Will PG-13, Porzingis and Oladipo return to full health this season?

How much risk are you taking by drafting Paul George early in fantasy basketball drafts, considering that he is recovering from surgery on both shoulders? Andrew D. Bernstein/NBAE via Getty Images

Those of you who play any fantasy sport should already know the name and outstanding work of Stephania Bell. She is a licensed physical therapist who has been helping us understand and better estimate the injury absences and return prognostications for professional athletes for more than a decade.

With key injury questions impacting the fantasy basketball landscape, I sat down with Stephania to discuss the status and prognoses of the most important fantasy basketball players who are working their way back from long-term injuries this season.


Paul George, LA Clippers (shoulder)

George was part of one of the biggest stories in the NBA during the offseason, when he and Kawhi Leonard made a power move to the Clippers, but George made this move while in the midst of major injury rehab. He had surgery in early May on his right shoulder to repair a partial tear of his rotator cuff, and in early June, he had surgery on a small labral tear in his left shoulder.

Of the two procedures, the right shoulder surgery was the more significant and the one that is likely the limiting factor in George's recovery timeline. The right shoulder was initially reported as an issue in late February, and it visibly and clearly affected George for the remainder of the season.

Even after he injured the left shoulder, George's bad games seemingly correlated more with difficulties with the right one. There were times when he seemed to have difficulty raising his right arm into his shooting motion, which makes sense, given the type of injury he sustained. With rotator cuff injuries, it can be difficult to lift an arm overhead, be strong when overhead or even hold an arm in space very well.

Back in May, it was reported that George would likely miss the start of training camp and preseason. In the most recent reports, George told ESPN that he will "be out of October fully, but who knows? We'll see. In the November range is our target date."

This fits with the expected recovery timeline for shoulder surgeries of this type, and Stephania says there is nothing to suggest that George is anything but on track with the recovery process. Healing time-wise, the six months from May until November should be enough for him to be at least close to fully healed. As long as he is able to get back to full strength and he is ramped up at a correct rate, he should be up to full strength early in the season.

Bottom line: George finished top-three in the MVP vote last season and was on pace for a similar placement in fantasy rankings before the shoulder injury derailed his season. There is some question as to how George's new role on a deep Clippers team next to Kawhi might affect his output, and it sounds like he might miss up to a month of game action once the season begins. However, from then on, he projects to be healthy and as productive on the court as his new role allows him to be.

Victor Oladipo, Indiana Pacers (quad tendon)

Oladipo ruptured the quadriceps tendon in his right knee on Jan. 23, when he collided with Raptors forward Pascal Siakam. He had surgery on Jan. 27, and initial estimates of his recovery time varied from six to nine months, comparable to that of an ACL tear.

As noted in our injury outlook piece from last year, when discussing Leonard's injury, the quad tendon attaches the quadriceps muscle to the knee and works with the patellar tendon to straighten the knee. Thus, despite most associating the term "quad" with the muscle located in front of the thigh, this injury is more similar to a knee injury.

In terms of rehab, the tissue has to be allowed sufficient time to heal before any rehab can begin. Because it can't be loaded or stretched during the early healing, the initial process called for the leg to be immobilized in full extension (straight). After the initial healing phase, the next phase called for a tradeoff between the need for healing and the just-as-important need to move and stretch the injury to avoid excess scar tissue and preserve range of motion while initiating strengthening. The next step in the slow progression is increasing strength and endurance, followed by a ramp up to noncontact basketball activity before scrimmaging in live action.

Oladipo resumed limited on-court work in June with 1-on-0 drills, and he participated in everything except scrimmaging when the Pacers opened training camp on Sept. 28. There is still no officially announced timetable for Oladipo's return, but he is clearly progressing. The surgery was in January, so nine months would be right around opening tip for the upcoming season, but it is worth noting that this injury is relatively infrequent and there aren't a large number of comps, like there are with ACL reconstructions.

Also, Stephania notes that recovery from ACL surgery tends to be a bit slower for NBA athletes than those in other sports, and she anticipates that the same is likely true for quad tendon ruptures. There is no reason for the team to rush Oladipo back and risk a setback with his injured leg or a compensatory injury elsewhere.

As such, based on available information, we are not expecting to see Oladipo contribute to fantasy squads until early 2020.

