Philadelphia 76ers star Ben Simmons will be out at least two weeks after being diagnosed with a nerve impingement in his back. What can we expect from this particular injury?
The Philadelphia 76ers will be without All-Star point guard Ben Simmons “for an extended period of time,” according to ESPN’s Adrian Wojnarowski, after being diagnosed with a nerve impingement in his lower back. Wojnarowski adds that Simmons will be re-evaluated in two weeks, though the Sixers expect the LSU product’s absence to extend further into the future.
Simmons reportedly suffered the injury on Saturday in a loss to the Milwaukee Bucks; various diagnostic images and consultations with medical professionals both inside and outside of the 76ers organization led to the determination that Simmons would undergo rehabilitation as a first-line treatment for his condition.
Nerve impingement is an umbrella term used within the medical and rehabilitation world to describe a situation in which a nerve has become irritated and/or pinched by a nearby tissue. Frequently the tissue in question is the intervertebral disc — a dense, cartilaginous structure located between each vertebra. However, nerves can become impinged by muscles, bones and other bodily tissues.
Frequent symptoms of nerve impingement include back pain — often accompanied by back spasms — numbness and tingling in the leg, and muscle weakness. While the condition and its symptoms sound scary and intimidating, the fact of the matter is that nerve impingement of the low back is common, both in the athletic and lay population.
Treatment often focuses on improving the strength of the hip and core musculature while trying to “free” the nerve from the tissue impinging upon it; this is often done with manual therapy and/or chiropractic adjustments as well as traction. Traction involves slowly pulling the lumbar spine while the upper body is stabilized; this causes the joint space around the nerve to open, reducing the amount of nerve irritation.
According to a study published in Sports Health in 2016, NBA players who underwent non-operative treatment for lumbar disc herniation — the condition most likely to cause nerve impingement — returned to play approximately 80 percent of the time and did not play in fewer games or see a decrease in Player Efficiency Rating compared to their control-matched peers.
If conservative treatment fails to reduce pain and improve function, surgical intervention may be warranted, with the most common procedure being microdiscectomy (again, this assumes that the disc is the anatomical culprit for the impingement). Microdiscectomy involves excising the portion of the disc that is irritating/pinching the nerve. The aforementioned Sports Health article reports a similar near 80 percent return to play rate after surgical intervention, but number of games played as well as PER did drop in the season following surgery. Fortunately, the statistics returned to baseline in the second and third seasons post-op. Another study published in SPINE found that rebounds per 40 also dropped in the season following surgery.
In all, Ben Simmons’ injury will likely be of little consequence for his career in the long-term, but it is a significant blow to the 76ers in the short-term. Philadelphia currently finds itself as the fifth seed in the Eastern Conference, a half-game behind the Miami Heat and 2.5 games ahead of the Indiana Pacers entering Tuesday’s action. The 76ers have outscored their opponents by 79 points when Simmons is on the court.