NBA report – No link between load management, less injury risk

The NBA disseminated an analytic report to its teams and select media members this week that said there is no correlation between players being load managed having a reduced risk of injury.

The report, the latest step in what has been a years-long debate over the place of the concept of load management in the NBA, comes in the wake of Joe Dumars, the NBA’s Executive Vice President of Basketball Operations, saying in October that there is no correlation between the two. NBA Commissioner Adam Silver backed up Dumars’ statement in a press conference last month.

Dr. Christina Mack, the Epidimiology and Clinical Evidence Head of IQVIA Injury Surveillance & Analytics, which produced the report, was careful to point out that the report does not definitively say that load management doesn’t work, either.

«We’re not saying it’s better or worse.» Mack said.

The 57-page report, which was sent to NBA teams earlier this week set out to determine — at the behest of the NBA’s Competition Committee, which Dave Weiss, the NBA’s Senior Vice President of Player Matters leads — was to see if there was any relationship between:

• frequency of game participation and injury

• schedule density and injury

• cumulative NBA participation and injury

And, ultimately, the report concluded that there was not.

«Results from these analyses do not suggest that missing games for rest or load management — or having longer breaks between game participation — reduces further in-season injury risk,» the report said, in bold type, in its executive summary.

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

The report went on to say that remained true even when factoring in things like player age, minutes played and injury history.

The report based its findings off looking at a 10-year sample — from the 2013-14 season through the 2022-23 campaign — using available league-wide data and focused on a group of 150 «starter-level players» each season. Those players were All-Stars from the past three seasons, top 10 picks in that season’s draft and the remaining players with the most total minutes played in the prior season who don’t fit into either of the previous two groups

The report also focused on players missing a single game, rather than multiple games in a row, and was split into ones including players specifically sitting due to rest, as well as all games where a player missed for either rest or injury.

And while the report said there were a variety of factors that limited the scope of the report — the inability to examine trends from outside the 10-year window of data, and the different things individual teams do on this topic — it repeatedly stressed that there was no correlation between load management and ensuring players will be on the court more regularly.

To that end, while single-game absences for starter-level players skyrocketed over the past decade — from a combined 169 among starter-level players in 2014-15 to 380 in 2022-23 — the number of regular season injuries among starter-level players also reached a 10-season high this past season.

Early in the report, it laid out exactly why it was commissioned this summer to begin with: the ongoing discussion surrounding star players missing games.

In the 1980s, NBA star players — a group defined by the report as players who were either All-Star or All-NBA selections in the current season or the prior two — missed an average of 10.4 games per season, a number that was 10.6 games in the 1990s.

But that number jumped from 13.9 games in the 2000s, 17.5 games in the 2010s and 23.9 games in this decade.

Weiss, asked if that dramatic increase in missed games over the past 20 years could be attributed to load management, said much of it was due to injury, but that single-game absences for players had increased by about five times over that span.

«Clearly, that’s happening more than at just the rate of injuries,» Weiss said.

The report’s findings — establishing that load managing players does not definitively lead to them being healthier — was in line with what Dumars said to the media back in October.

At last month’s In-Season Tournament, Silver reiterated the stance Dumars had taken that there’s no data-driven proof that the concept of load management keeps players healthy. He called the science and medical data «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 said. «The question is, does that lead to more injuries?»

That was in direct contrast to Silver’s comments on the same topic last February, when he said, in part, «The suggestion, I think, that these men, in the case in the NBA, somehow should just be out there more for its own sake, I don’t buy into.»

Weiss said that change in tone was a function of the league deciding it was necessary to study 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. «And it hit a point where we said, ‘You know, we have been looking at this for years and we are not seeing this effect, and so we think we need to get more formal and structured in terms of how we’re analyzing this and sharing it out with teams.’ And that’s really kind of what led to this.»