Looking ahead for Bosh and Heat
— -- It has been a disappointing season for the Miami Heat, from whom the injury bug seems to have taken a good chomp.
However, their previous injuries this season pale in comparison to frightening news that Chris Bosh will be out for the remainder of the season after being diagnosed with blood clots in his lungs.
Head coach Erik Spoelstra said, "We're not even thinking about [his return] right now. The most important thing is he'll be healthy again."
Indeed, but the question remains: Where do the Heat go from here? Insider's Kevin Pelton, Tom Haberstroh and Dr. Mark Adickes offered their perspectives on the outlooks for the Heat and Bosh.
Tom Haberstroh: How will the Heat miss Bosh's presence?
First, the following basketball analysis feels remarkably trivial in the context Bosh's condition. But alas, this has enormous implications on the Heat's planning going forward.
The Heat can't contend in the East without Chris Bosh. Best-case scenario, the addition of Goran Dragic can help drag the Heat back to .500 and maybe a first-round upset. But Bosh's vast repertoire of skills simply can't be replaced. Pat Riley and Spoelstra's faint dreams of Dragic pushing them to another Finals chase are all but gone.
This is where the Josh McRoberts season-ending knee injury goes from a gut punch to a haymaker knockout blow. Compounding the issue even further is that the Heat just traded away Shawne Williams, their only stretch 4 who could provide anything remotely close to a blurry facsimile of Bosh. Expect a steady diet of Hassan Whiteside pick-and-rolls now. The Heat have no choice but to look outside the organization -- or better yet, outside the box.
Because of his elite shot-making, crafty floor game and two-way headiness, the numbers say the Heat were 2.7 points per 100 possessions worse this season with Bosh on the bench. But that was when McRoberts and Williams could step in. Miami won't have that luxury now. Spoelstra will have to break the glass and use Udonis Haslem in an emergency role. Whiteside and Haslem have played a whopping 32 minutes together this season -- all in garbage time.
The Heat could look at Andray Blatche or Michael Beasley, both currently playing in the Chinese League, and D-League stretch 4 standout David Wear. But the smartest move in the short term might be for Spoelstra to shift Luol Deng to the 4 and play Mario Chalmers off the ball as a floor-spacer as Dragic and Dwyane Wade attack the rim. Spoelstra can unleash the positional versatility of Deng, Dragic and Wade; sometimes, crisis breeds innovation.
It's too late for the Heat to pack it up and tank for their top-10 protected 2015 pick. To be frank, Riley probably wouldn't even entertain such a scenario. But in the big picture, Bosh's condition could make Dragic think a little harder about signing long-term in Miami. Actually check that. Big picture, let's hope Bosh gets well soon.
Dr. Mark Adickes: Bosh should fully recover
With the diagnosis confirmed that Bosh does indeed suffer from blood clots in his lungs, let's answer three questions: First, how do blood clots form? Second, how are they treated, and finally, how soon could Chris Bosh return to the court if indeed this diagnosis is correct?
There are three main causes for the formation of blood clots:
Hypercoagulability, or when the blood becomes too sticky. Just as some people are hemophiliacs and bleed too easily, others clot too easily. Thankfully, this also is the most rare cause and, given no history of problems, I doubt Bosh has this problem.
"Given the rash of blood clots in athletes and former athletes lately, including Serena Williams, Jerome Kersey and Mirza Teletovic, it would be interesting to see if there is a common denominator. Perhaps a similar supplement or dietary habit could be contributing?
" -- Dr. Mark Adickes, ESPN Insider
Pathologic blood clots form because of dehydration. This leads to less blood volume and literally thickens the blood. Athletes who travel (and endure long periods of inactivity sitting in planes) extensively as NBA players do, coupled with their regular exertion and perspiration, certainly are at greater risk than the average population.
Stasis (sluggish blood flow) caused by inactivity can contribute to blood clot formation. Muscle contraction is needed for normal venous blood flow to occur. Again travel can be the culprit here as most people remain in their seats on airplanes and the longer the flight the greater the risk. (And it should be noted Bosh did travel overseas after the All-Star Game.)
Blood clots are successfully treated with anticoagulants or blood thinners. The purpose is to prevent further clotting while your normal system functions to break up the clots. Activity must be restricted for two reasons:
First, any blood clots in the extremities can travel to the lungs with vigorous exercise. Second, with the use of blood thinners, any physical contact or falls can lead to internal bleeding that can be life threatening when talking about the brain and vital organs. Treatment is continued for three to six months.
I believe Bosh will completely recover and will likely be treated with blood thinners for a period of three months with a return to play in roughly four months. As was announced, this timetable will end his season, but he should be completely ready for next season.
