NBA Trends: 'Significant' Injuries Aren't Up, but Work to Do on Prevention

Jared Zwerling@JaredZwerlingNBA Senior WriterDecember 29, 2013

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First, it was Steve Nash, Derrick Rose, Marc Gasol and Kobe Bryant. Then, it was Brook Lopez earlier this week. And on Friday, there were two more big names in the NBA who sustained long-term injuries, Russell Westbrook and Al Horford.

But even if it feels like a historic season of players going down for long stretches—not including role players such as Raymond Felton (strained hamstring) and Michael Kidd-Gilchrist (broken hand)—the number of these injuries has not been out of the ordinary, according to the NBA.

A league spokesperson told Bleacher Report on Saturday that a preliminary analysis of "significant" injuries, defined as those forcing a player to miss 10 or more games, shows that they are trending at a similar rate compared to the last five seasons through roughly the first two months of play.

When several superstars go down, such as Rose, Bryant and Westbrook, it can give the impression that things are worse than they really are.

The spokesperson said that the league didn't track injuries as closely before 2008 and that it doesn't have detailed data available as far back as 2000.

Given that limited range, the league pointed to 2010-11 as being one of the biggest seasons for significant injuries. There was Andrew Bynum (meniscus tear in right knee), Yao Ming (stress fracture in left ankle), Joakim Noah (torn ulna collateral ligament in right thumb), Shaquille O'Neal (right leg injuries), Brandon Roy (both leg injuries), Anderson Varejao (torn tendon in right ankle) and David West (ACL tear in left knee).

The season before that was also noteworthy, as these marquee players were sidelined: Blake Griffin (stress fracture in left knee), Tracy McGrady (microfracture surgery on left knee), Yao Ming (broken bone in left foot) and Michael Redd (ACL and MCL re-tears in left knee).

The league spokesperson also disputed recent reports that suggest ACL tears are on the rise, saying the league's averaged about 4.5 per season over the past seven years, with no more than five in a year and no less than three.

Trainers' Perspective on Injury Prevention

While there has been no significant difference in the number of major injuries this season, there are still deficiencies in the NBA training world, according to four experts in the field—trainers Ed Downs, Keith Veney and Micah Lancaster and Suns physical therapist Dr. Mike Clark.

For starters, Veney and Lancaster believe some of the players' injuries stem from their AAU days, as their summers—when some relaxation should be encouraged—have become much more competitive hoops with more travel across the country.

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"They are playing too much basketball as a youth," said Veney, who's also a shooting specialist and has worked with Dirk Nowitzki, Paul Pierce, Kemba Walker, Brandon Jennings and others while hosting camps across the country. "Way too much AAU basketball."

"I agree," said Lancaster, who has worked with more than 15 NBA players, including Dwyane Wade, Kyrie Irving and Evan Turner. "The whole AAU movement has guys putting so much wear and tear on their bodies at earlier ages."

Once they get to the NBA, Veney said "many" players don't do enough training; he suggested more than 50 percent of guys in the league don't go hard in the offseason or practice wrong techniques. Increased global travel and more off-the-court opportunities have been bigger distractions.

"How are you in the NBA for 10 years and can't shoot for an NBA player and you're overweight?" he said. "Many of them don't care enough about basketball when they're getting millions. They don't take advantage of all the things they have available to get better."

Downs said a good number of players simply play pickup basketball in the summer and then wait until training camp to get into real game shape; therefore, they can be playing catch up with their bodies. To that point, Lancaster said many development coaches on NBA teams these days are former players who don't have a high respect for quality training.

"They think that players are more so naturals that need to run through the normal fundamentals and shot reps," he said. "Then there are the new emerging trainers that rely on innovation and believe that training can be a ton of more effective and efficient workouts. The NBA is at a very interesting time right now."

Among the players that do care, Lancaster believes an increased number are training inadequately during the offseason. He said because there is more of an emphasis on "staying healthy rather than staying healthy and improving," more guys are turning to "repetition-based maintenance training" to help preserve their health and prolong their careers. The workouts involve slow-paced spot shooting for hours at a time—for example, taking 1,000 jumpers per day.

Lancaster said that style of training—which is high-rep, low-impact-based—can lead to more consistent injuries because the decrease in speed and intensity of the workouts can make it "a shock to their bodies when they return to fast and intense action."

"I know so many NBA trainers who train the maintenance way, and I cringe. I also completely understand why players get sucked into a maintenance approach; they feel it's safer for their careers," he said. "But I think it's actually more of a health risk, and they don't see the improvements to their game year after year—like Kobe, LeBron (James) and (Kevin) Durant experience. That's because they have very intense training styles and have stayed healthy for the majority of their careers—same with (Kevin) Garnett and (Paul) Pierce."

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Lancaster's approach is designing condensed training sessions that resemble game simulation through dynamic and difficult drills, but it doesn't wear the players' bodies down because of the shorter time on the court. He said his clients have stayed "pretty healthy" because they have utilized his techniques throughout the year. He provides useful training tools to help maintain their focus.

