“Obviously, this year he’s out. Next year, he may return”: Medical experts weigh in on Kyrie Irving and Anthony Davis' injuries (EXCLUSIVE)

After awkwardly twisting his left knee while driving to the basket, Dallas Mavericks star Kyrie Irving currently faces a series of unresolved questions.

How long will Irving stay sidelined after tearing the ACL in his left knee? Did Irving’s extended workload following the Luka Doncic trade contribute in any way to his downfall?

The Mavericks haven’t projected a timetable on Irving’s return, other than ruling him out for the 2024-25 season. Both the Mavericks and Irving dismissed whether his usage rate factor into his ailments.

Three outside medical experts spoke to Sportskeeda for their own perspective. They don’t work for the Mavericks and have access to any of Irving’s medical records. But they have a strong familiarity with ACL injuries and the rehab process. They can also be candid without concern with upsetting their employer.

The panel included:

Dr. Alan Beyer, executive medical director of Newport Orthopedic Institute

Dr. Michael Rosselli, sports medicine physician with South Florida Walk-In Orthopedics and Sports Medicine

Dr. Jay Shah, primary care sports medicine physician with the Pomona Valley Hospital Medical Center

Editor’s note: The following one-on-one conversations have been edited and condensed. Their interviews with Sportskeeda were conducted separately.

What was your initial reaction when you heard the news that Kyrie Irving has a season-ending ACL injury?

Beyer: “Kyrie is the kind of player where this often happens to. It was a non-contact injury and he was going up for a layup. He’s that kind of mobile player who is very susceptible to an ACL injury. It’s a straight-forward ACL injury. We see a ton of them in basketball and football. It’s no great shock. Lots of the times the players that have the size and body type of Kyrie are able to do astounding things with their bodies as opposed to a big player. They can also sustain an ACL injury, but usually theirs are usually contact injury. But for a nimble player like Kyrie, it can often be a non-contact injury. That’s kind of what happened here.”

Rosselli: “Any ACL injury is devastating, especially for a point guard and how he plays. So the rest of the year is concerning for him as well as next year. As you get older, these devastating injuries such as ACL and Achilles tears, you never know how long it can take to recover. When considering him, his body and how they will rehab him, he could be back hopefully within six months. But sometimes it becomes the mental aspect of it with trusting your body like you did before and getting used to playing at such a high level again. Sometimes that can take a season or so. Even for the most impressive athlete, it takes time to come back. So you wonder how he will recover. Obviously, this year he’s out. Next year, he may return. And hopefully the year after that he’s back to where he was preinjury.”

Shah: “It’s devastating from a multitude of angles. First and foremost, from a health standpoint, you feel for an individual that clearly shows a passion for the game. When there is a catastrophic injury, you are heartbroken for the individual. From a medical standpoint, you understand the gravity of that injury. From a sports fan standpoint, you’re devastated with the trajectory you’re seeing in regards to the Dallas Mavericks as a franchise with the way the past month has gone for them.

There’s a typical pattern that causes an ACL injury. It’s often classified as a non-contact injury. You don’t often have to collide with anybody to injure the ACL. The typical fashion is running, stopping really fast, twisting and then hearing a pop. Other symptoms you look are instability in the knee. Did they have immediate swelling in the knee joint? If players are checkmarking yes, yes and yes, that’s a concern they have mechanical symptoms alongside a moment in time where they were normal. This isn’t something that usually happens gradually over time. This often happens in a moment in time alongside mechanical symptoms. With Kyrie Irving’s injury, his was caused by an hyperextended knee. When you slow down the film, he collides with [Jonas] Valanciunas on his right knee. Since he collided, he was a little off balance. He’s used to being in that position. But then his weight went on the other leg and his knee went into a hyper-extended direction. When that happens, you’re worried about the ACL from tearing.”

Some wondered if there’s any correlation with his injury to his higher usage rate following the Luka trade. From an outside medical point of view, to what extent can usage rate factor into why an ACL injury happens?

Beyer: “That’s a good question. I saw a statistic that said since Luka was gone, that Kyrie had the most minutes than anybody in the NBA. There is a school of thought that says when someone is fatigued that they are more likely to tear their ACL and have other injuries because their muscles can’t fire fast enough to protect them. It’s often said that skiers have a higher rate of ACL injuries toward the end of the day after skiing all day slightly because of fatigue and because their muscles can’t fire as quickly.

