By: Dr. Nirav Pandya 
Assistant Professor, Orthopedic Surgery, UCSF 
Twitter: @drniravpandya

“Load Management.”  It has become part of our everyday vocabulary, and synonymous with players such as Kawhi Leonard.  Many players of past generations scoff at this concept.  Although many of us have a general idea of what this means, it’s important for us to understand the data behind load management, and how it may impact the upcoming season.  Will this change how much James Wiseman plays?  Will they rest Steph to preserve him for a late playoff run?  Will players who end up missing time due to COVID protocols be slowly worked back in?

In essence, load management is the process by which teams will attempt to control the stress to a player’s body with the end goal of improving performance and minimizing injury.   Popularized by Gregg Popovich, the desired result is to prevent chronic fatigue which can negatively impact performance.  A team’s medical staff, along with management and ownership, will look at hundreds of variables as part of this determination.  

Although it may seem that there is great data to guide teams in this process, the research is actually quite conflicting.  Looking at three years of NBA data, Melanie Lewis in the Journal of Athletic Training found that injury risk was actually associated with greater degrees of fatigue, game load, years in the league, and being shorter (!) than average.  If you look specifically at performance rather than injury, a ten-year study of NBA data in the Orthopedic Journal of Sports Medicine found that players who rested more during the regular season did not actually have improved playoff performance.   So, what does this mean?  Teams can potentially decrease injury risk in older players and/or those coming off injuries by managing the amount they play, but this doesn’t necessarily improve their performance

Where some of the most compelling data in terms of load management lies is not in what we typically think of as “load.”  Sleep and travel have a HUGE impact on performance and injury risk.   Air travel affects oxygen levels, hydration, nutrition, sleep quality, and recovery time for athletes.  When traveling more than two time zones, it can take up to 72 hours for the body to recover.  This is a huge competitive advantage for home teams.  In The Journal of Sleep Research, the authors found that major professional sports teams that traveled both westward and across multiple time zones were more likely to lose.  This is further exemplified by another study in The Journal of Science and Medicine in Sport that showed that NBA players were more likely to get injured playing away from home (i.e. traveling). Injury was not associated with playing in back-to-back games,  or four games in five nights. 

At the end of day, what does this all mean for Dub Nation?  It means that playing a lot of games and/or minutes will likely play a small role in injury risk and/or performance for younger, healthy players.  Those who might be coming off an injury, older, or perhaps off COVID protocols (think Draymond) might need to ease in a bit more.  More importantly, those long flights across the country to the East Coast are the greatest set up for injury.  That’s the time that you might see our key players (think Steph) taking a break.  Being on the cutting edge of science, can give our 2020 – 2021 Warriors the advantage they need.