NBA Draft Injury Series: Michael Porter Jr.’s Back

By Dr. Ankur Verma

The NBA Combine is this week in Chicago and while many of the prospects will go through drills and scrimmaging, the most important part of the Combine remains the medicals.

In honor of that, let’s take a look at 2018 NBA Draft prospects with injury questions and determine if we can glean anything about their future based on their respective injuries.

As always, we’re not privy to the specific medical information for these prospects; we’re just trying to draw conclusions based on available public information.

Today, we’ll start with likely top-10 pick Michael Porter Jr.

Michael Porter, Jr. (Credit: TonyTheTiger)

Michael Porter Jr., Forward, Missouri  Age-19   Height-6’10”    Weight-211 lbs

Porter is definitely an interesting case from an injury standpoint.  Once a top recruit, Porter’s season at Missouri ended just 2 minutes into the season with what was called a back injury.  He would undergo what appears to be a L3-L4 microdiscectomy.

Let’s start there.  In the above linked article, Missouri coach Cuonzo Martin apparently initially said that Porter suffered a leg injury.  There was also a report that Porter was spending home games in the locker room because he was “too uncomfortable to sit on the bench”.

Both of these things are consistent with a herniated disc.  Basically the discs between your vertebrae in your back can bulge and impinge on the nerves sprouting from your spinal cord.  Because the nerves in the lower back/lumbar region go to your legs, a lumbar herniated disc can cause leg pain, which is likely what Martin was referring to.  In addition, activities such as forward flexion and sitting can exacerbate symptoms as it increases intradiscal pressure.

 

Herniated Disc. (Credit: OpenStax College, Connexions Web site)

 

What a microdiscectomy does is relieve pressure on the disc, which should theoretically improve symptoms.

Next, let’s examine the success rate of such a procedure.  Outcomes are generally good in the larger population, but let’s try to get more specific.  This study published in 2008 by Dewing, et. al seems somewhat applicable to our situation.  They looked at a “younger, more active population” (age range 19-46) involved in the military.  84% returned to unrestricted duty, while the cohort experienced a significant decrease in leg pain.  And for what it’s worth, this study by Lurie, et al looked at specific herniation levels and found that patient’s suffering from upper lumbar herniations (including L3-L4) experienced significant improvement in symptoms after operative compared to nonoperative treatment, especially when compared to other lumbar levels.

So all in all, good indicators for Porter.

Is this corroborated by what we’ve seen in NBA history?

In my internal NBA injury database compiling injuries of 1989 draft picks to 2003 draft picks (more on this in a later post) during the 1989-2012 seasons gleaned from publicly available information such as press-releases and NBA.com (and allowing for the likelihood that  teams exploited the old Injury Reserve rule in the past, which casts some doubt on the accuracy of some reports), there were nine players that missed games due to herniated discs as their first injury in the NBA  (this excludes general “back pain” and “back spasms”, since we do not know the nature of these injuries and obviously excludes undrafted free agents).  A search through ProSportsTransactions reveals one additional player since then that fits the same criteria.  From the same database, there was one player, Scott Haskin, who suffered a herniated disc in college.  It is worth mentioning that Haskin missed one entire college season after surgery, but returned to play two more full seasons in the NCAA.  At this time, I won’t comment on players who had herniated discs later in their career (such as Dwight Howard) as I’m more interested in what the surgery means in a player who is otherwise ostensibly healthy.  Please see the table below.

Herniated Disc as First NBA Injury

NameAge at time of InjuryHeightWeight (lbs)Minutes Played%Recurrent?
Scott Haskin*206'11'2500Yes
Vlade Divac237'1''24385.5Yes
Greg Foster336'11''2407.1No
Antonio Davis266'9''21592.5Yes
Matt Geiger277'0''24347.9No
Brooks Thompson256'4''19384.2No
Loren Meyer256'10''2573.4No
Jake Tsakalidis237'2''28741.8No
Tayshaun Prince296'9''21643.2No
Chris Jefferies226'8''23060.1No
Brice Johnson226'10''230100Unknown
*Haskin's injury was during college basketball
Minutes Played%= Percentage of career minutes played AFTER the herniated disc
Recurrent= Subsequent back injury that caused missed games

 

It’s a small sample size, but three players on that list went on to have recurrent back issues that caused them to miss games.  However, those two of those players–Vlade Divac and Antonio Davis–accumulated above average value in their careers per basketball-reference.com Win Shares stat.  The third, Haskin, was a major bust after being the 14th overall pick by the Pacers and it’s safe to say that back injuries destroyed his career.

Tayshaun Prince is the closest physical comparison to Porter.  Once could argue that Prince wasn’t as effective a player after the injury, though he did play a good quantity of minutes afterwards.

Interestingly, most of these players went on to have knee issues, but I doubt that’s directly related to the back injuries.

Rehabilitation usually involves increasing hamstring flexibility, strengthening the core (both of these things help lessen the stress load on the spine), and extension-based spinal stabilization exercises such as the Mckenzie method.

Porter did come back at the end of Missouri’s season to play two games and posted a ghastly 38.3 effective field goal percentage, which is concerning for a player whose main skill is considered to be scoring.  Both The Ringer and ESPN agree that he tends to be upright when he plays, needs to improve his lateral quickness to become a better perimeter defender, and has to bulk up to withstand the physicality of the NBA.

If true, all three of these weaknesses loom as even bigger obstacles with someone who had spinal surgery.  And because of this, it’s unfortunate he will not participate in drills at the Combine this year, so we won’t be able to see how he performs in the agility portion.  It’s probably best for his draft status, though, to preserve some of that mystery.

Level of Worry:  There is the caveat that there are a few NBA players missing from the database.  In the media, teams generally use the non-specific words “back injury” and “back soreness”, so it’s unclear if some of these injuries are just strains or spasms or something more.  However, even if a few more players were added to the pool, the sample size is still small.  Therefore, it is difficult to draw conclusions and I would err on the side of caution with any of these numbers.  My belief in the power of sample size is incredible.  And outcomes are generally very good in the general population for microdiscectomies.  However, I do feel that Porter has some work ahead of him if he wants to be an effective NBA player and I admit that his weaknesses don’t pair well with this type of injury.  Thus, my level of concern is mild that this injury will prevent him from reaching his full potential.