NBA Notebook: Doctors say Kristaps Porzingis Finals return possible but not at 100%

When Kristaps Porziņģis started hobbling while stepping into a screening motion in Game 4 at Miami almost five weeks ago, many, including Porziņģis, feared the worst. The sudden stumbling without contact, Porziņģis' inability to get up the floor and his devastated reaction, putting his uniform over his face, all resembled the devastating Achilles tendon injury that's derailed many basketball player's careers, or at least sidelined them for roughly one year.

An on-site test and further ones back in Boston eliminated that, a major break for both Porziņģis and the Celtics long-term. The actual injury, a soleus strain, proved no less disruptive to this postseason and Boston's championship hopes on the verge of the NBA Finals. Boston still doesn't know if Porziņģis can play in Game 1 despite his return to light practice activity this week. The daily uncertainty regarding the strain reflects why it's one of the most frustrating and complicated muscle ailments to come back from for basketball players, according to multiple doctors Boston Sports Journal spoke with. You need your calf to jump, rebounds and explode toward the basket. 

"The challenge for a jumping athlete such as Porziņģis is that about 80% of your total force is generated through the soleus when planting off," said Dr. Adam Tenforde from Mass General Brigham Sports Medicine. "Without knowing the specific grade of injury, it's difficult to understand the arc of progression. Often times, what we guide athletes with the soft tissue injuries is really a graded return to sport and using this concept of load management where we're interested in the amount of symptoms they have as they increase their activity ... going from jogging to some light jumping to hopefully in the coming days, being able to do more progressive jumping and loading activities while monitoring his symptoms, and the goal of course is to keep his pain at a minimal level to allow for his calf muscle to continue to heal."

That's the challenge for Porziņģis as he attempts to play next week. Dr. Jessica Flynn, an orthopedic sports medicine physician, doesn't think it's likely Porziņģis will be 100% if he returns in the Finals. That could lead to pain management, aggravation or even injuries elsewhere along the kinetic chain. She, like many, noticed Porziņģis turn his ankle plays before the calf strain in Miami, which could've contributed to the added load on the muscle. Flynn also saw some KT tape on his calves during his pre-game warmups in the series. Porziņģis dealt with a calf strain in the opposite leg earlier in the season, a less severe version, he noted, that cost him four games before he rested in back-to-backs for the rest of the season. 

That's a risk factor, Flynn said, as is Porziņģis' size, with muscle fibers stretching rather than growing like bones do, 7-footers like Giannis Antetokounmpo deal and struggle more with muscle strains. Antetokounmpo suffered a soleus strain on Apr. 9 against the Celtics that also forced the star to the floor with what looked like an Achilles scare. He, like Porziņģis, took to the floor for various shooting and other on-court work, but Doc Rivers and the Bucks remained similarly vague about his timeline to how Joe Mazzulla and the Celtics have assessed Porziņģis' outlook. Antetokounmpo pushed to return for the late stages of the Bucks' first round series against the Pacers, but remained out just over three weeks after suffering the injury. He later revealed he wasn't close to playing, saying he could only run at 30-40% of his normal capability. 

"It's all about the sports-specific movement," Flynn said. "So being able obviously to do what a normal basketball player has to do, but specifically for the calf, being able to push off with force and kind of gradually increasing that force and replicating game-like scenarios and getting other athletes out there with him, because when you're doing a drill by yourself, you're moving very uniformly, right? But then you get other guys out there and suddenly there are other feet that you can roll an ankle on. There are other bodies pushing you, we call it like perturbing you, (when) you go to up to take a shot and someone hits you, you get bumped and it's those little movements that you need to get used to before you can get back into gameplay." 

Porziņģis hasn't suffered any setback, Mazzulla said on Thursday, before the closing moments of practice on Friday revealed Porziņģis stepping into threes and jogging lightly along the line. Nothing looked abnormal, but his involvement in practice drills that Mazzulla noted on Friday weren't visible to the media. It looked better than the near-stationary shooting with minimal weight on the calf that Porziņģis did after the Miami series and even the light shooting he did the morning before Game 3 at Cleveland. It didn't involve some of his usual post work with assistant DJ MacLeay that features contact and defensive resistance from the coach. The first weekend session presented lighter work than Boston expects to do on Sunday. 

