Updated Checklist for Derrick Rose's Return to Chicago Bulls

Will CarrollSports Injuries Lead WriterJanuary 31, 2013

Updated Checklist for Derrick Rose's Return to Chicago Bulls

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    Derrick Rose could be back soon for the Chicago Bulls. Rose had surgery in May of 2012 to repair a sprained ACL, putting his rehab in the low-normal range of nine months. 

    ESPN Chicago is reporting that Rose is doing full-contact, full speed drills in practice and is closing in on a return to games, probably right after the upcoming All-Star break. It appears that all Rose needs to do now is get in game condition, prepping himself for the rigors of the NBA game.

    But what can Bulls fans expect from Rose when he returns and what should they be looking for once he gets back on the floor? I asked my advisors—a group of doctors, athletic trainers, physical therapists, and added in some people inside the NBA—to help me come up with a checklist to watch for when Rose hits the floor.

    Here are the seven things you should be looking for when you next see Derrick Rose.

     

    All quotes were obtained firsthand unless otherwise noted. None of the medical personnel could be quoted due to league regulations and because they did not treat Derrick Rose directly.

    Will Carroll has been writing about sports injuries for 12 years. His work has appeared at SI.com, ESPN.com and Football Outsiders.

Sharp Cuts

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    One of the easiest things for fans to see will be whether Derrick Rose is making sharp cuts. Rose's quickness and dribbling skills are essential parts of his game. Shaking defenders requires him to change directions and break ankles, which will put pressure on his rebuilt left knee. 

    Cuts to the right will put the most pressure on the knee, so look for him to shade things to the left. Defenders will know this and will goad him into making cuts to his right. It won't take long for everyone to know whether or not he's able to do this and how much, if any, he's lost in the way of speed. 

    If Rose can come to the left side of the key and cut hard past his defender, taking it into the paint, that will be a huge positive. Once you see him do this a couple times, put a checkmark on this box.

Pivots

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    The ACL (anterior cruciate ligament) connects the bones of the upper and lower leg and keeps the tibia from accelerating past the knee. When a player runs and stops, the inertia of the lower leg has to be stopped. That falls on the ACL and PCL.

    The ACL is also involved in rotation and this is often one of the biggest tests for a reconstructed ACL. The graft, in this case part of the patellar tendon, is well established, but it has not yet undergone "ligamentization." The anchors where the surgeon attached it into the bone are solid, but not completely solid just yet. Rotation taxes both of those.

    Watch for Rose to rotate the knee slightly, especially from a standstill. It could be as simple as turning to his right while keeping his left foot down. It could be as complex as establishing his left foot as the pivot and being pinned to the sideline on a trap.

    One orthopaedic surgeon I spoke with said he would check this box off if he saw Rose step over a stationary left foot with his right. "It's a complex and relatively unnatural motion," he explained. "It's one that we do often see in basketball players. They'll lock the foot down and need to shift to get off a pass or even heave up a shot."

    This surgeon said he even worked on a drill (similar to the one on this video) with a basketball player he worked with where the player would run in, stop and pass across his established foot. "Without thinking, he would step across the affected leg to strengthen the pass. When that unconscious move can be made, the knee is ready."

Quick First Step

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    There's no question that Derrick Rose's quickness is almost defined by his first step. Any Celtics fan just cringed, remembering the time that their team had no answer for that first step, watching Rose breeze by, creating shooting space and passing lanes. 

    There is simply no better and no tougher test for Rose than seeing whether or not that quickness is back. Instead of watching Rose, watch the defender. An NBA athletic trainer explained to me that defenders seem to be better judges than we are. "They gauge the guy's quickness on an unconscious level," he explained. "The quicker he is, the more respect for it he'll get and the more space you'll see open up."

    This will be especially true when Rose goes to his right. Look to see if he favors accelerating off the right foot, which is the "good" foot now. Reluctance to push off the right foot or a need to "drop down" in order to get the acceleration is an indication that Rose isn't quite all the way back. When you see him shoot past a defender to Rose's right and that dumbfounded look on the defender's face, check this one off the list.

