It’s almost been a year since that infamous pass in the game 7 match between the 76ers and Hawks. Since then, Ben Simmons has taken the spotlight as arguably the most hated player in the NBA. From his viral outfits to being mocked for a back injury, it’s safe to say that 2022 was not his year. 

Yet, despite his homage to Australia’s rainbow lorikeet – did he really deserve the onslaught of hate? From Stephen A Smith excoriating outbursts to Kendrick Perkinson’ss comparing Simmons to a single woman who smokes cigarettes, the media has been ruthless in denigrating the three-time All-Star. 

I’m not here to speculate whether Simmons was ‘faking’ an injury or mental health issues to avoid fines. Instead, I’m here to discuss our expectations of professional athletes and to stop questioning their injuries. Also, as a physiotherapist, I’d like to provide some context behind his back injury and when we might be able to see Ben Simmons’ Nets debut. 

Timeline of Ben Simmons' Injury and Back Problems 

BEN SIMMONS INJURY TIMEILNE DIGITAL PHYSIO

Before analyzing Ben Simmons’ injury, return and media treatment, let’s put everything into context. Using Simmons’ injury history from Fox Sports, I independently researched the history behind his current condition. This allowed me to compile a timeline detailing key dates for his back injury and NBA activities. 

Even before the news of Simmons’ back tightness and being kicked out of practice on October 22 2021, it’s obvious he was dealing with back issues long before people commented about it. The first signs of back problems actually came two years prior. In 2018, Ben Simmons sat out two games with a back injury against the Orlando Magic.

It wouldn’t be until February 26 2020, until we hear news of another back injury problem against the Milwaukee Bucks. After playing for just 5 minutes, Simmons left the court where his ‘sources had described [him] as being emotional‘ after leaving the X-ray room. Shortly after, further testing revealed nerve irritation in the lower back. After missing eight games, the league went into a lockdown due to COVID-19 before returning on opening night (August 2 2020). 

The next we heard of Ben Simmons’ injury was October 22 2021, when he refused to actively participate in the 76ers pre-season training session due to back tightness and being mentally unfit. This was after Doc River’s and Joel Embiid’s remarks about Simmon’s performance during game 7 of the Eastern Conference NBA Finals against the Atlanta Hawks. 

After a tumultuous few months with the 76ers, Ben Simmons, Andre Drummond, Seth Curry and two first-round picks were finally traded to the Brooklyn Nets in exchange for James Harden and Paul Millsap. Hopeful of getting Simmons back before the NBA play-ins or the playoffs, the Nets waited in anticipation for their newly acquired star to finally play his first game since 2020. 

Unfortunately, this was not to be the case. After an epidural treatment in his L4 disc on March 15, 2022, reports surfaced and suggested that Simmons was ‘extremely hopeful‘ to return at the end of the regular season. Uncertainty around the 3-time All-Star playing status reignited as an ESPN report surfaced that his back pain was related to a potential L4 disc herniation. 

After failing to make his debut for the Nets, Kevin Durant and co. were promptly swept by the Boston Celtics in the first round of the Eastern Conference Finals. Reporters from ESPN and other networks unleashed scathing commentary regarding Simmons’ absence.

Finally, Simmons underwent a surgical procedure called a microdiscectomy at the Cedars-Sinai Marina Del Rey Hospital on May 5, 2022. He is expected to make a full recovery within 3-4 months after surgery

Analysis of Ben Simmons' Injury - Embellishment or Reality?

I preface this part of the article by saying that I am not a sports journalist nor an insider. My job isn’t to scrutinize the broadcasted information. Instead, I’m going to utilize the information above to make informed speculation about Ben Simmons’ status and disc injury. 

Remember – my analysis will be conducted through the lense of a physiotherapist, not an instigator (ahem… looking at you ESPN).

BEN SIMMONS 76ERS DIGITAL PHYSIO

Part 1. Getting Nervy - Ben Simmons' Back Injury Timeline

When looking at Simmons’ back injury timeline, it is clear that he has had back issues long before his recent episode. His nerve impingement on February 26 2020, stands out to me in particular.

Nerve impingement. Doesn’t sound good, does it? As a 6′ 11′ point guard playing at the highest level of basketball – it really isn’t.

CERVICAL THROACI LUMBAR PELVIC DIGITAL PHYSIO

In everyday terms, nerve impingement stands for ‘there is something in your back pressing against your nerve(s).’ You can visualize the complexity of the spine below. The image above shows you the side view of a normal spine. Made up of many boney parts stacked between each other – these are called ‘vertebrae.’ Between each ‘vertebrae’ is a spongy layer called a ‘disc’ which helps absorb the shock through the back.

cervical vertebrae digital physio

Hold up. Hold up. Hold up. This is the part where some of you might be dozing off, but I swear there’s a reason why I wanted to talk about this. Even looking at image 2, a spine drawing, shows how complex the back is. What is also shown, is how many damned structures could cause nerve impingement. 

