What’s the biggest reason for the playoff injuries?

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There really is no way to draw a direct correlation between this taxing NBA campaign — a shortened offseason, condensed schedule and COVID protocols that further limited preparation throughout — and the rash of injuries to star players that has impacted these playoffs. It is also no coincidence that the favorites to reach the NBA Finals from each conference have been two of the three healthiest teams all year.

Ask around the league, and you will get valid arguments on both sides.

LeBron James informed us all in an extended Twitter diatribe, “They all didn’t wanna listen to me about the start of the season. I knew exactly what would happen. I only wanted to protect the well being of the players, which ultimately is the product and benefit of our game. These injuries isn’t just ‘part of the game.'”

To which the league responded in a statement from spokesman Mike Bass, “Injury rates were virtually the same this season as they were during 2019-20 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.”

What’s the biggest reason for the playoff injuries?

Trainers are also split on the issue.

The “shortened offseason is definitely the biggest reason” for the slew of injuries we have seen in the playoffs, Drew Hanlen, who counts Joel Embiid among his All-Star clients, told Yahoo Sports in a text.

“A lot of people don’t take into account the rest these players got during COVID,” Justin Zormelo, an analytics-minded trainer whose own list of All-Star clients has included Paul George, Kevin Durant and Ben Simmons, told Yahoo Sports. “These players got three months off not playing basketball to heal their bodies, then they played the bubble, and then they had two months to get ready for the season. You can say they rushed back, but nobody’s talking about the rest they got to heal their bodies. It balances out.”

Eight teams never even returned for the bubble, including the Eastern Conference finalist Atlanta Hawks. Fourteen were done by the end of August, leaving almost four months between the end of the 2019-20 campaign and the start of this season. Only the Los Angeles Lakers and Miami Heat played into October.

LeBron James #23 of the Los Angeles Lakers and Anthony Davis #3 high five before the game against the Phoenix Suns during game six of the Western Conference first round series at Staples Center on June 03, 2021 in Los Angeles, California. (Photo by Harry How/Getty Images) NOTE TO USER: User expressly acknowledges and agrees that, by downloading and or using this photograph, User is consenting to the terms and conditions of the Getty Images License Agreement.
Injuries to LeBron James and Anthony Davis ended up playing a factor for the Lakers against the Phoenix Suns. (Harry How/Getty Images)

Injuries were not the reason the Heat lost in the first round. James is healthy for the Lakers if Solomon Hill does not land on his right ankle, and we can argue about whether Anthony Davis’ Achilles and groin injuries were a direct result of the shortest offseason in league history. On one hand, soft tissue injuries have “a more plausible connection” to player fatigue and workload, as sports injury analyst Dr. Brian Sutterer told Yahoo Sports. On the other, Davis has been injury-prone his entire career. Who is to say those would not have occurred had the Lakers enjoyed one full offseason rather the seven months off in a 10-month span?

What matters more is how players adjusted and mapped out their training regimens and how they plan to move forward, because the turnaround is comparatively short before the 2021-22 campaign starts in October. At the end of the day, as Zormelo said, “The players signed this deal. Nobody made them do this.”

How teams can try to prevent injuries

Trainers and doctors agreed that the best solution is to get all involved — players, coaches, front office and medical support staff — on the same page as it pertains to training, rest, recovery, injury prevention, workload and performance in a taxing schedule, and ensuring the plans are individualized for every player.

Take the Brooklyn Nets, for example. Kyrie Irving landed awkwardly on his right ankle in the Eastern Conference semifinals, an injury unlikely to be prevented. James Harden arrived to training camp out of shape after an early Houston playoff exit in the bubble. We cannot know for sure if that contributed to his hamstring strain late in the season, but he returned from the initial injury five days later, only to re-aggravate it four minutes into his first game back. He again pushed to return for the playoffs, and then re-injured the hamstring 43 seconds into Game 1 of the second round. Whatever Brooklyn’s plan was, it did not work.

Remarkably, Durant, after missing the entire 2019-20 season to recover from a ruptured Achilles tendon, was the last star standing for the Nets. They took every precaution when it came to their $160 million investment’s own hamstring injury this season, and he twice approached 50 points while playing all 48 minutes — plus overtime — in two of his last three games of the season. His approach worked.

Kevin Durant #7 of the Brooklyn Nets grabs the loose ball as Jrue Holiday #21 of the Milwaukee Bucks defends in the first half during game seven of the Eastern Conference second round at Barclays Center on June 19, 2021 in the Brooklyn borough of  New York City. NOTE TO USER: User expressly acknowledges and agrees that, by downloading and or using this photograph, User is consenting to the terms and conditions of the Getty Images License Agreement. (Photo by Elsa/Getty Images)

Kevin Durant managed to stay healthy after returning from his Achilles injury. (Elsa/Getty Images)

“At the end of the day, it’s the player’s body, they get paid a lot of money, and a lot of players know their own personal health, and you have to figure out how to manage that,” said Zormelo. “It’s a collective effort between teams, players and support staff. I don’t think you can just blame it on the condensed season.”