For how secretive Porziņģis' comeback sounds, it's natural that such a recovery would have ups and downs. Seeing him progress into practice is a positive and the Celtics could integrate him on a limited basis and see how he reacts. Porziņģis might deal with some pain he can play through, but in general, aggravations are common with this kind of injury, Flynn said. There is also some concern with the Achilles following a calf sprain, everyone remembering the most famous recent example of Kevin Durant suffering a calf strain during the 2019 playoffs weeks before going down with an Achilles rupture in the Finals. Strengthening that entire kinetic chain is part of the comeback process and it's no more likelier that that Achilles itself is more exposed than other corresponding muscle groups. Jeff Stotts, who covers NBA injuries and noted an average of 17 days lost to soleus strains, did not find a strong correlation between calf strains and Achilles tears in his data. Porziņģis is on day 33. 

"I'm sure he's doing all the little things from progressive strengthening exercises and loading, focusing on good diet, hydration, good protein stores, ways to help his body repair itself each day," Tenforde said. "From what we understand about the risk of a calf injury, the two factors that are most predictive of developing a calf injury is history of a leg injury, particularly of the calf, and age. The Achilles, if we look at some of the common risk factors, being male and being of older age is a risk factor for Achilles injury. So there probably is some associated underlying factors, but I'm confident with the great sports group that I'm sure Porzingis is working with, that they're focused not only on improving the quality of his calf movement, but also focusing on the loading that as you strengthen the calf muscle is also going to improve the quality of movement for the Achilles tendon."

ESPN first reported hope that Porziņģis could return to the floor later in the east finals and enough momentum built to at least make Game 4 a possibility. By that point, the Celtics built a 3-0 lead and the possibility loomed that he'd gain another week at that point, but Mazzulla later noted on 98.5 The Sports Hub that Porziņģis hadn't participated in team shootarounds during that series and with the every-other-day nature of rounds two and three, Boston didn't have the practices to begin integrating the big man in. It's hard to imagine, in retrospect, Porziņģis playing without absolutely needing to given the risks of a return at anything less than 100%. The Finals present both a long lead-up and an additional day of rest after travel days in the series. 

Both Tenforde and Flynn expressed optimism, albeit without direct knowledge or observation of Porziņģis' injury, that more than five weeks is enough to return from a soleus strain through a normal recovery. Boston has four more days of ramp-up, including the first TD Garden practice on Wednesday that'll feature a significant portion open to the media, along with the first injury report from both sides before the series. 

"I would expect they would work him in," Flynn said. "I realize it's crunch time and obviously every game matters, every minute of every game matters ... you can't throw a player, an athlete back in, especially in that specific situation, in the NBA Finals and expect them to be able to play a whole game. So I would definitely expect to see him limited, and they'll see how he responds ... and make a decision about Game 2, what his minute limitations will be." 

"They'll probably be working on him keeping those muscles warm when he's taking some time on the bench... when he's out there doing his individual training and he's doing enough intensity and volume that they feel like he's not having any pain or setbacks ...  then he'll be back with the team and sort of gradually being worked back into team play and team drills, and live play. That's the thing he has to be able to do before he can step on an NBA Finals court."

Here's what else happened around the NBA this week...

Boston (won 4-0 vs. IND): Jaylen Brown won east finals MVP after the Celtics completed two additional comeback wins in crunch time to improve to 6-0 on the road and sweep the Pacers. Boston trailed by 18 midway through Game 3 and eight with six minutes remaining in Game 4. Jrue Holiday (18.5 PPG, 58.7% FG) completed a pair of and-ones to key the final push in each win, while Brown averaged 29.8 PPG, 5.0 RPG, 3.0 APG and 2.0 SPG on 51.7% FG in the series, beating out Jayson Tatum (30.3 PPG, 10.3 RPG, 6.3 APG), 4-3, in media voting. Boston averaged 119.5 PPG in the series. Kristaps Porziņģis (calf) did not return despite reported hopes he could potentially play in Game 4. He returned to drills in practice on Friday, though his status for Game 1 of the Finals remains uncertain. Luke Kornet (wrist) missed one game after exiting Game 2 with a sprain in his left hand. He was available for Game 4. Boston hosts Dallas on Thursday at 8:30. This marks the Celtics' 23rd NBA Finals appearance.

