The knee is supposed to bend. It just isn't supposed to bend every which way.
In that time period, we've seen Derrick Rose go down with knee-related issues twice. We've seen Jrue Holiday, Eric Bledsoe and Ricky Rubio sustain major knee injuries. We've seen Rajon Rondo and Jeremy Lin do the same.
It's an epidemic, a sad and unexplained NBA contagion. Now, Westbrook has caught the bug. And for all we know, that's because of his abrasive style of play.
On Dec. 27, Westbrook had arthroscopic surgery to decrease swelling in his right knee. It was his third knee surgery in seven months.
Three in seven months. Westbrook is developing a pattern, a severely unfortunate, but highly obvious pattern.
Back in April, he tore the lateral meniscus in his right knee. That's when it all started, in the first round of the NBA playoffs against the Houston Rockets.
On Oct. 1, Westbrook had to have another surgery on that same knee, this time to remove a loose stitch. He was supposed to miss the first four to six weeks of the season, but instead he came back for the Thunder's third game of the year.
We rejoiced. Westbrook was back.
Remember that until seven or eight months ago, Westbrook's health was never an issue. I mean never.
We're talking about someone who had never missed an NBA game before his meniscus injury against the Rockets. Someone who never missed a college game while he was at UCLA. Someone who never even missed a game when he was at Leuzinger High School.
Westbrook never got hurt. Ever.
Now, Westbrook's right knee has recurring issues—or at least, it has seemingly recurring issues—and it might be time for Westbrook and the Thunder to start making some adjustments.
In most ways, it would be difficult for Westbrook to change his style of play. Sure, that abrasiveness may be what injured his knee, but it also is responsible for so much of what has given him success over his six-year professional career.
Westbrook's effectiveness comes in his ability to get to the hoop, to beat the defense off the dribble. Tuesday, I delved pretty deep into the part of the Thunder offense that Oklahoma City has missed so much with Russ out of the lineup: a point guard who can make a defense collapse in on him.
That's how much of the Thunder offense works. Westbrook goes to the hoop, and it's his quicker-than-anyone-else's first step that allows him to have so much success in that aspect of the game.
Maybe it means something that Derrick Rose, another hyper-athletic point guard who cuts as abrasively as Westbrook, has suffered from knee problems as well. Maybe a quick, physical point guard who primarily beats defenders off the dribble and loves to finish around the rim is prone to this sort of injury. Maybe not.
Ultimately, that's impossible for a layman to know. If you want to have a strong opinion on that issue, get back to me once you're done with med school.
What we can do, though, is connect some of the dots on our own. Maybe the picture won't completely draw itself, but we might be able to develop some sort of image.
If Westbrook does have to change the way he plays, that wouldn't necessarily be unprecedented. We have seen elite point guards change their styles after injuries while maintaining the same level of play. Actually, we've seen it just as recently as with Chris Paul in New Orleans.
Chris Paul's Development
In February of 2010, Paul was forced to undergo a similar arthroscopic surgery to Westbrook's, one on the cartilage in his left knee. Once Paul returned for the start of the 2010-11 season, he didn't have quite the same explosion or athleticism. Something was missing.
Early in his career, Paul made much of his living getting to the hoop.
Over the first five years of his career (up until that 2010 knee injury), Paul took 28.4 percent of his field-goal attempts at the rim. In four full seasons before the injury, he attempted about 325 shots at the rim per season.
Post-injury life has been different, though.
Paul takes more jumpers now. He doesn't shoot as often. He creates off the dribble more for other people and less for himself. He avoids contact far more regularly.
Now, when Paul tries to score around a pick on a classic pick-and-roll, we usually see him go to a spot on the right side, 12 to 14 feet from the rim for a pull-up jumper off the bounce. He's not going all the way to the hoop until late in games.
The numbers back it up. Between the time of his knee surgery and the start of this season (three years), Paul averaged only 149 attempts at the rim per season, less than half of what he averaged before he got hurt. Those 149 attempts are good for only one-sixth of his total shot attempts.
We've seen Paul's game develop. Maybe, at some point, we'll see the same thing happen with Westbrook.
