Dominick Barlow's Back Injury May Force Sixers to Shuffle Their Starting Lineup

The Sixers have started Tyrese Maxey, VJ Edgecombe, Paul George, Dominick Barlow and Joel Embiid in eight of their past nine games, including Wednesday's blowout loss to the Cleveland Cavaliers. They haven't had that type of game-to-game continuity in nearly two years.

It might wind up being short-lived.

Early in the third quarter against the Cavaliers, Barlow went up for a layup in transition and landed hard on his back. The Sixers later ruled him out for the game with a back contusion.

Dominick Barlow heads to the locker room with assistance after taking this hard fall.

Can't tell if he hurt his back, hip, or whatever other body part he might have landed on... so I'm not going to speculate. But Barlow was down for a little bit and struggled to walk after. pic.twitter.com/IbnsKMsCBG
— Erin Grugan (@eringrugan) January 15, 2026

After the game, Sixers head coach Nick Nurse told reporters that Barlow underwent X-rays, which were negative. He's set to undergo an MRI on Thursday.

Barlow missed two weeks early in the season with an elbow contusion, so we've already gotten a sense of how Nurse might replace him in the rotation. However, that was before Barlow had entrenched himself in the starting lineup and before Paul George made his season debut. Barlow has started in 22 of the Sixers' past 23 games and averaged 25.2 minutes per game over that span, so any length of time he misses would be noticeable.

"Soon as we finally start to get healthy, and there's some consistency with the starting group… it'll be another starting group come Friday," George told reporters after the game. "So, that has been the challenge."

The first question they'll need to answer: Who should replace him until he returns?

The trickle-down effects of Barlow's injury

Oubre might be the obvious choice as Barlow's temporary (?) replacement. He started the first 12 games of the year before going down with an LCL sprain, and he started in Sunday's overtime loss to the Toronto Raptors with both George and Joel Embiid sidelined. He has the most scoring upside of the potential Barlow fill-ins, although moving him into the starting lineup would force George to slide up and guard more 4s.

If the Sixers want to keep Oubre's scoring punch coming off the bench alongside Quentin Grimes, Trendon Watford and Jabari Walker would be their other top options. Like Oubre, Watford just returned from an injury that sidelined him for more than a month, although unlike Oubre, he's been playing sparingly since his return. He finished with three points, two rebounds and four assists in 17 minutes against Cleveland on Wednesday.

Watford had a 20-point, 17-rebound and 10-assist triple-double—the first of his career!—against the Raptors back in November, and he flirted with another triple-double two weeks later against the Miami Heat. His vision and ability to create for teammates differentiates him from Walker, who does most of his damage on the glass and either close to the basket or from deep.

If the Sixers want to stick with more of a traditional power forward in place of Barlow, Walker or Watford may have the inside track over Oubre. If they want their five best players to start in Barlow's absence, they'll likely go with Oubre and have Watford and Walker come off the bench. They could always get weird and start Adem Bona next to Embiid, too, although Bona might have too much value as a backup big for them to seriously consider going that route.

The two-way clock implications

If Barlow does wind up missing time due to his back injury, there would be one silver lining for the Sixers: They wouldn't have to be in quite as much of a hurry to sign someone to a 10-day contract.

As we originally noted in mid-December, the Sixers are limited to 90 total games from their two-way players until they sign someone to fill their open roster spot. As of Jan. 2, they were down to 12 games left where both Barlow and Walker could be active due to the Under-Fifteen Game rule. Both have been active in each of the seven games since, so the Sixers should be down to only 10 total Under-Fifteen Games left.

If Barlow is forced to miss time, the Sixers wouldn't have to be in such a rush to fill their open roster spot. They have 11 games left before the Feb. 5 trade deadline, and they figure to prioritize keeping at least one roster spot open so they can eventually convert Barlow from a two-way deal to a standard contract. Granted, they can always sign someone to a 10-day deal and extend the Under-Fifteen clock that way as well.

Barlow has been active for only 29 games this year, so he still has a ways to go on his individual 50-game clock. However, Wednesday's loss to Cleveland was Walker's 39th active game of the year. That means he can be active in only 11 more games over the rest of the season before the Sixers either have to waive him or convert him to a standard deal.

Barlow's back injury could force the Sixers' hand in that regard. They might not feel comfortable leaving Walker on the inactive list while Barlow is sidelined, but that could force them to make a decision on his long-term future right around the trade deadline. If they don't plan to convert him to a standard contract, that could inform their trade-deadline plans as well.

While Barlow's back injury shouldn't be as impactful as one to Maxey, Embiid, George or Edgecombe would be, there are some sneaky-big implications if he's forced to miss time.

Unless otherwise noted, all stats via NBA.com, PBPStats, Cleaning the Glass or Basketball Reference. All salary information via Spotrac and salary-cap information via RealGM.

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