I might’ve endorsed that concept more if this was a contact ACL injury rather than a non-contact ACL injury. But who knows. That is one of those hypothetical things. I don’t think you can affix blame and say this injury had to do with the fact that he played a few more minutes than normal. Playing 39 minutes out of 48 can be a lot. But even before Luka left, Kyrie was playing 32, 33, 35 minutes a game. So I don’t think the time can be implicated. When you have a contact injury, your body’s response to that contact is to tense up. Your muscles tense up to protect your knees and other structures. In a non-contact injury, that doesn’t happen. You’re just coming in for a layup and coming down a little awkwardly. I don’t think fatigue significantly measures into that occurrence.”

Rosselli: “That’s always going to increase the rate and risk because of just pure exposure. The more you do an activity, the more likely you are to injure yourself. Then you talk about muscle fatigue. Load management has become such a big deal in the NBA. If you’re working 82 games a year and the playoffs and you’re playing 40 minutes a game, that starts to take its toll on the body. That always is a real risk. But it’s hard to say definitively, ‘This is the reason why it happened.’ But certainly I don’t think anyone would argue if you’re playing more at a high level and if you’re increasing the volume by trying to make up the difference, more likely you’re going to injure yourself.”

Shah: “There have been some studies that show a correlation between minutes played and soft-tissue injuries. But that is correlation, not causation. What’s interesting with Kyrie Irving after the Luka trade that his minutes almost jumped up to 40 minutes per game. There is data to show that there is a correlation between minutes played and soft-tissue injuries. Soft injuries include ACL tears. It still is an evolving discussion. We’re starting to see the data show that.

Everyone has that question on whether he can return back pre-injury. That will be a question that will be lingering after his surgery and throughout his recovery. We’ve seen certain players that can return back to form. And we’ve seen others not really return back to that level. This is why it’s devastating for Kyrie. His game is predicated on being able to shift, turn and pivot. He makes magic once he leaves that second step. That’s a huge emphasis of his game. Will he able to return? He has the spirit, passionate and dedication and loves the game. It’s just with where he’s at with his age (32) and the injury, these are all lingering questions marks anybody would have.”

Kyrie is out at least for the rest of the season. But what is the typical timetable and rehab process for ACL injuries?

Beyer: “He’s out for this season, and now the question is if he’s out for part of next season. The fastest ACL comeback I’ve ever seen at the professional level was Adrian Peterson with the Minnesota Vikings. He came back in six months. But that’s very, very fast. Typically, an ACL injury involves a 9-to-10-month return. That gives time for the ligament to heal, to get vascularized and to get its strength back. So I don’t think we’ll see Kyrie back at the beginning of next season. I think he should be back during the season. But it might be after the first of the year or so. That would get to 10 months. That’s not an unreasonable expectation.

Most are in a long brace for four to six weeks. That lets the knee move. Then you don’t have to be in a cast and be immobilized. Then rehabbing usually starts two weeks after surgery with electrical stimulation to rehab muscles. They can let him move the knee. They can let him do physical therapy. You don’t wait until after they’re out of the brace to start rehab. Rehab starts as soon as it’s comfortable enough for the patient to do it.”

Rosselli: “You are usually back to your sport at around that six-month marker, depending on whether it’s an isolated ACL [injury] or if you had more complicated surgery whether it’s a meniscus or MCL injury. That can take long to get back. But if you just have an ACL, most elite athletes will be back around the six-month mark. With post-surgery, usually you’re pretty protected in a brace and on crunches. You increase range of motion. Then you increase intensity throughout. Usually around that three-month arc, you get back to doing some sports-specific activities. But it’s just not at a high level yet. Sometimes you put a cuff around your thigh to help your quadriceps, hamstrings and other muscles to fire. That helps your body get fatigued at a much lighter weight. Studies show you can build muscle and strength at a lower weight because the muscle is fatigued. Patients seem to bounce back faster with that and also protect yourself from reinjury.

All timelines can be case-by-case. Some may take six to 12 months just to give yourself a ball park. Six months is the minimum and for patients that get back out, rehab and everything goes well. But eight to 10 months is reasonable as well. There are so many factors – size of the individual, what position they’re playing, what sport they’re playing, how they’re taking care of themselves, their nutrition and their rehab. You’ll find it all over the map.”

