How will Celtics handle Kemba’s knee, Hayward’s foot and bubble injury concerns? Checking in with Dr. Flynn

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The Celtics will be arriving in the Orlando bubble on Wednesday with a host of uncertainty for the unique situation. On top of concerns about how healthy the league can keep players in the bubble setting in Orlando, the Celtics training staff will have a tough task trying to ramp up key players like Kemba Walker and Gordon Hayward to peak fitness as they manage lingering injuries and soreness. To get a better sense of all the factors at play, I caught up with BSJ's medical expert Dr. Jessica Flynn for her analysis on all of these issues and more. 

BR: We are seeing cases around the country on the rise and especially in Florida jut as teams are heading into the Orlando bubble. Do you feel like it was a mistake to pick that location at this point or do you think they will be able to maintain a relatively safe environment once they get everyone in there?

Dr. Flynn: The decision to go to Florida had to be made over a month ago and at that time I think the NBA was probably worried that the governors of other states wouldn’t allow it once the time came. Florida’s governor made it very clear early on that he was confident that he could keep professional sports teams safe and welcomed the business. I have to admit, Disney is a pretty good space - all the infrastructure is right there. Unfortunately, Florida is stuck in a very rapid surge right now, so what looked like a good decision three months ago, isn’t seeming so great right now. I talk to my good friend in Florida almost daily so I hear about how bad things are. She's a pediatrician, and at one point the positivity rate of teenagers they were testing was close to 40%. It’s a little nerve-wracking to think about NBA athletes flying into that sort of a situation.

You can only do so much to control the virus entering the bubble. You still have to have (Disney) personnel coming in and out – they can’t house every employee who has any type of direct or indirect contact with the athletes and playing staff. While the NBA is focusing on trying to seal the outside world out, one important thing to consider is that they are containing large numbers of athletes on the same ventilation system, same food service, laundry, housekeeping, etc.

The problem with that is if the virus gets in, then it's in a very closed-off area. The NBA medical staff has a great plan in place, but this is absolutely going to be an uphill battle that they’ll only succeed in if they follow the science. Like I heard, for example, that guys who have permission to leave the bubble might be able to return to play in only 4 days or so. I don’t know what the science is there. Playing out a season amidst a pandemic has never been done before, so the science is really all they have.

BR: What do you think is going to be the gameplan for the Celtics training staff as they try to ramp up players on the roster under a quick timetable here with games only three weeks after training camp begins? 

Dr. Flynn: The first thing you have to do is evaluate every player right when they start. You want to see where they are and test for fitness before things begin. I played lacrosse in college and we had this preseason test we all dreaded called the beep test. You basically have to run a certain distance between two beeps and  (the beeps) get closer and closer together. It was awful, but made offseason training so much easier knowing it was coming. The Celtics have a much more sophisticated preseason evaluation program, of course. Once they see where every athlete is, they’ll be able to slowly ramp the guys up and plan on their preseason.

BR: How would you handle the seeding games? The Celtics have something to play for in the standings but would you treat those more like preseason games? Or push them a little more in the seeding games so they are ready for big minutes in the playoffs?

Dr. Flynn: I think it's all going to depend on where everyone is when they get to Orlando. They’ll have to ramp them up slowly because otherwise there will be much more significant injuries. I worry about injuries during a stop-start season like this anyway, so they’ll have to be careful. Soft tissue injuries like hamstring strains will likely be more prevalent, but even joint injuries, like ligament injuries can happen if guys aren’t in the shape they need to be in. It’s hard to start a season this close to the play-offs.

BR: Kemba Walker's knee is an injury you have already written about at length here at BSJ. He says he's feeling much better now but he obviously hasn't tested it much yet. What do you think trainers will be looking for with him in Orlando? 

Dr. Flynn: Rest was likely “just what the doctor ordered” for Kemba. All indications point to Kemba having some arthritis in his knee. With an arthritic joint, symptoms can get worse with more mileage on the joint. Giving the joint a break can really help it recover and help reduce the inflammatory cycle that just keeps building on itself. The rest doesn’t get rid of arthritis but can be an opportunity to quiet things down and work on strengthening other areas to better support the joint. The surprise break may end up being a  big help for him in the short term. In the long term, though, I think it's an injury he's probably going to have to manage his whole career.

BR: How would you manage him during the seeding games? Sit him a bunch before the playoffs to maximize his best for the postseason?