FOR THE BETTER part of a decade, there have been three constants when it comes to Joel Embiid and the Philadelphia 76ers.
First, of course, are his health issues. Out of a possible 902 games in 11 seasons, Embiid has played in 452 -- just over half. In five of those seasons, including the first two in which he sat out, he played in fewer than 40 games.
Secondly, whenever Embiid has been on the court, he has been a dominant force, a singular talent who has racked up multiple scoring titles, All-NBA selections and a Most Valuable Player award.
But most importantly, whenever Embiid has played -- when not sidelined by problems with his left knee -- his 76ers have mostly been a juggernaut. Over the past four years, the 76ers were 158-66 when Embiid played. In those games he was, on average, an elite plus-7 per 100 possessions when on the floor.
But this seminal season in Philly, which is now over for Embiid after he was shut down last week, isn't defined just by letdown and underachievement. It has been a reckoning -- a dramatic shift to the 76ers' reality.
The team is used to Embiid missing time. What it is not accustomed to is Embiid, and the team, struggling when he doesn't. That is what unexpectedly happened in the brief stretches he was on the floor during this cursed season. It's not just Embiid's absences that have driven the 76ers to 11th place in the Eastern Conference, but the team's surprisingly poor results when he has been available.
So now, as he and the team work through what comes next and how that knee will be treated, the question is whether they can come up with a plan to return Embiid to the dominant player he was as recently as a year ago.
Because, if he doesn't, nothing else matters in Philadelphia.
LAST SEASON, EMBIID was a terror for opponents, leading the 76ers to a 31-8 record and averaging more than a point per minute on the court, something not seen since the height of Wilt Chamberlain's illustrious career. Had his season not been limited to those 39 majestic games by a torn meniscus, which required surgery, he was on pace to win his second consecutive MVP and third straight scoring crown.
This season, though, Embiid seemingly had the opposite effect. The Sixers lost 11 of the 19 games he played and were outscored when he was on the court by three points per 100 possessions. In short, the team was 10 points worse than when he'd played in recent years. In the final six games before he was shut down, Philly was a bewildering minus-61 with him on the floor.
Embiid was having the worst shooting season of his career (just 44% overall and 30% from 3-point range) and averaging his fewest points (23.8) in five years and his fewest rebounds (8.2) since he was a rookie in 2016-17.
When assessing what is truly worrisome with Embiid in Philadelphia, it's easy to point to other low points with Embiid during the season. There was the team meeting in Miami in November in which fellow players called him out for his lack of professionalism, including comments from star teammate Tyrese Maxey, who specifically pointed to Embiid's tardiness to team events. While he has since patched up any lingering tension with Maxey, Embiid was angry that details of the meeting became public, sources said, and attempted to identify a possible leak.
That same month, Embiid was enraged by a local columnist who had referenced his family in stories, and he physically confronted him. The league suspended Embiid for three games for doing so, resulting in a fine of more than $1 million. The league further fined Embiid $75,000 in December for making an obscene gesture during a game.
But none of that is as relevant as the reversal of production and corresponding game results that have defined this wretched season.
Last September, the 76ers gave Embiid a three-year, $192 million contract extension, increasing the team's commitment to more than $300 million over the following five years. ESPN previously reported the 76ers consulted numerous orthopedic specialists to review the health of Embiid's knee before making the historic commitment.
Based on the team's previous success with Embiid on the floor, wanting to make sure he was locked into a long-term deal made sense. Team president Daryl Morey made it a priority before the start of the season, wanting to take possible contractual drama next summer off the table.
"Players like Joel are so special," Morey said. "We're building around Joel, we've built around Joel, we continue to plan to build around Joel because he's the special player that can help us win the championship."
Morey didn't say this the day Embiid signed the contract, when everyone was under the belief there was a plan in place to protect his knees for the foreseeable future. He said it less than a month ago when Embiid had missed 16 of the previous 17 games.
In truth, the 76ers' bet on Embiid was much deeper and more expensive. Their four-year, $212 million investment in 34-year-old Paul George was a vote of confidence in Embiid too -- that he was healthy enough now to go all-in.
It is more than fair to question that judgment now, based on this tumultuous season, throughout which his left knee has unpredictably swelled, often without trauma, notice or explanation.
WHEN EMBIID LEFT Paris in August after the Olympics, Team USA officials didn't believe he had suffered any injury on their watch. He'd started slowly with the national team and didn't appear to be in great shape -- not surprising given his history of slow starts.