Shah: “The pendulum has swung more toward a conservative timeline. We used to hear about these glamorous stories of players returning from ACL injuries from nine months to eight months, six months to five months. They were gladiator like. But we’re learning these quick returns lead to a high risk of re-injury. The timeline tends to be an average of nine to 10 months. Obviously for this season, he’s out. I would assume that next season he’s also out. You really want him to get that affected leg as strong as an unaffected leg so he doesn’t suffer another injury .

After an ACL tear, you typically want to make sure the pain is controlled. You start working on range of motion and strength of the leg. Then you work on certain drills to help with balancing the knee joint. Before you can return on the court, you want to make sure you’re able to move on an unbalanced offense, be on one leg and catch a basketball in different areas around their body while trying to stabilize themselves on an unbalanced pad. Are they able to change directions? Are they able to start and spot? Are they able to replicate the demands they have on their knee as if they’re on the basketball court? Everyone’s physical therapy will be slightly different. But for Kyrie Irving, he’s a guard so he’s very shifty and his game is predicated on being able to drive and finish at the rim. So being able to start, stop, pivot, twist and change directions at a moment’s notice are things he’ll have to be able to replicate with the training staff before they would feel comfortable with him doing it on the basketball court.”

How would you characterize your level of concern or optimism with Anthony Davis’ injury (left adductor strain)?

Beyer: “He’ll be back. But AD has always been prone to these kind of injuries. In the last two years, he’s been kind of lucky. He played more games and minutes than I remember him playing his entire career. But he’s a big guy. He lumbers down that court. He’s a guy that has sustained a number of these injuries in his career. So I’m not at all surprised by it. The fact that they’re playing conservative with it and waiting four to six weeks before they let him come back is the right way to go. I’m kind of almost thinking now that with the other injuries they have on this team, I don’t know that you necessarily rush him back unless they’re still hanging on by a thread for that 10th place in the Play-In.”

Rosselli: “That is tough. It can be a week-to-week injury. But it can also be several months. This is similar to hamstring-type injuries. We see athletes look like they’re getting better, they get back and in the first game back, they’re back to square one and they’re rehabbing again. These are more difficult injuries to manage. They can change pretty drastically. You’re dancing on a fine line with pushing an athlete to get back to where they were prior to playing versus trying to take it slow. These are more challenging injuries than fractures or ACL tears. At least the timetables are a little bit more definitive. Soft-tissue injuries can be quite a challenge to evaluate. AD may come back, feel great and finish off the rest of the year. Or he could come back and boom, he’s out again. Then he’s shelfed for the year and you wonder if he’s going to play again next season.”

Shah: “A lot of it depends on the degree of strain. If it’s mild, it becomes a pain tolerance issue. If it’s severe, has there been any structural damage? Then that might take him longer to come back.

From a pure medical standpoint, I’m cautiously optimistic. It’s not an ACL, meniscus or Achilles tendon rupture. This isn’t a career or season-altering injury. So I’m optimistic in that regard. It just depends on if he can return soon.”

What’s the rehab process usually like to heal a left adductor strain?

Beyer: “There’s rest for a period of time until there isn’t any more pain and until the swelling and inflammation goes down. Then you have to proceed with a return to action by dialing it up slowly. If there’s any sign of more pain, you dial it back. But it’s a muscle injury. There is a finite period of time that it needs to heal. There isn’t any rushing it back. You can’t fool Mother Nature."

Rosselli: “Depending on if it’s just a degree, partial tear or complete tear, you’re looking at a few weeks. On average, it’s four to eight weeks. They work on their range-of-motion early. You don’t want to have a joint or muscle immobilized for too long. Or else that can be detrimental. It can take longer to come back from an injury if you’re immobilized or not doing much. Adding heat to the area and increasing blood flow, these are tools therapists use to get a player back even faster.”

Shah: “Is he able to do the things he needs to do to get back on the court? Is he able to jump? Is he able to rebound? Is he able to twist and pivot and rotate his core? Is he able to shift from right to left? All of that stuff comes into play. Strains are hard because it depends on the degree of severity and the body’s ability to recover. These adductor strains can linger.”

Mark Medina is an NBA insider for Sportskeeda. Follow him on X, Blue Sky, Instagram, Facebook and Threads.