Is fatigue from a condensed schedule causing a spike in injuries during the NBA playoffs?

I’m an enormous NBA fan. I traveled to Memphis to watch two Grizzlies games in person almost immediately after the team opened its arena to fans during the pandemic. I rarely miss a game on League Pass. And I have closely followed the NBA playoffs, despite my Grizzlies bowing out in the first round.

I’ve been following the debate over whether COVID-19 and the shortened offseason and compressed regular season due to it caused what looks like a large increase in player injuries. I’ve argued about it with family members. But as we have seen star after star go down during these playoffs, I felt it was time to look at the numbers to see where blame might lie. I share my thoughts in my latest newspaper column.

NBA All-Stars who missed at least one game during the NBA playoffs

Chris Paul, Kawhi Leonard, James Harden, Kyrie Irving, Joel Embiid, Donovan Mitchell, Mike Conley, Anthony Davis, and Jaylen Brown. These nine 2021 NBA All-Stars missed at least one playoff game due to injury or health and safety protocols, the most ever, according to the Elias Sports Bureau. The previous high was six.

If Milwaukee’s Giannis Antetokounmpo misses Game 5 Thursday night after his ugly injury in which his knee appeared to bend in a way it definitely shouldn’t, make it 10 All-Stars.

Injuries haven’t just sidelined NBA All-Stars

ESPN’s Kevin Pelton recently reported that if you look, not just at All-Stars, but all players who averaged at least 25 minutes per game in the playoffs (or the regular season, if they missed the entire playoffs because of injury), the 2021 playoffs have already seen more games missed due to injury than almost any season.

Is the shortened preseason and condensed schedule to blame?

When you have that many star athletes injured, immediately people will try to point blame. The obvious culprit is COVID-19, which led to a shortened offseason after the delayed restart in the bubble in Orlando. But did the condensed schedule cause these injuries?

Arguably the greatest player of the last 20 years thinks so. After Leonard went down with a knee injury in Game 4 of the Western Conference semifinals, LeBron James unleashed a series of tweets claiming he warned these injuries might occur when the NBA decided to start the 2020-21 season only 71 days after the Lakers won the championship in October.

Also read:
Avoiding injuries will be key for NBA teams during the COVID-19 restart

The NBA claims injuries were unchanged

In response to James’ tweets, NBA spokesman Mike Bass said in a statement: “Injury rates were virtually the same this season as they were during the 2019-20 season while starter-level and All-Star players missed games due to injury at similar rates as the last three seasons. While injuries are an unfortunate reality of our game, we recognize the enormous sacrifices NBA players and teams have made to play through this pandemic.”

Conflicting data shows the toll injuries took on players this season

According to the New York Times, Bass’s statement reflected the league’s internal data. ESPN’s Kevin Pelton started tracking injuries in 2009-10. His data paints a different picture. Pelton reported the average number of players sidelined per game due to injury, non-COVID-19 illness or rest this season was 5.1, the highest he has measured.

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Focus on the league’s stars, the situation looks even worse. This year’s All-Stars missed 370 of a possible 1,944 games. That 19 percent of missed regular season games is the highest percentage in NBA history, according to Elias Sports Bureau research.

Finally, if you look specifically at soft-tissue injuries, like hamstring and calf strains, the data seems clear. Jeff Stotts, an athletic trainer who maintains the most comprehensive NBA injury database, noted there were 2,909 games lost to soft-tissue injuries this regular season, according to ESPN’s Baxter Holmes. The only season with more soft-tissue injuries since Stotts started tracking injuries in 2005-06 was the 2017-18 season, with 3,038 missed games. That season had 82 games, 10 more than players faced this season.

Fatigue from the shortened NBA preseason and condensed regular season schedule

In addition to the shortened offseason, teams played a condensed schedule in the second half of the season due to games postponed by COVID-19. My Memphis Grizzlies played 40 games in 66 days, including four games in five nights. Teams across the league tried to combat player fatigue from this schedule with fewer practices and weight room sessions.

There is no question fatigue can lead to soft tissue injuries, like the hamstring and groin injuries that sidelined Davis and Harden. But what about ankle sprains, like those suffered by Irving, Mitchell, and Atlanta Hawks star Trae Young, or the knee injuries suffered by Giannis and Kawhi? Sure, stepping on someone else’s foot or landing awkwardly can happen any time. But it’s possible fatigue of the small stabilizing muscles around the ankle, knee, and hip can cause them to be slow to fire at the moment of impact, leading to ligament injuries and bone bruises that might not otherwise occur.

Also read:
Injuries to Kevin Durant and Klay Thompson and the role of the NBA regular season

It doesn’t matter who or what is to blame for these injuries

It doesn’t really matter who or what is at fault. The players agreed to this schedule, mainly to avoid losing a huge amount of TV money by playing fewer games.

Regardless, I’m disappointed for the injured players, who want to compete. Hopefully these injuries won’t linger into an already shortened preseason coming this summer or into next season.

I hate it for the teams. Only three NBA champions since 1978 had a player who averaged at least 25 minutes per game in the playoffs miss more than two games because of injury, according to Pelton. We could have a fourth this year.

And I hate it for the fans. As a die-hard NBA fan, I don’t miss many games. But casual fans tune in to see the stars play. Far too many of them are sitting on the bench in street clothes.

Note: A modified version of this article appears as my sports medicine column in the July 4, 2021 issue of The Post and Courier.

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