Pacers Tyrese Haliburton Suffers Calf Strain, Here’s What This Means

The Indiana Pacers are facing two types of strains right now. One is the strain of trying to stay alive in the NBA Finals while down 3-2 in the series to the Oklahoma City Thunder. The other is a muscle strain in the right calf of the Pacers star point guard Tyrese Haliburton. He’s been struggling with this injury throughout the championship series and seemed to further aggravate it in the Pacers’ 120-109 Game 5 loss to the Thunder this past Tuesday. So the big question is whether he’ll be able to provide the necessary muscle when the Pacers take on the Thunder in a win-or-the-series-is-over Game 6 this Thursday.

A Calf Strain Is When A Calf Muscle Gets Stretched Or Torn

Well, first, let’s take a closer look at his injury. I’ve written in Forbes before about calf strains when detailing what happened to Simone Biles during the last Summer Olympics. A muscle strain is a slightly fancier way of saying a muscle pull, stretch or tear. While your calf does have other muscles, the two major ones are your gastrocnemius and soleus. They are the James Browns of your calf and do most of the work. In fact, this is a two becomes one situation where in each of your legs, these muscles merge right above your heel to then feed into your Achilles tendon. So, in effect, the gastrocnemius and soleus function more like one big muscle with two sections.

When they contract, your gastrocnemius and soleus help lift your heel and point your foot. This is necessary when you run and jump. When these muscles get stretched too quickly, with too much force or by too great a degree, though, the result can be a calf strain. This can happen whenever your foot gets rapidly flexed such as when you land after jumping, sprint or change directions. Your calf muscles can be particularly susceptible to strains if they are tight—tight in a bad way, such as when you don’t stretch enough before exercising—weakened or fatigued.

It’s not clear when specifically Haliburton strained and perhaps re-strained his calf muscle. Running, jumping and pivoting are things that basketball players kind of do a lot during a game. Plus, typically, a basketball player who is playing in serious competition in the NBA is not going be like that “Weekend Warrior” rec player at the Y who shouts, “Muscle pull, need a moment,” when the injury occurs. However, Haliburton did leave Game 5 during the first quarter and return with his right lower leg wrapped. So, presumably the injury or re-injury occurred fairly early during that game.

Haliburton May Have Had A Grade 2 Calf Strain

Calf strains are usually diagnosed through a physical exam. A doctor can check for swelling, bruising and other color changes in the area. He or she may push on the calf to look for tenderness and see if movement of the ankle causes pain. Naturally, you want to be careful when doing these things because really mashing on the calf like you are making sausage could further aggravate symptoms.

In many cases, the doctor won’t need additional testing to diagnose a calf strain and recommend treatment. However, he or she may choose to use magnetic resonance imaging, otherwise known as an MRI, to confirm the presence, location and extent of the strain. Any or all of the above can help determine how severe the muscle strain is and into which of the following grades it falls:

• Grade 1: This is a mild muscle strain where the accompanying damage is quite minimal. The muscle fibers have been stretched with potentially a small amount of tearing. You may have felt a sharp pain at the time of the injury occurs but symptoms may not persist. Typically you can walk fine with such an injury. The risk of long-term complications is low.
• Grade 2: This is considered a moderate strain and consists of, guess what, a moderate amount of muscle damage. This equates to a tear through at least some and up to most of the affected muscle fibers. It’s common to experience sharp pains beyond the time of the injury that worsen however you move the muscle, whether you are flexing or extending your foot. This severity of the tear tends to impact your muscle’s strength or range of motion. If it’s in a calf muscle, your walking usually ends up getting impaired for a while at least to some degree. Haliburton’s strain likely falls into this category.
• Grade 3: This is when things get severe, which is why this is also called a severe strain. In this case, the affected muscle fibers have been torn completely through, which can leave significant bruising and swelling. When the tear results in rupture of the muscle, meaning separation of the two ends of the tear, surgery may be necessary to reattach the muscle together.

The grade of the strain will help determine the expected recovery time and potentially the treatment.

