Nerlens Noel, out of Kentucky, is drawing significant injury questions as the NBA draft approaches.
One of the key tenets of modern sports science is "don't acquire injuries." Four teams are about to do just that in this week's NBA draft.
With the four players I detail in this slideshow—Nerlens Noel, Alex Len, Anthony Bennett and C.J. McCollum—there is no doubt about the talent level, but there are serious questions about their short- and long-term health. NBA medical staffs, in concert with scouts and executives, are currently assessing how that will affect their careers.
It's one thing to draft a player with a known injury, but no one wants to make the next Greg Oden pick. What people are looking for is whether the injury is understood and if the player can be effective.
NBA contract rules limit some of the exposure and risk a team takes, but with players like these, a miss can be devastating for the franchise for much longer. Teams don't mind taking risks as long as they get production. Bill Walton is the exemplar of this; while he was often injured, he was also dominant when able to get on the court and in the proper role.
We'll see exactly how teams rate these players later this week, but it will take years before we know whether they were correct. At this stage, it doesn't appear that there is significant downward pressure on any of these potential draftees, but the boards are still fluid.
I spoke with teams around the league to help understand where teams are in their thought process on the four players with the biggest intersections of injury and upside.
Red Flag: Sprained ACL
Nerlens Noel dramatically tore his ACL on the court in February, ending his season but not ending his chance to be the first overall pick in the NBA draft.
The knee is progressing well, as Noel is rehabbing at Dr. James Andrews' facility in Birmingham. While he has not been ready to participate in workouts, there's a sufficient level of understanding of his rehab for most teams have relative comfort with the knee injury.
There was a complication once teams got into Noel's medical records. He also had a growth plate fracture while in high school, in the same knee where he later tore the ligaments.
A growth plate fracture is not uncommon, especially with tall kids like Noel, and as long as they heal properly, there is seldom a long-term consequence. The worry would be that there is an imbalance between his two legs, though this is easily correctable with orthotics.
Why This Impacts His Draft Stock
Teams are justifiably concerned about both when Noel will be back in the 2013-14 season and whether he'll have chronic knee issues. The ACL surgery is well-known and monitored, and with several similar injuries over the past few seasons as well as rehab advances, this isn't a major issue.
Many teams consider Noel to be a "redshirt" in that while he should be ready physically to contribute by December, he will miss training camp and will need to be worked into an offense. Unless a team is on a long-term horizon and doesn't think it can push up to a playoff position, Noel's rookie season will have limited value.
Noel's rehab has gone well, overseen by the Champions Sports Medicine staff in Birmingham. He should continue to progress and could get on the court as soon as October, though he will more likely be ready at the 10- or 11-month mark (December/January) than he will the extreme low end of the standard return range of eight to 12 months.
Noel's best case has a full return to function and no chronic issues from any previous knee injuries. That would make him a normal, athletic big man with the stable base and quick explosion that he showed prior to the injury.
It's hard to imagine a player not coming back from ACL surgery in this day and age. Even in the extreme case of Derrick Rose, that's a timing issue rather than a physical issue.
Noel's real worst case is that the rehab extends into February and that he ends up with a knee that is constantly bothered. The long-term concern would be a need for microfracture and a comparison to a player like Amar'e Stoudemire.
Red Flag: Ankle Surgery
The biggest issue for Alex Len is not so much the ankle injury and subsequent surgery, but how it was handled in the first place.
Len has made how Maryland handled his injury a bit of an issue in public and private interviews. Len has said he complained of pain and was treated, but the team did not have an MRI done until just after its season ended. However, Len has continued to rehab with the Maryland staff, creating a bit of confusion for evaluators.
Len's surgery was fairly routine, cleaning out the ankle and stabilizing the stress fracture. This surgery is very routine and seldom has a poor outcome. The worry becomes that with increased play and pressure, Len could have an arthritic development or additional stress fractures inside this or his opposite ankle.
Why This Impacts His Draft Stock
The downside comp for Len is a scary one: Andrew Bogut. Bogut's chronic ankle problems and size are a perfect comp. Len and his advisers have tried to combat this by being very open about the injury, the rehab and the process.
Len also had his surgery done by Dr. Robert Anderson in Charlotte, the same doctor who did Derek Jeter's ankle surgery. This gives teams some additional confidence in the repair.
