Phinisee remains out with concussion as Hoosiers return to Big Ten play

New year, same problem.

When No. 21 Indiana opens the second leg of Big Ten play against Illinois on Thursday, it will do so short-handed.

Rob Phinisee has not been cleared to resume basketball-related activities since suffering a concussion during IU’s win over Central Arkansas on Dec. 19, leaving the Hoosiers without their starting point guard as conference play begins in earnest.

Injuries have been a fact of life for Indiana through two months of action, a troubling trend that doesn’t seem to be letting up anytime soon. Miller says he expects to be without Phinisee for the “foreseeable future,” with the Hoosiers adapting to their latest injury concern in a season full of them.

“It’s been a difficult team to sort of be around every day because you’re disappointed that you don’t have the ability to really have all your troops together at the same time,” Miller said. “(You’ve) got to put that by you, obviously, and go with what you have, which is what we’ve done all year.”

Phinisee, who also missed IU’s non-conference finale against Jacksonville on Dec. 22, is one of seven Hoosiers that have missed time due to injuries through the first 13 games. Indiana has seldom practiced with a full roster since the season started in early November, with Miller managing the first two months with a mix-and-match rotation and a shortened bench.

Phinisee’s absence is concerning, given the importance of his position and his knack for delivering clutch moments in close games. The freshman point guard started each of IU’s first 12 games until suffering his head injury, which happened during a scramble for a loose ball nearly six minutes into that Dec. 19 contest at Simon Skjodt Assembly Hall. Although Phinisee was slow to rise from the court after diving for the ball, he played one more minute before leaving the floor. Phinisee has not returned since leaving that game.

After a four-day Christmas break, the Hoosiers returned to work on Dec. 27. Phinisee, however, wasn’t able to join his teammates on the court. The buzzer-beating hero of IU’s Dec. 15 win over Butler, Phinisee hasn’t practiced with the Hoosiers during the past week and also isn’t likely to be available when Indiana travels to face No. 2 Michigan in Ann Arbor on Sunday afternoon.

“He’s progressed and he’s getting better, but he has yet to practice,” Miller said. “I don’t anticipate Rob being available — especially, most likely, this week, and then we’ll see as he continues to sort of go through (the recovery process). He is doing more activity and whatnot, but he hasn’t been cleared to do anything basketball-wise in terms of engaging in practice. We’ll plan to move forward without him here for the foreseeable future, and we’ve got to have next man up, like we’ve been all year.”

Phinisee is the second Hoosier to deal with the lasting effects of a concussion this season. Race Thompson, a redshirt freshman forward who hasn’t played since debuting on Nov. 9, also remains in concussion protocol. Thompson suffered his concussion during a collision in practice on Nov. 11.

“He has improved a lot,” Miller said of Thompson, “but it’s been a very, very difficult injury. … Knock on wood, eventually Rob will rejoin us. It’s just a matter of when.”

Luckily for the Hoosiers, the 11-day layoff between games provided at least a measure of balm for their season-long injury woes.

Zach McRoberts, who missed the Dec. 22 non-conference finale with a back injury, gradually worked his way into practice across the past week. Barring a last-minute setback, McRoberts is expected to be available for Thursday’s game against Illinois.

If there’s good news to be found inside the mess of injuries this season, it’s that Indiana has found ways to cope.

“That’s always how we have approached it, next man up, so to speak, and continue to work to get better and create an opportunity to change the path of your own individual season,” Miller said. “That’s what these guys have done, and there’s been a lot of different guys step up at different times. I think that, hopefully, at some point in time, that can collectively be a good thing down the stretch.”

Devonte Green is the latest Hoosier to step up. The junior guard averaged 16 points, 5.5 assists and only two turnovers while filling Phinisee’s role in IU’s two final non-conference games.

Green also earned IU’s most recent gold jersey, which goes to Indiana’s most productive player in practice. It’s a nod to his growth in becoming a more consistent option inside Miller’s playing rotation, something Indiana needs as conference season returns.

“He does a lot of good things,” Miller said. “But what he’s doing in practice I think is translating to the game. Thursday is going to be a big one for him just in terms of how much he’s going to have to handle the ball. It’s a very difficult game for guards.”

