The Celtics received a critical blow on Wednesday evening when they revealed an MRI taken on Marcus Smart on Wednesday showed a partial avulsion of his left oblique abdominal muscle off of his iliac crest. The team has placed a return timetable of 4-6 weeks for basketball activities for Smart, but clearly, every day will be crucial in the midst of Boston's postseason run.
There is no questioning Smart's toughness on the floor and his desire to be out there but what can be considered reasonable expectations for Smart to get back out there if the Celtics advance out of the first round? To get a better sense of what the point guard is dealing with and what his rehab and recovery timetable might look like, I caught up with BSJ medical expert Dr. Jessica Flynn in an interview Thursday morning.
BSJ: So the diagnosis (partial avulsion of his left oblique abdominal muscle off of his iliac crest) is a mouthful. Can you simplify things a little bit for us with what happened here?
Dr. Flynn: In the video, it looked like Smart took some contact on his hip at the same time he was pushing off and pivoting. That can cause bruising at the attachment of those core muscles and oblique muscles. That’s called a hip pointer, but if the muscle is contracting at the same time, you can get some tearing. What happened is the muscle attachment, which is a tendon, actually pulled partly off the bone. Some of the tendon is still attached but some of it is not. It’s an injury we commonly see in young athletes, especially soccer players who are forcefully shooting the ball. We can see they pull a tendon off the pelvic brim. We don’t see it often in adult athletes.
BSJ: There has been some criticism of the C's medical staff for allowing Smart back into the game. Is that valid? Could he have made it worse by going back out there?
Dr. Flynn: I think it is highly doubtful that he made the injury worse. The injury had already happened and he likely felt he could push through it. The Celtics allowed him to go back out there and try and it just didn’t work. I don’t think it was dangerous trying to go back out there and I don’t think he will miss more time because he did go back out there.
BSJ: The timetable for Smart's return is basketball activities is 4-6 weeks. What can he do right now to help with the rehab or is just resting up so it can heal? How soon can he realistically get back on the floor in a playoff setting?
Dr. Flynn: I think the hardest thing for an athlete to do, the hardest treatment is rest and unfortunately that’s what he needs to do right now. He needs to let the tissue heal, let scar tissue build up in that area and let the tendon attach to the bone. That’s a tough thing, especially during the playoffs. The unfortunate thing about the timing of this injury and the fact it is an avulsion injury is I don’t think we are going to see Marcus Smart in the playoffs.
I think a 4-to-6 week return to play window is a return to some semblance of basketball activities, it’s not a return to a playoff atmosphere. I will be very happily surprised if we see him on the court this playoff season.
BSJ: If he does try to return ahead of the schedule, where would he be limited? Will it be apparent that he can’t move as well or is the pain the bigger issue?