Welcome to Day 1 of doom-scrolling for updates about Luka Doncic’s potentially playoff-compromising left calf strain.
For the few Mavericks fans unaware about the superstar’s injury, here are the basics:
Doncic strained his calf by planting his left leg to change directions after making a pass on offense with 2:24 left in the third quarter Sunday night, the regular-season finale against the San Antonio Spurs.
He hunched over and then limped off the court, directly to the locker room, with director of player health and personnel Casey Smith. He didn’t return to the bench, and the Mavericks didn’t provide an update while he received treatment after the game.
MRI exam results Monday afternoon will show the Mavericks the severity and location of Doncic’s strain and dictate their rehabilitation plan leading up to Saturday afternoon’s playoff opener against the Utah Jazz.
But answers about Doncic’s availability and outlook beyond this week likely won’t be so straightforward.
The Dallas Morning News interviewed a trio of sports medicine experts Monday who said muscle strains remain the most “finicky” and “complex” injuries for athletes because of the variability in severity, location and treatment options.
Doncic’s risk for re-injury amid heightened playoff physicality, and his calf’s response to 24-7 treatment in a recovery window shorter than after typical strains, will influence the Mavericks’ approach and factor into whether their All-Star will be available to start what appeared to be the franchise’s most promising postseason run since the 2011 championship squad.
“Muscle injuries are very difficult for us to treat because we don’t have a quick fix,” said T.O. Souryal, the Mavericks’ team doctor from 1993 to 2015. “We’ve made tremendous advances in ACL surgery and ankle and Tommy John, but we’ve not really made too many advances when it comes to a muscle injury.
“Because we don’t have a pill for a muscle strain and because we don’t have a brace for a muscle strain, we literally throw the kitchen sink at them.”
Experts classify calf strains at three levels:
— Grade 1 involves “microscopic damage,” according to injury analyst Jeff Stotts, and shows fibers in the muscle have overstretched and typically need seven to 10 days to heal.
— Grade 2 represents a partial tear of the muscle and a several-week rehab process.
— Grade 3 involves full ruptures and months-long recovery, which analysts consider unlikely in Doncic’s case because he walked off the court without help.
Stotts, who operates the sports injury tracking site InStreetClothes, said the location of the strain can impact recovery. Strains in the meaty, “muscle belly” of the calf tend to heal faster because of proximity to blood flow, while issues around the muscle tendons can take longer.
Should Doncic’s MRI exam reveal a minor-grade tear, experts predict he’ll embark on a round-the-clock treatment plan with Saturday’s Game 1 in American Airlines Center as his first benchmark.
No time to waste.
Souryal said treatment for muscle strains can include hyperbaric, compression and muscle stimulation approaches — multiple modalities in play at the same time.
While sufficient sleep remains a key factor, Souryal said it wouldn’t be unusual to have Doncic wear a NormaTec leg-recovery boot or connect to a stim machine while resting or to wake up at odd hours to ice.
“The biggest thing is going to be: How do they now build up that calf so it’s not re-injured when he goes back and does play?” physical therapist and sports scientist Rajpal Brar said. “A lot of it just comes down to what you’re seeing, of course, in the imaging, and then what you’re seeing when you’re actually doing the physio. When you are testing out some of his movement and his strength, what are you seeing?
”You’ve probably heard the term day to day, but it truly is day to day because you have to see how he responds and how his pain, how his function evolves, literally day to day.”
Good news for the Mavericks?
The team’s medical staff has a track record of helping players return from muscle strains quicker than the NBA average.
Stotts said the average time lost for calf strains in the league this season was 16 days — not specific to grade or location.
In his database that accounts for every NBA injury since the 2005-06 season, Stotts said the scores of Mavericks with calf strains — subtracting preseason and season-ending injuries that offer less timeline clarity — have returned, on average, in about seven days.
The list includes Frank Ntilikina this season — out for four games in November with a right calf strain — and some players later in their careers, such as Jason Kidd, Deron Williams, Wes Matthews and Shawn Marion.
“Age is a big factor in recovery and is a help,” Stotts said, “so it’s not surprising to see some of those veterans take a little bit longer and some of the older guys return a little bit quicker.”
Never have Mavericks fans had more reason to appreciate Doncic’s youthful dominance.
But Doncic’s current parameters still create unique obstacles.
He’ll face more intense physicality and movements in this win-or-go-home, seven-game playoff series against the Jazz than he typically would during the regular season.
He averaged a career-high 35.4 minutes per game this season — 1.1 more than last year — and 38.2 minutes over his first two playoff series. Doncic logged at least 38 minutes in all six playoff games last season that finished within 15 points — surpassing 40 in four.
“Now you’re adding even more load onto that calf,” Brar said, “so that’s really where it becomes more tenuous.”
The only time Souryal received a game ball during his two-plus decades with the Mavericks came after Game 3 of their second-round playoff series against the San Antonio Spurs in 2006.
Former coach Avery Johnson wanted to highlight Souryal’s exhaustive work to help guard Devin Harris recover from the quadriceps strain that he’d suffered at the end of the regular season and return to lock down Tony Parker in the playoffs.
No doubt the Mavericks hope they can soon reward the current staff in the same way.
“Casey Smith, [head trainer] Dionne Calhoun, their staff is fantastic,” Stotts said. “Really one of the best in the NBA. Numbers statistically always back that up, [and] they are considered an upper-tier, upper-echelon medical staff in the NBA, so Luka is in good hands.”
