How bad is a soleus strain and does it offer any potential insight on a timetable for Giannis Antetokounmpo? We asked an expert.
Just how bad is a soleus strain? The diagnosis for Milwaukee Bucks star Giannis Antetokounmpo has knocked him out for the rest of the regular season, with "daily treatment and evaluation" presumably before the team can determine his availability for the NBA playoffs, which begin April 20.
An MRI revealed the grade of strain in his left calf, but the Bucks didn't reveal that information. The severity of a calf strain — verbiage similar to "sprain," though sprain applies to ligaments only — can range from Grade 1 (mild) to Grade 4 (muscle fibers completely disrupted).
Antetokounmpo, who was able to walk gingerly off the court, isn't likely dealing with something as significant as a Grade 4 strain.
Mark Wichman, an orthopedic and sports medicine specialist with Aurora Health Care, said it might be another muscle that plays into how long of an absence Antetokounmpo endures.
"If it was truly isolated in the soleus and did not involve the gastrocnemius, I would think that would be more favorable prognosis than if the gastrocnemius tore," Wichman said, noting that the gastrocnemius is the larger of the two calf muscles.
"I am less concerned (about) this turning into something terrible should he give it a try," Wichman added when asked if playing on a strained soleus could create larger injury issues. "Based on what we know and assuming there's nothing else going on, I don't think that it's going to be super-concerning unless you get the feeling the athlete is going to go down."
Wichman reiterated that he hasn't visited with Antetokounmpo and doesn't have access to his medical records to know precisely what's happening in the left leg but said it was highly unusual for muscle strains to require surgery, "even bad ones."
But there's also the matter of the left hamstring soreness that he's been battling; Antetokounmpo even came into the game against Boston questionable with that injury.
"Most athletes go up to the hoop with the contralateral leg; if you're right-handed, you jump with the left leg. In order to jump off that foot, you activate your hamstring on the left and gastroc-soleus complex in the calf," Wichman said. "The hip extends with the hamstrings. You push off with your calf muscles. They are both an important part of the jumping movement. I am concerned that the two may not be friendly with one another; I don't know how completely he's recovered from that (hamstring)."
Antetokounmpo, who famously rallied from a hyperextended knee in the 2021 postseason and was back on the floor for the Finals a week later, has shown he can be a "quick healer" before. Can that "quick healer" reputation really apply to other injuries?
"I think it's real," Wichman said. "In 2021 … I thought it nearly impossible for him to come back from that, that quickly. That's the Giannis factor. Even amongst these top athletes … he seems to be one of those people who does come back differently than most.
"I think it has to do with flexibility, with training, discipline in training. He excels with both of those. Of course, just God-given talent and your desire, he has all those things; we all know that."
Wichman said he's used Giannis as an example of an encouraging anecdote about recovery when working with patients. Wichman did say a fatigued muscle is more likely to experience issues, and a minutes restriction would make sense as he returns to full strength.
This article originally appeared on Milwaukee Journal Sentinel: How bad is a soleus strain, like Giannis faces? We asked an expert.
