New York Liberty coach Walt Hopkins didn't mince words about guard Sabrina Ionescu's ankle injury, regardless of how long she might be out: "It's a massive loss."
In the Liberty's game Friday against the Atlanta Dream, Ionescu rolled her left ankle when she stepped on opponent Betnijah Laney's foot while bringing the ball up the court. ESPN's Holly Rowe has reported the injury as a Grade 3 sprain, which might put the rest of Ionescu's rookie season in jeopardy, especially a shortened season -- 22 games -- because of the coronavirus pandemic.
"We're still playing it by ear," Hopkins said Sunday. "She's gotta get some more in-depth work on it, and then we'll have a better answer."
Although we don't yet know specific details of Ionescu's injury, we can take a look at how similar injuries typically impact elite athletes and what might be next for the Liberty.
What is a Grade 3 sprain?
The Liberty have not yet confirmed the severity of the injury. ESPN injury analyst Stephania Bell, speaking in general terms without specific information on Ionescu's case, said it isn't uncommon in a circumstance such as this for the evaluation process to be ongoing.
If it is indeed a Grade 3, that's the most serious type of ankle sprain, marked by severe swelling and instability of the joint. It indicates that a ligament has been torn.
"We talk about a Grade 3 being a complete tear," Bell said. "But it is also true that there could still be some portion of the ligament that's involved that's still attached. But it's essentially a stability assessment. So from a functional aspect, it can be like a complete tear, even if some segments are still intact."
Bell said possible cartilage damage and bone bruising also have to be evaluated.
"Those things will all factor into the equation of how quickly someone can progress, as far as weight-bearing and what the healing parameters look like," Bell said.
How long might the recovery process last?
That depends in part on the severity of the injury -- Rowe reported that it was initially thought that Ionescu will not need surgery -- and in part on how different individuals heal. Bell said the general range for recovery of a Grade 3 sprain is several weeks to several months.
The WNBA's regular season concludes Sept. 12, followed by the playoffs. At this point, the 0-4 Liberty, in a rebuilding year and with seven rookies on the 12-player roster, are not expected to be a postseason team. As such, it's likely that there are six weeks left of their season.
"The danger in saying, 'Oh, it's always at least this long,'" Bell said of the recovery timeline, "is then for somebody, it's not that long or it's not as bad as they thought. In Sabrina's case, she's such an incredible athlete, and she really hasn't been hurt in her college career. If she rehabs anything like the way she plays, that could factor in to how quickly she could come back."
As of Sunday, Ionescu had not addressed the media about her injury. But she spoke briefly to Rowe before Sunday's game and expressed hope for the best for her prognosis and the desire to support her team from the bench.
.@sportsiren talked to @sabrina_i20 ahead of today's @nyliberty game. pic.twitter.com/4g2sNsWmaY
— WNBA (@WNBA) August 2, 2020
Ionescu missed four games her freshman season at Oregon because of a thumb injury. She did not miss any games her sophomore, junior and senior seasons.
Even if Ionescu is able to heal quickly enough to try to be back on the court before the season ends, the Liberty would have to evaluate if that is even prudent.
Will Ionescu leave the WNBA bubble for assessment or treatment?
Hopkins said Sunday that it's too early to say what the next steps will be.
"We will provide the best care for Sabrina," Liberty/Nets owner Joseph Tsai tweeted on Saturday. "She will come back stronger."
We will provide the best care for Sabrina. She will come back stronger. https://t.co/yNlsnvW6lB
— Joe Tsai (@joetsai1999) August 1, 2020
Bell points out that the Liberty and Nets are affiliated with the Hospital for Special Surgery (HSS) in New York, a renowned orthopedic facility, and associate Nets team physician Martin O'Malley of HSS is considered one of the nation's top ankle and foot specialists. He operated on Kevin Durant's Achilles injury last year.
"Sabrina will have access to some excellent people," Bell said, "who not only understand how to get a competitive athlete back but are very accustomed to dealing with these types of injuries."
What might the rehabilitation process look like?
Ionescu is on crutches and in a protective boot. The first goal is to control the swelling and protect the joint before she beings working on getting range of motion back. There is also work to be done on strengthening lateral muscles that support the outside of the ankle joint.
