Epidemiology and injury trends in the NBA

Epidemiology and injury trends in the NBA

22/02/2022 By: Víctor Escamilla Home

We review a recent article from the group of Lorena Torres-Ronda and José Fernández published in Plos One (2022), which analyzes the epidemiology and injury trends in the NBA, previous and during the Covid-19 pandemic.

The aim this study (Torres-Ronda et al. 2022) was to provide an epidemiological injury analysis of the National Basketball Association (NBA), detailing aspects such as frequency rate, characteristics and impact on performance (missed games), including COVID-19 related and non-related injuries.

The authors highlighted the importance of knowing and controlling the injuries that were analyzed and categorized as follows:

  1. bone related (bonestress, bone-fracture, bone-dislocation);
  2. tendon/ligament related (general soreness, sprain, tendinopathy, anterior cruciate ligament (ACL), other meniscus, tendon/ligament-bursitis, tear, tendinitis, ligament damage, medial collateral ligament (MCL), tendinosis, impingement, subluxation);
  3. muscle related (strain, general soreness, tear, tightness, inflammation, pain, muscle-stress);
  4. load related (management, load-stress related);
  5. and others (bursitis, dislocation, disruption, edema, effusion, fasciitis, impingement, inflammation, laceration, medical, muscle strain, nerve irritation/damage, neuropathy, NSBP, procedure, subluxation).

There is a growing concern about injury incidence and performance decrement in the NBA, as a result of the high density of games in the season (Teramoto al. 2017). With the advent of COVID-19, the league had to add modifications to the 2020–21 season schedule, resulting in an increase of game density again. For this reason, the authors wanted to analyze the incidence of injuries since the COVID-19 pandemic to understand how it affected the 2020 season.

The greatest quantity of injuries and missed games due to injury occurred from mid-season to the end of the regular season, in absolute numbers, there is a significant difference between the year 2020/21 for the missed games due to injury and the other years (Figure 1).

Figure 1. Missed games due to injury (MG) for the years of study.

When injuries occur in early stages of the season, Teramoto et al. (2017) in their study, showed that, players had long periods of off-season, could explain the results. However, for post mid-season and end of the RS injuries could be explained by other causes, such as fatigue accumulation (physical and mental), the accumulation of sleep deprivation (related to lack of recovery), or perhaps lack of competitive goals, for those teams reaching the end of the season without possibilities of making the playoffs. Moreover, playoff teams could be tapering key players for the playoffs, overloading players with less average minutes played per game, triggering load spikes. A progression of loads during season preparation, effective training programs, managing recovery strategies during season, specially facing the end of regular season, will be paramount if the goal is to decrease injury risk.

The unique injuries by type of injury showed that although there is no difference between the years for total injuries and injury type, load control-dependent injuries increased in the final minutes of matches during the 2020/21 season. The unique injuries by type of injury are shown in figure two (Figure 2). All of them (bone, muscle and tendon injuries) can be monitored by using infrared thermography. In addition, thermography can help prevent injuries related to training load control.

Figure 2. Number of players with unique injuries by type of injury

Despite there has been an increment of unique injuries and missed games through the period analyzed in the current study, the idiosyncrasies of the epidemiology and incidence of injuries varies between franchises.

The most important reflexion in this analysis, in our opinion, is to observe which injuries present higher
ratios for a given franchise and thus be able to carry out a critical analysis of the injury prevention and rehabilitation programs in that particular team.

Advancing towards a better understanding of the injury landscape in the NBA will help in developing not only prevention programs at a local scale (i.e., teams, franchises) but also global injury prevention initiatives through league wide regulations, as well as to reduce the economic impact, for franchises and broadcasters, when players miss games due to injuries.

ThermoHuman could help the franchises in this purpose to monitor the most frequent injuries that we find in NBA players to improve the epidemiology in the NBA. As Richard Williams explains in his podcast, the main efforts in this great league should go to methodologies such as thermography that help in the purpose of injury prevention rather than recovery. Figure 3 shows the specific protocols that ThermoHuman has developed to control these regions.

Figure 3. ThermoHuman has specific protocols for the most serious basketball injuries


Teramoto, M., Cross, C. L., Cushman, D. M., Maak, T. G., Petron, D. J., & Willick, S. E. (2017). Game injuries in relation to game schedules in the National Basketball Association. Journal of science and medicine in sport20(3), 230-235.

Torres-Ronda, L., Gámez, I., Robertson, S., & Fernandez, J. (2022). Epidemiology and injury trends in the National Basketball Association: Pre-and per-COVID-19 (2017–2021). PLoS one17(2), e0263354.

If you have any questions or would like to make a comment, do not hesitate to write to us. We will be glad to read you.

Europa Thermohuman ThermoHuman has had the support of the Funds of the European Union and the Community of Madrid through the Operational Programme on Youth Employment. Likewise, ThermoHuman within the framework of the Export Initiation Program of ICEX NEXT, had the support of ICEX and the co-financing of the European Regional Development Fund (ERDF).

CDTI Thermohuman has received funding from the Centre for the Development of Industrial Technology (CDTI), in participation with the European Regional Development Fund (ERDF), for the R+D activities involved in creating a new tool, based on thermography, for the prediction and prevention of rheumatoid arthritis. See project detail.