The NBA’s $525 million injury epidemic

LOS ANGELES - Golden State Warriors Coach Steve Kerr sparked a moment of introspection for the NBA last month when he said his team’s medical staff believed modern basketball’s fast pace and heavy mileage were contributing to a rash of injuries. After bemoaning the lack of practice and recovery time, Kerr demurred when asked whether he thought the league would consider shortening its 82-game schedule in an attempt to protect player health.

“The tricky part is all the constituents would have to agree to take less revenue,” Kerr said. “In 2025, in America, good luck in any industry. … That’s not happening.”

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Kerr’s doubt was well founded, because the NBA’s business is booming: Commissioner Adam Silver recently struck new media rights deals worth $76 billion over 11 years, the league’s 30 teams combined to generate a record $12.25 billion in revenue last season, and a record 16 players will earn at least $50 million in salary this season.

But as the NBA’s top-line financial metrics continue to increase, so, too, do the skyrocketing costs associated with lost productivity for injured stars. Remarkably, if early trends hold, the NBA’s 30 highest-paid players, according to salary data compiled by ESPN, could combine to cost their teams more than $525 million in empty salary associated with games they do not play this season.

Stephen Curry (who will earn $59.6 million) is sidelined with a quadriceps injury. Joel Embiid ($55.2 million) has missed more games than he has played because of recurring knee problems, Kawhi Leonard ($50 million) has already missed 10 games because of a foot injury, and Bradley Beal ($53.7 million including a contract buyout) played only six games before suffering a season-ending hip injury. LeBron James ($52.6 million) and Anthony Davis ($54.1 million) missed the first four weeks of the season because of injury, and Giannis Antetokounmpo ($54.1 million) and Ja Morant ($39.4 million) are out with muscle strains.

Jayson Tatum, Damian Lillard, Tyrese Haliburton and Kyrie Irving are on the books for $204.4 million combined but have yet to play because of major injuries suffered last season. During one recent loss, the New Orleans Pelicans took the court without their five highest-paid players, who will combine to earn more than $140 million.

Many of those absences have directly led to trouble in the standings. Haliburton’s Indiana Pacers, who reached the NBA Finals in June, have dropped to 14th in the Eastern Conference. Antetokounmpo’s Milwaukee Bucks are at risk of missing the playoffs for the first time since 2015-16 and must pay Lillard $113 million over the next five seasons after waiving him using the league’s stretch provision. And the Los Angeles Clippers, wobbly with Leonard and Beal missing time, are on track for their first losing season since 2010-11.

“When you lose your best player and a top-10 player when he’s on the floor, it’s hard to make up for that,” Clippers Coach Tyronn Lue said last week. “I know a lot of people say ‘next man up,’ but if [Leonard] is making [$50] million and your next man up is making $400,000, it’s not really the same.”

In two notable cases, star injuries have already contributed to major personnel changes. Without Davis and Irving, the Dallas Mavericks struggled out of the gate and fired general manager Nico Harrison less than a month into the season. And well before Zion Williamson’s latest injury, a hip strain that will keep him out for weeks, the Pelicans had crashed into the Western Conference’s basement and fired Willie Green after he coached just 12 games.

“We have a lot of guys that are in street clothes,” Mavericks Coach Jason Kidd said shortly after Harrison’s firing. “We’ve got over, I think, $100 million sitting on the sideline.”

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More injuries, more problems

The rise in star injuries goes well beyond this season’s most extreme examples of the Pacers, Clippers, Mavericks and Pelicans.

Flash back one decade: During the 2015-16 season, NBA teams averaged 102.7 points, 24.1 three-point attempts and 95.8 possessions per game. That year, the league’s 30 highest-paid players combined to miss just 14 percent of their teams’ games.

This season, teams entered Wednesday averaging 116.6 points, 36.9 three-point attempts and 100 possessions per game. The league’s highest-paid players have combined to miss 35 percent of their teams’ games. A faster, higher-scoring and more rigorous sport appears to be taxing players like never before.

John DiFiori, the NBA’s director of sports medicine, said the league views the 2019-20 season as an “inflection point” for star injuries. During the four seasons before that campaign, which was interrupted by the coronavirus pandemic, the NBA’s 30 highest-paid players missed between 14 and 20 percent of their teams’ games. Since 2019-20, that number has jumped, ranging from 24 percent to 35 percent. The missed games rate has remained elevated in the years after the NBA stopped requiring players to sit out if they tested positive for the coronavirus.