But in a moment that really mattered for him, the Olympic semifinal against Serbia and rival Nikola Jokic, Embiid scored 19 points on 8-of-11 shooting and helped drive a 15-point USA comeback. That's the player the 76ers were investing nine more figures in, hoping he'd reprise the role the following spring in the NBA playoffs.
There was never a hint that the left knee, in which he has torn the meniscus twice, would hold him back this season. Morey told the media that the 76ers planned to hold Embiid out of some back-to-backs to spare wear and tear. In the preseason, Embiid controversially told ESPN: "If I had to guess, I would probably never play back-to-backs the rest of my career."
The 76ers were later fined $100,000 for these statements because they were in violation of league rules about player health status. In other words, the league dinged the 76ers for announcing their plan to manage the load of their superstar. The key part of that being everyone thought Embiid was, at least by his standards, healthy.
"I've accomplished everything [individually]," Embiid told ESPN in the fall. "But there's one thing missing, which is to win a championship."
But when it came time to ramp up for the season, Embiid's left knee started painfully swelling. He shut down workouts and skipped early-season games. Some days, sources said, his knee would feel OK and he'd be able to complete a workout or scrimmage. Other days, sometimes out of the blue, the left knee would balloon.
So Embiid, as he had so many times in his life, went back into an MRI machine. The scans were sent by the team and Embiid to numerous specialists. If you were a renowned orthopedic surgeon in the United States, there is a good chance you've seen an MRI of Embiid's knee and were asked in recent months for an assessment.
He played in only four of the 76ers' first 21 games. He tried to play through pain and swelling, hoping better conditioning would improve the situation. He took various injections, sources told ESPN, hoping to get some relief or even some consistency.
Sixers coach Nick Nurse would routinely try to give updates, which were often vague by design, as Embiid was shut down for multiple games four different times to try to treat the knee issues.
After missing 15 games at one point, Embiid returned on Feb. 4 and immediately delivered a triple-double with 29 points, 11 rebounds and 10 assists in a win over the Dallas Mavericks. Three weeks later, after taking off more than a week during the All-Star break, Embiid looked terrible in a loss to the Boston Celtics, scoring 15 points on just 3-for-9 shooting in 27 minutes.
The inconsistency was mystifying -- to Embiid, to the Sixers, to the fans. Eleven games into that 15-game stretch in which he didn't play, Embiid was seen in practice doing multiple handstands, a remarkable feat of athleticism for someone of his size. His shirt was soaked in sweat from what was clearly a heavy workout that day and, after one handstand, he let himself down by crashing his knees onto the court. Yet he would miss four more games before playing again.
Eventually, Embiid started telling people he feared he would need another surgery and a long recovery time to address the knee issue. ESPN sideline reporter Lisa Salters made Embiid's thoughts on the matter public during a broadcast in Milwaukee on Feb. 9.
Meanwhile, team officials privately made it known there was no consensus from doctors that surgery was definitely needed or would ensure the issue was corrected. There was, it seemed, no simple fix.
With growing unease on the matter and some mixed messages, Embiid sought a discussion in late February with 76ers owner Josh Harris to discuss how to move forward.
Finally, after Embiid scored just 14 points in 31 minutes on Feb. 22 against the Brooklyn Nets in what was a seventh straight loss, the 76ers shut him down and announced he'd get a new round of imaging and another round of medical advice. Six days later, his season was over.
"After further evaluation, it has been determined that he is medically unable to play," the team said in a statement. There was no announcement for what comes next and no mention of any possibility of surgery, only that "the team and specialists will continue working with Joel to ensure the best path forward for his long-term health and performance."
The path forward is narrow and uncertain. Locked into that long-term Embiid contract and with George -- who has battled knee, finger, groin and ankle injuries -- also having a down season, the 76ers are limited in how they can change the roster.
Their only option to avoid a repeat next season is to find a way to restore Embiid's ability to manage the knee problems. And that option will have to be something Embiid agrees with.
The team's future is riding on it.
"Sometimes the team has to make tough decisions for me and save me from myself because I always want to play," Embiid said earlier this season. "It's a relationship. We've been working together for years now. I've always looked at the big picture and I've always listened to them."
ESPN reporters Tim Bontemps, Ramona Shelburne and Shams Charania contributed to this story.