Former Phoenix Suns director of player development Cody Toppert, now an assistant for the University of Memphis, describes a five-step holistic approach to the season. It begins with an accumulation phase focused on pushing past limits, followed by an intensification phase of higher intensity for shorter periods of time, a maintenance phase geared towards performance, recovery and injury prevention throughout a grueling season, the tapering phase of increased rest and lower volumes of high-intensity output ahead of the playoffs, and lastly the actualization phase of performing at the highest level of postseason intensity.

It is vital for teams to manage each player individually throughout. Max effort is not the same for everyone. Position and usage matter. What felt like a hard practice for one player can feel like a cakewalk to another. The workload Giannis Antetokounmpo carries in 30 game minutes is apples to Pat Connaughton’s oranges.

It is also probably no coincidence that four of the NBA’s top-five leaders in usage — Luka Doncic (cervical strain), Joel Embiid (meniscus tear), Bradley Beal (hamstring) and Donovan Mitchell (hamstring) — were battling injury by the end of the year, and the fifth, Stephen Curry, played only five games his previous campaign. The Golden State Warriors made it clear Curry needs more help carrying the load next season.

Los Angeles Clippers star Kawhi Leonard, out with a knee sprain, is the only player on any of the four teams left to play more than 34 minutes a night, and he load managed throughout the year. The Milwaukee Bucks were one of only five teams not to put a single player in the league’s top 40 in minutes per game.

“It’s like when you go to a doctor. There’s a file,” Toppert told Yahoo Sports. “Without intimate knowledge of a player’s medical history and what a specific individual is doing, it’s guesswork. A calf strain can start way back in the offseason. Were there imbalances? Was he overcompensating? Did you take corrective measures? The only people who would truly have an understanding of that are the people on that staff. … Without the context of that data set, it is hard to make a generalization, but for the most part teams that are staying healthy now foresaw how this season was going to change and made the necessary adjustments.”

The Suns have Devin Booker's load management mapped to a tee. (AAron Ontiveroz/MediaNews Group/The Denver Post via Getty Images)

The Suns have Devin Booker’s load management mapped to a tee. (AAron Ontiveroz/MediaNews Group/The Denver Post via Getty Images)

Toppert cites Suns star Devin Booker as an example. Research indicated that the Suns need to dial back his intensity if he plays 36-plus minutes in a back-to-back setting. The injury risk almost doubles as that number creeps closer to 40 minutes. And if Phoenix is playing three games in four days, he needs rest.

“A guy like Booker, he’s going to treat practice like its Game 7 of the NBA Finals,” said Toppert. “That’s part of his greatness. He’s got a great group around him. Their group, led by [Suns senior director of health and performance] Brady Howe, is as good as it gets. There’s a reason they have a reputation of saving careers.”

Booker played more than 36 minutes on the second night of a back-to-back once all season, and when he felt hamstring soreness heading into two sets of three games in four nights from Jan. 20-30, he took four games off. Booker has played every game since, save for a meaningless final game of the regular season.

Zormelo points to style of play as another risk factor. The past three seasons have seen the NBA played at its fastest pace since the 1980s, when stars regularly burnt out. Nikola Jokic, the ultimate halfcourt weapon and a slowpoke, played every game this season en route to the MVP award. The Clippers, Suns and Hawks were among the eight slowest-paced teams this season. (The Bucks played at the second-fastest pace). 

“If the players don’t change their style of play, what do you expect to happen?” asked Zormelo, who founded Best Ball Analytics. “You think John Wall is going to be able to play 15 years playing that fast?”

Hawks guard Trae Young may be an exception, ranking sixth behind Mitchell in usage. He is also 22 years old, built like a marathon runner and sets his own pace in the halfcourt. Strength is no longer the going currency in NBA training. Lean muscle and pliability are invaluable. There is a reason Chris Paul has enjoyed two of his healthiest seasons since adopting a plant-based diet in his mid-30s (Knock on wood).

“Basketball players need to study the science of recovery and the science of basketball, based on what your body type is, and they need to be monitored throughout the season,” said Zormelo. “You’ve got a $200 million investment in a guy like Anthony Davis, you need to do everything you can to protect that.”

You would think every team in the league has sports science perfected at this point, but as Toppert said, “I’m not surprised seeing all these injuries. I don’t know how many monitor the fully integrated element.”

If teams and their players have not already outlined individualized training and performance regimens for the next year, catered for another shortened offseason, they are already trailing in the race for the 2022 championship. Consider the Suns, the most overachieving team in the league this season, as evidence.

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Ben Rohrbach is a staff writer for Yahoo Sports. Have a tip? Email him at rohrbach_ben@yahoo.com or follow him on Twitter! Follow @brohrbach

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