Medical expert discusses Kawhi Leonard's mysterious injury, and what's next for him

The saga of Kawhi Leonard's mysterious quad injury has been one of the strangest storylines in the NBA this season. Originally, Leonard was expected to just sit out the preseason, but his debut kept getting pushed back, with Gregg Popovich at one point saying he had never seen something like Leonard's injury. 

Eventually, the Spurs star debuted on Dec. 12 against the Mavericks, but played sparingly in the following weeks, as the Spurs tried to work him back slowly. Leonard, however, could not get over the soreness in his quad, so last week the Spurs decided to shut him down once again. Then, on Monday, there was a big report from Adrian Wojnarowski, which said the lingering quad injury is causing discord between Leonard and the Spurs -- a report Leonard's camp denied

Given all the drama, and the questions surrounding Leonard's injury, CBS Sports spoke with certified athletic trainer Jeff Stotts to get a better understanding of what Leonard is dealing with, and where things may go from here. In addition to his work in the field, Stotts runs his own website, InStreetClothes.com, and serves as an injury analyst for CBS Sports partner Rotowire.com. 

CBS Sports: We hear about tendinitis or a torn tendon, but what do they mean by tendinopathy? That's one we don't hear about as much.

Jeff Stotts: Well, the problem with tendinopathy is it can kind of be a catch-all term. A lot of times it just refers to anything that's wrong with the tendon itself. It can be anything from tendinitis to an actual disease of the tendon, like a degenerative disease. It can be two extremes. It can be something mild like a tendinitis, or something a little bit more chronic, where it's more problematic. And even sometimes you can either reference tendon tears and include them in the tendinopathy category because they involve a tendon, though there's been no indication that Kawhi ruptured or tore his patella like Tony Parker did around the same time last season.

So that makes it hard in trying to figure out exactly what a timeline should be if we don't know exactly what he's dealing with, but are people correct in thinking that he should have been back already?

Stotts: I think the magnitude of the player -- top five player in the NBA -- the fact that it's taken so long, the fact that he had a teammate who had what appeared to be a more significant injury come back quicker in Parker, all those things are creating a situation for Kawhi that I think is a little bit unfair.

The big thing for me here, is San Antonio has historically the best medical staff in the NBA since 2005-06. They've lost the fewest number of games, and they have a long history of taking a conservative, proactive approach with their players. You can go back to 2000, Tim Duncan, when he tore his meniscus, they elected to shut him down rather than let him play through it. He elected for the surgery, and obviously went on to have a Hall of Fame career. Popovich and his staff, and the medical team in San Antonio, they were the precursors for the rest phenomenon, they were the first ones resting players for extended periods of times, targeting schedule rest days during the season for their players, with their eye on the postseason.

So I think we're basically seeing a prominent player placed in that protocol. It doesn't sound like he had any major setback, it sounds like he still has some lingering soreness that they weren't comfortable with. And they want him 100 percent. They want him to play on back-to-back games, they want him to be released, and not have to worry about "hey, how's your quadriceps doing." But the quotes I've seen suggest he still has some soreness on off days, and they want to make sure they can eliminate that, and eliminate the chance of something more significant happening.

Again, it's significant because it's an impact player, but I think it's a little blown out of proportion given Pop's success, the track record of the team, and how they've approached injuries from Day 1.

Now, from your experience, are there aspects of a quad tendon injury that make it a tricky one to rehab?

Stotts: Yeah, because it's an extremely powerful muscle. People have to remember the quadriceps is a muscle group -- it's four muscles, that's where it gets its name from. People tend to forget how much we use our quad, and how important it is to our knee -- for stability, for the ligaments inside, for so much of what we do just on a day-to-day basis involves the quad.

And then you're talking about about a player who has to make start and stop motions, he's an extremely good defender so he's making lateral and hard cuts off that leg, and then running and jumping at a high velocity. So the stress put through that leg is a lot. And you want to make sure that muscle is taken care of, because if it's not, it can make him susceptible to other injuries that are more problematic, or come with a definitive timeline. And you want to make sure you avoid those things and focus on player health and safety.

Again we don't know the exact injury, but he gets shut down again now. What, generally, is he doing every day when he goes into the facility to get treatment?

Stotts: Likely he'll be focusing on any lingering symptoms, so the soreness, if there is inflammation in the area, treating those. But also working on range of motion, strength, and progressive functional activity.

  • Do I have full range of motion i that joint? (Because we're talking about two joints here in the hip and the knee.)
  • Am I moving smoothly?
  • Do I have full strength compared to the other side? Do I have full strength compared to my normal baseline scores for strength?
  • How is the overall stability of the knee?

And again, is there any underlying structural issue that we're not catching that's causing this problem? But I think if that had been the case, they would have already proactively addressed it rather than letting him come back and prolonging the situation.

You're the athletic trainer, so it might be difficult to speak for the athlete, but from your experience, just how challenging and frustrating is it when you have an injury that keeps lingering like this?

Stotts: It's obviously mentally frustrating, because Kawhi is a competitor. He wants to be out there. And I think the Tony Parker situation makes things a little harder on him, because he can see another teammate that's already back from a "similar injury." And really, people are probably unfairly making the comparison between the two. Again, different style of player, different points of their careers, but it's just natural to compare, so that can be frustrating.

Then, you know, the team is succeeding, and you want to be out there helping. You want to be working up towards the postseason, you want to be in a good place (where) everybody (is) clicking. Especially San Antonio, that you know is so dependent on the system, the rhythm. And yes, they do it great in terms of interchanging people, but everybody needs a chance to get back out there and knock off some rust and get to a point where they're contributing. I mean, anybody, if you're at a job and you see somebody having success, and you aren't able to contribute as you know you can, it can be frustrating. That's part of the rehab process, it's a mental game as well. I do think it's easy to understand why Kawhi is frustrated, but I'd be interested to see where that frustration directed, and based on Kawhi's history it doesn't seem like it's directed directly at anybody. And that's definitely what the Spurs are saying as well.

Lastly -- and again, we don't know exactly what is wrong with Kawhi's quad -- do you see this as something that could linger throughout the rest of the season and into the playoffs?

Stotts: This is the point, right? The point is to make sure it doesn't linger. And it's already gotten to the point where they're a little bit uncomfortable with where he is, that he's still reporting this soreness between games. They want to just be proactive. Yes, it's frustrating, because you want Kawhi out there, but the goal is a championship. I think everybody would admit you want him 100 percent healthy for the postseason, rather than 85 percent now, and potentially 75 percent down the road, or he exacerbates something or makes it worse to where it sets him back and he's not even available.

The focus for San Antonio has, and always will be, winning championships. They seem to be comfortable where they are seeding-wise, they seem to be comfortable resting guys, and potentially forfeiting a loss here and there, knowing this is going to make us better in the postseason when it matters. 

NBA Writer

Jack Maloney lives and writes in Milwaukee, where, like the Bucks, he is trying to own the future. Full Bio

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