NBA report: No relationship between load management and lower injury risk

The NBA distributed an analytics analysis to clubs and select media members this week, stating that there is no link between load management and a lower chance of injury.

The research, the latest move in a protracted discussion over the idea of load management, follows Joe Dumars, the NBA’s executive vice president of basketball operations, who stated in October that there is no link between the two. Last month, Commissioner Adam Silver endorsed Dumars at a press conference.

Dr. Christina Mack, epidemiologist and chief scientific officer of IQVIA Injury Surveillance & Analytics, which published the paper, was cautious to emphasize that the analysis does not conclude that load management is ineffective.

“We’re not saying it’s better or worse,” Mack explained.

The 57-page study was delivered to NBA clubs earlier this week, at the request of the NBA’s competition committee, to investigate whether there was any tie between

• The frequency of game involvement and injuries.
• Schedule density and injury.
• Total NBA participation and injuries.

The study determined that there wasn’t.

“Results from these analyses do not suggest that missing games for rest or load management — or having longer breaks between game participation — reduces future in-season injury risk,” according to the report’s summary, which was written in bold font.

“In addition, injury rates were not found to be higher during or immediately following periods of a dense schedule.”

According to the analysis, this held true even after accounting for factors such as player age, minutes played, and injury history.

The report’s results are based on a 10-year sample, from the 2013-14 season to 2022-23, using leaguewide statistics and focused on a group of 150 “starter-level players” each season. Those players were All-Stars from the previous three seasons, top ten choices in that season’s draft, and the remaining players with the most total minutes played in the preceding season who don’t fall into either of the previous two categories.

The study also focused on players missing a single game rather than numerous games in a row, and it was divided into two categories: players sitting intentionally for rest, and games in which a player lost time due to rest or injury.

Although the report stated that a variety of factors limited the scope of the findings, including the inability to examine trends beyond the 10-year data window and the various ways individual teams handle this topic, it repeatedly stated that there was no correlation between load management and ensuring players are on the court more frequently.

While starter-level players’ single-game absences have increased dramatically over the last decade, from 169 in 2014-15 to 380 in 2022-23, the number of regular-season injuries among starters also hit a 10-season high this season.

Early in the study, it stated why it was commissioned this summer: the continuing debate over great players missing games.

In the 1980s, top players (defined by the study as players who were either All-top or All-NBA picks in the current season or the previous two) missed an average of 10.4 games each season, compared to 10.6 games in the 1990s.

However, that number increased from 13.9 games in the 2000s to 17.5 games in the 2010s and 23.9 games this decade.

When asked if the substantial increase in missing games over the last 20 years could be related to load management, NBA senior vice president of player affairs Dave Weiss responded that while much of it was due to injury, single-game absences for players had grown by approximately five times during that time period.

“Clearly, that’s happening more than at just the rate of injuries,” Weiss said in a statement.

The report’s results, which established that load managing players does not necessarily contribute to their being healthy, were consistent with what Dumars stated in October.

At last month’s in-season event, Silver repeated that there is no research to support the idea that load control keeps players healthy. He labeled the scientific and medical facts “mixed.”

“The question is I think the ultimate question behind load management isn’t so much that there isn’t a fall-off from performance when you are tired and fatigued,” he went on to say. “The question is, does that lead to more injuries?”

That was in stark contrast to Silver’s remarks in February, when he stated, “The suggestion, I think, that these men, in the case of the NBA, somehow should just be out there more for its own sake, I don’t buy into.”

Weiss explained that the shift in tone was caused by the league determining it was important to investigate the data.

“We accepted that conventional wisdom and some of the information that teams had shared with us over years, which included some data but never nearly as robust as what we’ve now shared back,” Weiss said in a statement. “And it came to a point where we said, ‘You know, we’ve been looking at this for years and we’re not seeing this effect, so we think we need to get more formal and structured in terms of how we’re analyzing it and sharing it with teams.'” And that is essentially what led to this.