NBA teams rest players to prevent injury. Nine years of data says it didn't work.
Games missed to rest or load management rose 125% over nine NBA seasons while serious injuries rose 43% — and players who sat out for rest showed no significant reduction in subsequent injury risk.
Load management — the now-familiar practice of NBA teams resting healthy stars for games to protect them from injury — is built on a widely repeated premise: that missing games for rest reduces subsequent injury risk. A nine-season analysis published in Sports Medicine this month tested that premise directly against the league's own injury data, and did not find it held up [s1].
What the study measured
Researchers analyzed nine seasons of NBA play, from 2014-15 through 2022-23, using the league's own Injury and Illness Database — the standardized system NBA teams are required to use to report every game missed to injury, illness, rest, or load management [s1]. The analysis covered 1,233 player-seasons and more than 1.5 million player-minutes of game play [s1]. Researchers used statistical models — the Anderson-Gill modification of the Cox proportional hazards model for hazard ratios, and Poisson regression for injury rate ratios — adjusted for age, prior injury history, games already missed, and average minutes played [s1].
How the numbers moved over nine years
Across the study period, games missed specifically for rest, load management, or single-game absences rose 125%, an increase of 211 games [s1]. Over that same span, injuries serious enough to cause two or more consecutive missed games rose 43%, an increase of 61 injuries [s1]. Both trends moved upward together — the league rested players more, and serious injuries also became more frequent — which on its own doesn't prove one caused or failed to prevent the other, but sets up the more direct comparison the study was built to make.
The direct test: did resting actually lower injury risk?
Comparing players who missed games for rest or load management against those who didn't, the study found no significant difference in subsequent injury risk [s1]. Players who missed one to two games for rest showed a hazard ratio of 1.24 for subsequent injury (95% CI: 0.92–1.65) — numerically higher risk, though not statistically significant given the wide confidence interval [s1]. Those who missed three to five games showed a hazard ratio of 0.91 (95% CI: 0.39–1.80) [s1]. Those who missed six or more games showed a hazard ratio of 2.16 (95% CI: 0.53–5.78) [s1] — numerically more than double the risk, but again not statistically significant, since the confidence interval spans from well below 1 to well above it.
What "not significant" means here
None of the three hazard ratios reached statistical significance, meaning the study cannot say with confidence that resting either raised or lowered subsequent injury risk in any of these groupings [s1]. What the study can say is that the data did not show the protective effect load management is generally assumed to provide: the researchers' bottom-line conclusion is that NBA players who missed games for rest or load management did not have a decreased risk of subsequent injury in the same season [s1].
Why this matters beyond one study
Load management has reshaped how NBA teams manage star players' seasons and has drawn criticism from fans, broadcasters, and the league office over its effect on game quality and ticket value — criticism teams have generally defended by pointing to player health and longevity. This study doesn't settle whether load management serves some other legitimate purpose, such as managing cumulative season-long fatigue or extending a player's career length beyond the single-season injury window this analysis measured. What it directly challenges is the specific, commonly stated justification that resting a player for a game measurably lowers their risk of getting hurt in the games that follow — a claim the league's own nine years of injury data, by this analysis, did not support [s1].
What the study doesn't establish
The study's authors note a specific limitation themselves: their analysis didn't incorporate training or internal load data — measures like practice intensity, travel schedule, or minutes accumulated across a season — that could meaningfully affect injury risk independent of whether a player sat out a given game [s1]. They explicitly call for further research incorporating those factors [s1]. The wide confidence intervals on several of the reported hazard ratios also mean the study has limited statistical power to detect smaller effects that might exist but weren't large enough for this sample to confirm with confidence.
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