“Injury rates are going up,” DiFiori said. “When we look back at what we’ve been doing the last 10 or 12 years, it’s a moving target. The game doesn’t stay the same. We’re trying to reduce injuries, and the game is also changing. All these other factors, the pace of play and what players are doing in training, those are all moving targets. To wrap our arms around that is a challenge. It’s something we’re quite focused on. … [Teams are] spending a lot of time and money and bringing in a lot of expertise. Despite all of that, we’re seeing an increase in injuries. It’s not for teams’ lack of focus on it.”

The NBA instituted the Player Participation Policy (PPP) before the 2023-24 season to address what it calls “a statistically significant increase” in star absences and to curb “load management,” a strategy used by some teams to rest players throughout the season. With the NBA negotiating new media rights deals and debuting the NBA Cup in-season tournament to spark interest, then-league executive Joe Dumars met with all 30 teams to remind them that the NBA is an “82-game league.” To reinforce that message, the PPP mandated that players appear in at least 65 games to be eligible for end-of-season awards, and the league began fining teams if they rested healthy players for nationally televised games.

The PPP enjoyed some initial success: The 30 highest-paid players missed just 24 percent of games in 2023-24, the league’s best mark since the pandemic. That progress proved short-lived, however; the availability of the NBA’s highest-paid players has regressed noticeably over the past three seasons. During the 2025 playoffs, Tatum, Lillard and Haliburton all suffered season-ending Achilles tendon injuries during a span of less than two months.

Muscle strains have been another point of immediate concern. The Mavericks shocked the basketball world by trading franchise player Luka Doncic last season while he was recovering from a calf strain; Antetokounmpo, Davis, Morant and Victor Wembanyama are among the stars who have been sidelined by the same injury this season. Haliburton was still recovering from a calf strain when he tore his Achilles during Game 7 of the NBA Finals, but the NBA’s medical staff has yet to identify clear evidence that suggests a prior calf injury increases the risk of an Achilles tear.

“When you have a small prevalence of injury, it’s hard to scientifically study that,” DiFiori said. “Typically over the last 15 years, we average about two Achilles tendon injuries per year. Last year, we had seven. That’s a lot. One year prior, also with a high pace of play, we had zero. We’re taking it very seriously. We’re concerned about it, but I don’t think we have our finger on what’s the driver here or what factors may have led to last season’s unusually high number.”

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More injuries, more money

Kerr is hardly the only voice in the basketball and medical communities raising the alarm about the increase in injuries. A range of theories abound.

The NBA cut its preseason to three weeks in 2017, reducing the amount of time players have to ramp up for game action to spread out the regular season more evenly and eliminate instances of four games in five nights. The league changed its shot clock reset to 14 seconds and emphasized greater freedom of movement for players to encourage faster and less restrictive play in 2018. The pandemic created calendar disruptions and shortened schedules in 2020-21 and 2021-22, and the NBA has tweaked its regular season schedule in each of the past three seasons to accommodate the NBA Cup in November and December.

Aside from those legislative moves and the possibility of unintended consequences, the use of analytics has swept through the league and transformed the sport into a perimeter-dominated endeavor. Playing at a fast pace and shooting a high volume of three-pointers are now generally viewed as optimal strategies for underdogs hoping to increase variance against more talented opponents.

The Pacers’ unexpected Finals run, driven by a breakneck offense and high-pressure defense, has spawned copycats. The results haven’t always been positive: The Portland Trail Blazers made waves by regularly deploying a full-court press to start the season, only to endure injuries to their guards in recent weeks.

It’s also worth noting that a cohort of superstars such as Curry and James has remained highly productive late into their lengthy careers. While these older players have remained among the league’s biggest earners, their durability has tended to decrease as they proceed through their late 30s.

On the flip side, a younger generation of high draft picks - such as Williamson, Morant, LaMelo Ball and Ben Simmons - has encountered recurring injuries before they reach their late 20s, which have typically been viewed as the prime years for basketball players. NBA executives have long expressed serious concerns that the modern generation of players is arriving to the NBA with preexisting injuries or risks that result from playing too many games at the youth level and specializing in only one sport.

As the NBA and its fans continue to debate possible solutions, the injury epidemic has reached staggering heights when it comes to lost productivity. Back in 2015-16, the 30 highest-paid players combined to earn roughly $560 million. Because those players only combined to miss 14 percent of their teams’ games, their teams combined to pay roughly $79 million in empty salary.

Last year, the empty salary mark reached more than $352 million. This season, with the 30 highest-paid players combining to earn more than $1.49 billion and missing 35 percent of their teams’ games entering Wednesday, the number is on pace to exceed $525 million.

That would easily set a record for lost productivity. As Lue and Kidd might say, NBA teams could soon have a half-billion dollars sitting on the sideline.

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