Ask your doctor: What you need to know about Kyle Lowry’s wrist injury

The fate of the Toronto Raptors season has been put on hold with Kyle Lowry back on the shelf.

The team announced Monday that Lowry needed surgery to clear out some “loose bodies” from his right wrist. They added that Lowry would hope to return for the postseason, but no official timeline was given.

The Vertical’s Adrian Wojnarowski chimmed in shortly thereafter with a 4–5 week recovery timeline, citing league sources. Assuming that’s correct, Lowry could conceivably return shortly before the playoffs.

Raptors president Masai Ujiri took a conference call from reporters on the injury. Lowry also fielded questions before the Raptors defeated the New York Knicks on the road. Here’s what they said:

Lowry:

I woke up and it was sore but I’d be fine. I go through the weekend and yeah, I’m a bit sore, but I’m going to enjoy this weekend and half my fun with my friends and family around. I never thought it would be anything where I needed surgery.
Yesterday we got some opinions and I came to see my doctors, she showed me some things, she said this is what it is, and I made the final decision.
Not surprised by anything. I was a little sore but I didn’t know what it was … I thought some local treatment would help but it wasn’t getting any better. We got some stuff done in Toronto and now we came to New York to get a second opinion.
A constant soreness. It never went up or down … It’s very sore. My wrist can’t go to a certain extent right now.

Ujiri:

We’re trying to get ahead of it and hopefully there’s a good time frame where he has this surgery tomorrow and then we see how it goes.
Kyle went to New York and we got a couple of opinions. Kyle went to see the doctor that did his surgery a few years ago. We discussed this with our doctors. From images and all that stuff, it was determined that with the loose bodies in Kyle’s wrist, and all the lodging — I’m not a medical expert — everybody drew the conclusion that it would be good to clean it out now rather than it be something that continues to re-occur by injection or waiting for it to settle down.
With this kind of problem, when it lodges in the joints, where there’s loose debris, there can be some discomfort one day, and the next day you can feel good, and the next day you can feel discomfort and swelling. That’s just how this kind of injury goes. I know because we had it with a player before. We can’t mention names, but I know from experience that this kind of thing can flare up or it can be tamed — you don’t know.

In an effort to gain more clarity into Lowry’s wrist, the cirumstances surrounding his injury, and to gauge a timeline for his return, I reached out to Shankar Sivananthan, an ICU doctor and an avid Raptors fan with a few questions.

Q: The Raptors referred to Lowry’s injury as having “loose bodies or loose debris” in his right wrist. What does this mean?

Sivananthan: The wrist is made up of 10 bones — eight small bones and the two bones of the forearm. The smaller bones, when fractured, are usually treated non-surgically. But, if the original fracture caused the bone to shatter in a way where a piece separates, that piece of bone can cause ongoing pain and inflammation. Depending on how many wrist injuries Lowry’s had, and how bad they’ve been — he could have one or many of these pieces in his wrist.

Lowry said he woke up sore the morning after the exhilarating comeback against Charlotte. He characterized it as a, “constant soreness” that didn’t go “up or down”. We saw him with an ice pack at the All-Star Game on Sunday night. The injury was announced the following Friday. Masai Ujiri and Dwane Casey said swelling went down in Lowry’s wrist two days later (when they called it day-to-day), but that the swelling returned on Monday. That’s when Lowry went to New York for a second opinion and decided on surgery.

Is this the normal prognosis for an injury of this kind?

Sivananthan: The Charlotte game could’ve been where a small fracture occurred, or it could have exacerbated a previous injury. Standard treatment is rest, ice, and over-the-counter pain meds. The rest and ice should control swelling. Most of the healing takes place in the first 1–2 weeks after a fracture, but it can take longer for full mobility. On Sunday, if Lowry had been icing and resting the wrist over the weekend, the swelling would have subsided. Overnight without ice, and depending on sleep position, it could have swollen more. It is common for pain and swelling to wax and wane over those first 1–2 weeks.

Could Lowry have exacerbated his injury worse by partaking in the Three-Point Contest and All-Star Game?

Sivananthan: The $200 million dollar question. I can’t say with certainty he made it worse, but it definitely wouldn’t have helped. The key to treatment is immobilization, and rest. Going through full extension/flexion of a 22 oz ball to throw it 24 feet, 25 times in 60 seconds is a lot of stress on a joint. Like I said before, the pain and swelling can wax and wane so maybe he felt better before the contest and thought it would be OK.

What kind of timeline are we looking at with Lowry’s surgery? Could he return for the playoffs if all goes well?

Sivananthan: This depends on what happens today. The surgeons will insert an illuminated camera and instruments into the wrist. They’ll look around, and pull out any loose bone fragments/debris they find. If that’s it as we’ve been told my Raptors MR, the return time tweeted by Adrian Wojnarowski yesterday of 4–5 weeks is accurate. That still gives Lowry a few games with the team before the playoffs.

If there’s a fracture that needs fixing with pins and screws (there’s no reason to believe that’s the case), recovery is often a lot longer, in the eight-week plus range.

Let’s work with the 4–5 week timeline. How soon could Lowry be back in practice for shooting drills? And since it’s a wrist injury, Lowry should be able to maintain his conditioning aside from his right arm, correct?

Sivananthan: The 4–5 week timeline is when he can start using the wrist for shooting. As long as there are no other undisclosed injuries, he should be able to workout and train as usual.

Could we see any long term or lingering wrist issues? Is it as simple as removing all the debris and he should be good?

Assuming it’s a success, there shouldn’t be lingering wrist problems. The literature around repeat arthroscopy shows the wrist doesn’t get better if there was a missed injury at the time of first surgery. I’m sure the team working on Lowry have done the right investigations to know what they’re getting into.

Finally, As a die hard Raptors fan, how confident are you that DeMar DeRozan and this revamped defense can keep the boat from sinking in Lowry’s absence? And if Lowry does make a full recovery and we make a deep playoff run, would you have any reservations about giving Lowry that $200-million max?

Sivananthan: I think the last 3 games have shown we can hold our own. DeMar DeRozan has been nuts — if he can keep it going and guys like DeMarre Carroll and Serge Ibaka can produce more than they did against the Knicks, our defence is strong enough to win the games we’re supposed to win. Matt Moore wrote yesterday on what this injury means and if we get to 45–48 wins that should settle us in 2nd or 3rd. I don’t think we’re sinking out of the playoffs … so if we don’t win games, hopefully we end up at 6–7 and hold off the Cavaliers.

If Lowry gets back to prime Lowry and leads us to the promise land, give him all the money!

Find Shankar on Twitter: at shanxonline