More than perhaps any other before it, this NBA postseason has been defined by injuries. After the conclusion of an NFL campaign that also saw an uptick in the number of players getting hurt, the world’s best hardwood hoopers seemed to drop like flies. As a result, the topic of load management has become a hot-button issue in the NBA, but has this tactic actually decreased the incidence of injury or increased it? That’s what today’s post is all about. 

Before the NBA Playoffs even began, there was a cloud hovering over the defending champions, the Los Angeles Lakers. In the final quarter of the regular season, the team was hobbled by the absence of one or both members of its superstar duo, as Anthony Davis and four-time Finals MVP LeBron James battled persistent injuries. The Denver Nuggets, one of their toughest opponents from last season (and home of the presumptive MVP, Nikola Jokic), fell from championship contention when All-Star guard Jamal Murray went down with an ACL tear. 

Then as the Playoffs kicked into high gear, other teams started to catch the injury curse. The Brooklyn Nets were the size of Kevin Durant’s big toe away from reaching the Eastern Conference Finals but had to push on with a hamstring-hobbled James Harden and a hurt Kyrie Irving. Joel Embiid soldiered on with a meniscus tear that he said left him with no lift, and the LA Clippers’ first-ever trip to the Western Conference Finals was derailed when two-time Finals MVP Kawhi Leonard was ruled out by what was later revealed to be a torn ACL. Even the Milwaukee Bucks, who managed to keep its big three of Giannis Antetokounmpo, Jrue Holiday, and Khris Middleton healthy, got a scare when Giannis hyperextended his knee and lost starting guard Donte DiVincenzo to an ankle ligament tear.

In a high-impact sport like basketball that involves a lot of jumping and landing, changes of direction, and acceleration and deceleration, some injuries are bound to occur. But is it typical for so many players to get hurt in the course of a single Playoffs? Even after a big win by the Bucks, it’s safe to state that there have rarely been as many high-profile players hurt at this stage of the season. 

Dialing In Rest and Load Management

So what is the root cause? In a story for SB Nation, James Dator wrote, “The season began on December 22 rather than mid-October — and finished the regular season just one month after it would normally conclude. This essentially cut four weeks from the normal NBA calendar and cut just 10 games. There were more games and less rest, which caused a breeding ground for injury. Then when the playoffs arrived the league gave itself no breathing room on the back end, forcing a breakneck pace to finish everything up before the Olympic Games, which are scheduled to begin at the end of July.” 

There are certainly a couple of valid points here. First, losing four weeks from any pre-season training program can make a significant impact on player readiness and preparedness. And after the rigors of the previous season and the COVID-19 restrictions it entailed, NBA players certainly needed a breather before launching right back into the next season. And yet there is an additional consideration that’s worth exploring: namely, how load management is perceived and implemented, and what effects this has on players’ physical state. 

When coaching maestro Gregg Popovich added Kawhi Leonard to the San Antonio Spurs roster in 2011, the two-way skills of the former San Diego State Aztec extended the championship window for the team’s core of Tim Duncan, Manu Ginobili, and Tony Parker. His full potential was realized when he was named Finals MVP and the Spurs claimed their fifth championship to cement their place among the NBA’s premier dynasties. But in 2017, the enigmatic star suffered a quad injury. He played just nine games in the 2017-2018 season. 

As the length of his absence increased, the NBA rumor mill went into overdrive as the media suggested that the coaching staff and Kawhi’s teammates were unhappy with him. Some irresponsible reporters wrote that he was holding out on the team or even exaggerating the severity of his injury, reminding me of similarly unkind and untrue comments about a persistent injury two-time NBA champion Hakeem Olajuwon struggled with back in the day. 

Increased Player Autonomy

Beyond the “he said, she said” gossip about the strained relationship between Kawhi and the Spurs organization, the thing I noticed was that he had taken charge of his own rehab process. In the past, most players had deferred to their team’s medical staff to establish a return-to-play timeline and meet the necessary milestones along the way. But while Kawhi was almost certainly consulting with physicians, physical therapists, and other professionals, he set a precedent by removing control from the team’s staff. 

