Warriors’ Klay Thompson can thrive after ACL, Achilles injuries, experts say. Will he be as effective?

For most of Klay Thompson’s NBA career, the Golden State Warriors often described him as “no maintenance.”

Why? Thompson consistently shattered shooting records. He played in nearly every game. And he rarely complained. But after experiencing two season-ending injuries in 2019-20 (torn ACL in left knee) and 2020-21 (ruptured right Achilles tendon), will Thompson prove in the 2021-22 season that he no longer requires such hefty repairs?

“I would be optimistic that he’s going to be able to get back and compete at a high level again,” said Dr. Michael G. Ciccotti, director of sports medicine and research at Rothman Orthopaedic Institute, an outside consultant for the Philadelphia Sixers and Eagles as well as the Phillies' medical director. “But his ability to perform precisely at where he was before? That is something that only time will tell.”

USA TODAY Sports spoke with other medical experts that expressed similar views.

Dr. Abhinav Gautam, co-founder of a company that specializes in tissue repairs (Vitruvia), considered himself “cautiously optimistic” that Thompson will become the same player who helped the Warriors win three NBA championships. Dr. Douglas Cerynik, CEO of Stabiliz Orthopaedics, predicted that “with Klay and his style of play, he can return from an Achilles injury really well.” And Justin Shaginaw, a sports physical therapist and athletic trainer at Good Shepherd Penn Partners, projected that Thompson “should be able to get back to where he was.”

Still, they all offered significant caveats.

These medical experts have not worked with Thompson. The Warriors have not offered clarity on Thompson’s expected return and his rehab progress. And other NBA players have experienced varying degrees of success and failure with returning from an ACL or Achilles injury.

“He will get back to playing, but I don’t think he’ll play every game this season by any means,” said Dr. Steven Raikin, director of foot and ankle services at Rothman Orthopaedic Institute. “Assuming no additional injuries, can he be good, be the same sharpshooter as he was before and have the same impact that he had? The statistics say no, but those players are statistics.”

No wonder Dr. Casey Humbyrd, division chief of foot and ankle orthopedics at Penn Medicine, cautioned that “trying to predict what he’s going to do is next to impossible.”

“There is a lot of uncertainty,” said Dr. Jonathan Kaplan, a foot and ankle surgeon with the Hoag Orthopedic Institute. “We know a lot about how players come back from ACL injuries. We know a lot about how they come back from Achilles injuries. But we really don’t know how players can come back from both.”

How have other NBA players returned from ACL and Achilles injuries?

In 2013, Cerynik co-authored a study published by the American Journal of Sports Medicine that detailed how 43 players responded from a major Achilles injury between 1988 and 2011. The study concluded that 37 showed “a decreased level of performance,” while six did not return.

Since that study, other players have navigated that challenge. Brooklyn Nets star Kevin Durant joined former Atlanta Hawks star Dominique Wilkins as the lone players to perform better than before they injured their Achilles. DeMarcus Cousins and John Wall joined the handful of others that returned albeit without the same effectiveness, including Kobe Bryant, Rudy Gay, Wesley Mathews, Chauncey Billups and Mario Chalmers.

In 2017, the Physician and Sports Medicine published a study that reported 11 out of 12 professional basketball players “returned to their prior level of play” after injuring an ACL between 2008 and 2014. Nine of them played in the NBA.

“When I talk to my sports medicine colleagues about if there is some sort of relationship between an Achilles tendon injuries and ACL’s, that’s something we have discussed,” Humbyrd said. “But I don’t have good research or evidence to share with you on if there is a relationship.”

For better or for worse, Thompson’s return could offer some clarity.

“It’s one thing to play in practice unrestricted; it’s another thing to be back in games,” said Shaginaw, who has worked with the U.S. men’s soccer team. “So the big question will be, ‘Is he really fully recovered from the ACL and now is he just dealing with the Achilles?’ Or is he still recovering from both of those injuries?”

The Warriors and Thompson maintained he had fully healed the ACL in his left knee that he injured in a decisive Game 6 loss in the 2019 NBA Finals to the Toronto Raptors. After rehabbing for all of the 2019-20 season, Thompson spent the following offseason completing two-a-day workouts that entailed weightlifting and shooting sessions. But then Thompson injured his right Achilles during a pick-up game with other NBA players on the day of the 2020 NBA Draft.

By March, Thompson said he had his walking boot removed and received medical clearance for various drills. Those included walking, lifting weights, calf raises, mobility and balance exercises as well as running on a weight-bearing treadmill underwater. Although the Warriors haven’t given a timeline on Thompson’s return, medical experts said most players take around a year to improve their range of motion, strength and jumping abilities. That sets Thompson up for a possible return in November or December.

“I think it would be harder for a player to come back from rupturing their Achilles first and then tearing their ACL second as opposed to how Klay’s injury was,” Kaplan said. “The Achilles tends to be the harder injury to come back from, tends to take a lot more rehab from and can be set back by a knee injury. Because Klay tore his Achilles tendon last, it gives him more time to recover and gives him a better ability to adapt.”

What will Thompson’s game look like?

Medical experts remained bullish on Thompson’s ability to adapt for reasons beyond his credentials as a five-time NBA All-Star and one of the league’s best shooters.

“Offensively, I think he’ll be just fine,” Cerynik said. "Larry Bird played with back injuries later in his career. But he still played for quite a while because he can shoot.”

In Thompson’s case, he can shoot without needing to drive to the basket or even have the ball in his hands for that long. In 2016, Thompson scored a career-high 60 points on only 11 dribbles. Thompson does not need to move too much considering Stephen Curry, Draymond Green and Andre Iguodala thrive as playmakers.

“If you just look at his shooting mechanics, he’s done an incredible job of squaring up to the basket,” said Gautam, who has treated various NBA players. “I’m optimistic in him as a shooter. He’s still connected to the ground when he rises up. He rises up in a very balanced fashion.”

Can Thompson adjust just as seamlessly on defense? Medical experts sounded less optimistic on whether Thompson can sprint back on defense, close out on the perimeter and guard the post as well as he did during his first eight NBA seasons.

“He’s a very smart defender that I think he can still do it,” Kaplan said. “He’ll find a way to use his body and space to control the players that he’s been defending. But I do think that there is a possibility with truly elite offensive scorers, he may have trouble stopping them because of how quick and explosive they are.”

There are other wrinkles that leave medical experts more encouraged than concerned.

They expressed confidence in the Warriors’ training staff. They praised Thompson’s work ethic and resiliency. And they argued Thompson is best equipped to handle the physical and mental tolls with his return because he remains in the prime of his career at 31.

“I do think that Klay’s age helps,” Kaplan said. “It’s never an ideal time to have an Achilles rupture. But if you were to have one and have this combination of injury, it benefits him compared to someone who is really young or really old.”

At some point this season, Thompson will show whether the medical community remained justified with their cautious optimism on his return.

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This article originally appeared on USA TODAY: Klay Thompson, Warriors face uncertainty after ACL, Achilles injuries