Why is this relevant? In hindsight, I speculate that this may be Simmons’ first encounter with back problems related to his current issue. If this is true, Simmons was most likely dealing with significant back injuries long before the 76ers feud. More will be discussed in parts 2 and 3 of the analysis.

 
 

Part 2. Will He Or Won't He? Ben Simmons Status Up In the Air

Fast forward to 2021. It’s a rough one for Ben. Thrown under the bus by his coach. Getting torn apart by the media. Even Joel Embiid, his partner in crime, didn’t share the kindest of words. I’ve never seen a passed-up layup receive so much scrutiny. For the few who don’t know what I’m talking about – let’s replay that moment

 

This… was the moment that triggered everything—a flourishing all-star, now relegated to the sidelines. Unable, or some might say unwilling, to suit up in the 76ers uniform. This was when rumblings of Ben Simmons’ mental health problems emerged. With Simmons now working with a mental health specialist, there was still uncertainty about when or if he could ever play for Philadelphia again. 

During the rest of Ben’s tenure on the 76ers, there were multiple reports regarding his health and playing status. Starting pre-season training, Ben did not participate and cited lower back tightness as the causal factor. Additionally, ESPN reporter Ramona Shelburne detailed that Ben Simmons was struggling with mental health and had been seeking help from professionals since the NBA finals incident. 

With news that the Philadelphia 76ers were still paying Ben Simmons his $200 million, many speculated these ‘issues’ were exaggerated to keep his finances in check. Evidentally, there was no love lost between the 76ers fans and the media. 

Despite the immense amount of negative press, Ben did have some supporters. Hollywood comedian Kevin Hart defended Simmons by saying, “I’ll say this on record – Ben is a f—king star” and “Now, because of the media and how they position things, well, somehow we forgot about all the good he did.”

Part 3. Mental Health. Lower Back Pain. Brooklyn Nets. 

“If I knew, I would tell you everything. But there’s just a lot of things internally that had happened over time, and it just got to a place where I don’t think it was good for me mentally. So, it is what it is. It happened and I’m moving forward.

Right after getting traded to the Brooklyn Nets, Ben Simmons commented on the state of his declining mental health, even before the playoffs incident. Despite these comments, there was continuous ridicule of his struggles. For instance, Shaquille O’Neale called Simmons “soft”, a “cry baby” and needed to distinguish “mental health” from “mental fortitude.”

While Simmons’ actions are not without fault, his mental health should not be a subject matter to poke fun. As beautifully said by Kensa Gunter, director of NBA’s Mind Health, “being excellent and elite does not absolve from being human.” We all know the consequences of mental health struggles. Demeaning and downplaying the quiet torture of an individual’s state of mind does not help.


nba tweet digital physio

Pain is complex. Overall, it serves as a way to protect the body against threatening movements. Suppose you’ve sprained your ankle. Your body’s mission is to protect the ankle because it’s been injured. Pain serves as a way to stop yourself from potentially causing more harm. As a result, Simmons’ disc injury could seemingly be the reason for his time away from the sport. 

But is it as simple as that? Like any difficult conversation, there are two parts to the dialogue. There’s the speaker and the receiver. The presence of pain alone does not reflect the state of the body. One must also consider how the pain signal is being received and tolerated. It can be extra challenging to process a difficult conversation in a poor state of mind. Likewise, the ability to tolerate pain can also be reshaped. 

There are multiple systems in the body that affect how pain is tolerated. Sleep. Nutrition. Physical fitness. These are just some of the factors that influence pain sensation. The term ‘central sensitization’ is another factor that describes the ability of someone to process and respond to their pain. 

The need to deal with mental obstacles is especially challenging for an elite NBA athlete like Ben Simmons. Meeting the coach’s expectations. Tolerating criticism from fans and the media. Earning the respect from your teammates. These are just some psychological hurdles that can change the central sensitization of a human’s pain. 

 

pain digital physio

Ben Simmons’ life was turned upside down in the space of a game. From his coach in Doc River’s dismissive take to the passionately vocal fanbase in Philadelphia, it would be a hard pill to swallow for any sane person. Understandably, it would be later revealed that Ben Simmons’ had been suffering from mental health issues ever since. 

Might this have been a guise for preventing paying fines? Maybe. 

But it could also be feasible that his mental health issues influenced his capacity to return to sport and tolerate his long-term back injury. Absolutely. 

Part 4. More Than Just A Back Injury?

Throughout Ben’s final tenure at Philadelphia, there was confusion about whether he was unable to play due to his back pain or mental health struggles. Like many people with chronic conditions, they are most likely intertwined. 

