LeBron James is entering his 24th NBA season with another physical challenge to manage.
According to ESPN’s Dave McMenamin, the 41-year-old is dealing with chronic arthritis in his left foot, an issue that receives specific attention during his daily preparation with longtime trainer Mike Mancias. James is also continuing to monitor his lower back after sciatica forced him to miss the opening month of the 2025-26 season.
The routine begins well before practice. James reportedly arrives at the Philadelphia 76ers’ training facility around 7:45 a.m., where Mancias takes him through stretching, activation work and other treatment before the team’s regular session. Special attention is paid first to the arthritic left foot and then to his lower back, illustrating just how much maintenance is required before James even steps onto the court.
The diagnosis does not necessarily mean the condition is new. James appeared on injury reports with left foot arthritis last season, and Philadelphia has already discussed carefully managing his workload as he moves deeper into his 40s. That could include monitoring minutes and potentially being selective with back-to-back games during the regular season.
What stands out most is the contrast between what James continues to do publicly and what goes into making that possible behind the scenes.
At 41, he remains capable of competing at the NBA level, but his longevity increasingly depends on an elaborate daily process designed to keep existing issues under control rather than pretending they do not exist.
Chronic arthritis in the foot and lingering back problems are significant realities for any professional athlete, particularly one preparing for an unprecedented 24th season.
For James and the Sixers, the priority will therefore be less about eliminating every physical issue and more about managing them well enough to keep him available when the games matter most.
