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Why do back injuries like Elena Delle Donne’s happen and what could Mystics fans expect from her going forward?

We asked Dr. Lucas Wymore, an orthopedic surgeon and sports medicine expert to answer questions on injuries that basketball players often get. First, we focused on back injuries, like what Elena Delle Donne experienced.

Los Angeles Sparks v Washington Mystics
Elena Delle Donne has only played three games in the last two seasons due to a back injury she suffered in 2019.
Photo by Stephen Gosling/NBAE via Getty Images

The Washington Mystics’ 2021 season was a setback for fans and the team alike. There weren’t full crowds for much of the season due to coronavirus restrictions. And two expected key players like Alysha Clark (foot injury) and Emma Meesseman (overseas commitments) didn’t play in a season where Washington missed the playoffs altogether.

But most importantly, Elena Delle Donne, the team’s franchise player, has still not returned to full capacity. She only played three games in 20201 as she continues to recover from a back injury that was initially diagnosed as three herniated discs in her spine. Ultimately these setbacks put the Mystics’ future at a crossroads, which Diamond Holton noted last month and as Nathan Snell noted in a FanPost earlier this week.

We aren’t experts on sports injuries here at Bullets Forever. We don’t know how these issues can arise, or how long they can take for one to recover from. To help us understand more on Delle Donne’s type of injury, we asked Dr. Lucas Wymore, an orthopedic surgeon who specializes in sports medicine at the Centers for Advanced Orthopaedics in Southern Maryland. He is also the orthopedist for student-athletes at St. Mary’s Ryken High School in Leonardtown, Md., and has worked with athletes at the college and professional level, including at the University of North Carolina-Chapel Hill, San Diego State University and the San Diego Padres MLB team.

Before moving forward with the Q&A section below, as a disclaimer, the answers Dr. Wymore gave should be considered as general trends among people in a similar situation as Delle Donne’s, and are not to be taken as medical advice. They are also not an indication of what Delle Donne herself has experienced or is experiencing. Please consult your specific doctor for your specific situation.

And now, the Q&A. Some of the text has been edited for clarity.

Bullets Forever: Dr. Wymore, how does a herniated disc back injury and nerve pain like Elena Delle Donne’s happen, whether it happens suddenly or over the course of years of playing basketball? (Note: Delle Donne experienced some back pain in 2014 while playing for the Chicago Sky in the Finals that season, but it’s premature to say that that injury directly has anything to do with her 2019 one. She first experienced her 2019 injury while grabbing a rebound in Game 2 of the Finals. This was not mentioned in our interview.)

Dr. Lucas Wymore: Either way is certainly possible. One can have a multiple disc injury that can be traumatic through incidents like a car accident. Or one can have acute disc injuries that are atraumatic, such as from sports or weightlifting or other types of athletic activities.

Typically, herniated discs are more likely as one gets older, the older with more degenerative wear and tear. But as Delle Donne has proven, younger patients can still get them.

Acute disc injuries come from when material in the spinal disc can bulge, and that can put pressure on the nerves. And that’s usually the big issue is when one starts having some nerve compression.

BF: How do discs become herniated for someone that would play a sport like basketball, where someone’s moving from side to side quite often as opposed to another sport where there is not as much lateral movement like a track athlete who specializes in running?

Dr. Wymore: With the back, there’s a lot of forces on it when we move, from rotational bending, from side to side and front to back. So especially with basketball where a player like Delle Donne is doing a lot of cutting, she’s making a lot of directional changes, coming up from higher up in the court. And her back will go through directional changes constantly over time. Those repetitive activities can result in some of those disc herniations, even without significant trauma to the back.

BF: In your current work with high school or college-age athletes, they’re still growing from a physical standpoint. At around what age do you see people peak physically? This is because Delle Donne was 30 years old at the time of her injury and that may affect her ability to recover as opposed to an athlete who is 15 or 20.

Dr. Wymore: It is not atypical to see athletes gain muscle mass and strength even into the fourth decade or their 30s. But it’s really around that time is when we start to notice some of the decline in muscle mass and bone density.

That said, the fact that some players are still able to gain strength and muscle is partly why we’ll see some of these athletes play very well in their 30s. Or in the case of Tom Brady, he is playing at a very high level in his 40s. But generally, physical decline starts happening in the 30s.

BF: Given Delle Donne’s age of 32, someone like her is generally at the end of her prime or moving to the twilight of her career. If someone like her had multiple back surgeries, does she have much time left to play professionally?

Dr. Wymore: It’s hard to say with any type of certainty if she’s able to come back from these injuries at her age. Some athletes were able to come back from various injuries and come back very strong. But others have multiple injuries and can never really kind of regain their form.

BF: Thankfully in the WNBA, they don’t start playing again until May. For Delle Donne specifically, she does not play overseas unlike most players in their league. Could having a long offseason help her longevity as opposed to other leagues with shorter offseasons like the NBA?

Dr. Wymore: Hopefully. A long rest period will allow her to rest her back, recover physically. From there, she can hopefully get back into playing shape.

Thanks again to Dr. Wymore for his help with this Q&A. We will reach out to him periodically as injuries occur on the Mystics’ and Wizards’ rosters, and also when their injured players are ready to get back on the court.

Also as a note, we have reached out to the Mystics for a status on Delle Donne’s injury or prognosis during the current offseason, but have not heard back.