Another star has a blood clot, and another Bucks season hangs in the balance

The Milwaukee Bucks announced Tuesday that Damian Lillard will be out indefinitely to treat deep vein thrombosis in his right calf. He's the second All-Star this season to be sidelined due to a blood clot after San Antonio Spurs superstar Victor Wembanyama was shut down in February when the same issue was discovered in his right shoulder.

Because this can be a career- and even life-threatening condition, concern should first and foremost center on Lillard himself. He's taking blood-thinning medication, and the answer to when he can safely return to the court depends on several factors, including the severity of the clot and its likelihood of recurrence. The biggest risk with clots is that they can dislodge and travel to the lungs, causing a blood-flow blockage known as a pulmonary embolism. That's what effectively ended the careers of Chris Bosh and Mirza Teletovic.

I spoke to a hematologist at the University of Toronto for a story about this issue a few years ago, and he laid out an important distinction between clots that are deemed to be "provoked" and those that are "unprovoked," with no clear trigger. The latter type is much more concerning, he explained, as that's when the issue would be considered likely to recur. In that case, the at-risk patient might even need to be prescribed a blood thinner permanently.

In this case, a source told The Athletic's Eric Nehm and Sam Amick there's a lot of optimism that Lillard can make it back this season, which suggests he's dealing with an isolated or "provoked" clot. That's great news, but expecting him to return within a month (which would be sometime during the first round of the playoffs) is still a significant departure from the recovery timetables we've seen in recent cases involving players such as Wembanyama, Ausar Thompson, and Brandon Ingram.

The hematologist I spoke to said it typically takes at least three months to fully treat deep vein thrombosis, and the biggest risk to an athlete playing a contact sport while taking blood thinners isn't the clot itself but the possibility of significant bleeding if they were to, say, take a hit to the head. Lillard and the Bucks may be hoping that he can quickly scale down to a lower blood-thinning dose or less aggressive regimen that reduces his level of risk. In any case, an NBA fitness-to-play panel will need to clear him before he can begin participating in game action, so it won't be up to him or even the team's medical staff to determine when he can return.

In terms of the on-court implications, if Lillard can't return in time for the postseason, Milwaukee is almost certainly doomed to a third straight first-round exit, despite the continuing otherworldly play of Giannis Antetokounmpo. The Bucks have already slipped to sixth in the East, making them likely to open the playoffs on the road against either the Knicks or Pacers.

And it's not as though they were playing like world-beaters when Lillard was healthy. They're just 32-26 with him in the lineup, and they've outscored opponents by less than a point per 100 possessions with him on the floor. Still, he's their best offensive guard by several country miles, and the way he complements Antetokounmpo on that end still gives Milwaukee a very high ceiling when he's available. The team teased its potential at various points this season, with that duo plus ageless defensive anchor Brook Lopez providing glimpses to dream on.

Milwaukee traded Khris Middleton for Kyle Kuzma at this year's deadline, ditching an aging franchise icon in favor of a younger, cheaper, bigger, more durable wing with a higher defensive ceiling. But Middleton is a vastly superior ball-handler, shooter, and playmaker to Kuzma, and while the Bucks might've been sunk without Lillard regardless, I'd feel better about their chances of surviving a first-round series if they hadn't made that move. They're now relying on the likes of Ryan Rollins and Kevin Porter Jr. as primary off-the-dribble creators in Lillard's absence.

The Bucks have been surprisingly stout defensively this year, ranking 10th in points allowed per possession. But it's hard to see how they'll score enough to win high-leverage games without their starting point guard, even though Rollins and Porter have acquitted themselves reasonably well so far.

Lillard had a down year by his standards in his first Bucks campaign but bounced back this season. He put up similar counting stats (24.9 points, 7.1 assists) while bumping his true shooting from 59% to 62%. He shot dramatically better on threes, floaters, and long pull-up middies, and he averaged 1.07 points per possession as a pick-and-roll ball-handler (92nd percentile leaguewide) compared to 0.99 points per possession in his first season in Milwaukee. He and Antetokounmpo looked way more comfortable and dangerous running a two-man game together after a choppy start to their partnership last season.

His untimely ailment is another blow to a Bucks team that's been snakebit every spring since winning the title in 2021. The following season, they lost Middleton to a knee injury in the first round and then fell to a formidable Celtics team without him in the second. In 2023, Antetokounmpo injured his back in the first quarter of their first playoff game and didn't return until Game 4. By that point, the eighth-seeded Heat were well on their way to an upset so seismic that Milwaukee's still feeling the reverberations.

Last year, after the Bucks made sweeping changes and emptied their war chest in response to that upset, Antetokounmpo suffered a calf strain in the last week of the regular season and didn't suit up for the first round against the Pacers. Lillard was cooking in that series ... before he aggravated an Achilles injury in Game 3, missed Games 4 and 5, and returned in time to get eliminated in Game 6. After this, another win-now season is at risk of being swept into the dustbin.

The front office has expended all its resources in an effort to maximize the remainder of Antetokounmpo's prime; the Bucks don't control any of their own first- or second-round picks between now and 2031. Lillard is 34, and even if he can make it back in time for the postseason, there's no telling how he'll look when he's thrown directly into that crucible after an extended absence. Lopez turns 37 in less than a week, and he'll be a free agent this summer. Milwaukee has no way to replace him, but re-signing him will lock the team into a geriatric core with no upward mobility.

Antetokounmpo is as good as ever offensively, and he's still a great (if slightly diminished) defender. But how far can he realistically carry this version of the Bucks in the future? When his three-year, $186-million extension kicks in next season, he and Lillard alone will take up approximately 82% of the salary cap. The Middleton trade got Milwaukee under the second luxury-tax apron, but the front office still has minimal wiggle room to augment the roster around its core duo (or trio, if Lopez returns).

For all those reasons, the Bucks had as much riding on the 2024-25 campaign as any team in the NBA. To have arrived at a point where they feel like a long shot to win a single playoff series isn't quite a Mavericks- or Suns-level disaster, but it isn't far off.

In short: Get well soon, Dame.

Joe Wolfond covers the NBA for theScore.