Bottom line: Oladipo had the best season of his career as a clear top-25 fantasy player during the 2017-18 season, but he regressed a bit last season even before the injury. He has resumed basketball activities and is working through the rehab process, but the recovery process of his injury has been compared to the recovery from an ACL tear, which typically takes close to a year and requires more time than that before the player returns to full production capacity.

It is in the Pacers' best interest to bring Oladipo along slowly to ensure the best long-term prognosis, so if he contributes anything to fantasy squads before the start of 2020, I would consider that a surprise. However, he projects as a top-50 player for the second half of the season.

Kristaps Porzingis, Dallas Mavericks (knee)

Porzingis missed the entirety of last season while recovering from a torn anterior cruciate ligament (ACL) in his left knee. The injury occurred on Feb. 13, 2018, and was surgically repaired by Dr. David Altchek of the Hospital for Special Surgery. Porzingis will have had about 20 months of recovery time by the start of this NBA season.

While Porzingis reportedly believed he could have returned to the court last season, taking the extra recovery time was the smartest thing for him to do. He is 7-foot-3 with extremely long muscles, and Stephania couldn't say enough about how much the extra time helped the surgical graft to become more incorporated and stronger. This is all very good, allowing Porzingis to develop more strength and endurance to help decrease the risk of reinjury.

Porzingis was reportedly scrimmaging at full speed with teammates as of mid-September, and Stephania expects that he'll be able to do everything at training camp. He shouldn't have the overt restrictions of a player typically fresh off knee surgery, though the Mavericks might control his workload a bit through camp to build him up slowly. Scrimmaging is good but doesn't have the adrenaline or feel of a real game, so it is possible that he could begin the season under a bit of load management for his new team.

After having an ACL tear, the data show that there is a greater risk of either an opposite side tear or a retear of the original. There is a known association with increased tear in the first few years afterward, as the body is reestablishing motor patterns and muscle memory. Thus, even if Porzingis returns to full production immediately, he has some added injury risk, though it shouldn't be considered a deal-breaker or a certainty. He could play a full, healthy season, but you should factor at least a small element of risk into your draft assessment.

Bottom line: Porzingis suffered a relatively clean ACL tear 20 months ago and should begin the season pretty close to full speed. He has some increased injury risk and did not have a great track record in terms of games missed even before the injury, but when healthy, he has top-25 fantasy upside and thus projects as an early pick in most leagues. You should factor injury risk into your draft plans, but his huge upside could be worth the risk, even in the first few rounds.

Klay Thompson, Golden State Warriors (knee)

Thompson tore his left ACL during Game 6 of the NBA Finals in late June and had surgery to repair it in early July. He has been very public about his desire to return this season, and it is good that he's motivated to return. He was reportedly walking without a limp or crutches in August and reported in late September that he's about a month away from jogging.

With that said, it is very unlikely that Thompson returns this season in enough time to make any sort of fantasy basketball impact. The All-Star break is in late February and would be less than eight months removed from his surgery -- and even the motivated Thompson said that he doubts he can return before that. Even if he were able to return after the break, the amount that he could be reasonably expected to contribute during fantasy basketball season is very low.

The Warriors just gave Thompson a five-year, $190 million contract extension this offseason, and Stephania believes that they would be smart to be conservative so as not to risk their investment. If Thompson does return this season, presumably he would most want to be ready for the postseason, which doesn't begin until after the fantasy season ends.

Bottom line: Thompson is one of the best, most consistent shooter-scorers in NBA history. But after suffering a torn ACL in late June, he should not be counted upon for fantasy basketball purposes this season. Even if he returns this season, he is very unlikely to produce much fantasy value. He could be worth taking a low-priced flier on in dynasty leagues but not with any expectation that he will be of value this season.

Kevin Durant, Brooklyn Nets (Achilles tendon)

Much like former teammate Klay Thompson, Durant is very unlikely to produce during this fantasy basketball season. In fact, unlike with Thompson, reports have already surfaced that Durant's team expects him to remain out for the entire 2019-20 campaign. Durant tore his Achilles tendon during the NBA Finals and had surgery performed by Dr. Martin O'Malley at the Hospital for Special Surgery.

Stephania says that we are starting to see improvements with how these injuries are approached, both surgically and in rehab, and we are starting to see players return to full preinjury form sooner. That said, the Achilles tear is historically one of the most difficult injuries from which to return to full speed and explosiveness. The Nets have banked the future of their franchise on Durant's ability to return to as close to full strength as possible, and they are unlikely to risk that future in any way by rushing him back.

