Kobe Bryant's shoulder surgery decision, explained by a medical expert

By: Adi Joseph

Los Angeles Lakers shooting guard Kobe Bryant has a torn rotator cuff in his right shoulder. Now the question is, does he need season-ending surgery?

The No. 3 scorer in NBA history will make his decision after another consultation with a team doctor Monday, the Lakers announced Friday. For The Win spoke with Subir Jossan, a Virginia-based sports medicine surgeon focused on the upper body and treasurer for The Centers for Advanced Orthopaedics, about Bryant’s injury and options.

How bad is a rotator cuff tear?

“The rotator cuff is comprised of several muscles that allow you to move your shoulder in different directions. Tearing the tendon attached to those muscles means … you won’t be able to move your shoulder without pain or dysfunction.

“Normally if the tendon is torn completely, they need surgery. But sometimes the tendon is partially torn from the bone or frayed. … I kind of describe this to patients as the rotator cuff is like a bed sheet fitted to a mattress. If the bed sheet is tucked well, you’ll lift the mattress. … If you untuck the rotator cuff, the bed sheet, it won’t lift up the mattress (arm) properly.”

What is surgery like, and how long is the rehab?

“If he has a full tear, it’s a long rehabilitation and he is out for the season. There’s the initial surgery, the post-op phase doing just motion exercise with a therapist, where you have someone else moving your arms to keep you limber for six weeks. Usually for overhead athletes, it’s a minimum of six months before you can return to your sport, and that’s not even the top level of your sport. It may take a little bit longer. … But with pro athletes, the rehabilitation can be accelerated (because they do more rehab every day).”

Chris Humphreys, USA TODAY Sports photo // For The Win illustration

How would you advise him?

“It really comes down to, can you perform with a rotator cuff tear at that level? The pain is going to force him to do something, surgery or not. … With competitive athletes, they’re nuts and they’re driven. I would expect him, even if it’s surgically, to fix it and try to perform again. The psyche of an elite athlete, they’re warriors. They jump back into battle.”

Could he play without surgery?

“The real question is, what does the MRI show in how significant it is? … He would basically have to have conditioning exercises, extra care for the muscles, anti-inflammatory medicine and maybe cortisone shots to help with the pain. But to perform at that level, even a partial tear may sideline him.

“We operate on partial tears, too. Go in, clean things up. … At that elite level, it’s six weeks till you’re doing major weight training, and at three months, you could be back playing basketball. It’s a much shorter rehab, and that’s a big deal.”

Is there a risk of re-injury?

“With surgery, at his age, a relatively young age, he’ll have full range of motion, full strength. It’s certainly an injury that can be fixed and rehabilitated.

“If he plays with a full tear, where the tendon is actually detached, and the tendon stays detached for too long, it can alter the fact that you can fix it later. … We say with these things, we have about a year’s window to fix it. Then sometimes you can’t do that.

“But if he has a partial thickness tear that he can play through, he’s not going to do any long-term damage.”

Bryant’s past two seasons ended with injuries (torn Achilles tendon, broken knee bone). Can he keep recovering?

“These are the scars of being at that elite level for so many years. This is not unheard of or uncommon. Especially in basketball, Achilles tendon injuries, they occur. With this shoulder issue, he can still do well. But he’s at that age. He’s experiencing the wear and tear of all he’s put his body through.”

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