Lauri Markkanen to miss 4-6 weeks with a pelvic stress reaction

Chicago Bulls’ forward Lauri Markkanen will miss the next 4-6 weeks with a pelvic stress reaction. Sitting out will hopefully prevent the injury from progressing.

The findings of the MRI exam were surprising. Two days after scoring 21 points and grabbing six rebounds in a 117-110 win against the Minnesota Timberwolves, it was announced that Chicago Bulls’ forward Lauri Markkanen would miss the next 4-6 weeks with a stress reaction in his pelvis.

The news was just the latest health-related disappointment for Markkanen, who had battled through an ankle sprain and oblique strain earlier in the season.

A stress reaction is the beginning stage of a stress fracture; together, these injuries are known as stress injuries. Stress injuries most commonly occur in the lower extremity, with a study published in the Journal of Athletic Training in 2017 finding that the foot, shin, and lower back were locations most frequently implicated in elite athletes. The study grouped stress injuries of the pelvis along with those of the lower back, which together accounted for 12% of all stress injuries. This makes intuitive sense as the feet, legs, and lower back are subjected to the greatest amounts of forces during repetitive running and jumping.

Unlike an acute fracture — such as breaking a wrist after a fall — stress fractures occur due to the body’s inability to adapt to chronic, repetitive forces. These repetitive forces — also known as loads — create minute fissures within the bone, which the body is normally able to repair, ultimately strengthening the bone. With stress injuries, however, the cells that build up new bone — osteoblasts — aren’t able to maintain pace with the cells that break down the injured bone — osteoclasts.

Stress injuries are often nagging and painful. Injuries of the foot and shin are easier to diagnose due to their proximity to the surface of the body, while stress injuries of the lower back, pelvis, and hip are more difficult to diagnose as they are located deeper within the body and often mimic other injuries such as muscle strains.

If an athlete were to push through the signs and symptoms of a stress reaction, it is possible that the injury could progress to become a stress fracture.

Stress reactions usually heal much more quickly and easily than stress fractures; the typical treatment for stress reactions is relative rest and a gradual, controlled return to play over the course of 1-2 months. This allows for the osteoblasts to “catch up” to the osteoclasts, fully repairing the injured bone.

Stress fractures on the other hand may require surgical intervention and can sideline players for much longer, as the healing rate of the injury is much more variable depending on the location of the injury and the bone’s relative blood supply.

Markkanen will likely return to play without major complications, but his loss is a big one for the Bulls. Despite having a relatively down year compared to his two previous campaigns in the NBA, Markkanen is second on the Bulls in scoring (15.0 points per game), rebounding (6.5 rebounds per game), and 3-point attempts (294). Markkanen is a focal-point in the young Bulls’ lineup and the team considers him a key cog for their future.

With Markkanen out, the Bulls will likely expect more on offense from the likes of Zach LaVine, Wendell Carter Jr., Coby White, and Thomas Satoransky.

Chicago are 17-30 and in 10th place in the Eastern Conference, with a mere three games separating them from the eighth-seeded Brooklyn Nets. The Bulls’ close proximity to Brooklyn in the Eastern Conference standings may prevent Chicago from tanking, though their winning percentage, while Markkanen is out, will likely determine their future plans.