Serious Questions Emerging About Bulls' Medical Staff

The Bulls' recent rash of injuries has focused an unwelcome spotlight on the way the organization manages injured players.  It is unclear whether the culprit is the Bulls' medical staff, coach Tom Thibodeau, management, or some combination of the above, but the organization has now developed a substantial track record of allowing players back on the court when evidence indicates they should be on the bench.

For the 2012 Bulls, injuries like these have too often resulted in a return to the game.

It must be clarified that every injury is different, and that the team and the medical staff clearly know more about each individual situation than anyone sitting at home.  However, the repeated pattern of allowing players to nonsensically gut out injuries has spawned some serious questions about the team's approach.  Consider the red flags in the injury management of the following players:


Richard Hamilton--After playing 31 minutes against the Clippers on December 30, the soon-to-be 34 year old Hamilton missed the next two games against Memphis and Atlanta with an injured groin before returning at Detroit on January 4.  He played 32 minutes that night but aggravated his groin. Said Hamilton:

"When I went back to Detroit, there was no way I was going to sit out that game,’’ Hamilton said. ‘‘The adrenaline alone was like, ‘You’re good. It’s OK.’ I don’t care who would tell me how hurt I was, I was playing regardless. 
"It pulled during the game. I wrapped it up during the game and stuff like that. [On Thursday], it was bothering me.’’

After that game, which he finished despite reinjuring his groin, Hamilton was forced to shut it down for the next 8 games. Although Tom Thibodeau was of the belief that Hamilton was ready to go, it would certainly appear that Hamilton was allowed to return before he was ready against Detroit.  Had he sat another game or two to fully heal, he might not have needed to miss 8 further games before returning to action.

Then, after playing 38 and 42 minutes in home games against New Jersey and Indiana, Hamilton missed Friday's game against Milwaukee with a thigh bruise.  He returned against the Heat Sunday but apparently aggravated the thigh bruise, the groin, or both.  He's now day to day.

In both of these instances, circumstantial evidence indicates that Hamilton was allowed to return before he was ready for a "big" regular season game.

Derrick Rose--Rose first injured his toe January 10 against Minnesota when Anthony Tolliver fell on him as he attempted to retrieve a loose ball.  He finished that game, missed the next, then returned for a back to back against Boston and Toronto, playing 39 and 41 minutes respectively.  He aggravated the injury against Toronto and would miss the Bulls' next 5 games, in which the team went 4-1.  Various reports have indicated that turf toe usually takes between 2 and 3 weeks to heal, so it may be that Rose is not yet 100%.  He has acknowledged that he expects the toe to be a problem all season.  That said, Rose has certainly looked great the last three games, though he has gone more to his floater rather than a hard pull-up jumper of late.



Rose was also the subject of some questionable injury management in last year's playoffs.  In Game 4 against the Pacers, Rose suffered what looked like a severely sprained left ankle.* Nevertheless, Rose continued to play despite the fact the Bulls led the series 3-0 against the 8 seed.  Although Rose was able to complete some marvelous athletic plays in the Miami series (and I can't say I saw much difference in his game by that point), some analysts stated that he was less explosive than normal in that series.  He certainly was far below his regular season numbers against the Heat and was often unable to take advantage of being guarded by Mike Bibby.  Although no one will be able to say for sure, playing the rest of Game 4 on a sprained ankle may have contributed to Rose's subpar performance in the Miami series.


*Amazing that he made the shot anyway.


Taj Gibson--Gibson injured his ankle on January 20 in Cleveland coming down on a foot after an attempted tip in.  He was unable to run up and down the court for 3 trips before a timeout was called to attend to him.  However, he stayed in the game to badly brick a lefty jump hook on which he clearly had no explosion before he was finally taken out. He missed the next 3 games; if he was that badly hurt he should not have been allowed to return to the court.

Joakim Noah also injured his ankle against the Cavs but returned.  He looked quite spry that game, but was forced to miss the next game at home against Charlotte.  He has looked great since, however.

