The Truth Behind Serge Ibaka's Shocking Return from Injury

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The Truth Behind Serge Ibaka's Shocking Return from Injury
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If you want to believe in miracles, I won't stop you. People have made fortunes based on hologram bracelets and horse placentae, after all.

Most so-called miracles aren't that at all. They shortchange the hard work of both medical staff and players. In the case of Serge Ibaka returning to the Oklahoma City Thunder lineup for Game 3 of the NBA Finals, there's a lot happening behind closed doors.

The first point that must be noted is this: While Ibaka was initially ruled out for the series, this was never more than a mild calf strain. Thunder GM Sam Presti called it a Grade 2 strain, which would have a normal timeline of about two to four weeks.

It's been two weeks, and with the incremental goals, the Thunder medical staff gave Ibaka tangible goals. The small steps helped the quiet Ibaka, as detailed by Yahoo Sports' Adrian Wojnarowski, though it was more about healing and modalities than anything Ibaka went through in his native Congo.

Again, it's less about miracles and more about medicine.

The other thing that changed is that the risk/reward calculation shifted. Down 2-0 to a San Antonio Spurs team that was playing some of its best basketball, competing without Ibaka wasn't working for the Thunder. If he could come back, even in a limited capacity, they would obviously be a better team.

The question then becomes what the risks are. With any muscle strain—which is simply a muscle's fibers tearing—the worry is that the strain will become larger or more complete. The worst-case scenario is that the muscle ruptures—a complete tear. With simple diagnostics, the Thunder medical staff could determine whether that was a significant risk.

The tougher part for Ibaka is pain. Playing through a muscle strain hurts. His body will be reacting, trying to protect the area, which he would have to fight through. A painkiller is possible but would slow his reaction time and lead to a higher likelihood of exacerbating the injury. Ibaka may have had a low-grade topical anesthetic, but not enough to greatly dull the pain.

And let's clear this up right now: Steroids wouldn't have helped. While anabolic steroids do help grow muscle tissue, they don't do so overnight. While Ibaka might have had a corticosteroid as treatment, that is an anti-inflammatory, not a banned performance enhancer.

The treatments available to help Ibaka are pretty standard. Ice and rest probably did the most, but the Thunder are known to use more high-tech devices like NormaTec recovery sleeves, a cryotherapy chamber and cold lasers. Any and all of these could be used to help Ibaka.

The key seems to be that while publicly saying that Ibaka would be out for the series, the medical staff never stopped treatment. They pushed him on a day-to-day schedule, while not thinking purely in the short term. They seem to have been focused on some point they determined, a balance point between function, pain management and long-term safety. 

The challenge now is to keep Ibaka on the floor. Not much should change, unless there's a re-injury, which would of course change everything.

The same treatments that got Ibaka to this point should be able to keep him there. There will be a great deal of emphasis on keeping everything else normal, so the medical staff will be watching closely to guard against any sort of cascade injury. Any limping will get him off the floor. 

There's a bit of a secret weapon in play as well. The NBA has SportVu cameras that watch every play in games, giving real-time feedback on player movement. While I could not confirm with any source, it is very likely that Ibaka's in-game speed and distance covered are being closely monitored.

While teams are still coming to grips with all the things they can glean from this sensor data, a drop in mobility would be a red flag for Ibaka. 

You may not have SportVu access at home, but you can watch Ibaka for any sign of overt limping. His other leg is as much at risk if there's a significant change in his movement pattern. The knees and ankles are also at risk, so the medical and coaching staffs will be watching this closely. This is especially key late in games as physical play and fatigue come in. 

Willis Reed walking in for the Knicks remains the gold standard—his career has been overshadowed by one moment. It wasn't a miracle for Reed any more than it is for Ibaka. Reed's significant quad strain was overcome by pain management in the form of a big needle and a willingness to accept the risks of playing through it.

While sports medicine has made big strides since Reed walked back into Madison Square Garden, Ibaka did his own version. Calling it a miracle cheapens it. Call it what it is: hard work.

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