instance, remember when Quincy Pondexter looked primed to return earlier this season? Right after the New Year, Q-Pon's injury status was upgraded to questionable. Not a week later, his season was declared over before it had begun.
The precise scenario repeated itself this week with Anthony Davis. AD went from out to questionable to a consensus decision of season-ending surgery, all within a span best measured in just days.
This is simply not a good look, and on it's face, it's easy to jump to conclusions and place blame on inept medical diagnosis; however, that is not what is going on in this instance. Rather, a lack of transparency is at fault because the organization has routinely failed to give updates at appropriate moments in time.
Had they made the public aware of the fragile nature of Pondexter's cartilage in his knee from the start, fans could have better prepared for a setback. The same can certainly be said of Davis' situation. Had the franchise alerted all to the true condition of Davis' shoulder when it first occurred, the public would have had the requisite knowledge that the medical staff didn't ignore an issue but chose to follow a diligent and smarter plan.
Remember how AD entered the season looking much larger, but especially in the shoulder/chest region? In addition to accruing overall strength, it now appears Davis had focused on this specific area for another reason: to better protect his labrum tear.
"A conservative approach is often a good first choice," Bell adds. "If it works, great. Even if the athlete needs surgery down the line, the strengthening will still have been beneficial because it will improve the process post-surgery."
After his last offseason round of workouts, Davis should have the desired amount of strength that will assist him through his upcoming rehabilitation. Now, if only the New Orleans franchise could learn to prepare similarly in advance with their public image, maybe the misconceptions wouldn't be so potent and unwelcome.