With time, work and patience, George can return to his All-Star self

By Jeff Caplan, NBA.com


VIDEO: Mike Krzyzewski and Jerry Colangelo talk about Paul George’s injury

HANG TIME SOUTHWEST – The  injury suffered by Paul George Friday night during the USA Basketball Showcase in Las Vegas was shocking, but the Indiana Pacers’ All-Star small forward can make a full recovery and even regain the tremendous explosiveness and athleticism he displayed on the very play on which his lower leg snapped.

To get to that point is going to take time, perseverance and a lot of sweat.

Paul George

Paul George faces a long road to recovery from his injury.

He suffered what’s called an open tibia-fibula fracture of his right leg, meaning he fractured both the tibia and fibula. George was immediately taken to the hospital and underwent surgery performed by USA Basketball team physician Riley Williams (who is also the team physician for the Brooklyn Nets). The procedure typically involves inserting a titanium rod over the fracture and using screws to hold it in place.

The good for news George, an All-Star in each of the last two seasons, is that while the injury is rarely seen in basketball, it is a common sight among orthopedic surgeons. The procedure to repair it is also very common, according to Dr. T.O. Souryal, head physician for the Dallas Mavericks and a renowned orthopedic surgeon in sports medicine who is also president of the NBA Team Physicians Association.

“This is orthopedic surgery 101. They know what to do with an open tibia fracture,” Souryal said. “We see this injury in car accidents, we see this injury in motorcycle accidents, we see these injuries with people falling off a ladder, we see these injuries on the soccer field, so this is a relatively common orthopedic trauma injury. There’s a long track record of dealing with this injury and dealing with the issues that are unique to this injury.

“What makes this unique is that it was videotaped from five different angles.”

George, 24, faces an exhaustive rehabilitation process that begins immediately with simple, muscle-firing exercises that can be done from his hospital bed. As George moves away from early recovery challenges — such as infection — in the initial weeks following surgery, his rehab will escalate incrementally in intensity, complexity and duration as the bone heals over a period that typically spans 4-6 months. Souryal cautions that healing time for the tibia can be slow and involve complications, but he noted that for a young, well-conditioned athlete such as George, odds are high for a clean healing process.

Once the bone heals, the real work for George begins with what Souryal terms the late challenges. Regaining motion in his ankle and knee are crucial as George then begins the gradual strengthening process. A regimen that includes — at various phases — a stationary bike, walking on the underwater treadmill or zero-gravity treadmill and ultimately weight machines and leg presses is typical.

“During the recovery and healing, both of those joints can be involved in the injury, so he has to work on getting his mobility back, getting his knee moving normally and getting his ankle moving normally, and ultimately getting his strength back,” Souryal said. “During the stages, sometimes you’re on crutches, sometimes you’re in a machine or in a cast and you suffer a tremendous amount of atrophy. Part of the recovery is going to involve strengthening, and that by itself takes a long time to get your strength back.”

Will Carroll, sports injuries writer for Bleacher Report, recently spoke with Dr. Bert Mandelbaum about George’s injury. Mandelbaum is one of the top orthopedic physicians in sports medicine and said George can expect to be on crutches for six weeks.

“Then the athlete gradually progresses to rehabilitation, physical therapy and cross training,” Mandelbaum told Carroll. “Once the fracture healing is strong, the athlete will return for progressions to practice and games. Once completed, most athletes can perform at pre-injury levels.”

Souryal, who has not examined George, but has treated numerous similar injuries, agrees. Souryal said George’s final hurdle will be getting his explosiveness back, a goal that will challenge George both physically and mentally. But it is one that can be reached.

“That’s always the last thing to come back after a major injury like this,” Souryal said, “is your ability to explode and dunk the ball and have the confidence to land back on that leg.”

Once George completes the recovery process, one which Souryal cautions against setting a timetable because of the numerous variables in play at this early stage, Souryal said George can feel confident that he won’t re-injure his leg. Souryal said the bone heals stronger than it was prior to the injury and the titanium rod inserted during surgery reinforces it.

Unlike an ACL injury, Achilles injury or other soft-tissue injury in which consideration of re-injury is always present, Souryal said the risk of re-injury with a tibia fracture “is almost zero.”