That’s because of Illinois’ desire to create havoc and force turnovers in any way possible. Illinois isn’t a good team, and it doesn’t have many great qualities — except its ability to force turnovers. Opponents are turning the ball over on nearly a quarter of their possessions against the Illini. Illinois’ defensive turnover rate of 24.9 ranks sixth nationally.

“You almost can’t prepare for a team like that,” IU senior forward Juwan Morgan said. “You just have to deliver the first blow, I guess. They’re going to get in there, they’re going to try to muddy everything up. They’re a real intense team, and when you play a team like that, you have to be able to run things, and you also have to be able to have a play get broken up and make something of it. So I think that will be the key, just making sure we stay calm and confident in what we do, and even if a play breaks down, we can’t get frazzled.”

Especially as injuries continue to take a bite into IU’s roster.

30 comments

  1. Wow, two key basketball players out for extended periods due to concussions. What are the odds? I don’t recall every witnessing such a thing before.

    Either the concussions were very serious, or this reflects the much more conservative approach to managing the recovery from concussions. Player safety is paramount, especially when involving the brain, but this just seems like very bad luck for IU.

    Next man up!

    1. We both know that concussions were not taken seriously in the past. Now the medical knowledge and treatments are well developed. Playing hard is what every coach wants. But it does expose your players to head injury. I am appalled at English Premier League Football (Soccer)’s lack of due diligence to head injuries despite our medical knowledge!

  2. Bizarre to be out so long for a concussion….Things have sure changed with concussion protocal. I suppose it’s all for the better to err on the side of extreme caution. I’d guess some guys get severe concussions in pick-up games, are never advised by or see a doctor, take an Advil and are right back at activities/games the next day. Are certain medical staffs more cautious simply depending on the school? Is there a set protocol that must be enforced throughout the NCAA, or is it merely a judgment call based on the feeling of medical staff at University A as opposed to University B?

    A prolonged absence of Phinisee is the last thing we need. He is the only point guard I desire running this team. I am not confident with Green being anything beyond a role player/minute filler off the bench.

  3. I wish I could find one local media type that would say what most feel…what the heck is going on with these guys? Concussion protocol is typically 2 weeks at most…even in football. Good point in Ebron for the Colts with a full blown concussion and he was back after one week. You take the computer and verbal tests and go from there. I’m lost on why Race is still out and Phin as well. It just isn’t normal! I do recall IU doing concussion studies starting last year within the athletics program and I wonder if this extended wait time is part of the study. I have nothing…this is an over the top unheard of amount of time for even a severe concussion.

    1. JPat, Always like your direction and thoughts you develop. You prompted my memory when mentioning IU research study last year. I agree it definitely has been added into the protocol equation at IU. Didn’t hear or sense the same over the season of FB. Makes me wonder if they determined concussions from activity without headgear needs different protocol establishing the need for more time. Hope someone establishes if indeed procedures changed.

    2. J Pat you are terribly wrong in your opinion. You cite pro football as an example when the record shows that sport to be one of the worst to treat head injuries correctly!

  4. BeatP, I am no doctor, but coaching 5 sports at almost every age level in the past 25 years and having a Kinesiology degree with health…I know a bit about concussion protocol. This is not normal at all!

  5. Clarion, thank you. This is a hot topic with fans and my family was talking about it over the holidays. Appreciate the words and Happy New Year!

    1. Hope these protocols are in place for every time someone slips on a bathroom floor while being totally wasted at a weekend dorm party. “You have been held out from all future dorm room drinking parties…until further evaluation. You will be placed in a padded room with upholstered headboard. You are to avoid all steps….If sidewalks have a dusting of snow, you are to remain in your dorm room until the sun and salt has melted and dried any potentially slipper seyurfaces. You are not to shower. You must avoid soaps not containing pumice. It’s not like we’re trying to make you paranoid…or anything. If you being to get dizzy spells, don’t blame the paranoia.”

      If these protocols are all based on scientific assurances giving evidence of concussions permanent and lasting effects, I am now convinced everyone who ever played high school sports with is fully brain damaged. This explains much.