"You really want to train those, not only to make sure you've got the strength there, but the reactivity," Bell said. "Your biggest worry after a sprain like this is a reoccurrence of this type of injury. You don't want it to become a chronic ankle instability issue. You don't overdue the activity too much too soon.
"There's also neuromuscular coordination training as a part of the higher-level rehab. That's training the reactivity. If you're thrown off-balance, does your nervous system pick up on that and kick those muscles into gear to try to prevent you from rolling over? Because those little joint receptors can also get damaged with this kind of injury. It's essentially coordination and reaction timing and then ultimately integrating it into sports-specific activities."
What impact will Ionescu's absence have on the Liberty?
New York lost 96-67 to the Phoenix Mercury on Sunday. With such a young roster, the Liberty were picked to finish last with a healthy Ionescu. Without her, things are even more difficult for New York.
After a tough shooting performance -- 12 points, 6 rebounds and 4 assists -- in the Liberty's opener on July 25 against the Seattle Storm, Ionescu had 33 points, 7 rebounds and 7 assists in her second game four days later against the Dallas Wings. She had 10 points on 4-of-5 shooting before she suffered the injury against Atlanta.
"There's not a lot of time to adjust X's-and-O's-wise when someone gets hurt," said guard Layshia Clarendon, the Liberty's most experienced player, who is in her eighth season. "Then emotionally, Sabrina just brings a tenacity to her and a fire and the competitiveness that you could really tell we were missing, especially toward the end of [Sunday's] game."
The Mercury outscored New York 34-11 in the fourth period.
"We just kind of lost our fight and quit," Clarendon said. "It was embarrassing to see and something we just addressed in the locker room. That's a character thing that we're continuing to grow in."
Ouch!! @sabrina_i20 Get healthy as soon as possible! 🙏🏾. Health is wealth
— LeBron James (@KingJames) July 31, 2020
Clarendon was limited to nine games last season while with Connecticut, as she stepped on a teammate's foot and suffered an ankle injury that required surgery. She knows what Ionescu is going through.
"I gave her a really big hug. There's not a lot of words," Clarendon said. "I told her at least it was this year, when it was a rebuilding year."
Again, no one has said officially how long Ionescu will be out, but Clarendon seems to think she might not be back for 2020.
"She got a taste of what it was like to play in this league," Clarendon said. "Now she can just really have a good, healthy offseason and get prepared for next season."
Who needs to step forward for New York?
Short answer: everybody. Specifically, more weight is on guards Clarendon, Kia Nurse, a third-year player out UConn, and Jazmine Jones, a rookie from Louisville.
New York isn't without only Ionescu. The Liberty are also missing guard Asia Durr, the No. 2 overall pick last year who is medically exempt this season after being ill because of COVID-19.
Clarendon and Nurse started Sunday and combined for 29 points and five assists. Jones came off the bench for 3 points, 7 rebounds and 4 assists.
"Not one person is going to be able to do everything that Sab has done for us," Nurse said. "Really, everybody has to step up just a little bit more, especially us on the perimeter who have the ball in our hands a lot."
But the Liberty's other five rookies -- forwards Joyner Holmes, Kylee Shook, Leaonna Odom and Megan Walker and forward/guard Jocelyn Willoughby -- can be an important part of the team's future as well as its present. Willoughby is averaging the most points of that group so far, at 7.0.
"After the first week of training camp, I had a meeting with all the younger players," Hopkins said. "And we talked about how special this opportunity is. Very few rookies get to come into the league and play significant minutes and have an impact and play through mistakes.
"You don't see it very often. We have literally all of them playing significant minutes and in important points in the game. And that's not gonna change. There's gonna be even more of that now."
Has any other No. 1 WNBA draft pick missed a substantial part of her rookie season?
In 2007, the Minnesota Lynx's Lindsey Harding had her first season cut short on July 10 because of an ACL injury she suffered in a game at Washington. She was limited to 20 games, the fewest that a No. 1 pick has appeared in since the WNBA launched in 1997. No other top pick has appeared in fewer than 27 games as rookie. Harding averaged 30.1 minutes in her 20 games.
Charlotte's Janel McCarville, the top pick in 2005, was slowed by a back injury as a rookie. She played in 28 games but averaged just 11.1 minutes. Cleveland's Ann Wauters (19.3 MPG in 2000) was the only other top pick to average fewer than 21 minutes as a WNBA rookie.