Why Pistons’ Cade Cunningham is weighing rest vs. surgery on injured shin

To get surgery or not to get surgery?

That is the question pistons starguard Cade Cunningham is currently mulling over.

Cunningham, the no. 1 overall pick in 2021, has been sidelined since Nov. 10 with what the team said was “left shin soreness.” He was set to be re-evaluated in a week. More than a week has passed and Cunningham is still out because of injury. The Athletic reported last week that there is fear that Cunningham has suffered a stress fracture in his tibia (shin bone) and continues to sit out as he decides between further rest to try and heal the lingering issue or get surgery, which would likely be season-ending .

Certainly, one can understand why a 21-year-old who is viewed as the face of the franchise would be hesitant to sit out an entire season. He’s also a competitor. However, the Pistons are very likely going to miss out on the playoffs and Cunningham’s future is far more important to the organization than his trying to play hero during a potentially lost season. Yet, with all that said, it’s possible that rest, the least invasive option of the two, does the trick. Only time will tell, though.

So, given Cunningham’s importance to the Pistons, his age and Detroit’s current status in the NBAwhat’s the best course of option?

“If he were my patient, I’d present both options and see what he prefers,” Deepak Chona, MD, founder of SportsMedAnalytics told The Athletic. “Given the risk-benefit ratio of surgery, my thought is that most young NBA players in his shoes would probably choose surgery.”

Per sources, Cunningham has been dealing with shin soreness for a little bit of time now. The pain started to flare up again in the preseason and reached a point earlier this month that he needed to take time off and address it.

Taking the rest of the route has its benefits, but, like anything, doesn’t guarantee that the problem won’t persist long term. Resting, obviously, is the least invasive option. However, these types of fractures don’t always heal with rest alone. The resting process would have Cunningham off for four-to-six weeks, which he is inching toward, with limited ability to bear weight on the leg. He’d typically undergo more imaging studies after that period to see the progress. If all is well, he’d be able to ramp up his activity but would still likely be out another four-to-six weeks after that.

Ultimately, resting can work, but it also has a higher chance of allowing the injury to linger.

“The chances of healing the injury with surgery are higher,” said Chona, who also recognized that surgery doesn’t guarantee a 100 percent recovery. “All surgeries, though, carry some risk. In Cunningham’s case, those risks should be very low, but are never going to be zero.”

On the flip side, surgery would all but guarantee that Cunningham would be out for the season. The recovery period can be as little as three months, but the average is four to six months of recovery. Even on the low side, Cunningham wouldn’t hit the three-month mark until March, and the Pistons’ campaign is currently trending toward another lottery season. Additionally, with surgery can come side effects such as wound infections, anesthesia-related complications, etc. Although the side-effect risks are low, the possibility does linger and could delay the recovery process even more.

Cunningham’s teammate Rodney McGruder underwent stress fracture surgery on his left leg in 2017 as a member of the Miami Heat. McGruder ended up returning that season because he received the surgery in October. McGruder didn’t make his season debut until late February, which means he missed the first four months of the season.

McGruder appeared to not have any more significant issues with his tibia following the surgery.

If Cunningham skips the nonoperative treatment trial and goes straight to surgery, that would maximize his chances of healing at the expense of the risks associated with the surgery. With that, a three-to-four-month return to the court would be realistic if the Pistons somehow found themselves in the playoff picture down the season’s final stretch.

Ultimately, with Cunningham, Detroit has the bigger picture in mind. Sources tell The Athletic the Pistons are encouraging their franchise cornerstone to get the surgery but are allowing him to decide what he feels is best for him. Cunningham has met with specialists over the last few weeks as he attempts to learn more about the injury and recovery options.

He is turning over every stone before making a decision.

“In the long term, the implications aren’t too worrying for Cunningham,” Chona said. “Recurrence rates, assuming healing goes well, are low, and these injuries aren’t usually associated with lingering performance declines or durability issues.”

It’s understandable why Cunningham is taking his time to decide which route he wants to take. Surgery is scary. He’s a competitor who, surely, feels he can help the Pistons climb out of the cellar of the NBA standings. No one wants to be taken away from what they love to do. Resting, though, doesn’t guarantee that the pain will go away and could cause Cunningham to be bothered not just this year, but regularly throughout his career. But, again, surgery isn’t a 100 percent success rate, either.

It’s undoubtedly a tough call, but one Cunningham will have to make in the very near future.

(Top photo credit of Cade Cunningham: Bob DeChiara-USA Today)

Leave a Comment