The Truth Behind Load Management
The seemingly misaligned incentives between the NBA and its teams
Where are my data nerds at? This one's for you.
Most people don’t know what the data actually says about load management. I’m here to break it down for you. But first, what is load management? And why has it been such a big topic of conversation in sports, especially the NBA?
Load Management…What’s That?
Load is a pretty complex topic, but it is basically the amount of stress and exertion an athlete puts on their body. What’s more of a challenge is how sports trainers and researchers measure load. It has been defined and redefined among dozens of academic researchers, but the most commonly accepted way to define load is the rate of perceived exertion. Essentially, it means how hard an athlete is exerting themselves (ref).
So how does the ‘management’ part come in? Sports teams are now managing the load their athletes take on by having them sit games that aren’t as important. The sole purpose is to reduce the risk of future injury and ensure star players are available for the most important games.
The Load Management Controversy
The Toronto Raptors coined the term, ‘load management’ in recent years, which has resulted in stars sitting more games than ever. Single-game absences of star players in the NBA have increased five-fold and more and more fans are complaining that their favorite players sit when they buy expensive tickets to the game.
Seemingly, team incentives are at odds with the NBA’s incentives. Teams want their best players available when it matters most. The NBA wants to maximize revenue and entertainment by having its best players on the floor, especially during nationally televised games.
So what gives? A rule was recently passed that states players must play in at least 65 games to be considered for certain awards at the end of the season, which can impact salaries for players.
The crux of the issue is whether load management actually works. If it does, incentives will never be aligned. However, if the data on load management is murky or doesn’t actually impact health outcomes, teams and the NBA may be able to find common ground after all.
The NBA’s Independent Study
In January, the NBA sent a 57-page document with the results of a 10-year study on load management to all NBA teams. The document concluded that resting healthy players for a game didn’t make those players less susceptible to future injury compared to players who didn’t rest.
David Weiss, a Senior Vice President for the NBA said:
“Some members of the Competition Committee had taken it as the conventional wisdom that there is evidence, that it is proven, that within the NBA, load management reduces injuries. We just haven’t seen that in about 10 years’ worth of data.”
David Aldridge wrote in The Athletic that the report also stated that 1) Playing a high number of minutes, 2) Schedule density, and 3) cumulative game load did not impact future injury rates.
Naturally, some skeptics say the NBA’s data is biased, despite hiring a third party, because they need the data to progress their agenda. Luckily, we have hundreds of other academic studies that are public and can be found with a simple Google search. I wanted to see if the research backed up the NBA’s claims. Here’s what I found.
Public Research on Load Management
Claim #1: Resting while healthy doesn’t make a player less susceptible to future injury
This claim seems to stick. Athletes can operate at high loads while healthy without any issues. A day off probably isn’t going to reduce the odds of injury.
The data shows that high loads are probably not the problem. However, injuries most often occur when there are excessive and sudden increases in load over a short period. Studies conducted in Australian football, basketball, cricket, soccer, and rugby state that 10% increases in load from week to week are safe and don’t increase the risk of injury (ref, ref, ref, ref, ref, ref, ref, ref, ref, ref, ref, ref).
When load increases too quickly (greater than 10%) from week to week, that’s when injuries happen (ref, ref, ref, ref). Interestingly, injuries are more likely to occur 2 - 4 weeks after the sudden load increases due to built-up fatigue (ref). Put simply, this data provides strong evidence for the need to be in tip-top shape and the need to work steadily and consistently to get there.
In 2019, a data analyst analyzed NBA injury data over the past 20 years and found that injuries have regularly increased from season to season. From the 1990s to today, the average number of games missed by star players has risen from 10.6 games to 23.9 games per season. Some of those games missed today are due to load management, but injuries have also influenced that number.
One reason for the increase in injuries could be due to the increase in the pace of the game during that same period. As the game gets faster and players get stronger, it seems natural that more injuries and freak accidents will occur.
Another reason could be due to the regular decrease in NBA team practices. The year after the Lakers won a championship in 2020, they only held five practices between the start of the season and the All-Star break. When James Harden was on the Brooklyn Nets he said, “We use the games as practice.”
Former coach Jeff Van Gundy has a little bit of a ‘back in my day’ mentality, but his comments on practice are illuminating as to how practices in the past helped players get in shape and be prepared for a long, grueling season:
“More time spent on the floor…with more contact, and more repetitions. And it was more competitive. It wasn’t just five-on-zero. It was more drill work and more physical competition, you know?... More would be the word. More often. Longer. More competitive.”
