How To Solve Kawhi Leonard's Injury

In a nutshell, it's not his quad-it's his brain.  Yes, I believe a neurological issue is causing Leonard to still experience pain despite his quad being structurally-ready.  And yes, there is a solution.

If you've been following the NBA this season, you'll know that MVP candidate and best two way player in the game, Kawhi Leonard, has only played 9 games.  As a Spurs fan and someone whose work involves health, performance, and athletics, I've had a nose to the ground all year.  I've also been speaking with those close to the situation and have some insight with a potential solution.

There is some media narrative drama going around, which, hey-that's their job, I guess-but I'm not going to address that here.  THIS article inspired me to make a public post about what's likely going on with his injury and how I would solve it.

What Is The Injury?

Kawhi was diagnosed with quadriceps tendinopathy.  The concerning thing is that this is something he's battled in the past.  Certified Athletic Trainer, Jeff Stotts, who runs his own website,, weighs in on the issue:

"Well, the problem with tendinopathy is it can kind of be a catch-all term. A lot of times it just refers to anything that's wrong with the tendon itself. It can be anything from tendinitis to an actual disease of the tendon, like a degenerative disease. It can be two extremes. It can be something mild like a tendinitis, or something a little bit more chronic, where it's more problematic. And even sometimes you can either reference tendon tears and include them in the tendinopathy category because they involve a tendon, though there's been no indication that Kawhi ruptured or tore his patella like Tony Parker did around the same time last season."

The demands of the NBA also necessitate that players-especially an elite, athletic wing player-have optimal functioning quads.  Here's the interesting thing, though-from what we know, he was structurally cleared by physical therapists.  We're going to loop back on that in a second.

espn kawhi

What's His Current Care Like?

Stotts drops some more insight:

"The big thing for me here, is San Antonio has historically the best medical staff in the NBA since 2005-06. They've lost the fewest number of games, and they have a long history of taking a conservative, proactive approach with their players. You can go back to 2000, Tim Duncan, when he tore his meniscus, they elected to shut him down rather than let him play through it. He elected for the surgery, and obviously went on to have a Hall of Fame career. Popovich and his staff, and the medical team in San Antonio, they were the precursors for the rest phenomenon, they were the first ones resting players for extended periods of times, targeting schedule rest days during the season for their players, with their eye on the postseason."

It's true-while basketball purists will tell you of the warlocks that are behind the Phoenix Suns' medical and training staffs (and this is true), no team has lost less games due to injury than San Antonio in many years.

What Do We Know

First things first-the major caveat here is that the following is only proposition until further notice.  But hey, if team doctors and training staff closest to the situation don't know-everyone should be all ears at this point.  That said, here's what we know, according to what's been validated:

  • He has been structurally cleared
  • He hasn't returned because there is lingering pain in days following games
  • He's getting a second opinion in New York
  • He has had mild spurts in the past of the same injury

What I Feel Is Going On


PROTECT ------------------------ PERFORM


    In the case of many injuries, athletes can be structurally cleared to play.  But in that return to play, the brain can still send out pain output signals to try and prevent the athlete from doing something it perceives as harm.  I've seen it happen in many examples in my own experience, as well.At this point, I feel that Kawhi Leonard's injury is a neurological ghost in the machine.  To quote neurologist, Garrett Salpeter, "the brain works on a protect to perform continuum.  Our brains want to protect us at all costs."  Sometimes, we do activities that our brain thinks is dangerous and it sends out pain signals.  Picture this-pain is an OUTPUT signal.  The rigors of training and playing basketball at an NBA level are demanding on the body-these are INPUTS.

    Pain is always produced in the brain.

    Pain is an action signal, intended to make a person change their behavior.

    pain is a response to threat, so any perceived threat can cause pain, even if it, "shouldn't," necessarily be painful.

    How To Fix It

    If he has been structurally cleared and there is no lingering chronic inflammation, then we're left with a solution of changing the INPUTS aka tapping into his nervous system.  This lets us truly tap into the dialogue between nervous and musculoskeletal systems.  This is something I do in my own practice to support athletes in their rehabilitation process, oftentimes alongside preexisting PT's and trainers with the rare technology, neuwave direct current electrical stimulation.

    kawhi leonard injury

    Most electrostim devices use alternating current.  This uses direct current, which is engineered to match the dynamics of the body’s own, internal signals. When the current is sent, it gets interpreted the same way as if actual movement is taking place. This allows us to identify exactly where there are any flaws in the neurological control of movement, and retrain them. We all know that proper movement can be very beneficial for the body. That movement always reaches the brain as electrical impulses, and we now have a way to send those same signals directly.  TENS units also use direct current, but aren't nearly as strong , nor do they allow for diagnostics or customization.

    Unlike most electrostim devices, this has the ability to relax the brain.  What does this mean for Kawhi and similar athlete injuries?  It means that we can have the athlete perform movements that trigger this response-cutting, jumping, running, etc. with the machine attached to target areas and relax the brain under these conditions.  This lets the brain know that these said activities aren't true threats, therein relaxing the pain reflex and killing the pain output signals.  Combine this with some personalized training protocols and movements and there you have it.  This can reinforce the already-quality rehab practices of the training staff, while also enhancing the performance of Leonard's nervous system for a quicker return to peak performance, not to mention providing additional injury prevention.

    There you have it.  I'd love to hear what you think.

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