Brooklyn: Among Jake Fischer's notes on the center market, Nets free agent Nic Claxton is expected to stay in Brooklyn for roughly $80-100 million, a figure set by Jarrett Allen that'll likely be followed by Knicks free agent Isaiah Hartenstein. The New York big men headline this summer's big man class that also includes Andre Drummond, Moe Wagner, Jalen Smith and Celtics depth centers Luke Kornet and Xavier Tillman Sr. 

Charlotte: Head coach Charles Lee will try to win his second NBA championship before joining the Hornets beginning this week. Lee has made staff hires in the meantime, bringing on Utah Jazz assistant Lamar Skeeter, Chicago Bulls assistant Josh Longstaff and Los Angeles Lakers assistant Chris Jent, according to the Charlotte Observer. PJ Washington will start in the NBA Finals after beginning the season with the Hornets, who traded him along with two second-rounders to Dallas for Grant Williams, Seth Curry and a top-two protected 2027 first round pick. 

Cleveland: Will interview Knicks assistant Johnnie Bryant and Steve Kerr's assistant Kenny Atkinson for the head coaching job they opened by firing JB Bickerstaff. Cleveland also received permission to interview James Borrego of the Pelicans and Chris Quinn of the Heat. Brian Windhorst noted that Donovan Mitchell exerts enormous control organizationally with the Cavs, perhaps more than LeBron James has in LA. Mitchell, of course, can ask out this summer with one year left on his deal and Cleveland will likely move him if he does so. For now, Jake Fischer notes that the Cavs have little motivation to move any of their core, including Mitchell, Evan Mobley, Jarrett Allen and Darius Garland. Bryant is a 10-year assistant between Utah and New York. Atkinson coached the Brooklyn Nets while Borrego led Charlotte to consecutive play-in tournament appearances. Quinn has coached in Miami for nine seasons with Erik Spoelstra. 

Dallas (won 4-1 vs. MIN): Luka Dončić won west finals MVP unanimously by leading the Mavericks to a surprising run through the Clippers, top-seed Thunder and favorited Timberwolves to meet Jayson Tatum and the Celtics in the Finals. Dončić averaged 32.4 PPG, 9.6 RPG and 8.2 APG on 47.3% shooting, burying a lethal 43.4% of his 10.6 three-point attempts per game in five west final games. He slammed the door shut on Minnesota after the Wolves took Game 4, scoring 20 points in the first quarter to put Minnesota way on the road in a runaway clinching victory. Boston won both games against Dallas this year, though the first came before their deadline adjustments that helped solidify their defense. That didn't come into form on Mar. 1, their last visit to Boston, when the Celtics unloaded on them for 138 points. 

Dončić, who alongside Kyrie Irving has fared well in isolation in the playoffs, allowed Boston's players to shoot 11-for-15 against him in that loss, with the Celtics unloading on his teammates too. They need to defend to have a chance. Irving scored 27.0 PPG on 49% shooting in the west finals, but has lost 10 straight games to his former Celtics going back to 2021. Rookie Dereck Lively II, who returned from a neck sprain midway through the series, and Daniel Gafford give Dallas size, rebounding and lob threats inside, combining for 20.3 PPG and 14.6 RPG in round three. PJ Washington struggled (37.7% FG). Maxi Kleber, a stretch big, returned from a nine-game absence with a shoulder injury for two brief appearances in Games 4-5. Irving discussed his perspective on boos, Jaylen Brown and Tatum, along with facing his former team in March with the Globe and CLNS Media. 

