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Odds of Klay Thompson returning to Warriors an All-Star, or at all

San Francisco Chronicle logo San Francisco Chronicle 11/22/2020 By Connor Letourneau
a group of people standing in front of a crowd: SAN FRANCISCO, CALIFORNIA - JANUARY 04: Klay Thompson #11 of the Golden State Warriors looks on before the game against the Detroit Pistons at Chase Center on January 04, 2020 in San Francisco, California (Photo by Lachlan Cunningham/Getty Images) © Lachlan Cunningham / Getty Images

SAN FRANCISCO, CALIFORNIA - JANUARY 04: Klay Thompson #11 of the Golden State Warriors looks on before the game against the Detroit Pistons at Chase Center on January 04, 2020 in San Francisco, California (Photo by Lachlan Cunningham/Getty Images)

Warriors general manager Bob Myers could hear the melancholy in Klay Thompson’s voice.

Nearly a year and a half removed from a torn left ACL, Thompson was three weeks away from returning to NBA games, only to suffer a torn right Achilles tendon in a pickup game. During a phone conversation Thursday shortly after Thompson learned that he’d miss his second straight season due to injury, Myers told Thompson, “I feel like for you, basketball is like air and water. You have to have it.”

“I’ve never not played basketball this long,” Myers recalled Thompson saying.

Before Thompson suffered that ACL injury on a dunk attempt in Game 6 of the 2019 NBA Finals, he was one of the league’s most durable players. Now, as he stares down another recovery process expected to last nine to 12 months, Thompson is left to wonder: Will he play at an All-Star level again? Is he even guaranteed to suit up for another NBA game?

History suggests that players with torn Achilles tendons are more likely to never play in the league again than to return to their pre-injury form. Though Thompson’s age (he is still in his prime at 30) and size (wings put much less pressure on their lower bodies than big men) only buoy his odds of a full recovery, he is navigating somewhat uncharted territory.

According to ESPN, only three players other than Thompson are known to have endured a torn ACL and a torn Achilles tendon during their NBA careers: Emanual Davis, Jerome James and DeMarcus Cousins. Davis and James both suffered their ACL injuries years before their Achilles injuries, never returning to the NBA after they tore their Achilles tendons in their mid-30s.

Fresh off missing nearly 12 months with an Achilles injury, Cousins — a four-time All-Star — struggled to return to his dominant ways in 38 games with the Warriors in 2018-19, only to suffer a season-ending ACL injury that following August with the Lakers. Desperate to prove he still belongs in the NBA, Cousins is reportedly receiving interest in free agency.

That leaves Thompson as the only player in league history to have suffered a torn ACL and a torn Achilles tendon without appearing in a game between the injuries. Perhaps the closest example is two-time All-Star Norm Nixon, who, after missing the entire 1986-87 season with a torn patellar tendon he suffered in a softball game, suffered a season-ending torn right Achilles tendon in a preseason practice with the Clippers in November 1987.

Though Nixon returned to start 30 games in 1988-89 at age 33, he averaged just 6.8 points — less than half his career average — on 41.4% shooting (27.6% from 3-point range) before finishing his career in Italy. The good news for Thompson is that, in the three-plus decades since Nixon last played in the NBA, medical advances have improved players’ chances of a full recovery from Achilles injuries.

The surgery is now conducted with stronger sutures and smaller incisions. Instead of waiting weeks to put pressure on the injured heel, players can begin rehab exercises days after the procedure. Some players in peak physical shape have been known to make successful recoveries in as quickly as six months.

But given that Thompson was in the final stages of coming back from an ACL injury when he tore his Achilles tendon Wednesday, the Warriors will be careful not to rush his rehab process. This is a team that, after letting Kevin Durant return from a strained right calf in Game 5 of the 2019 NBA Finals, came under heavy criticism when Durant tore his right Achilles tendon two minutes into the second quarter — an injury that forced him to miss all of last season with the Nets.

It’s worth noting, however, that Thompson’s torn Achilles tendon likely had nothing to do with how he approached his recovery from the ACL injury. Dr. Timothy Gibson, an orthopedic surgeon at MemorialCare Orange Coast Medical Center in Fountain Valley (Orange County), told The Chronicle that most Achilles injuries in players Thompson’s age are “freak accidents.”

“I would expect him to do extremely well,” said Gibson, who has worked in elite sports medicine for more than two decades. “I would expect him to come back and be close to his peak.”

If Gibson is right, Thompson would be a bit of an outlier. The Achilles tendon, which connects the heel bone to the calf muscle, absorbs force when an athlete lands from a jump before providing power when he or she pushes off the ball of the foot. Since an NBA player’s career hinges on the ability to jump and change direction, Achilles injuries often derail careers.

Much of the recovery process is focused on strengthening the calf muscle, which tends to atrophy during the healing process post-surgery. But many players, especially big men, never get the calf muscle as strong as it was pre-injury. Even the most minor loss of explosiveness can have devastating consequences for NBA athletes.

In 2013, an American Journal of Sports Medicine study found that more than a third of players who sustained major Achilles injuries between 1988 and 2011 didn’t play another game in the league. Those who did return missed an average of 55.9 games per season the rest of their career.

If a player is able to play for years post-injury, his playing time and performance will probably plummet. A 2015 CBS Sports study showed that the 14 players who had returned from Achilles injuries since 1992 had both their field-goal and three-point shooting percentages drop, on average.

But if anyone is well-equipped to beat the odds, it’s probably Thompson. In addition to being in the heart of his prime and a modest size by NBA standards at 6-foot-6, 215 pounds, he doesn’t rely on athleticism to affect games. An expert at moving off the ball, Thompson is a jump-shooting metronome: plant, catch, release.

Those closest to Thompson are more concerned about the mental toll of another lengthy injury rehab than any potentially diminished explosiveness.

After not sitting out a game in high school or at Washington State because of injury, he played 214 consecutive games for the Warriors — the longest such streak to start a career in franchise history — before he missed a loss against Cleveland to attend his grandfather’s funeral. Eight months later, Thompson missed his first game because of injury, a loss to Phoenix, with a strained right hand.

Before his torn ACL, Thompson hadn’t been sidelined more than nine games in a season. Forced to go the past 17 months without playing in an NBA game, he got anxious, often complaining to teammates about being bored. To pass the doldrums, Thompson bought a luxury boat and took up fishing.

Many of his days were spent catching sea bass off the coast of Dana Point (Orange County). But as Thompson ramped up his recovery from the ACL injury in recent weeks and began to scrimmage, he was happy to give his fishing rod a break. Basketball has long been his refuge from the demands of celebrity and day-to-day stress.

This is why, after Thompson injured his heel during a pickup game Wednesday in Los Angeles against current and former NBA players, he sat on the court for several minutes as he tried to process what had just happened. In those moments, he suspected he had torn his Achilles.

What that meant — another season away from basketball and, perhaps, worse — was almost too much to handle.

“No one deserves anything like this that befalls them, but this is a guy that loves basketball,” Myers said. “He bleeds basketball. When it gets disrupted like this for an athlete of his caliber, it hurts. It hurts us that care about him. It hurts me, and it hurts the organization.”

San Francisco Chronicle staff writer Rusty Simmons contributed to this report.

Connor Letourneau is a San Francisco Chronicle staff writer. Email: cletourneau@sfchronicle.com Twitter: @Con_Chron

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