News of Simmons’ lumbar disc herniation appeared in March 2022. This was after his epidural earlier in the month and before his back surgery in May 2022. As detailed in part 1, this is an injury where fluid leaking from the spongy layers of the spine can cause back aches and nerve pain shooting down the legs. 

disc herniation digital physio

Health professionals generally understand that most disc injuries will naturally improve over time. In fact, an MRI study showed that 88% of people with disc injuries and nerve pain would naturally experience a 50% improvement within 3-12 months [1]. Yes, that’s right. Most disc injuries do not need surgery to recover.

Despite having access to world-class medical treatment, Ben Simmon’s remains sidelined throughout the rest of the 2021-2022 season with the Nets. Despite multiple attempts to return for the NBA finals, he was unable to do so. Unfortunately, these actions drew even more criticism and negative commentary. 

Ben Simmons was absolutely torn apart for sitting out of game four after his hopeful calls to return. A livid Steph A Smith described the situation as ‘pathetic.’ At the same time, fans were left disappointed as the Celtics swept the Brooklyn Nets. 

A delayed return from injury is not uncommon, and setbacks are expected during recovery. Disc herniations are typically slow healing. Symptoms, such as lower back pain and stiffness, can take up to several weeks to months to disappear. 

But… with video evidence of Ben Simmons dunking, it could easily be suggested that his back pain wasn’t as significant as some may think. That is a simple outlook. Dunking isn’t the only metric used to gauge a 48-minute playoff game where everything is on the line. 

I preface the following part by mentioning that I do not have insider knowledge and cannot tell you what exactly happened. However, I will simply analyze the situation under my clinical opinion, and the evidence presented. 

The mounting pressure from Simmons’ long-awaited return could have impacted his return – whether he knew it or not. Central sensitization can prolong the feeling of pain even in the presence of injury healing. The aforementioned mental health problems coupled with the gnawing expectations and incoming scrutiny from the NBA community would be a large burden. 

As a result, any level of pain felt before the series could be amplified even more. Imagine you’ve just missed your haircut appointment. What do you feel? Sure you panic, but you call to reschedule and let your hairdresser understand your circumstances. Now, imagine the same scenario, but you have work deadlines due tonight and an unwell relative who needs help. The same problem, however, the gravity of the circumstances may feels greater because of the state of duress. 

This is the same as pain. Psychological, mental or social stressors can add to it. While we often connect physical pain to physical injuries, this is not the case. Pain is complex. 

Elite athletes are some of the most scrutinized humans on Earth. Not only was Ben Simmons scapegoated by the 76ers, but he has taken the brunt of it from the media, teammates and even fans. 

simmons embiid digital physio

As outsiders, it’s hard to understand what these athletes endure physically and mentally. No one in the world can feel what you feel. And to Ben, he felt that pain stopped him from being able to contend, and that’s that. Only Simmons will understand what he felt in the moment. 

We need to stop bringing this man down. The media need to stop writing negative articles intended to slander. At the same time, fans should only look to get excited about his potential return next season. 

At the end of the day, athletes are human too. They feel pressure, and they suffer from mental stress. And, yes, they feel pain too. What is causing them pain should only matter to them.

When they return should only be a matter of themselves. We’ve had plenty of instances where players have returned too early, only never to play the same again. Look no further than Isaiah Thomas, who pushed through his hip injury for the Boston Celtics in 2017, only to have his NBA career derailed ever since. 

All we should do is look forward to Ben successfully rehabilitating from his back surgery to see this All-Star shine again. 

Take Away Points

No one can doubt that the situation with Ben Simmons was unprecedented. Back injuries are not rare in the NBA, but this situation showed that external factors could’ve played a role. Often, many people are unaware or forget that chronic pain is not purely biological. The stressors of life can cause the central sensitization of pain. For Ben, the immense abuse from the media, teammates and coaching staff may have contributed to his absence from the court. I personally, and hope others, wish Simmons a speedy return.

Summary of Ben Simmons' Injury - TL;DR Version

 

  • Ben Simmons has had a history of lower back pain dating back to 2018

  • This was likely related to his current injury after the 2020 Finals run with the 76ers.

  • He underwent surgery (microdiscectomy) for his back in May 2022, with an expected 3-4 month recovery timeline. 

  • His mental health issues and scrutiny from the NBA community may have contributed to his response to his lower back pain and absence from games. 

  • [OPINION] We need to put Ben’s history aside and look forward to his return to the basketball court. More elite talent will only make the NBA better. There is no need to stack on any more criticism about what happened. At the very least, let’s not add to the damaging social discord so that we can see a mentally and physically healthy Ben Simmons on the court. 

Lower back pain and sports injuries  requires immediate rehabilitation to help you return to sport quickly.  Physiotherapy is important for kickstarting your recovery an return to sports. Click on the ‘BOOK NOW’ button below to start your journey with a digital consultation with one of our qualified physiotherapists. 

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