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The Relationship Between Games Missed for Rest or Load Management and Injury in the National Basketball Association,
Mackenzie M Herzog1, Alexandra Brink1, Rahul Gondalia1
1IQVIA, 2400 Ellis Road, Durham, NC, 27703, USA.
Background:
One often-stated aim of load management in elite athletes is injury reduction. However, current literature on the efficacy and effectiveness of specific load management strategies to reduce injury risk is limited.
Objective:
The aim of this study was to investigate the relationship between missing regular season games for rest or load management and subsequent injury in the National Basketball Association (NBA).
Methods:
A 9-year observational analysis of a select group of NBA players participating in each of the 2014-15 through 2022-23 seasons was conducted using the NBA Injury and Illness Database. Standardized, league-wide player participation and health information rules require reporting of any game missed due to injury, illness, rest, or load management. The main outcome was a game injury that resulted in two or more games missed consecutively. Hazard ratios were calculated using the Anderson-Gill modification of the Cox proportional hazards model. Injury rate ratios were calculated using Poisson regression. Analyses were adjusted for age, number of prior injuries, games missed due to injury or other reasons, and average minutes played per regular season.
Results:
A total of 1233 player-seasons contributing 1,538,917 player-minutes of NBA game play were included. From 2014-15 to 2022-23, games missed for rest, load management, or 1-game absences increased by 125% (+ 211 games), and 2+ consecutive games missed injuries increased by 43% (+ 61 injuries). Among players who missed games for rest or load management (n = 129,578 player-minutes), there was no significant difference in injury risk compared with players who did not miss games for rest or load management (n = 1,409,339 player-minutes; 1-2 games missed: hazard ratio [HR] = 1.24, 95% confidence interval (CI): 0.92-1.65; 3-5 games missed: HR = 0.91, 95% CI 0.39-1.80; 6 or more games missed: HR = 2.16, 95% CI 0.53-5.78).
Conclusions:
NBA players who missed regular season games for rest or load management did not have a decreased risk of subsequent injury in the same season. Further studies that add assessment of training and internal loads will offer additional insights.