George’s recovery process will be grueling and require patience. But through it he can remain focused on the likelihood of resuming his burgeoning career where it left off. How long that takes will depend on how quickly the bone heals followed by the rigorous, time-consuming strengthening process.

“Can he be back to his old self? Yes,” Souryal said. “How long will that take? I don’t know.”

67 Comments

  1. Clero Matocinos says:

    Paul George should be traded for Terrence Romeo and then draft Japeth Aguilar on 2015.

  2. bars says:

    get well soon PG..Godspeed!

  3. Flexy says:

    PG wasn’t getting enough calcium into his system. His bone cracked like it was brittle, thats why its very important to have a fully balanced diet. I wish him the best and a full recovery, but after an injury like that even if he fully heals, he will face many mental challenges from the mental trauma an injury like that causes. Examples like this show why it is important to treasure your blessings and live everyday to the fullest, you never know what the future may hold. PG best wishes and hope you get back healthy

    • asdas says:

      Injuries like this is very uncommon to reinjure, im a big soccer fan, and here in europe we see similar injuries like this, and is far from as bad as knee injuries, especially in basketball where you have to jumo, move sideways and change direction, George should be fine.

  4. I actually meant like most, if not everyone this board, I hope that Paul George heals fast and returns to his explosive self too. This is obviously a huge blow to the Pacers, but I’m confident that they will still be a great team.

  5. Like most, if not everyone this board, I hope that Paul George heals fast and returns to his explosive soon. This is obviously a huge blow to the Pacers, but I’m confident that they will still be a great team.

  6. Rodg says:

    Paul George is a real hot dog. I don’t like his dimeanor, always showing off.

  7. King LBJ says:

    LOL he cant do a 360 windmill dunk anymore. F yall who say it aint funny

  8. Pacersdynasty arch nemesis says:

    PacersDynasty is having a bad day :(

  9. Anmol says:

    PG get well soon
    But now that’s y people don’t play defense these days

  10. kivensbeneche says:

    Man! That hurts to hear that Paul. I never like the Pacers whenever they are playing Against LBJ, when he was playing for the Heat, but I’ve always like Paul George and Hot head Stevenson, who now going to play for another t team. I hope you the best my brother. Don’t rush to get back. Your health first. You will be back better than ever before.

  11. jdub455 says:

    nasty injury! i hope he returns back in PG form, however i doubt it… just look at g.hill… but i wish him and his family the best.

  12. NBAfan says:

    get well soon Paul George; your health before anything else

  13. john says:

    get well soon pg…nba needs you!

  14. paul george for life says:

    stay strong and put in some work to get back on top again hope u have a good recovery. I belive in you man.

  15. lbj says:

    Paul george will never be the same player. he will be better and we will trade james jones and future first round pick to indiana so that we can have paul george to play with our “king” lebron in cleveland

  16. the shark says:

    PG you’re one of the best so just hang in there buddy, Everything will be fine.

  17. mark says:

    PG will recover just fine just don’t rush take your time and rehab at his own pace don’t try to be superhuman and try and make it back to nba by the all star break what good will it do for a team that was hurt in the off season by the loss of lance Stevenson so there is no rush to get back he should take 1 whole year to recover because rehab should be 4 to 6 months rake the other 6 months to regain the athletic ability slowly because 4 to 6 months is not him being his old self that’s getting back to everyday normal like you and I to a athlete that’s not enough time to get back to where it took them all there life to be as far as strength and athletic ability goes these guys who pro sports are above average in these areas so I think 1 year and he should come back stronger and better it gives him the best chance to regain all his athletic ability and time.to work on his game and a fresh season to start from instead of coming in messing up whatever flow the pacers would have around that time But this could all work out in the end for mr bird and the pacers Free agency is coming for the pacers this could make the pacers a lot better team in the future if they do it right

  18. Luke Duke says:

    Feeling bad for PG. You never want to see that with any player. As a Bulls fan I know what Pacer fans are feeling right now… don’t worry, he’ll come back and still be a very good player. It’s unfortunate, but these things happen in physical sports. I’ve always thought he’d be more dominant by adding another 10-20 lbs of muscle, maybe he comes back stronger than ever? Good luck on your recovery, best wishes.