  6. I think it is safe to assume that at IU, athletes who are suspected of having suffered a concussion are being treated in the most cautious way possible. Of course, we don’t know the medical facts, but with Race being held out for 5/6 weeks, that suggests either he suffered a very severe concussion or IU is taking extreme precaution on his condition. And now with Phinisee being held out for at least two weeks, either we’re witnessing a weird coincidence, or the result of IU’s policy/protocol regarding the treatment of head injuries. I do not ever recall a situation like this.

    Technically speaking, Thompson’s season may not be over, but it is effectively over. Assuming he does not play again this year, I wonder if he can get another red shirt? The rules governing red shirting basketball players may need to be modified given these new cautious concussion protocols.

  7. Found this chart for you guys:

    *most concussions avg 7 or 8 days in length until an athlete can participate again.

    Concussions are sometimes graded on the severity of their symptoms:

    grade 0: headache and difficulty concentrating
    grade 1: headache, difficulty concentrating, and a dazed feeling for less than a minute
    grade 2: grade 1 symptoms, with a longer period of feeling dazed, possibly accompanied by dizziness, confusion, amnesia, ringing in the ears, and irritability
    grade 3: loss of consciousness for less than a minute
    grade 4: loss of consciousness for longer than a minute

    Returning to very limited activities following a grade 0 or 1 concussion may be allowable within a day or two. A grade 2 concussion may require a few days of rest. A grade 3 or 4 concussion will mean at least a few weeks of recovery time.

    Now we all know Rob didn’t lose consciousness. Maybe this will help folks understand a bit better. Makes you wonder if Race had a grade 4 which I will admit that I have NO experience with. Or, there is more to it or the study has come in to play and they are treating it differently than in the past.

  8. This is an area of expertise on my end. Those grading protocols are old. It isn’t about the symptoms which are outward. It is about brain activity and neural pathways that fire abnormally after a trauma. Outward symptoms may be completely gone, but the brain may be operating differently and it’ll be something that will cause many problems with that person down the line.

    Unfortunately, high schools and youth sports don’t have access to brain imaging and lab testing. I assume now that NCAA teams may have the capability. Brain trauma is extremely complicated. RP might have had some scans done, which reveal a much bigger problem than headaches and loss of balance.

    Also, just diagnosing the problem is only half the battle. What to do about treatment and getting back to normal is the wild west right now. As human beings, it is a wonderful time to be alive knowing there’s hope in this area. Well, also there are some treatments that are incredibly effective, but our culturally antediluvian view of which “drugs” are considered ok and which aren’t isn’t helping us to research on the ones showing the most promise.

    In this case, though, billions of dollars on the line in professional and collegiate sports isn’t going to stop and wait for us to figure this out. Add in HIPPA (patient privacy) and as a fan it must be pretty frustrating when no one is able to communicate clearly about this stuff. I’m inclined to have faith that they are treating RP properly and with some of the best of what we know.

  9. Good stuff, Double Down.

    I can’t help but think of baseball players sliding into bases or hitting the ground hard in whiplash fashion while attempting to make circus catches in the outfield, etc, etc, etc….who will likely have major brain jolts with zero “protocol” ever investigating potential concussions. Where does it end? Where should it end? If there is no dizziness or no loss of consciousness, does it necessarily mean all is fine?
    And what of our new favorite sports to watch? What of MMA fighting and cage fighting? Are these activities even humane? Should they be banned? Should kids be allowed to participate in judo, karate, etc. What’s the likelihood of a hard throw to a mat causing a undetected brain injury?

    Science and detection is wonderful…but when does any organization, school, program, coach get released of legal assumption of risk? Could abnormal nerve/brainwave activity go back to previous brain trauma or head injuries which had little to do with a current diagnosis/event? Will they have the ability to differentiate? Should the athlete be given a pass from being held accountable in a classroom when under concussion protocols? Should the brain be removed of stressful activities causing anxiety(e.g. a big final exam). Is RP still being held accountable in the classroom while his brain heals?

    1. Harv, you just nailed it. There are some many questions, because it is so complex. Hard to get perfect answers too. Check my last post to J Pat, but I think it just has to come down to the agency of the person who has the trauma. Obviously, while diagnostics are getting sooooo much better, only the upper levels of athletes have affordable access to them. So that’s an issue, even beyond the science around this stuff being so new.

