The sight of LeBron James being carried off the court at the AT&T Center on Thursday night will be one of the lasting images from Game 1 of these NBA Finals.
As the four-time league MVP sat on the bench in the steamy-hot arena, his muscles painfully, uncontrollably contracting during the final three minutes of regulation, the Spurs polished off their comeback against the Miami Heat to take the first game of the series with a 110-95 win.
And James came under some harsh scrutiny from the public -- which those who treat athletes say was unfair and unnecessary.
"Cramps can be really debilitating and come with excruciating pain. Just imagine your muscles in a constant state of being stressed and spasming and you have no control over it," said Dr. Clifton Page, an assistant professor of orthopedics with UHealth Sports Medicine and a team physician for the Miami Hurricanes and the Marlins. "Your body is trying to shut the muscle down so it doesn't damage itself ... . For someone to say 'just play through it,' it's hard to play through something you can't control."
The good news for James and the Heat is that there's no reason to believe he'll suffer any lingering effects when Game 2 is played Sunday.
"There's plenty of time. You're talking about a couple of days and it usually takes two days to get the tank back after something like that," said Dr. Andrew Kusienski, the team doctor at Nova Southeastern University. "He's going to be sore from the cramping in and of itself, but he's got some of the best support staff and he's a highly conditioned athlete. He'll be stretched, and I don't anticipate there being a problem."
James has dealt with cramping issues in the past, most notably during the 2012 NBA Finals against Oklahoma City. But even as recently as the Eastern Conference finals against Indiana, he required additional stretching to prevent a situation like the one he experienced Thursday.
Still, Heat coach Erik Spoelstra bristled Friday at the notion this was a chronic problem for James.
Courtside temperatures reportedly reached near 90 degrees on Thursday after the air conditioning system at the AT&T Center malfunctioned, creating a stifling environment that taxed players and fans.
"Game 4 in Oklahoma City that everybody knows about, since then we think that our staff and LeBron's diligence has really taken care of the matter," Spoelstra said. "Just in terms of his preparation before games, what he's doing during games in terms of always filling himself up with electrolytes, fluids, cramping pills when necessary. All of those things, we have been much more on top of it since Game 4 of Oklahoma City ... but last night was extreme. It was very extreme."
Also extreme -- and rare -- is the kind of damage that can come from ignoring cramps.
According to Page, playing through severe cramps can cause permanent damage, not necessarily to the muscles, but to the kidneys, which may be taxed while having to process the high amounts of creatinine generated by cramping muscles. Ignoring cramps can also lead to rhabdomyolysis, which also taxes the kidneys.
That's not necessarily the situation James faced last night, but it can be an issue with cramping.
"If you try to play through them consistently, there's some form of badness that can happen," he said.
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