Rose headed for long recovery

An injury-plagued 2011-12 campaign culminated in a season-ending injury for Chicago Bulls guard Derrick Rose on Saturday. In the final minutes of the first game of the playoff series against the Philadelphia 76ers, Rose went to the floor when his left knee gave way. The suspected culprit, a torn anterior cruciate ligament (ACL), was later confirmed by MRI. Rose is done for the remainder of the season but the consequences will extend beyond that time frame. The likely timetable for Rose's recovery will undoubtedly affect his availability for the summer Olympics and even threatens the start of his next NBA season.

A look back at the video of Rose's last few seconds of play Saturday suggests the injury happened not when he went up in the air, nor when he landed, but rather in the jump stop he made just prior to attempting to dish the ball off to teammate Carlos Boozer. Rose moves into the lane and jumps to his right, landing as if to square up before taking a shot, and his left knee can be seen quickly collapsing inward (valgus). As Rose goes upward, he appears to have no power and is off balance, then opts to try to pass the ball outside and lands askew. His left leg comes down and as he tries to step it does not support him and he goes to the ground, holding his knee. There is no doubt he is in pain, but how much is physical discomfort and how much is exasperation at this latest devastating blow is unclear. Perhaps Rose knew what everyone in the suddenly silent arena feared; this indeed was the end of a cruel and tortuous season where his days missed due to injury nearly equaled games played.

The list of Rose's injuries is long, particularly for a young and otherwise healthy professional athlete. It all began less than two weeks into the season when Rose fell hard enough on his elbow to warrant X-rays. He escaped unscathed (X-rays were negative) but that would be the last time he would be so lucky. Less than a week later a collision with Timberwolves forward Anthony Tolliver resulted in a sprained left big toe. He missed one game but returned to action three days later, despite persistent pain. He lasted two games but then was forced to miss the next four because of the toe. Rose returned to the lineup in late January and seemed to be off to a fresh start.
Then the problems really began. Back spasms cropped up in February and forced Rose out for more than a week. A few weeks later there were reports of a groin strain which led to another dozen absences. Rose returned for one game (yes, just one) before a sprained right ankle caused him to miss more time. Days later it was his right foot sidelining him. Rose, who had missed very little game action before this season, expressed frustration with the cumulative injuries, at the time telling reporters, "For someone to not miss more than seven, 10 games in a year (my first three seasons), to miss 20 something, 30 something games, it hurts, man."

It has to hurt even more now. Rose, who missed nearly 40 percent of the regular-season contests, did not get through even one full playoff game before an injury finally did him in. Although the injuries were not reported as related, it is hard to imagine there is zero connection. The body is, after all, a series of kinetic chains and as the familiar saying goes, a chain is only as strong as its weakest link. Any residual weakness from one injury, no matter how subtle, can certainly contribute to a lack of overall strength, potentially creating an inherent risk in further injury.

For Rose there is no sense in dwelling on the past; instead he has to focus on what will be an intense rehabilitative process. Although the Bulls have not yet publicly outlined a plan of treatment or a timetable for Rose, the expectation based on the reported diagnosis of an ACL tear is that he will undergo reconstructive surgery. He will then have to regain not only his left leg motion, strength and coordination following surgery, but he will also have to repair the rest of his ailing frame, including his core musculature and virtually his entire right side. If there is any positive takeaway from his unfortunate circumstance it is that Rose will finally have an opportunity to completely recover from the physical toll this season has taken on him.

As for the time it will take, presuming he undergoes a straightforward ACL reconstruction, Rose's recovery can be expected to take somewhere between six and nine months. Surgery is often delayed until the athlete's inflammation subsides and range of motion approaches normal. There are numerous variations in how an individual is able to progress through the rehabilitation process, including whether there are any additional procedures performed (such as meniscus repair), the type of graft used and whether there is any cartilage damage present. Then there is the athlete's capacity for healing to take into account. The demands of basketball -- sudden stops and starts, frequent lateral movements and directional changes, along with the repeated impact of running and jumping -- require a high level of performance prior to releasing an athlete to competitive play.

While the incidence of ACL injury in NBA players is less frequent than in some other professional athletes (such as NFL football players for instance), just this March Minnesota Timberwolves rookie point guard Ricky Rubio tore his left ACL. Rubio underwent surgery later that month to reconstruct his ACL and also his lateral collateral ligament (LCL) and will miss the Olympics, where he had been scheduled to represent Spain. He told reporters earlier this month that he is not sure if he will be ready for training camp. According to the St. Paul Pioneer-Press, when asked about his return date Rubio said, "It depends on how my knee feels. We will see. The most important thing I want to make sure of is I want to be 100 percent." Rose will likely be issuing similar statements in the not-too-distant future.

Even when recovery timetables are provided, they are typically issued as ranges of time to allow for unexpected elements that can influence the healing process. The good news is Rose has youth and fitness on his side and barring something, well, unexpected, there is every reason to be optimistic he will return to the MVP-caliber player we saw in 2011.