Editor’s Note: This piece was written before the announcement that Collin Sexton would miss the rest of the season.
On Sunday, November 7th the Cleveland Cavaliers put together one of their best performances of the year, riding a tough defensive effort and a scorching-hot shooting night from Ricky Rubio to a victory in Madison Square Garden over the New York Knicks. The team was riding high.
Unfortunately, that win largely came without the Cavs’ leading scorer, Collin Sexton, who suffered a left knee injury in the second quarter and did not return to the game. The following day the team announced that Sexton would be out indefinitely with a torn meniscus. Nearly two weeks later, that continues to be all that we know.
Collin Sexton injured his knee nearly two weeks ago but there is still no timeline on his injury recovery. When should we expect to see him back?
Eight days after Sexton suffered his injury, Evan Mobley went down with an elbow injury. The following day after testing was done his injury was announced — a right elbow sprain — and a recovery timetable of 2-4 weeks was provided.
Why haven’t we received a timetable for Sexton’s recovery? Is his absence going to be measured in weeks or months? Will the Cavs see him again before the end of the season? These questions are unanswered for the prolific guard; why is that?
It is most likely because there are three incredibly divergent paths for Sexton to address a meniscus injury, depending on the location and severity of the tear, and whether Sexton prioritizes a short-term return or the long-term health of his knee. Complicating things is the fact that he did not sign a contract extension before the season, and therefore will be a restricted free agent this summer.
Sexton may be feeling pressure to return quickly and prove his worth before the summer hits and he needs teams convinced of his value. He has to balance that with his long-term career; if he loses his burst and athleticism as an undersized guard he will be a greatly reduced player throughout his prime and into his 30s.
For those who need a refresher, the meniscus is a piece of cartilage that sits between the thigh and shin bones inside of the knee. It is commonly torn when a knee is violently twisted one way or the other. Depending on the severity of the tear, Sexton has a number of options to address this injury.
Let’s walk down each of those three possible paths of treatment and recovery. For each, how long would Sexton be out, and why might that be the option that is chosen?
Editor’s Note: Thank you to Dr. Brian Sutterer, whose YouTube channel on sports injuries is an invaluable resource. Check out his video on James Wiseman’s meniscus injury for some related information, some of which was used in this piece.
Cavs: Can Sexton avoid surgery?
The first option is Sexton trying to manage the tear with rest and not surgery. If the tear is relatively minor and not in a crucial location in the knee itself, it’s possible that whatever bruising occurred can heal, the swelling decrease, and Sexton could find his way back onto the court without surgery.
This was the case for Joel Embiid in last season’s playoffs. He suffered a partially torn meniscus in the first round against the Washington Wizards but returned to play just six days later against the Atlanta Hawks in Game 1 of their playoff series, playing significant minutes in all seven games.
That’s certainly the exception for these injuries, but it could explain why there has been no word on Sexton’s injury timetable yet. He could be waiting for the swelling to go down and rehabbing it without surgery in hopes that he can return as soon as possible, perhaps even in the next couple of weeks.
This approach is risky, because if he does need surgery this will only set his return back even further by delaying that surgery. Yet if he can avoid surgery his return would be a major boon to the Cavs on offense and help boost their chances at making a playoff push — as well as Sexton’s chances at receiving a major payday this summer.
Cavs: What if Sexton gets the meniscus trim?
The first of the surgery options is the meniscus trim, or “partial meniscectomy.” This approach involves cutting free a small portion of the meniscus rather than seeking to repair or reconstruct it. This results in a shorter recovery period, but could have long-term ramifications for Sexton’s knee.
For this to be an option, the tear in his meniscus can’t be at the point where it connects to the tibia. This is what keeps the meniscus anchored during shock absorption, and a tear here would mean the longest recovery time and require a repair. If the tear is small enough, and in the inside portion of the meniscus where the blood flow is lessened and thus less likely to heal on its own, a tear becomes more possible as a course of action.
The timetable for recovery is significantly shorter, as Sexton wouldn’t need to wait for the meniscus to heal. He would just need to recover from the surgery itself and then could ramp back up into game readiness.
If Sexton is feeling pressure to get back onto the court to earn a larger contract this summer, he might do what he can to pursue the trim. He could get back to action in a matter of weeks, perhaps around six weeks or so after the trim surgery. If he got the surgery now, he could be back around the end of 2021.
Recent NBA players who get a meniscus trim include Zion Williamson, who missed the beginning of his rookie season. He was out around eight weeks before returning on a minutes limit, although as a much larger and heavier player than Sexton he isn’t a perfect analog.
Cavs: What if Sexton has his meniscus repaired?
The other option for Collin Sexton is to have his meniscus repaired, which would mean suturing the cartilage back together so that it would heal and preserve the meniscus. Repairing the meniscus is the best scenario for the knee long-term, as you maintain as much of the shock-absorbing cartilage as possible. This helps to prevent wear on the knee and decreases the likelihood of successive knee injuries in the future.
Because Sexton in this scenario would need to allow time for his meniscus to heal after the surgery, the recovery time would be significantly longer. Jaren Jackson Jr. suffered a torn meniscus in the NBA Bubble and had it repaired, and he did not return for nine months. James Wiseman tore his meniscus last year during his rookie season, and while he is nearing a return, seven months later he is not yet cleared for 5-on-5 play.
Rushing back too early from a meniscus repair would probably be the worst scenario, so hopefully if Sexton goes this route he will take the time to recover. Taking that time, however, could mean he misses most or possibly all of the rest of the season. Can he afford to do that, hitting restricted free agency without any further demonstration of what he can offer on the court?
A healthy Sexton didn’t get the number he wanted in a contract extension, and surely he planned to prove on the court that he was worth more. That hasn’t happened yet, and now he has to weigh whether it’s worth it to hurry back. Is it riskier to go into free agency not having played in eight months, or to come back and possibly play worse as Evan Mobley, Jarrett Allen and Darius Garland supplant him in the pecking order? It’s a tough decision.
News has to be coming soon on whether Sexton will attempt to get back onto the court without surgery, or if he is pursuing either the trim or the repair, and the timetable should be built from there. The question is whether he returns to find a roster that has moved on, or one that welcomes him back in desperate need of his scoring? Get healthy, Young Bull.