The standard recovery time for this type of surgery is four to six months. That could put Len on the floor as soon as August, and at this stage, teams seem confident that Len's rehab won't extend too far into the season.
While he won't be ready to play, he will likely be able to participate in training camp, which should help him integrate into the NBA game more quickly.
Down the line, the best case is that Len's injury is a one-off corrected by surgery, and it remains stable and asymptomatic for years to come.
The Bogut comparison is the downside for Len. As a big man, he's going to be asked to plant himself in the low post and keep other big men from pushing him around. The lack of a stable base could make him ineffective, and the additional pressure on his ankles could cause more injuries.
The biggest downside is that Len's ankle turns into a chronic issue, limiting his availability. Even if he retains some effectiveness, as Bogut has during his career, his value is going to be well below what is expected from a lottery pick.
Red Flag: Strained Rotator Cuff
Anthony Bennett is a physical specimen, a pure power-based power forward with upside. That's why so many were surprised when at the end of UNLV's season, Bennett was diagnosed with a strained rotator cuff and had surgery to repair it.
The muscle strain was not full-thickness, so Bennett should recover quickly. He is expected back on the floor for camp and should be fully recovered by the start of the season.
Why This Impacts His Draft Stock
The question NBA teams are having is more about Bennett's ability to stay healthy. The shoulder injury is more an indication than a real problem. As a power forward, if Bennett is susceptible to injuries in one season of college ball, there's worries about whether he can stay healthy against bigger and stronger competition.
Combined with new concerns about his size, teams are questioning whether the power potential will be held down. Comparisons to Dwight Howard are a reach on talent, but the chronic shoulder issue that Howard played through is a similar situation.
If the long wingspan and bruising inside play lead to continued problems or worse, a severe re-injury of the shoulder, Bennett's strengths are irrelevant.
Bennett is showing good recovery so far, though he is far from full strength. The best case is that this continues and that the surgery is fully corrective. As a power forward, Bennett's comparisons to players like Elton Brand give a solid upside to picking him. Shoulder injuries do tend to be correctable, especially in young players.
While shoulder injuries can be corrected, including rotator cuff and labrum issues, a percentage do indicate an inherent and chronic instability. Bennett's long wingspan can be an issue, given that will increase pressure on the joint if it is levered.
The worst case is that Bennett is plagued by shoulder injuries and loses some of his inside strength and rebounding ability.
Red Flag: Fractured Foot
C.J. McCollum lost the last few months of his college career after breaking his foot. McCollum exploded onto the college scene with a huge upset of Duke in the 2012 NCAA tournament, but the foot injury has dropped his draft stock as much as anyone.
There's some concern about his being from a small school, but it's the questions that a fractured foot raise that make him one of the biggest wild cards in the draft.
McCollum did have the foot fixated and has made much of working with Dr. Mark Meyerson, whom he called the "Michael Jordan of doctors," according to USA Today. (Take that, Kanye!) McCollum is back on the court and showing no significant deficits. His performance at the combine and in private team workouts has been encouraging.
Why This Impacts His Draft Stock
McCollum is listed as a shooting guard, but at 6'3" he will need to adjust to the point guard spot. Any loss of quickness or lateral movement will make that transition even more difficult.
McCollum also likes to burst inside, looking for contact. More physical contact does often lead to more injuries, especially for players who like to jump into contact, risking awkward landings in return for foul opportunities.
Foot injuries like this also have a tendency to be recurrent. With a new role and faster, more physical competition, teams will look closely for any physical weakness or sign that this was not a one-off issue with his foot.
McCollum's use of a well-known physician does help, but teams will have their medical staffs combing his records and physicals.
If McCollum's foot is fully healed, he could become a point guard with a scoring touch, something so many teams are looking for in this draft. While early projections that he would go in the top 10 may be a bit lofty, he does have that kind of potential.
If one team decides the foot is a one-off, fluky injury that has low recurrence risk, McCollum is the kind of player who's easy for a scouting staff to fall in love with.
Foot injuries do have a tendency to be recurrent. While McCollum's injury was fixated, that is no guarantee there will be no future problems. A recurrent injury would be a major setback. Even a minor setback that cost him quickness and stability could hurt his ability and value.