  19. san says:

    How they said, in futbol (soccer) its not a weird injury, we’ve seen it alot, in basketball it is, thats why usually the players are so scared when it happen. But its not the end of the world for him, he’s going to be fine.

  20. LIST_ener says:

    That comparison with T-Mac is not accidental at all…get well PG

  21. olbl says:

    with one leg and a new long haircut i think he has a shot with the WNBA

  22. jcreep20 says:

    IF you believe in a higher or Someone up there above. Really coach K. I just lost respect for this dude. Im positive that there aint a player in any sport that wont hesitate to give GOD the glory and thanks. First and foremost.

  23. Cheng says:

    To be honest, I do not like PG very much. However, I acknowledge his talent and his toughness. I wish him well and a very thorough recovery, and I hope to see his 360-between the legs-dunk again. Cheer up.PG.

  24. ron fabian says:

    I am not an Indie fan but I like PG for being a gentleman player. Hang in there PG! Be strong with lots of patience.

  25. Chris says:

    Hate to see any athlete go down this way whether it’s a superstar or a roleplayer. Come back strong, much love for my fellow Antelope valleyian

  26. Barley says:

    a piece of advice from a guy who also got injured while playing bball…it would be helpful to reach out to people who suffered the same injury…know their experiences, their hardships, their sufferings….the very first step to recovery is to be mentally tough…and for sure these things will help you get through all the difficulties…been there and it really gave me a lot of motivation knowing that others were able to overcome the same fate…goodluck and godbless!

  27. lebron is a journeyman says:

    everyone is sad about paul george but lebron

  28. bjorn says:

    actually no one knows for sure what the outcome will be, tho he is an athlete, very young, have prolly better medical and rehab attention than most people, and better yet, he don’t have to work- he can focus 100% on getting back.
    get well George man !

  29. thespectator says:

    that injury looked nasty..hope he comes back well…anyways..bulls and cavs for the eastern conference finals…and for the finals spurs vs cavs..spurs win in 5

  30. VJ says:

    they will rebuild him bigger stronger and faster he is young so he should return to his original self quickly

  31. Pacersdynasty arch nemesis says:

    It’s sad for PacersDynasty

  32. Jame Cab says:

    For basketball fans, let’s just wish PG24’s fast recovery. There has been a lot of players who were able to gain back their confidence.

  33. kobeballhog2 says:

    Im sure pacers have other jobs lined up for him within the organization.if the whole team usa has the westbrook thinking meaning attack like theres no tomorrow even after he got injured then its safe to say team usa wouldnt have a hard time recruiting players. Lol

  34. Ernesto says:

    Sorry,you are big and GOD is with you….from Cuba I am praying for you men…..

  35. russel says:

    paul will be back…. i thnk he can fully recovered physically but its the mental aspect will be hard to recover…. it will haunt him everytime he will do that move again…. or everytime he jump and worry about his fall….

  36. Frankie says:

    We need you on the court playing, players like you its what makes me follow the NBA this days. Sending all my positive energy from here and hope you come back soon. #prayforPG

  37. Jonathan says:

    Paul George is an amazing athlete and it’s sad when one of the game’s best gets hurt. Hopefully he has a speedy recovery

  38. lebron james says:

    horay!thats gives a bvbreak for lg

  39. Old mate and the sea says:

    I feel sorry for Paul George. I think he’ll be okay though.
    I had a similar injury on the soccer field when I was younger. It’s true your leg will heal stronger and you can get back to your old self, only you’re a little different. You have a titanium rod inserted down the middle of your leg; it’s the stuff they use on the space ships. You change a little in the sense you are now a bit of bionic man.
    But you are stronger, both physically and more important, mentally.
    It takes a very long time to come back and a big part of it is patience and confidence.
    Hope to see him back strong soon.

  40. lbj says:

    Getting injured isn’t going to help you win a ring, you need to play with the KING and join the Cavs… We will give you James Jones and a second round pick for Paul George!