Treatment For A Calf Strain

In most cases, the treatment for a calf strain is RICE. This doesn’t mean that you turn your lower leg into a piece of sushi. Rather, RICE is an acronym that stands for:

• Rest: This should be obvious. This is not the time to engage in a shuffle dance contest. Your muscle needs the time and opportunity to heal.
• Ice: Applying some sort of cold compress during the first 48 hours after the injury can reduce inflammation and relieve symptoms. Don’t be overzealous and keep the cold stuff on your calf for longer than 20 minutes at a time. Otherwise, you may end up damaging your skin such as giving yourself frostbite. Also, don’t do this more than eight times a day for the same reason.
• Compression: Wrapping your calf can keep the swelling and inflammation down. Make sure, though, that you use the appropriate elastic bandages or compression stockings. Trying to shove your lower leg into something like skinny jeans or a condom could end up cutting off blood flow.
• Elevation: Keeping your calf elevated, such as putting a rolled up blanket or towel under it, can also reduce swelling.

After two days have gone by, you may want to do the opposite of that Katy Perry song Hot N Cold and move from cold compresses to hot packs. The heat can relive any muscle soreness and stiffness. You can also use pain relievers, such as ibuprofen, to bring down the inflammation and manage your symptoms. But be careful with such medications as they might upset your stomach.

Again, surgery is usually not needed unless there’s been a rupture of the muscle. In most cases, the two sides of the tear remain close enough next to each other that the body’s natural healing mechanisms will eventually seal up the tear. Of course, returning too quickly to physical activity can cause further tearing, making a strain even more severe. But more about that later.

Will Haliburton Play In Game 6?

Haliburton’s return will depend heavily on the grade and severity of his injury. Typically it takes four weeks for a mild calf strain to heal properly. A moderate calf strain usually takes a bit longer: six to 12 weeks. When you’ve got a severe or grade 3 calf strain, it can take well over 12 weeks to return to the court, field or wherever else you do your athletic thing. This absence could extend to months, depending on the severity.

Of course, Haliburton is not your average athlete, and the NBA Finals are not your average situation. There isn’t the luxury of time. And a less than 100% Haliburton is worth more than 100% of over 99% of the population. Pacers coach Rick Carlisle explained during a press conference, “He’ll go through the day tomorrow. Our prep session is tomorrow late afternoon. They’ll get together and do some testing. That will determine whether he plays or not. If he doesn’t play, we have a plan, obviously, if we’re without him.”

In case you have any question about what Haliburton will be listed as on the injury report, Carlisle answered that too: “He is going to be carefully evaluated over the next 36 hours and will likely be listed as questionable on the injury report and probably will be a game-time decision for Game 6.”

Could Haliburton Further Injure His Calf Muscle?

If you are wondering whether Haliburton could cause further damage his calf muscle by playing in Game 6 (and Game 7 if the series goes that long), the answer is “Yes,” with a capital “Y.” And a capital “ES,” as in “extra susceptible.” Returning to vigorous physical activity before the muscle has had the proper amount of time and rest to fully heal does significantly raise the risk of tearing the muscle further or even suffering a completely new tear. If you recall, a weakened or stiffer calf muscle in general is more susceptible to a calf strain.

For all these reasons, if you were to suffer a calf strain, a doctor will typically urge you to follow treatment recommendations and not return to sports until well after the symptoms have completely disappeared and there is no sign of tenderness or other limitations. But again you are not Haliburton. And you are not playing for the possibility of an NBA championship, unless, of course, you are Haliburton.

Even if Haliburton can make it back it to the court this series, his mobility may be limited. He may not have the same explosiveness when jumping, pivoting or zig-zagging in the typical Haliburton way. Then there’s the whole mental thing. When you are playing with such an injury and are at risk for injuring your calf even more, you may consciously or subconsciously be more careful to protect the calf.

Game 5 did see a limited Haliburton. He wasn’t a zero like his uniform number, though. Far from it. He did play 17 minutes in the second half, grabbing more rebounds and dishing out more assists than any other Pacers did after half-time. However, he made little effort to shoot and didn’t make a single bucket from the field, the first time that’s happened in an NBA game that’s he’s played at least 34 minutes in since, well, forever.

Haliburton did say, “I have to understand the risks, ask the right questions. But I’m a competitor. I want to play. I’m going to do everything in my power to play.”

Time will tell if Haliburton’s got the power to make it back on the court and score at a greater pace for the Pacers in Game 6 than he did in Game 5. In other words, will Haliburton overcome the strain in his calf and help the Pacers overcome the strain of having to win two straight games to steal the championship from the Thunder?