Given the rash of blood clots in athletes and former athletes lately, including Serena Williams, Jerome Kersey and Mirza Teletovic, it would be interesting to see if there is a common denominator. Perhaps a similar supplement or dietary habit could be contributing? The frequency of these cases of blood clots should be alarming enough to warrant some investigation by team physicians or the league.
Kevin Pelton: Projecting the second half
Despite the frightening news about Bosh, the good news for Heat fans is that even without Bosh, the revamped Heat roster looks like a playoff team. Using the long-term, predictive version of ESPN's real plus-minus and my estimates of playing time, Miami rates as a slightly better than average team the rest of the season sans Bosh -- one that would win about 42 games over a full season.
That's much better than the Heat's current 35-win pace, since the upgrade from the departed Norris Cole (one of RPM's lowest-rated players) to Dragic is bigger than the drop-off at power forward. Previously, my playoff simulations showed Miami winning an average of about 36 games and reaching the postseason 57 percent of the time.
Using the new estimate bumps those numbers up to more than 38 wins on average, and a trip to the playoffs 85 percent of the time. That doesn't factor in Brooklyn dealing for Thaddeus Young or a possible Paul George return to the Indiana Pacers, but remember that as Tom Haberstroh noted on Monday, the Heat have one of the league's easiest schedules the remainder of the season.
Unfortunately, Bosh's absence probably does mean Miami will be first-round fodder rather than having a real chance to spring an upset. With Bosh, the Heat would rate as a 48-win team over a full season, which would have put them fifth in the East in terms of the "true talent" ratings I use in my playoff simulations -- not far behind the Toronto Raptors, a possible playoff opponent.
Given the rash of blood clots in athletes and former athletes lately, including Serena Williams, Jerome Kersey and Mirza Teletovic, it would be interesting to see if there is a common denominator. Perhaps a similar supplement or dietary habit could be contributing?
Pathologic blood clots form because of dehydration. This leads to less blood volume and literally thickens the blood. Athletes who travel (and endure long periods of inactivity sitting in planes) extensively as NBA players do, coupled with their regular exertion and perspiration, certainly are at greater risk than the average population.
Stasis (sluggish blood flow) caused by inactivity can contribute to blood clot formation. Muscle contraction is needed for normal venous blood flow to occur. Again travel can be the culprit here as most people remain in their seats on airplanes and the longer the flight the greater the risk. (And it should be noted Bosh did travel overseas after the All-Star Game.)
Blood clots are successfully treated with anticoagulants or blood thinners. The purpose is to prevent further clotting while your normal system functions to break up the clots. Activity must be restricted for two reasons:
First, any blood clots in the extremities can travel to the lungs with vigorous exercise. Second, with the use of blood thinners, any physical contact or falls can lead to internal bleeding that can be life threatening when talking about the brain and vital organs. Treatment is continued for three to six months.
I believe Bosh will completely recover and will likely be treated with blood thinners for a period of three months with a return to play in roughly four months. As was announced, this timetable will end his season, but he should be completely ready for next season.
Given the rash of blood clots in athletes and former athletes lately, including Serena Williams, Jerome Kersey and Mirza Teletovic, it would be interesting to see if there is a common denominator. Perhaps a similar supplement or dietary habit could be contributing? The frequency of these cases of blood clots should be alarming enough to warrant some investigation by team physicians or the league.
Kevin Pelton: Projecting the second half
Despite the frightening news about Bosh, the good news for Heat fans is that even without Bosh, the revamped Heat roster looks like a playoff team. Using the long-term, predictive version of ESPN's real plus-minus and my estimates of playing time, Miami rates as a slightly better than average team the rest of the season sans Bosh -- one that would win about 42 games over a full season.
That's much better than the Heat's current 35-win pace, since the upgrade from the departed Norris Cole (one of RPM's lowest-rated players) to Dragic is bigger than the drop-off at power forward. Previously, my playoff simulations showed Miami winning an average of about 36 games and reaching the postseason 57 percent of the time.
Using the new estimate bumps those numbers up to more than 38 wins on average, and a trip to the playoffs 85 percent of the time. That doesn't factor in Brooklyn dealing for Thaddeus Young or a possible Paul George return to the Indiana Pacers, but remember that as Tom Haberstroh noted on Monday, the Heat have one of the league's easiest schedules the remainder of the season.
Unfortunately, Bosh's absence probably does mean Miami will be first-round fodder rather than having a real chance to spring an upset. With Bosh, the Heat would rate as a 48-win team over a full season, which would have put them fifth in the East in terms of the "true talent" ratings I use in my playoff simulations -- not far behind the Toronto Raptors, a possible playoff opponent.