"I train using tools that help simulate the game, and I think lower reps and higher intensity are key," he said. "I have med balls for contact and game resistance, rip cones that force lower hips on the drive and other tools that are designed to simulate realistic game movements. That way, players can train like they have a trainer all the time. Once players learn how to use those tools to simulate game-like action, they can train with that kind of intensity all year round."

Downs, who has worked with Wade, James and Chris Bosh and more than 10 All-Stars, said while maintenance work is helpful during the season, he agreed with Lancaster in that players "need reps, high intensity in the summer."

He also said because NBA players test multiple athletic attributes to the limit consistently—running, changing directions, jumping and banging, especially during a three-to-five-game-a-week schedule, unlike many other pro sports—they need "almost every system of training to be effective throughout a long, arduous season."

"There are different levels of training that should be done by an NBA player versus other athletes," Downs said. "They are arguably the most athletic athlete because of explosive power, and different aerobic and anaerobic fitness, and they need systems to be prepared for all of that. So there are times they need high intensity with high reps versus low intensity with low power reps."

Downs said he sees way too much improper training in the NBA nowadays, and a lot of it stems from too focused muscle-gain regimens such as CrossFit. He said maintaining build in strength programs is more critical. He's even heard of NBA wives getting their husbands into CrossFit, but explained the workouts are not designed for pro-level basketball players.

"It's great, quick 20 minutes of work—get in and get out—but it's risk of injury and the way it sets you up for them is tremendous," he said. "Studies have shown that CrossFit has its benefits, but not for the typical NBA guy. It causes too many imbalances, which in turn causes overcompensation issues. Then you put too many minutes on top of that, and a disaster waiting to happen."

Downs stressed that NBA players should not be going for the NFL tight end look, which has become a far too common trend. He made it clear there is only one LeBron in the league.

"There are a lot of skinny dudes that are bad as hell on the court, built for endurance and speed versus a big tight end," he said. "And to clarify the tight end comparison, LeBron James does not count. I don't know where the hell he came from, but he is a freak of nature if there has ever been one. I think his ancestors lived on Mount Olympus. Within minutes, he adapts to advanced functional movement balance exercises that a Cirque du Soleil performer would find challenging."

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Besides James' unique biological makeup, there is an underrated element of his training that more players can follow: his detailed stretching and recovery routines for maintenance.

He goes through a half hour of stretching before every workout, and every minute pregame and postgame, he's doing something with a purpose to peak just for the start of the game or to prepare for the next one, respectively. Then on off days, he has an entire recovery process with hyperbaric chambers. He pours in hours focusing not even on lifting or drilling—just on maintenance.

Post-playing recovery speaks to a larger issue, according to Dr. Clark, who is a leading member of the Suns' highly praised training staff. He said it's an important, overlooked area that could help players not only play longer minutes, but also remain healthier throughout the season.

"Everybody could do a much better job on recovery, and recovery is your nutrition," he said. "When you're done with practice or a game or training, you have a 30-minute window opportunity where you can take a sports protein shake. Your body can recover nutritionally very, very quickly, but most athletes don't like that. They just want to get out, practice, shower up and get out of there.

"Also, a lot of guys don't hydrate themselves enough after practice, training or a game. Once you start to become dehydrated, that affects your tissue, flexibility, it affects your recovery, all that stuff. A lot of guys don't go through and re-lengthen their muscles that just got short by either training, practice or the game, so they don't stretch. While a lot of guys are pretty good about icing their knees—getting into the cryotub, sauna, whatever—most guys do not do enough flexibility and tissue laceration at the end of the session."

No matter what, as Downs and Lancaster made sure to address, no type of training can duplicate real-time game action and unexpected movements. Therefore, occasionally injuries are bound to happen, and fans need to face that reality.

"It's difficult to simulate the exact torque and explosiveness in training; the game is too far separated," Lancaster said. "Sweating through hard work and actually simulating the game can be very different beasts—the speed, the reactions, the unexpected and isolated bumps. Getting your hips and shoulders to game realistic levels are tough to simulate in training, and even in offseason game play."

Overall, better precautions can be taken: more sufficient training, not rushing back from injury, increased research on trainers and better collaboration between team doctors and individual trainers, so the players' medical histories are always factored into workout planning. Downs and Lancaster also pointed to sitting out one to two games per week for older players, if necessary, to improve their longevity. Both trainers called the protective rest "the new strategy" in the league, which the Spurs and Heat have made popular recently.

"That's why you see how the Heat are being smart sitting D-Wade at times for his body, to build it throughout the season versus the first 10 games," Downs said.

While some fans might be turned off to the idea of Wade playing one night and then sitting the next, his stats (20.0 points, 5.0 assists, 4.8 rebounds and 2.1 steals per game while shooting a career-high 54.7 percent from the field), and the Heat's record (22-7), tell a story of where the Heat want to be—and will likely be—at the end of April entering the playoffs. by then, they should still be the team to beat.  

Jared Zwerling covers the NBA for Bleacher Report. Follow him on Twitter and Instagram.


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