It has been three weeks since Cade Cunningham played a basketball game. He has missed the Detroit Pistons’ past 10 games with left shin soreness, and there’s a possibility he has played his final game of the 2022-23 season.
A hairline stress fracture is the likely cause of Cunningham’s shin soreness, per sources. The second-year guard is averaging 19.9 points, 6.2 assists and six rebounds in 12 games this season, but the team is preparing to be without the 2021 No. 1 draft pick for an extended period of time as he mulls treatment options. The Pistons have lost eight of 10 games without Cunningham, though they’re in the midst of their most competitive stretch of play this season after losing close games to the Los Angeles Clippers, Sacramento Kings, Phoenix Suns and Cleveland Cavaliers over the past two weeks.
Here’s an FAQ on what we know about Cunningham’s injury, and what could come next for the NBA-worst 5-17 Pistons:
What are Cunningham’s treatment options?
There are two paths the Pistons can pursue to treat Cunningham’s shin: Rest and surgery. The former option could carry a potentially shorter recovery period if the injury heals on its own, but there’s no guarantee the injury will heal with rest. The team is evaluating his shin to see if the pain and inflammation subside on their own. Sources say Cunningham would prefer to avoid surgery if he can, but surgery is likely the best option longtime.
If Cunningham goes under the knife, it would address the root cause of his soreness but almost certainly cost him the rest of the season. NBA injury analyst Jeff Stotts, who runs NBA injury database instreetclothes.com, said players who undergo surgery for stress-related tibia injuries miss an average of 61 games. The Pistons have already played 22 of 82 games, so it would be unlikely Cunningham returns this season.
It’s unclear when Cunningham first started experiencing soreness in his left shin, but it has been a recurring issue since last season and recently flared back up.
What would surgery mean for Cunningham’s career?
In the short term, surgery would likely mean the next time we see Cunningham play basketball is the start of next season. It would be a hugely disappointing outcome for the sophomore guard, who bulked up this offseason and had high expectations after finishing third in Rookie of the Year voting.
But long term, Cunningham is unlikely to face further setbacks with his shin if he undergoes surgery. His teammate, Rodney McGruder, underwent surgery to treat a stress fracture in his shin before the start of his 2017-18 season in Miami. McGruder made his debut at the end of February after 60 games that season. Per Stotts, the surgery would be unlikely to negatively affect Cunningham’s career beyond this season.
What would surgery mean for Pistons?
Season-ending surgery would be a blow for a rebuilding Pistons team eager to see how Cunningham would fit alongside their other two lottery guards, Killian Hayes and Jaden Ivey. General manager Troy Weaver said before the season the goal for the team this season was to compete every night. That will be tougher without their best player.
However, Cunningham’s injury has paved a path for Hayes and Ivey to play more minutes. Hayes came off the bench and averaged 18.1 minutes per game before Cunningham exited the rotation. Since Cunningham’s injury, he’s averaging 30 minutes per game and has started nine straight. Hayes is also playing well, averaging 11.3 points and 5.6 assists while shooting 37.5% from 3 in his last 11 games.
Detroit’s 2-8 record without Cunningham suggests the team has been struggling, but the record doesn’t show how much more competitive it has been compared to earlier in the season. The Pistons’ net rating of minus-4.5 in that 10-game stretch is significantly better than their league-worst minus-10.3 net rating during their first 12 games. Alec Burks, who is averaging 16.7 points off the bench, is a big reason why. Burks made his season debut Nov. 11 against the Boston Celtics, coincidentally the first game Cunningham missed.
Beyond this season, a potential long absence for Cunningham could also better-position the Pistons in the 2023 draft lottery, which is headlined by a generational prospect in 7-foot-4 center Victor Wembanyama.