Could the recent surge in NBA injuries be attributed to what players in the league did when they were kids?
A report published by ESPN last week points to that conclusion.
In a two-part series, ESPN's Baxter Holmes examines injuries in the NBA and he reports that youth basketball is a major factor. Despite the fact that basketball is now the most popular youth team sport in this country, it has largely escaped the scrutiny baseball has endured when it comes to overuse injuries. As an orthopedic surgeon, I can tell you this look at the potential damage on elite basketball players is long overdue.
The report cites data from athletic trainer Jeff Stotts and his NBA injury database. In the 2017-18 season, NBA players missed more than 5,000 games due to injury or illness, the first time it has reached that mark since the end of the injured reserve in 2005.
Perhaps worse, the past four NBA seasons have had the highest numbers of games missed by players in their first two seasons in the league ever. NBA Commissioner Adam Silver told ESPN injuries are “the highest priority for the league.” Health and well-being aren’t just issues for the NBA, Silver believes, but for the millions of kids who play in the U.S. and the rest of the world.
The problem seems to start long before players reach the pros. In the report, an official with the Nike EYBL circuit estimates that a kid who plays consistently from age 7 to 19 might play as many as 1,000 games in that span, equal to 12 NBA seasons.
Young basketball players and their parents and coaches see the huge salaries, the shoe deals and marketing opportunities — LeBron James, Steph Curry and Zion Williamson — and do whatever they can to get into the league. They join club teams at early ages to improve and get noticed by scouts. They only play basketball, play it year-round, and play in every elite tournament and all-star game they can.
These kids are becoming better players than ever under this system. But all of that play from specializing in basketball and playing it all year with no break over a decade sets them up to break down physically by the time they reach the NBA.
The ESPN report discusses the challenge of rising through the club circuit with Kobe Bryant, who has a daughter who plays. Bryant did not specialize in the sport until he was 15 or 16. But he worries about the potential long-term damage on his daughter from playing so much at a young age.
Likewise, the mother of this year’s No. 1 draft pick, Zion Williamson, expressed similar concerns for her son when he was 16. She limited him to four tournaments per summer.
The NBA and USA Basketball established guidelines for youth basketball to try to keep kids healthy. Much like those in youth baseball, these guidelines offer recommendations about game and practice length, number of games and hours per week. They also include the amount of rest a kid should have based on his or her age, and recommend avoiding playing only basketball until 14 years old.
We have to do something about this issue. A 2017 study in the American Journal of Sports Medicine (AJSM) found a clear relationship between kids specializing in one sport at an early age and a higher rate of injuries.
Likewise, another AJSM study found that NBA first-round draft picks who played multiple sports in high school experienced fewer injuries, played more games in the league and had longer careers than those who specialized.
Playing sports other than basketball will help get them to the NBA and keep them healthy enough to stay there.
The problem is that it won’t happen unless parents choose to take action. With no governing body overseeing and enforcing how much kids can play, coaches will convince them to play for their teams, play in every all-star game and elite tournament, all year, ever year.
Basketball has the same issue as youth baseball. Sure, Little League has pitch counts. But the bigger risk might be the number of innings a kid pitches throughout the year. But a coach of a spring team can’t dictate how much a kid throws on his summer team, or his fall or winter team. A young pitcher might abide by the pitch counts in each season but badly overuse his arm by pitching every season.
If we want to keep young basketball players healthy, now and in the future, kids need shorter practices, fewer games and tournaments played each season, and three or four consecutive months off each year to play other sports. Parents have to step up and take these steps because most youth coaches won’t. Otherwise they risk their kids becoming a statistic in Stotts’ database, assuming they even make the NBA.
Dr. Geier is an orthopedic surgeon in Charleston and author of “That’s Gotta Hurt: The Injuries That Changed Sports Forever.”