Early in the fourth quarter of the Golden State Warriors Game 2 win over the Toronto Raptors in the 2019 NBA Finals, All-Star guard Klay Thompson suffered a left hamstring injury that would sideline him for the final eight minutes of the game.
Once the team returned to the Bay Area, Thompson underwent an MRI that revealed a mild strain of the hamstring, leaving his status for Game 3 of the NBA Finals as 'questionable'.
Klay Thompson & Kevon Looney injury update: pic.twitter.com/TTwO4rWEVU- Warriors PR (@WarriorsPR) June 4, 2019
Our medical expert, orthopedic surgeon Dr. Michael S. George of the KSF Orthopaedic Center in Houston, Texas, weighed in with some expert analysis of Thompson's injury and factors that will influence his recovery and potential limitations should he play through this ailment.
On the composition and responsibilities of the hamstrings:
"The hamstrings are comprised of three separate muscles: The biceps femoris, semitendinosus and semimembranosus. These muscles originate from the pelvis and attach on the tibia below the knee. The hamstrings are primarily fast-twitch muscles, responsible for providing power for knee flexion, hip extension, and most importantly deceleration of the lower leg.
On the varying severities of hamstring strains and initial treatment:
"MRI is used to determine the extent of the injury by visualizing edema and hemorrhage as well as any muscle or tendon disruption. A Grade 1 injury involves a strain of the muscle with only mild muscle tearing. Grade 2 involves a more severe partial tear while Grade 3 injuries involve a complete muscle or tendon rupture which is much less common."
"The length and cross-sectional area of the injury are directly proportional to the recovery time. The initial treatment involves ice, anti-inflammatory medications, compression and rest. Resting the knee in full extension along with compression limit bleeding from the small blood vessels which reduces the size of the hematoma, or blood collection, and can also help to reduce muscle spasm."
On the rate of rehab and the risks associated from returning too soon:
"As soon as it's comfortable, range of motion and gentle stretching is started. The rate of rehab then depends on the severity of the injury and how the hamstring responds to treatment. If the athlete returns too soon than the re-injury rate can be very high. The risk factors for re-injury include hamstring weakness, fatigue and a strength imbalance between the hamstrings and quadriceps muscles, so the rehab is focused on avoiding these injuries."
On how Thompson's game is impacted by an injury of this calibre:
"With Thompson's style of play, a hamstring injury would most likely affect his defence and driving to the basket more than it would affect his jump shot but with fatigue being an important risk factor for re-injury, it will be interesting to see if his minutes and also if his defensive assignments are adjusted when he makes his return."
While Thompson is listed as questionable for Game 3, history would indicate that he will look to play through the injury. He has yet to miss a playoff game in his career, appearing in each of a possible 120 games.
In the 2018 Finals, he suffered a high ankle sprain in Game 1 but would go on to appear in all four games of the series, averaging 16.0 points per game while shooting 48.0% from the field and 42.9% from beyond the arc.
Warriors head coach Steve Kerr alluded to this, joking with reporters after Game 2 of the 2019 Finals that "Klay said he'd be fine, but he could be half-dead and he'd say he's fine." Kerr added, "he pulled his hamstring and he thinks it's minor - we'll see."
Thompson himself told Yahoo!'s Chris Haynes after Game 2 that "I don't see myself missing Game 3."
While the diagnosis of a mild strain has affected his listed status for the game, The Athletic's Shams Charania reported that Thompson will test his body in practice with intentions on playing Game 3.
As indicated by Dr. George, this injury will likely have the greatest impact on Thompson's ability on the defensive end. Thompson, who earned All-Defensive Second Team honours this season, has spent 44 possessions as Kawhi Leonard's primary defender in the Finals (per NBA.com's matchup data), second behind only Andre Iguodala, who has spent 58 possessions as Leonard's primary defender.
While the matchup data isn't without flaw, the numbers emphasize Thompson's importance on the defensive end. Offensively, if his timing is thrown off in the slightest, his effectiveness could be negatively impacted. Thompson is averaging 23.0 points per game in the Finals including a team-high 25 points in Game 2 despite leaving early with his injury.
As the injuries pile up for the Warriors, Thompson's health becomes even more important as the team's rotation thins.