Bottom Line: Most likely, Simmons will be able to return at or near full strength if/when the NBA resumes its season. He is dealing with impingement of a lumbar nerve root (pinched nerve in the lower back), with the most likely cause being a herniated disc. Data suggests high rates of return, without significant decrease in performance. Durability concerns are mild, with mixed effects on career length reported in the literature.
2016: Jones Fracture (5th toe), treated with surgery Oct 2016
Also seen in: Kevin Durant, C.J. McCollum
2020: Impingement of nerve in lumbar spine (lower back), ~2/19/20
Return to Play:
Although Simmons’s injury specifics have not been made public, his reported nerve impingement in the lower back is most likely due to herniation of an intervertebral disc - when the cushion in between the bones of the spine moves out of place, exerts pressure on the adjacent nerve, and causes (potentially very severe) pain in the back and leg. Simmons has stated that he is planning to trial nonoperative treatment, which is associated with a 78% return rate in NBA players and 84% return rate in professional athletes overall. In the general population, >90% of all patients (not only athletes) will experience resolution of their pain in 6 weeks, and Simmons has now been rehabbing for 8 weeks. Reports from mid-March indicate improvement, and there are no reports of a plan to pursue surgery. Therefore, our suspicion is strong that he is continuing to improve and will be ready for return whenever the NBA resumes its season.
Expect full return to pre-injury level of performance. Data in non-operatively treated NBA players indicates no change in PER (Player Efficiency Rating) after return from injury. Simmons’s 2016 Jones fracture (foot) represents his other prior significant injury. Data in NBA players indicates that this does not impact performance levels, even multiple years following the injury.
Jones fractures, as sustained by Simmons in 2016, recur in 20-30% of NBA players in small studies published in the medical literature. However, there are many examples of NBA players (including Kevin Durant and C.J. McCollum) who have recovered successfully from this injury. In a small study of NBA players, lumbar disc herniation - Simmons’s likely current injury - treated without surgery was associated with decreased career length, but in larger studies of professional athletes, there have been no longevity differences associated with history of this injury. Overall, there is mild level of concern regarding his durability.
Image Source: All-Pro Reels, CC BY-ND 2.0