Detroit: Let GM Troy Weaver go after four seasons where the Pistons struggled immensely, the first major move since former Pelicans assistant GM Trajan Langdon became Detroit's president of basketball operations. Langdon would ultimately make the call on Weaver and head coach Monty Williams' futures with the organization, the latter a more complicated case after coaching the first season on a mega-deal. The Pistons finished 74-244 with no playoff appearances during Weaver's tenure and will now pick No. 5 overall after another rough lottery result. Pelicans executive Michael Blackstone could take over Weaver's No. 2 role. Weaver drafted Cade Cunningham and Isaiah Stewart, hits, but a major miss in Killian Hayes (2020) will likely define his tenure. Detroit waived Hayes this season. Langdon oversaw successful drafts in New Orleans alongside GM David Griffin. 

Golden State: Free agent Klay Thompson's market continues to take shape through reporting over league-wide interest while the Warriors reportedly maintain interest in keeping him at the right price. The Sixers, Thunder and Magic are possible cap space suitors, or leverage. Thompson and Golden State can agree to an extension at any time. Thompson turns 35 this season and has played inconsistently since his back-to-back seasons lost to injury (2019-21), at times resembling his Hall-of-Fame self and other times posting 0 points, including the Warriors' elimination game at Sacramento. Golden State is also bracing for a massive coaching staff overhaul behind Steve Kerr, with Kenny Atkinson interviewing in Cleveland, Mike Brown and Jama Mahlalela gone, and Dejan Milojević dying in January. They've talked to former Lakers coach Darvin Ham, though he isn't expected to join GS. Chris Paul, whose non-guaranteed $30 million deal locks in on June 28, is reportedly willing to work with the Warriors as they navigate their summer. 

Indiana (lost 0-4 vs. BOS): A fantastic season came to a bittersweet end when Tyrese Haliburton exited Game 2 with a hamstring injury in the same leg that cost him significant time earlier in the season. Haliburton did not return and, despite monumental efforts by TJ McConnell (15.0 PPG, 50% FG) and Andrew Nembhard (21.0 PPG, 7.8 APG, 54.1% FG) that built Pacers leads into the fourth quarter of Games 3-4, Boston came back in each game to sweep the Pacers. Pascal Siakam expressed a desire to remain with Indiana after leading the team in scoring in round three following his arrival from Toronto earlier this year. He's a free agent this summer Aaron Nesmith (18.8% 3PT) struggled in the rematch against his former team and missed a buzzer-beating three that would've forced overtime in Game 3. Head coach Rick Carlisle, a member of the 1986 Celtics, shared Bill Walton stories before Game 4. Walton died at 71 earlier in the day. 

Clippers: Ty Lue and the Clippers agreed to a contract extension through 2028-29 that'll pay him roughly $14 million per year. A move that begins the team's effort to keep its core together and officially eliminates efforts like the Lakers' rumored hopes to pry Lue from the Clippers. Lue is 97-47 in games with Kawhi Leonard and Paul George available, a rarity that's completely derailed LA's annual championship hopes. Now, George is an impending free agent along with veteran guard additions James Harden and Russell Westbrook. George, as arguably the best free agent in this class, will become the team's next priority with the ability to extend him at any time. The Clippers move into the Intuit Dome this fall after long playing at the Lakers' arena. 

Lakers: Keep their first-round pick (No. 17) after the Pelicans opted to defer the selection to the 2025 draft that LA owes them from the Anthony Davis trade. LA will reportedly decide between JJ Redick and James Borrego as its next head coach. That final compensation will officially complete the Davis deal from 2019. The Athletic has reported that LA will pursue depth additions this summer over major star splashes. 

Miami: Keep an eye on the Jimmy Butler headlines here. Whether leveraging or actual movement toward a breakup, it feels like this will be a make or break summer for where the Butler era is headed in Miami. The Philadelphia Inquirer and Miami Herald reported that the 76ers, among multiple other suitors, would sign Butler to his max contract extension if they traded for him. He's reportedly pursuing a two-year deal worth $113 million through 2027. Butler turns 35 this fall and has expressed an interest in finishing his career with the Heat. Caron Butler signed a four-year extension as assistant coach.

