George injury illustrates risk of international basketball

Paul George is taken off the court after being injured during the USA Basketball Showcase game on Aug. 1.

Only diehard basketball fans saw Paul George suffer a rare but brutal injury a week ago. The fact that his injury occurred during a fairly meaningless scrimmage while he played for his country made it even more painful.

George, a forward for the Indiana Pacers and arguably one of the 10 best players in the NBA, suffered an open tibia and fibula fracture in the fourth quarter of a USA Basketball scrimmage. He tried to contest a fast-break layup when his foot landed on the base of a backboard stanchion, causing his leg to snap violently.

George was taken from the Thomas & Mack Center in Las Vegas to a nearby hospital. He underwent surgery hours later. While specific details have not been released, surgeons likely washed out the open wound to decrease the risk of infection. They then most likely placed a rod down the center of the bone.

Doctors have suggested George will likely miss the entire 2014-15 season. An athlete's tibia can heal solidly in four to six months. On the other hand, it can take much longer to regain full motion, leg strength, power, speed and explosiveness - if he ever does at all.

Hopefully Paul George heals quickly and returns to his previous form. If he returns as a shell of his former self, or if he doesn't return at all, it will be a huge loss for everyone involved.

For USA Basketball, George's fracture might only represent a minor setback. Assuming the remaining players can rebound from witnessing a teammate's horrific injury, the Americans should still be favorites to win the FIBA World Cup.

On the other hand, the Pacers could suffer immensely, especially if George never returns to his All-Star form. The team stands to lose much of the $92 million owed to him in a five-year contract he begins this season. The Pacers can recoup his salary through disability insurance and can sign another player with an injury exception from the NBA. Both George's salary and salary of the signed player count towards the salary cap and the luxury tax.

Losing Paul George to an injury that occurred with USA Basketball could turn the Pacers from a title contender into a mediocre team for the foreseeable future.

The Pacers aren't blaming the national team, though. Indiana Pacers president Larry Bird, a member of the 1992 Dream Team, emphasized his support for USA Basketball in a statement released last week.

"We still support USA Basketball and believe in the NBA's goals of exposing our game, our teams and players worldwide," Bird said. "This is an extremely unfortunate injury that occurred on a highly visible stage, but could also have occurred anytime, anywhere."

George's fracture might convince NBA owners to lobby for the right to keep their players from participating. Through an agreement between the NBA and FIBA, NBA owners can only prevent players from playing for their national teams in the event of "reasonable medical concern that such participation will place the player at substantial risk of injury, illness or other harm," according to an NBA memo to teams.

Dallas Mavericks owner Mark Cuban has been an outspoken critic of international basketball. According to ESPN's Mark Stein, Cuban reiterated his concerns about NBA players participating for free while the International Olympic Committee and corporate sponsors reap the profits. "The greatest trick ever played was the IOC convincing the world that the Olympics were about patriotism and national pride instead of money."

Regardless of how much money the International Olympic Committee or FIBA makes off the players in these tournaments, I would never criticize any athlete for wanting to compete for his or her country. It is widely believed, though, that many of our top players participate in these tournaments to increase their marketing potential in other countries.

NBA contracts are guaranteed, so Paul George will collect his money. But George is 24 years old. As one of the NBA's top stars, he could have earned one or two more maximum contracts later in his career. Not only could he miss out on millions in salary if he never returns to superstar performance, but his marketing deals might vanish as well.

Many NBA sportswriters have debated whether NBA owners will now block their players from competing in international competitions. I wonder what effect Paul George's injury will have on the players. Will more stars decide that the risk of career-ending injury - no matter how unlikely - isn't worth selling more sneakers?

Dr. David Geier is an orthopaedic surgeon and sports medicine specialist in Charleston.

For more information about basketball injuries and other sports medicine topics, go to his blog at