The Cleveland Cavaliers knocked off the Boston Celtics on Sunday afternoon to seal advancement to the 2nd round of the NBA Playoffs in sweep fashion. While normally that would have a great feeling attached to it, Cavs fans are forced into some serious worry, as they will have to deal with a possible suspension for J.R. Smith, and the possibility Kevin Love could miss extended time with a shoulder dislocation, suffered under some questionable circumstances after getting tangled up with Kelly Olynyk.
Love will be getting another evaluation when the team gets back to Cleveland, and an MRI to reveal the extent of the damage. What that evaluation reveals will determine what course Love's rehabilitation will take, and when he will be able to come back. In the meantime, amid the rampant speculation, let's talk a little bit about shoulder dislocations, and what the possibilities for Love's prognosis are.
What do we know about Love's injury?
Love suffered his dislocation after getting tangled up with Olynyk after a rebound (Please direct your anger towards Olynyk here). It appeared to be an anterior dislocation, meaning that Love's humeral head slid forward out of the joint capsule. I say this, because the mechanism of injury (Olynyk forcing Love's shoulder into abduction and external rotation) is how many anterior dislocations occur. Anterior dislocations are also the most common type of dislocation at the shoulder, and the least likely to cause significant damage, due to the anatomical relationship of the glenohumeral joint and its surrounding nerves, arteries, and musculature. A posterior or inferior dislocation would likely be much more serious.
We also know that Love's shoulder dislocation was reduced, or, "popped back in."
Kevin Love is wearing a sling. Says he hasn't had any MRI on the shoulder yet, but it popped back into place in the locker room.— Dave McMenamin (@mcten) April 26, 2015
That's always a good thing.
So if the shoulder is not dislocated anymore, what's the issue?
Weakness and instability always follows a dislocation. The shoulder has great dynamic stability and poor static stability. What this means is that, unlike the ankle, which is stabilized by a complex of ligaments on either side and has little muscular support, the ligaments of the shoulder are generally looser, and muscles provide a great deal of support. This allows for the amount of motion we require to have proper function of our arms. When a dislocation occurs, it stretches or tears these ligaments, as well as the surrounding musculature, which causes weakness. In the case of an anterior dislocation, this will potentially affect the deltoid, biceps, pecs, and rotator cuff, and that means that shoulder strength will be greatly reduced.
Instability goes hand in hand with this muscular weakness. Because the musculature is weakened, it isn't fully capable of protecting the joint as it should. This increases the risk of future dislocations if the same mechanism of injury occurs, because the muscles aren't strong enough to limit the anterior movement of the shoulder. This is how chronic dislocations occur, and that's what makes instability such an issue in the rehabilitation process.
Further, other structures of the shoulder could be affected. Nerves and arteries in the area can be stretched during the injury event, and can also get pinched in the joint upon relocation. This obviously has long-term negative affects on proper function of these structures. The labrum of the shoulder can also be injured during a dislocation, and this requires surgical repair, which prolongs the recovery process. This is what happened to Jameer Nelson in the 2008-2009 season, when he dislocated his shoulder and missed 54 games due to the associated labral tear. Either of these possibilities are probably the doomsday scenario for Love's situation, as they'd have long-term effects that would take a long time to recover from.
So how long is Love likely to be out?
That'll depend on the extent of the damage, and how safe the Cavs want to play it. If there's labral or neurovascular damage, the rehab will be prolonged, such as was the case for Nelson and Elton Brand in 2008. If it's something like Iman Shumpert suffered earlier this season, where there was no significant structural damage but a lot of weakness, we can expect a 4-6 week recovery period, especially because I'm assuming Love is a first-time dislocator (No previous injury in the NBA, at least), and the Cavs would want to play it safe to ensure Love doesn't have a second dislocation at a later date. Some guys, like DeMarcus Cousins and Channing Frye, have come back after missing little to no time, and because of it being the Playoffs, the Cavs may be a little more aggressive with Love's return if there's not significant damage to the labrum. That has an inherent risk of re-injury, though. In Frye's case, he returned after missing just two weeks, but re-injured in 2012 and was forced to undergo surgery.
So, in summary:
Depends on what the MRI determines, and how aggressive the Cavs want to be to get him back.
What's Love's prognosis? Will this affect him long-term?
We've discussed the possibility of re-injury, but if that doesn't happen, Love's potential to return to his full capabilities is good. Plenty of players have suffered this injury and been effective immediately upon their return: Shump, Frye, Cousins, Avery Bradley, Dwyane Wade. As long as the Cavs' medical staff can ensure that Love won't be likely to re-injure when he comes back, his play shouldn't be affected. It's also good news that Love's shooting hand isn't affected, especially if there is labral damage. In the case of a labrum tear, shooting can take a little bit to come back to full power, but that's probably not an issue here.
We will need more information before we can truly speculate on whether Love will be seen again in this playoff run. The next couple of days will be a little nerve-racking as we wait for the results of the MRI to be announced and a timetable to be set. If Love doesn't have any serious damage, though, I wouldn't necessarily rule it out.