The recovery of Kevin Durant’s calf injury (muscle strain) is coming along but not fast enough as it appears he is not playing in game 1. Head coach Steve Kerr said on Monday that Durant hasn’t even resumed on-court work with the team at this point. “Not with the team,” he said, per Matt Eppers of USA Today. “If he did anything on the court, it would’ve been pretty light. I know he’s been out kinda shooting some shots, but I haven’t talked to (director of sports medicine and performance) Rick Celebrini today, so I’m not exactly sure what he’s done today.”
Kevin Durant is officially out for Game 1 of the Finals. pic.twitter.com/I9gBBmIyz5
— Bleacher Report NBA (@BR_NBA) May 27, 2019
The initial injury of a calf tear is managed like any other muscle strain. It usually consists most importantly of rest, along with anti-inflammatory medication (i.e. ibuprofen) and icing. It is also combined with wrapping of the injured muscle to decrease the chance of a large amount of blood collecting (hematoma) which can slow the rehabilitation process down and lengthen the time an athlete is unavailable.
As soon as the acute inflammatory phase is over, usually after one to three days, the active rehabilitation begins with the early part of the proliferation phase (Days 3-7). This consists of simple exercises such as gentle stretching, ensuring the gait (ability to simply walk) is normal and if it is not then working towards normalizing it. It also involves deep tissue work and massaging the involved area to limit the amount of scar tissue that forms and mobilizing any hematoma that might be present.
The intermediate portion of the proliferation phase (Days 7-14) involve more athletic activities but still not sports specific exercises.
This includes simple jogging, progressing to more active movements, such as easy side to side drills and even light jumping using both legs depending on how the muscle is responding.
The Maturation phase begins when the muscle has healed enough to be able to withstand more explosive maneuvers such as full jumping, sprinting and quick bursts on the court. This may be delayed depending on how the rehabilitation is progressing and also due to the degree of injury (grade I, II or III muscle strain).
Once the muscle is able to withstand explosive maneuvers, such as full jumping and running, it is time to introduce full contact sports specific drills. In basketball this involves jump stop shots, dunking of the basketball and explosive cutting with and without the ball.
Obviously, the ability to withstand playing for long periods is important to as the muscle will fatigue and the rehab will involve focusing on improving the endurance so as to not be prone for a repeat injury.
The ability to do simple basketball activities to keep ball skills up such as free throws, layups etc can be introduced earlier as tolerated. Bracing is not effective for muscle strains and certainly not for calf strains. However, kinesiotape aka K-tape, can be utilized to try to minimize the forces on the injured area and have become popular on any number of extremity injuries. It is frequently seen on shoulders, thighs and even forearms on professional athletes to assist in the rehab process.
Another rehabilitation option for these injuries involve blood flow restriction (BFR) therapy which allows the muscles to feel as if they are getting high loads even though they are not.
This is accomplished by utilizing a blood pressure adjustable tourniquet that adjusts in real time in order to limit the blood flow available to the extremity. This is very helpful when one is not able to put the leg (or arm in cases of upper extremity injuries) through a normal workout due to an injury or even recent surgery.
— Warriors on NBCS (@NBCSWarriors) May 28, 2019
One of the biggest hurdles in overcoming an injury such as calf strain is the mental component. This can often be difficult and requires the athlete to fully trust the rehabilitation process and feel no residual effects in order to be able to return and be as explosive and successful as prior to the injury.
This can sometimes delay the return to play if the rehabilitation process has setbacks or there is not the appropriate support team around the athlete. Of course, the entire rehabilitation varies from person to person and injury to injury and is not always straight forward and may need to adjusted accordingly. In Kevin Durant’s case, like most elite professional athletes, he has access to care every hour he is awake be it in the form of nutrition, physical therapists, athletic trainers and other specialists in order to minimize time away from the game and a speedy recovery.