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

An In-Depth Look at The Injury History of LeBron James

The New Year is starting poorly for the Cleveland Cavaliers. Amidst rumors and speculations about coaching issues, injuries are mounting for a franchise currently seeded as fifth in the East. The loss of Anderson Varejao to a ruptured Achilles tendon was the first setback but Cleveland’s Big Three have all recently battled nagging issue. The biggest blow came Thursday when the team revealed LeBron James will miss at least the next two weeks with a lower back strain and a strained left knee.

James has been a relative ironman throughout his career but he’s been far from injury-free. His rookie season was marked by a few minor injuries including a knee contusion during the preseason and left pinkie sprain. He missed the first games of his professional career in mid-January following a right ankle sprain that kept him out for three straight games.

James was forced to wear a facemask during his sophomore season in the NBA after fracturing the zygomatic bone (cheekbone) in his face following a stray elbow from Dikembe Mutombo. He stayed in the lineup despite the injury but a sprained left ankle would later sideline him for two games. The ankle remained sore throughout the season but wouldn’t cost him any more time.

The 2005-06 season started off poorly for LeBron following a preseason pectoral strain and a battle with pleurisy. He was ready for the start of the year and went on to play through a right hamstring strain, rib and shin contusions, and a flu bug. His left ankle would again be an issue and force him to miss three of Cleveland’s last four regular season games. However it wouldn’t keep him from participating in his first postseason as James would averaging 46.5 minutes of action in the Cavaliers’ 13 playoff games.

James played in 78 games the following season missing time with three different injuries. A sprained big toe sidelined him for a pair of games in late January and a case of knee tendinitis cost him a game in April. The 2006-07 season was also the first time James endured a back injury missing a game after experiencing lower back spasms. He would also suffer two more ankle sprains and a knee contusion but again played a heavy dose of minutes in the postseason, leading the Cavaliers to the Finals.

James opted for LASIK surgery prior to the 2007-08 season but was ready for the start of training camp. An early season shoulder contusion didn’t slow him down but a sprained left index finger sidelined him for five straight games, the longest amount of time James would miss for an isolated injury. Back spasms and soreness in his big toe resurfaced at various stages of the year and a right ankle sprain cost him yet another game.

A season of relative good health fueled James’ first MVP campaign. He suffered a minor left ankle sprain and a left knee contusion but neither forced him into street clothes. His lone missed game would come on the final day of the season when he sat to rest in preparation for the postseason.

LeBron underwent surgery just two days after the season ended to remove a benign tumor from his parotid gland, the gland responsible for creating saliva. The procedure was the first time in James’ career that he was placed in an anesthetic state.

James made a full recovery and entered the 2009-10 healthy but plagued by questions about his impending free agency. A flu scare early in preseason wasn’t enough to slow the would-be MVP and the Cavaliers steamrolled through the NBA. LeBron amassed wrist and quad contusions along the way but it wasn’t until he aggravated his previously sprained right ankle in early March that he missed any time. The absence lasted just two games and an additional sprain of the opposite ankle failed to keep him out of the lineup. He did begin experiencing pain and soreness in his right elbow and that injury, along with other bumps and bruises, were the basis for the team’s decision to rest him for the final four games of the regular season.

The playoffs began with a rested James averaging 31.8 points a game in a five-game rout of the Bulls. However late in the series-clinching win, James’ elbow again became a problem. He was forced to shoot a free throw left-handed and a subsequent MRI revealed a strain and bone bruise. It limited James for the remainder of the postseason and the Celtics eliminated the Cavaliers in the second round.

The Decision and the shift to Miami didn’t appear to affect James physically. He experienced cramps in his hamstrings early in the preseason and a minor shin issue in early November. It wasn’t until January when he sprained his left ankle that James was forced to miss a game for the Heat. His two-game absence, both Miami losses, reiterated his importance to the team and would be the last time he appeared on the injury report during the regular season. James took the final game of the regular season off to rest before Miami’s extended playoff run. A mild head cold slowed him during Game 1 of the Eastern Conference Finals and was his only issue in the postseason.

James took a pounding in route to his first championship as illness, right shoulder, wrist, and elbow contusions, and a dislocated ring finger on his left hand marked year two in a Heat uniform. He missed a game to a left ankle sprain and later aggravated the area. James rested in three of Miami’s final four regular contests before leading the team to a Finals matchup against the Thunder. James, perhaps feeling the effects of the condensed lock-out shortened season, experienced leg cramps late in Game 4 of the Finals but posted a triple-double two days later to secure the first title of his career.

LeBron opted to play for Team USA in the 2012 Summer Olympics despite the quick turnaround. The extensive workload appeared to be an issue early in the 2012-13 season as he experienced additional leg cramps in the preseason and developed tightness in his knee. As the season progressed, both knees would become sore as James also battled illness, a shoulder contusion, and a hamstring strain that would force him out of five of the Heat’s last 10 regular season games. However James again overcome these nagging ailments to secure his two straight Larry O’Brien Trophy.

James’ final season in Miami would be a bit bumpier. He endured reoccurring soreness and spasms in his back that forced him out of one game in March. He also sprained his left ankle twice and missed one game with a right groin strain. He was forced to once again don a protective mask after breaking his nose and sitting out one game. While teammate Dwyane Wade was given routine games off to manage his assortment of ailments, James remained in the lineup despite a turned right ankle and soreness in his left shoulder. James did get a late season respite, sitting for the final two games of the regular season.

The playoffs would begin with a quick dismal of the Bobcats but James would come up limping after a collision with Bismack Biyombo. The incident would leave James with a painful quadriceps contusion. It didn’t do much to slow LeBron and company as they then eliminated the Nets and Pacers, setting up a rematch with the Spurs. With the air conditioning at the AT&T Center on the fritz, Game 1 was played under sweltering conditions. With the game hanging in the balance, James was forced to watch from the bench succumbing to leg cramps. The Heat went on to lose the game and the series.

Now James has donned a new but familiar jersey after resigning with the Cavaliers in the offseason. He experienced lower back tightness during the preseason and battled a head cold in mid-November while critics began making reference to his sudden drop in explosiveness. His troublesome right elbow has also become an issue but nothing has been quite as problematic as his left knee. It kept him out of a game against the Thunder and was aggravated during the team’s loss to the Heat on Christmas Day. The lingering pain forced Cleveland’s hand and further evaluation revealed a strain in the knee and an additional strain in his lower back. Now the King is expected to miss at least the next seven games resting and recuperating. Both areas appear structurally sound and the Cavaliers’ medical team appears to be taking a proactive approach to treatment.

LeBron has proven time and time again that he is capable of playing with and through injury. However the now 30-year old All-Star has amassed an unprecedented amount of mileage over his 12-year career, including a season’s worth of games over the last four postseasons. The question now becomes can the Cavaliers stay afloat with their leader all but guaranteed to miss the longest stretch of games in his career. History suggests it will be tough, as James’ teams have gone 17-17 in the 34 games he has missed due to injury during his career. This year’s Cavs team is winless in James’ three missed games this season.



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