Westbrook's Potential Development
A Paul-like transition seems to make the most sense for someone like Westbrook, who is more athletic than Paul ever was and could still physically dominate most opposing point guards even without going straight at the rim every single possession.
For all the flak Westbrook gets for his shooting, most of his misses tend to come on threes. Once he steps out past the three-point line, the Thunder point guard is hardly a dominant shooter. But when he keeps his jumper in two-point range, all of a sudden he becomes a dominant shooter.
We're talking really, really dominant.
Westbrook is fantastic from mid-range and his hasty feet (and yes, his abrasiveness) allow him to let go of his pull-up jumper as quickly as anyone else in the league. Add in that release, which happens in a nanosecond, and the Westbrook pull-up jumper can be extremely hard to stop.
That's how Paul has sporadically dominated games as a scorer in recent years. Westbrook, who is sinking an almost-unrealistic 58.9 percent of his pull-up jumpers this season, is fully capable of doing the exact same thing.
Yes, stopping short for pull-up jumpers is another way to blow out a knee. And yes, that sort of action does create some amount of extreme torque completely on its own. But working in a more jumper-heavy offense is one of the best ways to limit contact injuries for a player who has a history of getting hurt.
Paul's change of style may not have had everything to do with CP3 himself. There were some external changes, which surely affected at least some of the refinement of his approach. Namely, the system he played in changed.
Immediately following his return from injury in the 2010-11 season, Paul welcomed in new coach Monty Williams. Williams instituted a new system, which had Paul creating less for himself and running tons of pick-and-rolls with loads of double screens instead. Paul then turned around and headed to Los Angeles for the following season.
Essentially, there were major system changes that followed Paul right after his knee injury.
Those could've been contributing factors to his shot selection and style, even though a reasonable person could argue that Vinny Del Negro's roll-the-ball-out-and-let-CP3-do-his-thing system wasn't much of a system at all.
The Thunder run a similar type of offense now to what the Hornets ran with Byron Scott in the Paul pre-injury seasons. It's a lot of one-on-one matchups with Westbrook and Kevin Durant. It doesn't rely much on shooters on the outside, because, frankly, there aren't many capable shooters to put on the outside.
The system is there to let Durant and Westbrook do their things. But what if "Westbrook's thing" doesn't maintain in the long term? There has to be somewhere else to go.
Thunder coach Scott Brooks could institute more of a motion offense. He could let players move more off the ball, taking some of the burden off Westbrook's shoulders. If you carry less weight, there isn't as much mass to break your back—or your knees.
That's on Brooks, though. And those are major system changes to contemplate in an offseason. A coach can't implement any of those adjustments in the middle of a season. It's just not practical.
The Westbrook knee problems all seem to stem from one injury, when he collided knee-to-knee with Patrick Beverley back in Round 1 of last season's playoffs. The operation in October was a repair. The one in December was likely for a reaction to the previous injuries.
So maybe we should all just blame Patrick Beverley and call it a day. Maybe that would be easiest.
Maybe Westbrook will be banged up for this year only to recover perfectly in the future. Maybe this is just a nagging, part-time injury that an offseason can fix completely on its own.
If that's the case, there's no need for Westbrook to change. There's no need for anything around him to change—at least for health reasons.
Ultimately, you don't want to take someone who is arguably a top-five player and start tweaking with the subtleties of his ability and style. You don't want to get in his head; you don't want to break him altogether.
Putting in some sort of motion offense may help Westbrook. It may not. That all depends on if doctors and trainers actually believe Westbrook's game needs to experience some sort of reconstruction.
For now, though, we can only hope that we get back the same Russell Westbrook, the one who has been so fun to watch for the last six years and the one who can finally help take the Thunder to their end goal, winning an NBA championship.
Fred Katz averaged almost one point per game in fifth grade, but he maintains that his per-36 minutes numbers were astonishing. Find more of his work at RotoWire.com or on ESPN’s TrueHoop Network at ClipperBlog.com. Follow him on Twitter at @FredKatz.
*Statistics accurate as of Jan. 15.