N.B.A. Playoff Teams Feel the Pain of Bubble Injuries

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LAKE BUENA VISTA, Fla. — Joel Embiid of the Philadelphia 76ers was in one of his playful and provocative moods when we crossed paths for the first time at the N.B.A. bubble.

As he walked to the team bus after a narrow Sixers win over the San Antonio Spurs, Embiid responded to a question about the legitimacy of winning a championship in such unusual circumstances — no fans, no travel and 22 teams at a single site — with a typical Embiid line.

“If we win it, it might be the toughest based on the conditions, and we intend to do our best to do so,” Embiid said. “If we don’t win it, then to me this would be a glorified summer league.”

That was Aug. 3. Two days later, Ben Simmons abruptly limped off the floor in a game against Washington with a partial dislocation of his left kneecap. Simmons underwent surgery the following week, and the vibe around the 76ers has since declined to downright dour.

Losing Simmons weakened the Sixers significantly before a first-round playoff matchup with Boston in which the Celtics jumped out to a 2-0 lead — and Philadelphia is hardly suffering alone. Injuries at the N.B.A. bubble, if not all as severe as what happened to Embiid’s fellow All-Star, have been frequent enough to put a wider damper on the playoffs.

There have been at least five season-ending injuries during the restart at Walt Disney World over the past six weeks, in addition to the likely end of Simmons’s season: Portland’s Zach Collins (ankle), Orlando’s Jonathan Isaac (knee), Sacramento’s Marvin Bagley (foot) and the Memphis duo of Jaren Jackson Jr. (knee) and Justise Winslow (hip). That unfortunate club will grow if Domantas Sabonis, the Indiana Pacers’ All-Star forward, is unable to return from a case of plantar fasciitis in his left foot.

Then on Thursday, Portland’s Damian Lillard dislocated the index finger on his left (non-shooting) hand by swiping at the ball from behind the Los Angeles Lakers’ Anthony Davis, though Lillard vowed to tape up the finger and play in Saturday night’s Game 3. The episode added the freakish sort of contact injury inevitable in countless sports to the slew of soft-tissue injuries many teams feared as they embarked on the resumption of the 2019-20 season.

Numerous N.B.A. medical experts warned — after a shutdown of more than four months — that players were more vulnerable to soft-tissue injuries with only three weeks of full-speed practices and scrimmages to get ready for Opening Night 2.0 on July 30. Although many experts also expressed hope that eliminating the rigors of travel would be a significant boost for players’ between-games recovery, their injury fears are proving prophetic.

Toronto’s first-round series with the Nets, in fact, is the only of eight first-round series in which neither team has lost a key player who got hurt in the bubble.

Russell Westbrook, Houston’s All-Star guard, is out indefinitely with a worrisome quadriceps strain in his right leg. The swarming Rockets have taken a 2-0 series lead over Oklahoma City without him, but that is perhaps partly because the Thunder’s Chris Paul has been playing with an injured thumb that required a tape job in Thursday’s Game 2.

Despite finishing the season with a better record than Miami, Indiana quickly fell into a 2-0 series hole against the Heat without Sabonis, who left the team less than three weeks into the Pacers’ Disney stay.

The Los Angeles Clippers dropped to 11-11 this season without Patrick Beverley in the lineup when Beverley (calf strain) was scratched from the Clippers’ Game 2 loss to the Dallas Mavericks on Wednesday.

The Denver Nuggets have badly missed the swingman Gary Harris (hip muscle strain) against the Utah Jazz, who were short-handed when they arrived in Florida minus Bojan Bogdanovic (wrist surgery in May) and have since lost the key reserve Ed Davis (knee) indefinitely.

Even if Lillard makes good on his vow to play in Game 3, Portland announced Friday that there will be no comeback for Collins, who needs season-ending surgery on his left ankle. CJ McCollum also continues to play through a lower-back fracture he sustained in the Blazers’ first game of the restart in late July.

Nor can Boston feel as comfortable about its long-term prospects as a series lead over the Simmons-less 76ers would normally suggest because Gordon Hayward severely sprained his right ankle in Game 1. Hayward is expected to be sidelined for at least one month.

And maybe no team has felt the injury pain more acutely than the Magic, who were without both Aaron Gordon (hamstring) and Michael Carter-Williams (foot) — on top of Isaac’s absence — for the first two games of their first-round series against top-seeded Milwaukee in the East. After springing a Game 1 upset, Orlando was routed in Game 2.

“None of these guys have ever, since they were kids, gone that long without playing,” Orlando Coach Steve Clifford said of the March-to-July break because of the pandemic. “You knew it was going to happen — pulls and strains and this and that. We did a Zoom meeting as soon as we got here, when everybody was still in quarantine, and that was a big part of it, telling our players that you’ve got to be talking to the performance staff if you’re feeling sore.”

Injuries like Lillard’s and Hayward’s are indeed sometimes random, bad-luck events that just as easily could have taken place had the playoffs gone on as scheduled this season without the intervention of the coronavirus.

Yet there is also a cumulative fatigue factor that all elite athletes face. Playing games every other day, after such a long layoff, can make that matter more.

“Especially now in the playoffs,” Clifford said, “when the intensity is so amped up.”

Dr. Harlan Selesnick, the Heat’s team physician since the inception of the franchise in 1988-89, said in a recent interview on WRLN radio in Miami that “no one knows how much” this season’s dramatic stop/start has increased injury risk. “But it’s certainly a concern,” Dr. Selesnick said.

Jeff Stotts of the Sports Medicine Analytics Research Team, which consults sports franchises on injury analysis and performance, said “the spike in injuries hasn’t been as pronounced” as he initially feared, but he added that the bubble variables were “always going to present issues” for teams.

Stotts, who also operates the injury-tracking website In Street Clothes, cited “the extended layoff, a condensed schedule, and the forced separation of players and team medical personnel during the hiatus.”

The foremost medical priority for teams remains trying to keep the coronavirus from infiltrating the N.B.A.’s campus. The league announced on Wednesday that, for the fifth week in a row, its considerable measures to combat the virus are working: 341 players tested daily returned zero confirmed positive tests.

Yet the science of injury prevention and the pursuit of reduced injury risk are complex and elusive in their own ways, rife with challenges and mysteries that were never going to be solved in the N.B.A.’s 113-page guidebook that governs campus life. For all the things at Disney World that are so different from the playoff norm, from the largely empty gyms to the shared hotels, how teams cope with injury losses persists as an unavoidable feature of the N.B.A. postseason.

“It’s frustrating,” Clifford said. “I would say it’s that way for the whole league, though.”