Given the data on working steadily towards heavier loads, the idea that practicing fewer times is protecting players from future injuries may actually be backfiring. Practicing to get in and stay in game shape likely goes a long way in reducing the risk of injury.
Claim #2: Playing a high number of minutes doesn’t impact future injury rates
This claim doesn’t seem intuitive, but now that we have research on how sudden load increases impact injuries, it makes more sense. The same data analyst mentioned earlier observed that as players increased minutes played in a game, the percentage of games missed actually decreased.
It is plausible that players who receive fewer minutes in games tend to have lower stamina and fatigue quicker. This could be especially true with the reduction in practices over the years. The spike in the load exerted on their bodies during gameplay could result in more injuries and games missed.
Just one caveat—it is unclear from the methodology, but there could be some bias in the data from low-minute players missing games due to getting ‘DNP - Coach's Decision.’ Still, even if ‘DNP - Coach’s Decision’ was included in this data, it would likely only impact players who average fewer than 10 minutes per game. The trend of missing a larger percentage of games the fewer minutes played still holds up, even if the data is only directional.
Claim #3: Schedule density, including back-to-back games, doesn’t impact future injury rates
The NBA’s data found no relationship between back-to-back games and injury rates. However, the public data on increased games in a short period is muddy. There have been 12 studies exploring this very topic and eight have found that increased competition in a short period leads to more injuries while four found no significant association (ref). Of the 12 studies, none of them were with basketball players.
The evidence seems to have thresholds, which if passed, athletes experience higher chances of injury. In essence, there is a line drawn in the sand for the number of games played in a certain amount of time, where if crossed, injury risk will increase.
For example, in soccer, players seem to have a significant increase in injuries if they play two games with only three or four days between games compared to six or more days between games. More research is needed in this area, but each sport is likely unique in the recovery time needed between games to reduce fatigue.
It is interesting to note that the NBA has eliminated four games in five nights from their team schedules in the last two years. They may have seen something in their injury data to make this change, which might point to an injury risk threshold being identified in the NBA, similar to those found in soccer.
One thing the NBA did find in its study is that back-to-backs do reduce the quality of play. In the last few seasons, the NBA has reduced the number of back-to-backs and has cut down on the amount of team travel. Similarly, research in other sports suggests that traveling across time zones does impact performance (ref, ref, ref) and increases susceptibility to illness (ref, ref), but doesn’t have an established link to injuries.
Claim #4: Cumulative game load doesn’t impact future injury rates
This claim has the least amount of public research conducted, which makes it hard to find definite answers. Most studies on this have been on youth soccer players, who use a different muscle group than basketball players. The study subjects are also still growing, which likely has an impact on the results.
Regardless, the data shows there is a positive association between cumulative game load and injuries (ref, ref), which is the opposite of what the NBA found. In addition to the points made above, competitive youth sports tend to be played almost year-round, which could also explain some of the differences in findings.
What are the implications of this data for the NBA?
With anything, many factors at work can influence injuries, but a few things are clear:
Load management doesn’t prevent future injury risk
Players need to ramp up to game speed over time. The pre-season and practice should be used as a way to gear up for and continue to stay in game shape throughout the regular season and playoffs
NBA teams, especially those players who don’t get heavy game minutes, need to practice more at game speeds to stay in shape and avoid fatigue
Load management for long periods without real game action could potentially lead to more injuries if it reduces the load a player can take on
More public research is needed on schedule density in the NBA. Back-to-back games may not introduce more injury risk, but other frequencies such as four games in five or six nights may. We need to better understand where that threshold is
More public research is needed on the cumulative game load risk for the NBA. Knowing this will help us understand if 82 games plus the playoffs in nine months increases injury risk
One Last Thing…
Now, there is one thing I haven’t covered yet. What the NBA hasn’t addressed is the fact that teams are also resting players not just to reduce the perceived risk of future injury, but because it means there is a 0% chance that player gets hurt in the games they sit.
The NBA needs to realize the regular season has become watered down and teams are ok with sacrificing a win to preserve their star players. This is one area where team and NBA incentives are harder to align and less rooted in injury data. Until the NBA can make regular season games more meaningful, we’ll likely still see a trend of managing load.
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