The Markelle Fultz Injury: Patience vs. Panic

The Process has run into yet another injury problem. Markelle Fultz's shoulder injury is troubling on a number of levels, but there is at least one silver lining. How will Philly handle its latest setback?

If Markelle Fultz really does have a lingering shoulder injury, it's good news in at least one respect. We now have an explanation that actually makes sense. 

Fultz has looked lost and overwhelmed through his first four regular-season games. He's playing hard, but something clearly isn't right. He's shooting free throws like Shaq and ignoring open jumpers like he's Andre Roberson. The entire league has spent the past month watching this happen, wondering how things could've gotten this bad. 

This is where a confirmed shoulder injury is actually a little bit comforting. Despite murmurs about lingering pain for a month, the Sixers have continued playing Fultz as if he's healthy. And in that case, if it wasn't the shoulder, the conclusions only got scarier. It looked like Fultz was feeling pressure, cracking mentally, and developing habits that could complicate the rest of his career. 

If it's the shoulder, this seems like a simpler problem to solve. Of course, even as things became clearer Tuesday, the situation remained complicated. 

"Markelle had a shoulder injury and fluid drained out of the back of his shoulder," agent Raymond Brothers told ESPN's Adrian Wojnarowski on Tuesday afternoon. "He literally cannot raise up his arms to shoot the basketball. He decided to try and fight through the pain to help the team. He has a great attitude. We are committed to finding a solution to get Markelle back to 100 percent." That report was retweeted by Markelle, himself, but later un-retweeted, and the details were amended by the agent. 

As Brothers clarified to Woj in a second report Tuesday night, "He had a cortisone shot on Oct. 5, which means fluid was put into his shoulder—not taken out. My intention earlier was to let people know that he's been experiencing discomfort. We will continue to work with (Sixers general manager) Bryan Colangelo and the medical staff." The second ESPN report also included assurances from Sixers sources noting that multiple physiotherapists have approved the team's treatment plan. 

So this is a mess. Obviously. But whatever the specifics, discussing the injury publicly feels like progress. 

After a month of speculation and Twitter film study on his jumpshot mechanics, we've hit a point where Fultz pretty clearly needs a break for either his physical health, mental health, or both. Regardless of how much the shoulder is really bothering him or what the Sixers doctors have said, the official disclosure of the injury gives the team cover to make the smart move from here. 

Fultz should be sidelined indefinitely—either this week, next week, or whenever the Sixers finally admit this isn't working. It will give Fultz time to get healthy, get some distance from the flurry of viral clips that have defined him thus far, and allow him to return with a much better chance to succeed. 

As for everyone else who's watched this unfold, there are two ways to process the past month.

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• The first, most reasonable response is to preach patience. Fultz is 19 years old. He was never going to walk into the NBA and dominate. The problems with the jumper are probably at least partially psychological at the moment, but the shoulder injury seems real enough to make that distinction irrelevant. He's hurt. If he sits and gets healthy, scoring is not something to worry about.

For now, his task next to Ben Simmons and Joel Embiid in Philly is much trickier than the freewheeling control that's been given to Lonzo Ball, De'Aaron Fox, or Dennis Smith as they've thrived early on. The Sixers are asking Fultz to play off the ball for the first time in his career, while learning in the NBA on a team that's trying to win immediately and make the playoffs this spring. 

Compounding the problem, Fultz sprained an ankle in Vegas Summer League that kept him out of workouts for most of the summer, and he doesn't look like he's in very good shape right now. Injured shoulder or not, he looked more explosive in college than he's been in the NBA thus far. He probably needs a good trainer, and perhaps less Chick-Fil-A. But again, none of this is a reason to write off his career. 

Fultz has plenty of time to get his bearings and excel. It doesn't have to happen this year. The comparison I keep coming back to is Bradley Beal, a player who was plagued by nagging injuries for the first few years of his career, and looked overwhelmed for most of his first season. He was playing on a Wizards team that had zero stakes that year, but it wasn't pretty. Many, many Wizards fans spent the year wondering why Washington didn't take Andre Drummond. 

Eventually Beal learned how to take care of his body, and by Year Three, he was surprising the entire league in the NBA playoffs. That timeline is still right there for Fultz.

