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On the Sixers' Markelle Fultz: The mind, the body, and a connection his camp is foolish to dismiss | David Murphy

A few thoughts on Sixers guard Markelle Fultz's latest diagnosis, and the concerning way in which his agent has framed it.

What's in the future for Markelle Fultz?
What's in the future for Markelle Fultz?Read moreYONG KIM / Staff Photographer

It was the kind of statement that only reinforces the belief that Markelle Fultz is first and foremost the victim of an inner circle that is vastly under-qualified for the task of building him back into the player that he once was. This was Tuesday night. The former No. 1 overall pick had just received his latest reprieve, a diagnosis from an unnamed medical specialist that the shooting woes that have plagued him for the last 15 months could be attributable to a physiological condition most often found in professional baseball pitchers. With it came another chance for Fultz to take a few weeks away from the withering glare of the national spotlight and focus on restoring his faith in his abilities.

That last notion is an important one to remember when you process the viewpoint that Fultz’s agent expressed after his diagnosis. On a fundamental level, it is what Raymond Brothers sought when, a couple of weeks ago, he scheduled another round of specialist visits and informed the clients that he was shutting his client down. After all, from an end user’s perspective, the greatest utility of any medical diagnosis is often the psychological empowerment that the establishment of a cause-and-effect relationship can provide, the knowledge of the existence of a concrete explanation for an individual’s symptoms instilling within them a belief that they can overcome those symptoms. One of the greatest benefits of medicine is that it allows us to operate with a sense of control over the world around us. In that, it is like every other science.

The concepts of control and belief are inseparable aspects of any medical ailment. While that should not diminish the role of physical science in returning athletes to the playing field, it is a matter of fact that there is an objective limit to the benefit that external intercessions can provide. Spend enough time listening to athletes talk about their rehabilitations and you will often hear them mention the mental hurdles that stood in their way. This is particularly true over the last quarter pole, during the stage of recovery when the mind must convince the body that it is once again capable of performing the movements that it had executed with precision before. You might hear a baserunner talk about the hesitation he feels when accelerating around first, or a running back talk about the lack of confidence he experiences when planting his foot. You might notice the tentative nature of a quarterback’s follow-through as he drives his weight onto his front leg and its surgically reconstructed knee.

The first part of recovery is a physical battle, the second part a mental one. It isn’t enough for an athlete’s body to be healthy. His mind must also believe it. It is similar to a car transmission: A mechanic can repair it, but it will do no good until the operator drives fast enough to change gears.

Which brings us back to Fultz, and to Brothers, and to some disconcerting framing of the player’s diagnosis.

“People were saying it was a mental problem and it is not,” Brothers told ESPN on Tuesday night. “There’s no way you’re the No. 1 pick in the world and all of a sudden you aren’t able to consistently raise your arms to shoot a basketball. Something is physically wrong. Now we have the answer to that problem.”

At the very least, it is a sentiment at odds with established scientific fact. The mind controls the body. Just like human bodies can go haywire, human minds can, too. The fundamental difference between the two is that we know a lot more about bodies than about minds.

Furthermore, the comment betrays a mentality that is at odds with objective diagnosis, and it raises concerns about how Fultz’s camp will proceed if his current regimen of physical therapy fails to return him to being a player who shoots a basketball without reluctance.

There is a lot we do not know about the medical opinions Fultz has received over the last 15 months. According to people familiar with the situation, he had visited more than 10 specialists before receiving this most recent diagnosis. These are medical experts who are highly credentialed and, in some cases, renowned. More than one has experience treating major-league pitchers, the subset of athletes that most frequently suffers from thoracic outlet syndrome, a condition where a bone in the upper body constricts a nerve or veins.

According to the aforementioned sources, Fultz’s current diagnosis is mostly one of omission, arrived at mostly because all of the other more likely causes had been ruled out. The protocol for the next three-to-six weeks isn’t much different from what it has been before: Do some physical therapy and see if it works. There has been no suggestion that surgery would help, as has sometimes been the case with pitchers. The bottom line is that whenever this current hiatus ends, Fultz will have to learn how to play with whatever it is he has.

In other words, at some point there is going to be a mental component. The hope is that it will lie toward the end of the spectrum where most athletes spend time when working their way back to the field of play. With physical therapy will come a feeling of health, and the confidence that comes with an individual’s belief in his biomechanical abilities. But it is hard to imagine it doing Fultz any good to feel the pressure to prove that he is not suffering from a “mental problem.” That’s the sort of thing that can push a person toward the opposite end of the spectrum.

One thing that we do know about minds is that they operate in loops. We know that thought patterns reinforce themselves. And we know that there is most definitely a connection between such phenomena and the performance of the body. In a perfect world, Fultz’s shooting problems will have stemmed entirely from TOS. This latest batch of PT will alleviate his symptoms, and thus restore his ability and his confidence in his natural shot. If that is the case, it will eliminate the possibility that Fultz’s problems lie on the less understood, more abstract end of the spectrum. At this point, though, it can’t do the kid any good to pretend the spectrum does not exist.