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In Street Clothes

Covering sports injuries from the perspective of a certified athletic trainer and backed by analytics.

Breaking Down What We Know About CP3’s Shoulder Injury

The Clippers may have walked away with a win over the Mavericks Saturday yet there was little to celebrate as the team lost All-Star point guard to a sprained right shoulder. Coach Doc Rivers called the injury a separated shoulder that would keep him out three-to-five weeks. The team also said he would undergo a MRI and more detailed evaluation, including a Monday appointment with a shoulder specialist. As media outlets looked to provide information, conflicting reports about the true nature of the injury began to emerge. However based on Rivers’ classification of the injury it is reasonable to believe Paul suffered a very specific but common shoulder sprain.

Anterior shoulder final

When the majority of people think about the shoulder they think of the ball-and-socket joint that allows for high degrees of motion. This joint is known as the glenohumeral joint and is formed between the head of the humerus and the glenoid fossa of the scapula (shoulder blade). While the glenohumeral joint is susceptible to damage, the associated injuries are called subluxations or dislocations. These types of injuries are common in the NBA and the length of recovery is generally dependent on the amount of damage to the labrum, the cartilage that helps stabilize the area. Carmelo Anthony and Dwight Howard both suffered labrum injuries last season and missed minimal time.

However Rivers didn’t call the injury a subluxation or dislocation, he used the word separation. Separation is most commonly used to describe an injury to entirely different joint of the shoulder, the acromioclavicular (AC) joint.

The AC joint is located where the clavicle (collarbone) connects to a bony process on the shoulder blade known as the acromion. The joint serves as a strut, allowing the arm to be raised overhead. It is stabilized by two ligaments, the acromioclavicular (AC) and coracoclavicular (CC) ligaments. Both are susceptible to injury when the tip of the acromion is forcibly pushed downward following a direct blow or collision. In Paul’s case his right arm hit the ground after getting tangled up with Dallas’ Monta Ellis and teammate DeAndre Jordan.

AC sprains have their own grading scale, a six-grade system based on amount of damage to the involved ligaments and neighboring structures. A Grade 1 sprain is considered minor and involves overstretching and microtearing of the ligaments. A more severe Grade 2 sprain involves a tear of the AC ligament but minimal CC ligament involvement. A Grade 3 injury denotes a rupture of both ligaments with accompanying upward movement of the collarbone. The final three grades are considered severe and each grade is dependent on the degree of movement of the collarbone and the damage done to the surrounding musculature. Rivers stated after the game that the team has yet to assign a specific grade to Paul’s injury with the Clippers likely waiting until the MRI has been performed.

Examining previous NBA players to sustain AC injuries does help provide some insight to what we can expect with Paul. Toronto’s Tyler Hansbrough suffered a Grade I AC injury earlier this season and missed just two games. However based on the recovery timeline provided by Rivers, it’s highly doubtful Paul suffered a minor AC sprain. A better comparison may be Cleveland’s Kyrie Irving who suffered a more severe left AC sprain last season. Irving missed exactly three weeks and eight total games recovering from his injury. Returning that quickly could be a best-case scenario for Paul and will likely prove more difficult as his injury is to his shooting arm. More information will emerge in the coming days but it appears the Clippers will have to stay afloat in the talented Western conference without their floor general for at least a few weeks.