This is by no means meant to be a criticism of Kawhi or the Spurs. The former had every right to have the final say over what happened with his body, and I’m sure the latter offered all the same care and service that it would to any player who was injured. But it was clear that once others took notice of how the dynamic had changed, more athletes would demand the kind of autonomy that Kawhi now had. 

When he was traded to the Raptors, Kawhi was back to full strength, as shown by his MVP-winning performance in the NBA Finals that gave Toronto its first NBA title. Along the way, he continued to oversee his own load management and decided when he should play and when he shouldn’t. Having worked with elite players like Kobe Bryant and Steve Nash while serving as the strength and conditioning coach of the Lakers, I understand that no one knows an NBA player’s body better than themselves. So more power to Kawhi for taking charge. 

That being said, as other players around the league noticed what Kawhi was doing, they began making assumptions about the games that he didn’t play in. The impression was that he was taking a day off. Yet as quiet and private as Kawhi is, it’s highly unlikely that he was just sitting on the couch eating Cheetos and playing video games on such days. Instead, he was probably in the weight room, doing light sessions on the practice court, and using recovery modalities like massage and contrast therapy. In other words, taking an active rest day. 

Keeping the Bucket Topped Up

Yet as more players started handling their own load management strategies and the term became a hot topic, some athletes might have decided that if they weren’t playing on a given night, they weren’t going to do much of anything earlier in the day. While the 82-game season (or, in the case of this year’s COVID-shortened one, 72) and Playoffs undoubtedly take their toll, total rest is usually unwise for players at the NBA level. 

Even during his recent layoff with a knee injury in the series against the Phoenix Suns, Kawhi was still staying active according to teammate Luke Kennard. “He's behind the scenes. He's always working, always talking to us, always sending texts... He's our leader. He's our guy,” Kennard told Sports Illustrated writer Farbod Esnaashari.  

Think of readiness as being like a big plastic bucket with a small hole in the bottom. While it isn’t going to go from full to empty overnight, when someone isn’t training and/or doing active recovery, they’re not topping off the bucket. If this repeats itself often or for long enough, that seemingly small leak can become a big problem as readiness dips below the fill line. When the athlete does return to competitive play, they might not be ready for it because they’ve created a delta between the water level they need to be at and where it actually is in the bucket. And as a result, they’re more susceptible to injury. 

Such spikes in intensity and volume aren’t unique to NBA players, but also apply to the rest of us. Muscular and connective tissue injuries typically occur when our supporting structures are exposed to loads greater than they can handle, whether that’s from jumping and landing, cutting, or speeding up and slowing down. The way to increase your load tolerance is to keep topping your bucket up. It’s not about filling it all the way in one go, but constantly topping off your water level with regular resistance training. That way, your body will be prepared to handle the rigors of whatever sports and daily life can throw at it. 

So if you can take any lesson from the spike in NBA injuries, let it be this: you probably don’t need more off days. Rather, if you train on Mondays, Wednesdays, and Fridays, make sure you’re doing something active in between sessions. Go for a family walk, shoot some hoops with your kids in the driveway, or rent a paddleboard to take out on your local lake or river. And be proactive with your recovery as well. This way, your body will be in a constant state of readiness, and your chances of getting hurt will decrease. As photographer, climber, and Academy Award-winning director Jimmy Chin said, “It’s not about getting into shape, it’s about not getting out of shape.” 

Need Help Getting and Staying Ready for Anything? 

If you don’t know where to start with a new training program or think your current plan could be better, we’d like to come alongside and help. Check out our online training services here, or if you live in the Boston area, we’d love for you to join us at the TD Athletes Edge facility.


Timothy DiFrancesco

Tim DiFrancesco, PT, DPT spent 6 seasons as the Head Strength & Conditioning Coach of the Los Angeles Lakers and is the founder of TD Athletes Edge. He is nationally renowned for his evidence-based and scientific approach to fitness, training, nutrition, and recovery for athletes and fitness enthusiasts.

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