      When it comes down to it, we all should assume our own level of risk. But we should never feel that our livelihoods are dependent on it by pressure from someone that doesn’t have to assume that level of risk (coach, GM, owner, etc). I think this is where governing bodies, and the government itself, are critical. Unfortunately, when those bodies and institutions get involved in determining which treatment is appropriate, they are making the problem worse.

      Regarding athletes, there are many substances on the banned list of “PEDs” that are effective. “PEDs” isn’t a medical term. It is a made up term for labeling something bad or good. And it only has one purpose. Regarding the fed or state gov’t, in the next 10 – 30 years, we’re all going to laugh at what we considered illegal to the point of not even allowing research on certain things.

      It isn’t a perfect solution, but it is the best one in my opinion.

  10. DD, it is your field…you know infinitely more than I do. I did find this in a periodical I taught from and the date from this article was March 2018. I know a lot has changed very recently.

  11. DD, in your experience…can CTE be reversed or is there a chance that this can be treated in the future. Maybe it is too early to know at this point. I’ve read everything I can get my hands on because of the # of concussions I sustained in high school and college. I worry!

    1. J Pat, it’s all good. We’re all doing the best with the info we have. There’s a balance here and the problem is that the issue is so complex, it is really hard to decide what works and what doesn’t. On that note, it my opinion that it is up to the individual, no a governing body like the NCAA, NFL etc to come up with the standards. They’re too inflexible. What role those bodies have is protecting players from owners, GMs and coaches who need those players on the field regardless of the impact to their long-term health.

      On the CTE side, we’re already seeing incredible results on reversing it in more cases than had been originally hoped. On a bell curve, I think for most in the middle, it can absolutely be reversed in many cases. The human body is so complex though, so sometimes people who don’t respond to treatment have a lot of other things going on. I dunno how many folks here deal with, or have someone close to them with autoimmune issues, but that’s one example that there is so much going on, that it hard to pin down the source. The traditional way that American and Western Medicine treat the problem, which is often about the symptoms and not the actual problems, we’re behind the ball. But Western medicine is GREAT with diagnostics.

      The diversity in biology/physiology of people is really fascinating. For example, you can see someone come out of a coma, but completely recover and their brain scans are normal. A major trauma, but fully healed. Some people just get bumped a little and they begin this cascade down to worse and worse symptoms that mire them in a deep depression they can’t get out of. Most of the promising research out there is in two areas, 1) the incredible correlation to the inflammatory response of the body given certain traumas or even inputs (like food, etc), and 2) establishing or reconnecting broken neural pathways. And #2, the best (and it isn’t even close) results are coming from “psychedelics”. Unfortunately, in the US, most of them are Schedule 1, which means that you can’t even legally do research/trials on them. So it’s slow going and the research is done underground, or in other countries.

      There are a LOT of other factors and treatment options, too. Some of them don’t require any substances at all. Regardless, there will never actually be a “silver bullet” here. People recovering from brain trauma all need to be treated individually. We’re tapping into the meat between our skulls in ways we could never have imagined.

      1. Genetics….How people heal so differently is probably a fascinating area of study.

        My dad had severe glaucoma….He foolishly never had enough eye checkups while having very high blood pressure and the early attempts to treat diabetes. His physician never stressed the necessity to see eye doctors …and it was damage to his eyes had occurred which could have been avoided. He would undergo multiple eye surgeries and cornea transplants. His vision deteriorated to the point one of his greatest joys, merely driving a car, was soon out of the question.
        He would have complications after eye surgeries from actually healing too fast….His eyes could not drain off pressure because his body/DNA was wired to heal extremely quickly. As a kid, I remember my dad having a super high threshold to pain. He’d nearly cut his thumb off with a Skill saw and just give a hard grimace. Slap on a band-aid and act as if he just had an encounter with a thumbtack. Was the brain wired to heal so quickly and have such a high pain threshold?
        The mysteries of the human body are as distant in discovery as the furthest galaxies our arrival.

