San Francisco Chronicle Interviews Dr. Williams about Golden State Warriors Klay Thompson's concussion

Posted By Rusty Simmons || 28-May-2015

Warriors grateful for chance to heal before Finals

By Rusty Simmons

OAKLAND, CA - MAY 27: Stephen Curry #30 of the Golden State Warriors celebrates late in the fourth quarter against the Houston Rockets during game five of the Western Conference Finals of the 2015 NBA Playoffs at ORACLE Arena on May 27, 2015 in Oakland, California.

Cleveland Cavaliers' Kyrie Irving (2) drives past Golden State Warriors' Stephen Curry (30) during the third quarter of an NBA basketball game Thursday, Feb. 26, 2015, in Cleveland. The Cavaliers defeated the Warriors 110-99. (AP Photo/Tony Dejak)

This season’s one-week break between the conference finals and the NBA Finals is the longest in history, and boy, are the Warriors thankful after a three-day span of injuries that appeared to threaten the postseasons of their All-Star guards.

Point guard Stephen Curry was so bruised on the right side of his body after a horrific Game 4 fall that he played much of Wednesday’s first half using predominantly his left hand in dribbling, passing and defense.

Shooting guard Klay Thompson took a fourth-quarter knee to the head that caused concussion-like symptoms late Wednesday and left him resting at home on his couch with his dog Thursday.

  • We’ve got a good break here,” said Warriors general manager Bob Myers, who said he hadn’t heard anything alarming from his team physicians Thursday. “We don’t need to rush him. We’re going to make sure he’s healthy, follow all of the rules, listen to our doctors and hope he’s back in time for us to play.

“It’s a good window of time to get healthy, so we’ll take it slow.”

The fact that the Warriors didn’t exactly take it slow with either player has resulted in criticism of the team’s medical decision-making.

After his convulsive landing in the second quarter Monday, Curry rubbed his head and squinted throughout his return to action in the third quarter. And after taking his knee-buckling shot Wednesday, Thompson was in the locker room for mere minutes before returning to the bench and was deemed available to return to the game.

It was only after blood started streaming from his ear that Thompson was forced back to the locker room and kept out of the game. A little more than an hour after celebrating the Western Conference championship with his teammates, the Warriors announced that the previously reported ear laceration might be a concussion.

“Sometimes there’s a tendency to jump on the trainer or team physician and say, ‘Oh, how could they let that guy return?’ or ‘How could they not know that he had a concussion?’” said Dr. Vernon Williams, a neurologist and the director for sports neurology and pain medicine at Kerlan-Jobe Orthopaedic Clinic in Los Angeles. “But the truth of the matter is: You can’t look at the blow or the fall or the hit and tell if a concussion occurred, so we rely on a series of questions and tests and maneuvers to decide that there doesn’t appear to be a concussive injury.

“Still, things can evolve hours or even days later.”

That appears to be what happened with Thompson. He’s one of the Warriors’ toughest players, a man who missed one game in first three seasons — and that was to attend his grandfather’s funeral.

Myers rushed to the locker room from his suite and found Thompson to be “coherent” and “himself” as he was being evaluated. The Warriors’ medical staff tried to patch the laceration inside Thompson’s ear.

He headed back to the court, but the bleeding continued. That’s when the medical staff decided to give him stitches to an external cut above the eardrum.

“The last thing you want is for something like that to be blown off or dismissed, in case there was some catastrophic injury, but the good news is that that blood was accounted for by a laceration,” Williams said.

Thompson showed no acute symptoms immediately. He even celebrated the team’s conference-clinching win, danced with teammates on the court and carried out an interview with ESPN’s Doris Burke, during which he was intelligible and called her by name.

An hour later, however, the concussion symptoms started. Thompson, who already had admitted to being a little woozy, asked his father to drive him home — where he vomited twice.

“When I left his house, he was resting comfortably,” Thompson’s father, Mychal, told ESPN. “After a couple of days off, he seems to think he’ll be fine. The trainers and doctors that I talked to said he needs a couple of days to shut it down. He’s got a lot of time to get ready” for Thursday.

It’s not uncommon for concussive symptoms to be delayed. Williams said most neurologists don’t even grade concussions at the beginning of the process anymore. Instead, they wait until the injury is resolved.

“We tend to think of concussive events as injuries where there’s a really rapid onset of symptoms and signs, but that’s not the case all of the time,” Williams said. “In fact, increasingly, we’re aware of the fact that the injury can evolve over time.

“It can just be an issue that it takes some time for the physiologic changes that underlie the symptoms to occur or develop.”

That’s why the NBA evoked a standard concussion protocol, which includes education for every player and coach, and baseline testing. If a player is diagnosed with concussion, he cannot return to participation that day. He is to be held out of all activity until he is symptom-free at rest and until there is no appreciable difference from his baseline neurological exam and his baseline score during a series of activities.

“It’s great that they have a protocol in place and a uniform approach,” Williams said. “… It was good to see Steph come back and suffer no ill consequences, but that was a scary-looking event that occurred with him. By all external factors, it appears that they did all of the right things, he passed all of the tests and has done well going forward.”

For Thompson, it’s impossible to give a recovery timeline “because every concussion is so individual and idiosyncratic,” Williams said. “Every person is going to respond and recover differently.”

Williams said 85 percent of concussed people return to baseline and are symptom-free within 10 days. Among the adult population, it’s often within two or three days.

“Obviously, you don’t want to see guys go down, but it happens,” Warriors forward Draymond Green said. “They both gutted through it. Klay tried to come back, but they didn’t let him. That’s what it’s about.”

Rusty Simmons is a San Francisco Chronicle staff writer. E-mail: Twitter: @Rusty_SFChron

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