Noah also missed time intermittently with chronic plantar fasciitis in 2010, although that season he was desperately needed to ensure the Bulls made the playoffs.

Luol Deng tore a ligament in his left wrist against Charlotte, but was reinserted into the game with the wrist taped when Charlotte made a run to transform a blowout into a 10-point game late in the 4th quarter.  Considering that nobody knew the severity of the injury at the time, it was not a good idea for him to return.  Whether he exacerbated the injury in his return or not, it certainly was not a risk worth taking.

And who can forget the saga over Deng's stress fracture/reaction in 2009? Deng, who was seriously injured but misdiagnosed by the team, was publicly encouraged to "challenge himself physically" by none other than team physician Brian Cole.  After weeks of being "day-to-day," Deng was forced to shut it down for the season, missing the epic first round loss to the Celtics.

Omer Asik suffered a "muscle strain" in Game 3 against the Heat last year and was considered day-to-day.  Thibodeau told the media that "[Head Trainer] Fred [Tedeschi] will take him onto the court to see if he's having any problems and hopefully he'll be ready to go."

Presumably this occurred and Asik was cleared to play in Game 4.  He played two minutes but was unable to continue.  It was later revealed that he had a broken fibula, an injury with a healing time of 4-6 weeks. Apparently, the Bulls knew the leg was broken before the game, but let him play anyway. Yes, the Bulls actually allowed a young 7-footer to play on a broken leg.  Lower leg injuries have, of course, been the death-knell of many a promising center.*

*We often hear the refrain that a player can continue playing because he "can't hurt it any worse."  I am always skeptical of this claim, especially when it comes to leg injuries.  For example, think I remember hearing that about Brandon Roy's return from arthroscopic knee surgery in the 2010 playoffs.  He was never the same again. According to deposition testimony, doctors said the same about Dirk Nowitzki's knee sprain in the 2003 playoffs. Really, you can't hurt a knee sprain any worse by playing on it?

CJ Watson has returned much earlier than one might have expected given his gruesome elbow injury.  However, he acknowledged that he's only playing at 60 percent right now.  He played well since his return until his recent wrist injury.

It must be stressed that I am not privy to any inside information on the players' health.  But the fact that multiple players have had to miss multiple sets of games for the same injury indicates that players are being rushed back as soon as they are physically able to play, rather than when they are healed.  Even more troubling is the failure to remove freshly injured players from relatively meaningless games in which they risk worsening the problem.

Overall the Bulls organization has done a great job the last few years, with the hiring of Thibodeau and the team's drafting particular highlights.  Part of what makes Thibodeau and his players so good is the fact that they are hardwired to fight as hard as they can at all times.  The Bulls have exhibited a particular organizational focus on good character players with never-say-die attitudes, but one of the unintended consequences of acquiring such players is that they will do anything to be on the court. It is the job of others in the organization, whether the team doctor, the training staff, or management, to counterbalance this tendency with the team's long-term success in mind.  That does not appear to be happening right now.  Instead, the organization consistently fails to see the forest for the trees where player health is concerned.*  In this season where the Bulls are clearly one of the three best teams in basketball, playoff health would seem to be more important than playoff seeding.

*The same could be said for the high number of minutes for Rose and Deng, although I'm less outraged by this than many because I still haven't seen conclusive evidence that more regular season minutes leads to worse playoff performance.

In a more macro sense, the Bulls should consider the case of the Mavericks and Dirk Nowitzki.  Nowitzki sprained his knee in Game 3 of the 2003 Western Conference Finals, a game the Mavs lost to go down 2-1 to the Spurs.  Nowitzki and owner Mark Cuban wanted him to return, but coach Don Nelson famously overruled them.  Nine Hall of Fame-quality years later it seems clear that Nelson's philosophy was correct, and one that an organization that let a young 7-footer play on a broken leg would be wise to emulate.



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