Remaking of Yao a great unknown

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The last time Yao Ming laced up his sneakers in a game that mattered, on May 8, 2009, he was on top of the world and at the top of his game as the Rockets took the floor for Game 3 of the Western Conference semifinals against the Lakers at the Toyota Center in Houston.

He had played an almost fully healthy season for the first time in four years, on the heels of carrying China's flag at the Beijing Olympics. He had earned his first career playoff-series victory, over the Trail Blazers. And against the top-seeded Lakers, he had helped the Rockets earn a two-game split in Los Angeles to start the series.

And then his left foot twisted. He felt it pop in the second quarter of Game 3 but played on. He felt more pain in the third quarter and more still in the fourth. After finishing with 19 points, 14 rebounds and two blocked shots in the loss, Yao felt his foot throbbing but brushed off questions with his typical wit.

"It hurt in the second quarter, third quarter and fourth quarter," Yao told reporters, smiling. "One for each quarter. There's different twists, one for each time."

Doctors initially said Yao had an ankle sprain, but ordered a CT scan for precautionary reasons. Previously, Yao had sustained a stress fracture in the same foot in February 2008; missed 33 games a season earlier with a hairline fracture in his right leg; and broken his left foot with four games left in the 2005-06 season.

The CT scan would reveal another fracture. Later, it was determined to be a stress fracture that required a complex surgical procedure if Yao was going to play basketball again. That was 16 months ago.

Yao has yet to play a meaningful game since. But as he labors through preseason games in a much-anticipated return to the NBA, the question remains: Will Yao ever again be the player and transcendent star he once was?

So far, no one knows. To fully understand the grueling and meticulous rehabilitation the 7-foot-6, 310-pound Yao has undertaken -- and the challenge he faces returning to greatness -- the drastic nature of the surgery in July 2009 should be considered.

Rockets team physician Tom Clanton performed a bone graft to heal the fracture of the tarsal navicular bone and also lowered the arch to lessen the stress on his foot. Yao's foot in essence was broken into pieces and rebuilt.

"He has two different feet," Houston sports medicine specialist and orthopedic surgeon Kenneth R. First said. "I mean, you're trying to play a professional sport and now you have two different engineered feet. His left foot has sort of been completely remanufactured."

To the naked eye, the 30-year-old Yao looks like his old self. In shooting drills and controlled scrimmages, he perfectly executes up-and-unders, spin moves and familiar soft jumpers that lifted him to a dominant place in the game. Off the floor, he continues to rely on the humor, focus and -- more than ever -- patience that helped him bear the burden of lofty expectations from his NBA team and his nation of 1.3 billion.

"I'm always happy," Yao said. "I keep saying, 'The worst time is already gone.' What can be worse than sitting in a wheelchair or [using] crutches after surgery? The time off was the worst time."

On the floor this preseason, however, clearly Yao is not yet close to the same player he once was. He has moved laboriously, at times been overwhelmed by the pace and had every minute on the floor closely monitored. He has averaged 14 minutes in four exhibition games, including a preseason-high 19 in Wednesday's victory against the Nets in Beijing. The Rockets plan to restrict him to 24 minutes in the regular season.

Yao, who is averaging 6.8 points and 4.5 rebounds in those limited preseason stints, maintains that he has been pain-free. The "Team Yao" medical staff says everything is on schedule. Still, occasionally he has walked with a limp, a result, his specialists say, of muscle soreness as he plays his way back into shape. He has looked much more like a massive man trying to play basketball than the smooth player he once was in a massive man's body.

"I probably wouldn't use the words, 'flying around' for me, but I'm trying to catch my speed," Yao said. "In past years, my speed was never above maybe 3 miles an hour. I'm trying to get to maybe 4 now."

Everyone involved in Yao's recovery recognizes there is much science involved in the rehab, but there also is educated guesswork. Such is the quandary of remaking Yao. Since completion of the surgery, the process of returning Yao to the floor has been a combination of the world's most advanced medical techniques meeting a franchise's fingers-crossed hopes for the best.

The rehab process began with simple upper-body and core exercises while his surgically repaired foot was in a cast and boot. Not long after surgery, Yao sat in a wheelchair and shot bucket after bucket in an empty gym. He couldn't wait, but he had to wait. He underwent five- and six-hour sessions of treatment, from range-of-motion exercises to arduous therapy to non-weight-bearing water exercises, underwater treadmill work and every medical therapy available. For days, and weeks, and months, Yao often saw little or no improvement.

"You can get through pain," Rockets vice president and athletic trainer Keith Jones said. "Yao's always managed the pain. It's the mental part that kills you. It's every day, I mean for long periods of time. The hardest part is mental."

Yao returned to full basketball work before training camp opened. Ultimately, the ideal outcome would be for Yao to follow the lead of Zydrunas Ilgauskas, the 7-3 center who had almost the identical procedure as Yao and fully recovered. But there also are too many sad stories of big men with foot problems never recovering.

Every day is another step. Every day, there also is the possibility of another misstep.

"We can't keep him from falling," Jones said. "We can't keep him from stepping on anyone's foot. We can't keep him from running or jumping if he's playing basketball."

All they can do is rely on medicine, therapy and the hope that Yao's hard work and patience lead him back to the top.