    • Marcus says:

      That’s the dumbest trade in the galaxy. Do you think he planned to get injured so he could win a darn ring man ?
      You don’t need to be with Lebron to win a ring.The Pacers need to stop thinking about championships right now and they need to build there team up.

      • dreadyjun says:

        You don’t need to be with lebron to win a ring. It’s actually lebron that needs good players around him so he can get a ring.

    • Dionte Christmas says:

      not the time for jokes homie

    • Jason says:

      The guy that got outscored by 70 points in five games less than two months ago? That king?

    • Denholm says:

      how many seconds after lebrons decision did you swap your heat jersey for a cavs one?

  41. mc says:

    I wonder how this incident will psychologically affect team USA. We all know pro players are earning millions in NBA but if they get injured (like George) while playing in the world championship their cash flow might be affected. I wonder if this will affect recruitment? Will players play less aggressive to avoid injuries?

    • harrythehawk says:

      If I was a player, I’d be thinking twice about playing during the summer. It’s just not worth it.

    • Cheng says:

      It is about being a patriot and keeping NBA’s domination in the world. So……what do you think??????

  42. MPaul says:

    Get well soon PG from all the Indiana & NBA fans in Australia.

  43. fact checker says:

    “Souryal said the bone heals stronger than it was prior to the injury and the titanium rod inserted during surgery reinforces it.”

    This is not exactly true. It’s only TEMPORARILY true that the bone will be stronger AT THE SITE OF FRACTURE while it’s healing. But the rest of the bone will be weaker due to inactivity. Once he starts using his leg again, the strength will return to normal in both areas, i.e., the fracture site is not more or less likely to fracture again. (Even if the “almost zero” risk of re-injuring the tibia according to Souryal were statistically true, that doesn’t say much about the fibula.)

    That being said, I hope PG gets well soon.

  44. this is a serious injury. george has to have patience cause if he not he will not join the nba back, i think in 2 years he should be back to basketball playing if he wants to last. if he comes before does 2 year it could be a big risk

  45. Peter says:

    Google Djibril Cisse injuries, he had 2 of those and he keept playing on international level in soccer. If PG tissues didnt suffer any damage he will be fine. It looks bad on video but ACL is probably worse than that.

  46. geraldaro jeudy says:

    Get well geogre. I want you to get heal. Even thought you my big rivalry in Miami heat. Get well so I could have a real competion with you in the new opening.

  47. Evan says:

    @ase, @cp10, the risk of reinjury is low, do yourselves a favor and read the article prior to spewing nonsense

    • cp10 says:

      It’s not nonsense Evan, it’s common sense – if I land on one leg from a dunk, it causes more micro-damage to my cartilage and tendons than landing on two legs, not just with PG but with anybody. I say cartilage and tendons because that is the more common damage which leads to patelar tendonitis among other things.

      • Average Joe says:

        OH my God! Didn’t you watch the video of the chase down and injury? Or bother to read the article? It was an open tibia-fibula fracture, meaning the breakage was on the bone itself, not on the soft tissues (i.e. cartilage, tendons). As the bone heals it becomes stronger by adding non-porous material (bone scars). The only way that George could re-injure that BONE is if he lands the way he did when he got injured.

    • cp10 says:

      Everybody knows PG broke his leg Joe, we’re talking about good landing technique.

  48. TheKush says:

    I knew he’d be okay he’s got star qualities! It looked a lot worse than it was! I wish him all the best! He’s a great basketball player and great role model!

  49. Ase Tilburg 013 says:

    his career is over, from now on his ankle is vulnerable because what happened. This is very sad but true u stuk bok

    • 31for3 says:

      Bro, did you read the article? Dude just said he’ll be able to be back to his explosive self with a stronger leg than before. Lay off the negativity.

  50. Pops says:

    Get well Paul George, we will all be sending you good energy and love. Stay positive through the next few months and we’ll see you back in form soon.

  51. cp10 says:

    Good timely piece. I’d comment that though Souryal has downplayed the risk of reinjury, I personally wouldn’t land again on just one leg – there are better ways to involve both legs, knees, and feet to absorb shocks from landing. PG is also weight-bearing on one leg so that makes it definitely easier.