Explosiveness

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    Over and over, my advisors, especially the ones inside the game, told me that explosiveness was one of the main things to look for with Rose. However, getting them to define explosiveness is a little tougher.

    The best description of what to look for came from a physical therapist, saying she wanted to see "a suddenness, going from slow to fast, from stop to go." At a physiological level, the test for Rose will be to use the strength in his quads and calves without having the left knee hold him back, physically or mentally. 

    This is a bit different than first step quickness, though the two are interrelated. This is more about being able to effectively use the full range of his strength, rather than one specific motion. An orthopaedic surgeon explained it this way: "I'd rather call it a smoothness. He's going to do things normally for him, which to us involves explosive muscular activity we can only dream of. We're used to see that sudden burst, that quick stop, that change of direction and when we see it again, it's a very good sign for that knee."

    Very good sign, indeed. When you see any combination of these skills, go ahead and check this box.

Legs in the Shot

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    Derrick Rose isn't a pure shooter. He uses his legs to get his shot, both with the quick first step but also with a pop or a change of direction. Rose often will drive the lane, then stop and use something of a fallaway jumper to get his shot. It appears awkward, but it's effective. It requires a lot of strength, especially in the ankles, but Rose's knees will take some of this stress.

    Rose also uses a lot of leg in his three-point shot. He may need this, especially if he's a bit reluctant to test the knee or drive into traffic early, which could leave him with more outside shots. Watch to see how Rose goes up on these shots. Is he "arming" the shot? Is he going up with more strength on the unaffected side? If so, that will have him fading a bit to his left or seeing shots miss left. 

    Fatigue is going to be a huge factor here, especially early as he works himself back into game condition. Shots that he takes toward the end of his floor time will be a better indicator than early ones, so if he misses short at that point, it means he's still working on checking this off. 

    Another good sign here? A big dunk. 

Defense & Bounce

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    All of the activities we've talked about so far are offensive. One of the biggest challenges for Rose will be at the opposite end of the floor. 

    "He knows if he's going right or left off the dribble," explained a physical therapist. "He can compensate for any deficit he has or feels he has. On defense, it's all reaction. If he's thinking about the knee, we'll see it quickly." Players that he is guarding are going to test the knee, to see if he can backpedal, make quick movements to both sides and if there's any delay in those movements.

    Another thing to watch for will be what people around the NBA called "bounce." Medical personnel, especially strength coaches, know and teach this as plyometrics. Whether on defense or in a rebounding situation at either side, Rose will need to be able to jump and then immediately jump again when he re-contacts the ground. 

    Plyometric drills will have been a major part of his rehab since he regained weight bearing, but in game, it's going to be a major test for him. When you see players passing rather than trying to get past Rose and when you see him giving a good bounce, check this off the list.

Mental Readiness

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    The toughest test for Derrick Rose won't happen in his reconstructed knee. It will happen inside his head. He's going to have to be mentally ready to do all the physical things that he can do.

    Fact is, the Bulls would not medically clear him to play if they did not feel very confident in his physical status. He's passed test after test during the rehab process and while he's eager to get back on the court, there is a mental obstacle for many players coming back from serious injury.

    "The last time he was on that court, he ended up in pain. He ended up missing games," said one surgeon I spoke with. "That's not something he's used to. He'll need to get past that and we see adjustments."

    The physical acceptance often comes with stylistic changes. "Maybe we see him a bit reluctant to go into traffic," explained an athletic trainer. "Maybe we see him looking pass first rather than dribble-drive. It could be something as simple as looking more to the coach for set plays."

    It is impossible for any of us to get into Derrick Rose's head, but we'll see signs of what's going on by the style of his play. It will be the final checkbox on this list. Once Rose's head is as ready as his knee is, we'll have the old Derrick Rose back.