Minnesota (lost 1-4 vs. DAL): Looked like the triumphant upset over the Nuggets left them with nothing for the west finals against the Mavericks. Anthony Edwards played inconsistently, aside from a season-saving Game 4, averaging 24.6 PPG and 7.8 APG on 43% shooting. Karl-Anthony Towns' foul trouble continued while he lost his shot, hitting 37.9% of his attempts from the field. Naz Reid came through with 44% three-point shooting, nearly hitting a game-winning heave after hitting seven threes prior in Game 2. That leaves the Wolves with three centers and an expensive roster for an ascendent team, leaving them with next to no avenues to improve into 2024-25 other than internal growth. They'll take their most successful season in 20 years, but Mike Conley isn't getting younger and dealt with injuries late in their run, some playoff matchups still challenge Rudy Gobert and Towns' fouling still undermines his impact despite his growth defensively at the four. They'll be one of the most interesting second apron teams under the new rules. An ownership battle looms and Towns makes $49.4 million next season, the highest salary on the team. Jaden McDaniels leaps to $22.6 million. 

"I've been here nine years and I would love for the tenure to keep going," Towns said. "I'm confident I'll be able to be here with my brothers and continue what I love to do here at home. So that's the plan. Nothing's changed on my side. I love this city. I love this organization. I love this city. It's given me my life, me and my family."

New York: Isaiah Hartenstein enters free agency with a case for being the best big man available. New York is limited to a four-year, $72.5 million offer due to only having Hartenstein's early Bird Rights. Other suitors with cap space could reach offers of $80-100 million, according to Jake Fischer. Hartenstein, 26 next season, averaged 8.5 PPG, 7.8 RPG and 3.5 APG on 59.2% shooting in 13 playoff appearances with Mitchell Robinson and Julius Randle missing with injuries. Fellow big Precious Achiuwa joins Hartenstein in free agency while Randle and Robinson are signed through 2025-26. 

Oklahoma City: Robyn Hayward sounded off on Gordon Hayward's playing time after Thunder GM Sam Presti called the trade a miss. Oklahoma City sent Charlotte Tre Mann, Vasilije Micic and Davis Bertans with a pair of second-round picks in February for Hayward, who went on to score only 5.3 PPG on 45.3% shooting in 26 regular season appearances before logging only 46 minutes total in the playoffs, missing all three shot attempts. Hayward turns 34 next season after droves of injuries. Hayward called his time with the team disappointing and frustrating. 

"I missed on that," Presti said. "That's on me. But I'm learning, I'm trying to learn this team, I'm trying to learn the pace of the team a little bit. And trying to be a great observer of the team as it's going through its paces, knowing that it's really going to change on its own in and of itself."

Sacramento: Mike Brown and the Kings agreed to a contract extension through the 2026-27 season worth roughly $8.5 million per season, according to The Athletic. The two sides hit a bump in negotiations earlier in the week as reporting over Sacramento's competitive offers and Brown's desire to match the growing head coach salary market. Brown, the unanimous 2023 coach of the year while leading the Kings back to the playoffs, didn't reach Gregg Popovich, Erik Spoelstra and Monty Williams money, but approached that ballpark to stay with a team still fighting to join the west's elite. The Kings lost in the play-in tournament this spring. 

Washington: Brian Keefe will remain head coach of the Wizards after taking over for the final 39 games of Washington's season. They went 8-31 over that stretch and will pick No. 2 overall, hoping to find a foundational young piece around solid prospects like Deni Avdija and Bilal Coulibaly into year two under their new front office. Coulibaly finished fourth among the players left off the All-Rookie team at 19-years-old. Keefe, who grew up in Winchester, Massachusetts, is 48 and previously coached Brooklyn, Oklahoma City, the Lakers and Knicks. Wes Unseld Jr., who has since moved on to the Bulls, had Washington at 7-36 before his reassignment in January.