  12. DD- Are you a neurosurgeon? When you say “expertise,” can you be a bit more precise?
    I’ve always wondered how this will evolve in the study of mental illness. How much of mental illness can be associated with early brain truama? Will insurance companies pay for treatment and drugs if early brain truama …or brain injuries can be found to have a causation link to emotional stress/instability/depression/manic episodes, etc?
    Does care and coverage step up to the plate and pay for diagnosis and treatment? Will multiple concussions qualify as a preexisting condition?
    I don’t have a lot of confidence in healthcare companies fostering an environment that could conclude much of behavioral abnormalities could be tied to brain trauma.
    Keeping someone removed from activities after brain trauma is certainly the smart and ethical thing to do…But how ethical is it to keep sending the brain to war knowing the likelihood of multiple similar events is very high?
    Legal ramification? I see lots of waivers and lots of releases for anything and everything you enroll your child. Wonder if there are many concussions in pole vaulting? Have we studied “impact” events to the brain far more than “whiplash” events? Should we start studying prolonged brain activity/patterns in what we always thought to be relatively “safe” sports?

    1. I’m working in treatment areas “outside” the “mainstream,” and I too share your concern with insurance companies and big pharma driving policy here. The government is also a major problem. As mentioned, when it comes to treatment, our “big players” here have dropped the ball so badly through a combination of willful ignorance and, sometimes, outright corruption. But I don’t think they’ll be able to stem the flow of information coming out. People are passionate about this and I’ve never met smarter and more thoughtful people in my life, than those who are bucking big pharma paychecks to really come up with solutions.

      1. Marijuana treatment? I could definitely see big pharma getting in the way of those studies outside the mainstream.
        Mitch was probably taking it for his back pain.

    2. Oh, and also, not a neuroscientist. My Indiana University education was solid, but not that good. Someone very close to me had some brain issues about 15 years ago and I deeply immersed myself into it. I was tired of getting blown off, and non-answer/answers for years and years from people who should have known better. Recently, I’m involved in stuff on the treatment side. I’ll leave it at that!

      1. Interesting…It’s great that you are honoring the person close to you in ways that will hopefully make future people experiencing the same issues more educated and with more options. Thanks for educating us as well….I’m still a bit interested in what you mean by ‘outside the mainstream’…but I understand and respect your privacy.

  13. Lots of conflicts of interest. I wish I would have gotten involved in the medical field. Always loved my few biology electives….

    I do sometimes wonder if the abundance of caution is coming from the very top…..It’s not that I don’t believe in caution and making sure an injury is fully in the rear-view mirror, but there is a point where protecting someone else can ultimately be disguised as protecting oneself….or the organization.
    It could be a coincidence, but it sure seems like we’ve extended a far more cautious approach since the ESPN investigative piece. on Wilson and the IU Women’s rowing team.

  14. Great stuff, DD. What makes the issue so complex is that all brains are unique and can withstand different amounts of trauma. A minor knock on the head for one person could be a severe concussion for another. They’ve diagnosed CTE in HS kids who played contact sports for only one year while some men have no syptoms after decades of boxing or playing in the NFL for 15 years! They’ve found CTE in men who claimed never to have had a concussion, while men who claim to have had dozens of concussions never experienced any symptoms. But until the diagnosis and treatment of head trauma/concussions advance substantially, the “safe” policy, in terms of the player’s health and the risk of legal liability, is to prescribe an overly cautious recovery period. If five years ago the commonly accepted medical protocol was as JPat shared above, then to minimize health and legal risks, doctors will simply double or triple the amount of time the player is held out of physical activity. Organizations and doctors will simply err on the side of caution and practice defensive medicine to the extreme. And who can blame them?

  15. DD, thanks for the great info. This has been a really good thread. Harv, I did not even think of the piece ESPN did and yes, that could factor into all of this.

  16. Late to the party but plenty of background.

    I worked in emergency medicine, TBI rehab, and I taught a course in neurophysiology in the UNC system for 12 years.

    That being said…good stuff here.

    The only thing I would add is that a brain injury is significantly different from an orthopedic issue. There is no way to attach a time for recovery to it. It takes however long it takes.

    To be honest, while I want these guys back as much as anyone, it is refreshing to see that the program is putting the long term health of these kids as their first priority.

    There is a classic sports book titled ‘Meat On the Hoof’. It was an expose of the abuse of players at Texas under Darryl Royal. What IU is doing is the opposite of that.

    It is a good read.

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