Zion Williamson—the most-hyped rookie since LeBron James—is starting his NBA career on the sideline.
The 19-year-old forward selected No. 1 overall in this year's NBA Draft by the New Orleans Pelicans is expected to miss the first quarter of the season after an operation on a torn lateral meniscus in his right knee.
It is, undoubtedly, a bummer.
By all accounts, Williamson is a good dude, and his athleticism in action is jaw-dropping.
I mean, who wouldn't want to watch this:
But this latest injury has raised a burning question—did early specialization break Zion?
Here's what we know: over the past 15 years, the number of young athletes who specialize early has grown exponentially.
By specialize, we mean focusing exclusively on one sport year-round rather than competing in multiple sports. We know that young athletes who specialize are at a higher risk of future injury compared to athletes who grow up engaging in multiple sports.
For example, a 2018 study published in the American Journal of Sports Medicine examined 237 first-round NBA Draft picks and found that those who competed in multiple sports in high school suffered fewer major injuries, played in more games, and enjoyed longer NBA careers than those who specialized.
More generally, a 2017 study from the University of Wisconsin found that high school athletes with a "high specialization classification" had an 85-percent higher incidence of lower extremity injuries than high school athletes with a "low specialization classification."
Theoretically, the earlier an athlete specializes, the higher their risk of future injury. So specializing at age 8 is, generally, significantly riskier than specializing at age 16.
We know the past few classes of NBA rookies have missed far more games than the rookie classes who came 10 or 20 years before them, and that many of these are due to "overuse" injuries.
"All injuries stem from the body's inability to absorb force. Period. Force is constantly coming into the body, (and it) should be absorbed by the muscles," says Dr. Tommy John, author of the book Minimize Injury, Maximize Performance: A Sports Parent's Survival Guide. "If it's not fully absorbed by the muscles, it will go into tissues not designed to absorb that amount of force for that amount of time for that amount of reps. That could be a ligament, meniscus, tendon, cartilage, bone, etc…The force comes in and chips away at those areas. Constantly chips, chips, chips."
Eventually, that gradual erosion causes issues.
While many overuse injuries are of the more nagging, persistent variety such as shin splints, more traumatic injuries can absolutely be the result of overuse. When a player suffers a serious injury on a move "they've made a thousand times", for example, it's usually the result of overuse. Kevin Durant's recent achilles tear can be categorized as an overuse injury.
Overuse injuries typically impact older adults, which makes their rise among young athletes all the more startling.
In 2017, NBA commissioner Adam Silver said the league's orthopedic experts reported that they were now seeing "wear-and-tear issues in young players that they didn't used to see until players were much older."
Which brings us back to Zion.
In ESPN staff writer Baxter Holmes' recent article on overuse injuries in basketball, he provided a glimpse into the life of a 16-year-old Zion Williamson:
Zion, however, began playing on youth basketball teams at 5 years old, competing against those twice his age, and he's been playing on the travel circuit ever since. These days, his school season starts in October, then he rolls into summer youth basketball…During the summers, he'd play four games in a weekend, maybe even five or six, then train for hours every day during the week. Before they knew it, Friday would roll around and he'd be off to play in another tournament….Early on, Zion's parents felt the pull of the youth circuit, as if attendance were required and missing it meant missing out on a future in the game. But as Zion got older, his parents fielded more requests for him to appear at tournaments and events. So earlier this year, they decided to limit him to four per summer.
The article goes on to detail how Zion's parents, in response to him dealing with a series of injuries and persistent soreness, were making a deliberate attempt to cut back on his workload.
But it's hard to wonder if it wasn't too little, too late.
This isn't to blame his parents.
The part about a young Zion "missing out on a future in the game" should he miss certain events or forgo playing for certain teams is incredibly important, and it's a lie many coaches, trainers and club team execs are selling young athletes.
In the modern youth sports system, the pressure to always be playing can be suffocating.
"We're applying that pro sport mentality to kids, and in addition to many other factors, it's almost impossible for anyone to heal in the current system of any sport because of the way it's set up. The time frame and the guilt that's laid on them," says John. "They're being sold this idea that if you miss anything, you will be left behind."
Of course, one year later, Zion was off to Duke. A year after that, the NBA.
Zion specialized early. He began playing AAU basketball at 5 years old. By age 9, he was waking up at 5 a.m. every day to train. Although his drive is admirable, the repetitive pounding of doing the same sort of actions, over and over and over again for hours a day, took its toll.
Let's take a quick look back at Zion's recent injury history.
A knee injury in the spring of 2017 caused Williamson to miss a few months of AAU ball.
Then, during his senior season at Spartanburg Day School (Spartanburg, South Carolina), Williamson missed over a month with a foot injury.
His infamous injury at Duke—a Grade 1 right knee sprain—can certainly be categorized as "freakish," as it was the result of his shoe inexplicably exploding open as he attempted to plant and change directions. He was out for five games.
Zion then suffered a "bruised" left knee during his first game of Las Vegas Summer League with the Pelicans, an injury which led the team to keep him out for the rest of the tournament.
Now, his most serious injury yet—a torn meniscus and a subsequent procedure to remove the damaged tissue. Zion's timeline for return is reasonable enough, but this is also the type of injury medical experts say could haunt him for years to come, as it increases his risk of developing arthritis.
The less-severe injuries leading up to the torn meniscus are what John calls "breadcrumbs"—recurring warning signs that, when their root cause is left unaddressed, often lead to more significant trauma.
"There's always something beforehand that leads to the big stuff. There's always some precursor to that point. There's always some sort of warning system the body gives. It's so rare (when there isn't)," John says. "It's only a matter of time before the body can't warn anymore. Then comes the catastrophic injury."
Some may argue that specialization is what got Zion to this point. I'd argue they're wrong.
Zion was good enough to play against kids twice his age as a 5-year-old, and he was averaging 20 points per game in middle school. Pelicans executive Vice President of basketball operations David Griffin recently referred to Zion as a "genetic marvel."
Do we really believe Zion needed to specialize early in order to get to the NBA?
"Let's be real honest—he's not where he's at because the system is so amazing," says John. "He's such a small percentage of the people born with this ability, but the system didn't make him great."
Williamson's status as a genetic outlier does expose his body to higher forces than most NBA players—when you carry more muscle mass and can jump higher than just about any other athlete, that's just a fact of life. But that same genetic freakiness also likely contributed to him being able to handle such an extreme, prolonged work load before finally succumbing to serious injury.
"He survived in spite of the system, because he's such a genetic freak," says John. "It's amazing he made it this far…We only read about the elite, but there's about 50,000 other not-Zion-Williamsons going under the knife who were just trying to make their high school or college team."
Perhaps dropping some weight could help Zion. At 6-foot-6, 284 pounds, he's currently the third-heaviest player in the NBA. Propelling that much mass around the court and above the rim—as well as decelerating and safely landing it—isn't easy on the structures of his body.
But considering Zion's background, it's hard not to wonder if the current youth basketball system broke perhaps the greatest athletic talent of this generation.
Here's hoping we're wrong.
Photo Credit: Jonathan Bachman/Getty Images
- What are 'Overuse' Injuries? Inside a Youth Sports Epidemic
- Matt Campbell: Early Specialization a 'Crime' Against Youth Athletes
- 5 Reasons College Coaches Love Recruiting Multi-Sport Athletes