What's next for Kyrie Irving and Gordon Hayward as they return to live action? Checking in with Dr. Flynn

The start of Celtics training camp is less than a month away but Gordon Hayward and Kyrie Irving will be ready to go at full strength well ahead of that point.

Danny Ainge told ESPN’s Chris Forsberg on Monday that both players are expected to return to Boston next week and take part in 5-on-5 pickup games ahead of training camp.

“I don’t want to hype it up too much, but I’m saying that if our training camp were starting today that they would be here today going full speed,” Ainge said. “It’s not like they need an extra month. I think that they know they have an extra month, so they are sort of pacing themselves. They’re playing as if to build up to that opening day of training camp (Sept. 25)."=

So what exactly can we realistically expect from both players as they return to the court for 5-on-5 action in the coming weeks? How will the Celtics help them ease their way back in? What are some potential pitfalls that lie ahead? To get a better sense of it all, we caught up with Dr. Jessica Flynn this week to dissect the road ahead for the two All-Stars.

Q: Heading into this season, is there one of Irving and Hayward fans should be concerned about the most in terms of potential setbacks or complications arising over the short or long term?

Dr. Flynn: It's interesting. Hayward had this much more dramatic, terrible injury, but I would actually be more concerned about Kyrie Irving in the long run, just because

of the nature of his initial injury. Just going back and reviewing Kyrie's injury history, he dealt with issues in Cleveland with chronic jumper's knee, which is tendinitis of the patella tendon. He had this one episode where he broke the patella. Cleveland said it was a contact injury, but it sounded a lot more like a stress fracture that was related to the jumper's knee that finally broke through.

That was in 2015, but the problem with an injury like that is that the mechanics don't really go away. He was overusing his quads in the front of his knee. Yes, he had the fracture, he had it repaired, he had the hardware removed and then they found the infection and cleaned that out. You think the problem should be completely gone, and I think there is a great chance it is.

The question is what if during this rest time, the problem is still not corrected? He is at increased risk of going back and having chronic issues with jumper's knee, stress injury to the kneecap and now, because of his history, some arthritis under his kneecap is definitely a possibility with the fracture, the hardware and the infection, all of those things can impact the joint. Long term, that's a little bit more of a concern than Gordon Hayward's one-time acute, terrible injury.  

Q: Is all the team can do with Kyrie and his knee vulnerabilities just to try to maintain it with keeping his minutes down and giving him nights off on back-to-backs? They are in a position to do so with all the depth they have. Is that it along with all the maintenance stuff that we won't see behind the scenes?

Dr. Flynn: I do not look at Irving's history and say damaged goods. People were saying that, that was the quote that was thrown around. I don't think he's damaged goods because of this. There is a risk all of that stuff could happen and that's what we need to watch for. I don't necessarily think he needs to be under a huge minutes restriction and have this veteran's rest. I think they will probably ease him in slowly, but I think there is a lot that he probably did in rehab to help this. He probably worked on his quadriceps flexibility, his strength of certain muscles like his core and glutes, stuff that can take a little bit of pressure off his kneecap. Obviously, they will be managing any symptoms he develops.

Q: It seemed like he went through a pretty rigorous rehab process after the infection with medications, etc. Does that process make it tougher for him to readjust or has enough time passed where that shouldn't be a concern at all beyond just getting into shape?

Dr. Flynn: The infection itself hopefully is completely clear. If they left the hardware in, there would have been a very high risk of it coming back, so it's good that it was removed. Even when the hardware is removed, there is still a possibility that the infection wasn't completely eradicated. It's a really low risk, but it's possible it could come back. Given how healthy he is, I don't expect that to happen.

With an infection in hardware, especially the kneecap, there is a chance it affected the quality of the bone. That's why he had to wait so long to start playing again. If you don't, there are screws and wires most likely, and those made holes in the bone. Those had to fill in with new bones and the bone that was already there was a little bit softer and of poorer quality. That had to become healthy again and that was that long wait. That's why they kept him away from basketball for so long. That's also why he had to wait longer than Gordon Hayward had to wait after his hardware was removed. Hayward, as far as we know, wasn't infected. His hardware was in there for a short time, but he still had to let his holes fill in with the new bone.

Q: When wondering how to work a guy like Gordon Hayward back into the mix for this year, how much is mobility an issue for injuries like this when a player comes back? Is it tough to get back to 100 percent physically after something like this? It's obviously going to be case-by-case, but is there something that fans should be expecting?

Dr. Flynn: I think, physically, mobility can certainly be an issue after an injury like this. The good news is that the hardware is out now, so hopefully, he's not getting any more of that irritation that he was getting from the hardware. His ankle will never be exactly normal and exactly the way it was before.

The good news is that he indicated in some of his writing on his website during the offseason, when they scoped the ankle after his injury, at the time of surgery, they didn't see any kind of joint surface or cartilage injury. The hope is he doesn't have any acute issue with arthritis and the ankle. Arthritis would be something you would worry about with him, but hopefully not for years down the road.

As far as return, honestly, I think the biggest hurdle for him is going to be mental. That was such a brutal injury. Anyone who saw that replay, they probably want to stay away from watching basketball for a bit. Can you imagine being Gordon Hayward's size and going up for a layup with the chance you are going to roll your ankle on someone's foot? I think that will be one of the biggest things for him, overcoming the mental side of it.

Q: It seems like the timetable will hopefully help him on that front, giving him the chance to ease into 5-on-5 before training camp. The mental stuff is going to be there obviously, but what type of stuff will the team be on the lookout for him physically after being out so long?

Dr. Flynn: Any soreness or inflammation from scar tissue. As you move the ankle suddenly and put it under different stresses, especially in live action and you are going 100 percent. His brain is distracted and he's thinking more about the game than his ankle, the ankle might move a little bit and that can irritate scar tissue and things like that. I'm really not expecting any major setbacks for him at this point. It sounds like he's progressing nicely.

Q: Do you think there is anything the team will do to try to protect him beyond just easing him in? Do you think they might reduce his minutes or give him extra rest regularly due to the injury?

Dr. Flynn: I don't think because he had this injury he has to have his minutes reduced. I do think it's smart to work him in slowly because gameplay is so different. You are actually under the lights, there's a crowd, it's a totally different situation. I think easing him into that makes the most sense. Short of that, as long as he's doing well, I don't think that he would definitely need a minutes restriction.

Q: Have you dealt with an athlete with a traumatizing injury similar to what Hayward went through who have had a huge mental hurdle to try to get back? What type of advice do you try to give the player to help them get through that or what techniques are used?

Dr. Flynn: I've dealt with a lot of athletes who have had major injuries at different levels of play. I had to hold a high-level soccer player out of sports for a year. When it comes to getting over the worry about re-injury or the mental side of it, it's mostly just easing them in really slowly and making them feel prepared at every step. Eventually, most athletes get back with the team and I think that's a really helpful thing. A lot of these guys are on their own training (besides their training staff) in the offseason. I think it will be really good for the guys to be back with their teammates in a place they are comfortable. I think that will really help.