• The second, completely valid response is to panic. Be real. All of this should be terrifying for Sixers fans. Anyone who's not worried is lying. Even if you can convince yourself that the shooting woes will correct themselves when his shoulder heals, Fultz looks more ordinary athletically than anyone would have expected. Maybe that's because he's not in shape yet, but what if it's not? Also, he's 19. Why isn't he in shape? 

The worry isn't simply that Fultz isn't scoring, but he's struggling to stand out at all, even as he plays the bulk of his minutes against mediocre second units across the league. That's not a good sign for a No. 1 pick. He'll have an easier time creating space for himself when he has a jumper, but he already looks further behind schedule that anyone would've imagined six months ago.

The shoulder injury could explain a lot of the struggles we've seen, but another Fultz injury is concerning in its own right. He missed six of his final seven games at Washington with an injury that was described as "knee soreness." Then he sprained his ankle in Vegas Summer League. Now he's dealing with a shoulder injury that his agent claims is serious, and the Sixers have been downplaying it for the past month. 

Whatever it is that's happening here, it's not encouraging. The injuries alone would probably be enough to scare teams off from taking Fultz at No. 1 if you re-drafted this rookie class today. 

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In the end, both perspectives are fair. It's hard to say how this will play out from here. Fultz is still incredibly talented, and if his body can cooperate, his ceiling remains as high as any rookie in the league. I wouldn't bet against him. But he's also spent the bulk of his career playing outside the national spotlight, and his introduction to the mainstream could not be going worse. It's been hard to watch. And this is where questions about Fultz become questions about the way the Sixers have handled this situation. 

After a five–year basketball depression in which the Sixers saw season-ending injuries to Simmons, Embiid, Nerlens Noel, and Andrew Bynum, the trade for Fultz in June's draft helped jumpstart the excitement surrounding a new era in Philadelphia. "We felt like Markelle was a great fit for our organization," Bryan Colangelo told The Crossover at the outset of Sixers training camp. "He can be a great complement to Ben Simmons with or without the ball." 

"We also looked at Markelle as the player with the greatest ceiling. Whether or not that plays out in Year One, time will tell. But long term, Markelle was the best fit for this organization. The move itself certainly got the fanbase excited. Really put a jump into everything that we were doing from a business and marketing standpoint. It was like a final piece being added, that brought everything together." 

Colangelo's appraisal isn't any different than the consensus around the NBA after the draft. If Fultz wasn't quite the cornerstone next to Embiid and Simmons in Philly, he was seen as the keystone who would make the rest of the lineup fit. Everyone loved what Philly was becoming, and there was playoff talk, and as Colangelo said, this offseason helped create more local and national buzz than this team's seen since Iverson. I get it. I wrote about it. But the plan has fallen flat with Fultz. 

It's acceptable to panic over the No. 1 pick who won't shoot a jumpshot, it's reasonable to be patient, but the Sixers haven't committed to either approach. They were never going to be patient enough to start Fultz at point guard and let him work through his issues in losses like Smith, Fox, and Ball. They want to make the playoffs. They are committed to Ben Simmons at point guard. So instead, they've played Fultz out of position, half-injured, and in four and five-minute bursts off the bench where he's expected to get acclimated on the fly and live up to the lofty expectations. It's kind of unbelievable that anyone thought this was a good idea.

Then, as it's become clear that Fultz's shoulder isn't improving, they've apparently been reluctant to betray concern and sideline him entirely. I don't know whether this is because they don't want to undermine the progress and excitement of the summer, or they're looking to avoid a Ben Simmons sequel, or maybe they think eventually their star rookie will be scared straight into getting a healthy shoulder and shooting 42% from three. 

Whatever the motivations have been, continuing to play an injured Fultz has left him open to armchair psychology, skepticism all over the league, and lots of lost minutes that have only made the problems more obvious. It's now gotten so bad that Fultz's agent had to go directly to the media to clarify things, then confer with the team and go back to the media to clarify the clarification.

It leaves you with two questions at the end. First, how did the Sixers let this happen? 

And, cosmically speaking, how does this keep happening to the Sixers?