Bottom line: Durant will be ultra-motivated to return and reestablish himself as one of the great players in the NBA, but the severity and timing of the injury -- in addition to Durant's new team situation and relatively advanced age at 31 -- make it very unlikely that he returns in time to contribute fantasy basketball production this season.

Jusuf Nurkic, Portland Trail Blazers (leg)

Nurkic suffered one of the more visually gruesome leg injuries of the season with a compound fracture to the tibia and fibula of his left leg in late March. The biggest risk with compound fractures that penetrate the skin is infection, which the medical staff responded to right away to try to minimize. Nurkic had surgery to restore the alignment and repair the fracture, but there was no nerve or muscle damage in the leg, which is encouraging.

The first step in the recovery process is healing the bone, which involves progressively increasing the amount of weight the leg bears. The bone has to be gradually loaded over time to increase strength and heal properly.

There have not been a lot of public updates on Nurkic's status. In early June, an Instagram post showed him doing light agility work with a ladder and rowing machine. In late July, Trail Blazers president of basketball operations Neil Olshey said Nurkic was "on or ahead of" pace in his recovery. Just this week, Olshey said the team would be "purposefully vague" about Nurkic's rehab, according to Joe Freeman of the Oregonian, but Olshey did acknowledge that Nurkic is working out with the team and participating in shooting drills.

Typically, base healing of this type of injury takes about six months, which would be around the end of September for Nurkic. The next step is progressively increasing functional activities, including a ramp-up of basketball activities. Nurkic is a really big guy, and size and weight could factor into his recovery time due to the length and load on the leg.

Also, it should be noted that the Trail Blazers traded for Hassan Whiteside during the offseason. Whiteside is set to make more than $27 million in salary this season, and the Trail Blazers currently have almost $150 million committed in salary. With potential luxury tax implications factored in, this suggests that the Trail Blazers were motivated to add a starting-caliber center. Given that neither Whiteside nor Nurkic can play any position besides center, this move could be read to suggest that the Trail Blazers wanted to be prepared for Nurkic to miss significant time this season.

Bottom line: Nurkic's exact timetable is unknown, but he is not expected to be available at the beginning of the season, and there are reasons to believe that he might not be back for the first few months. Then, after he returns, he projects to have to battle Whiteside for minutes. While Nurkic showed himself to be an easy top-50 fantasy producer last season, this season, he is a late-round prospect at best as a potential upside play in the second half of the season.

Wendell Carter Jr., Chicago Bulls and Cam Reddish, Atlanta Hawks (core muscle surgery)

Carter and Reddish both had core muscle surgeries this summer. Core injuries take approximately six to eight weeks to recover, and it can take longer for players to feel like themselves and be able to generate full power. But given the surgery times, Carter and Reddish have had plenty of recovery time and should be fine for camp.

Bottom line: Carter and Reddish are expected back for camp and, barring a setback, should be good to go for the season. Carter was considered a dark horse Rookie of the Year candidate to begin last season and showed some promise before injury ended his season early. He's a midround prospect this fantasy season.

Reddish is considered by many to be one of the more talented rookies in the 2019 class, but he didn't produce as much as expected last season as a college freshman and has a lot of competition on the wing for the Hawks this season. He is a late-round upside flier, at best, in fantasy drafts.

Blake Griffin, Detroit Pistons (knee)

Griffin had arthroscopic surgery on his left knee in April. This wasn't necessarily a new issue, as the procedure likely was dealing with fragments resulting from chronic issues. Griffin is now a relatively older player (30 years old) with a lengthy history of knee injuries and procedures. He has been cleared to participate in training camp, but this issue is less about that and more about whether you can rely on him throughout the season.

At this point in his career, we can't just assume that Griffin's knee issues are behind him. Instead, he will likely be dealing with them on some level for the rest of his career. This season, the Pistons have said they are likely to start managing his playing time, so expect him to get more DNP-CD days off this season. Griffin might have that in common with new teammate Derrick Rose, who has been dealing with the aftermath and current reality of chronic knee issues for years.

Bottom line: Griffin has top-25 upside when healthy, but knee issues look like a constant fact of life for him moving forward. His upside keeps him toward the top of fantasy drafts, but the health issues definitely push him down my draft board by a couple of rounds to the point that I am unlikely to have him on (m)any of my teams this season.