This NBA season has see-sawed between crisis and celebration. Victor Wembanyama dropped 40 on opening night but then strained his calf and missed 14 games. Giannis Antetokounmpo got hurt. Then, it seemed like everyone got hurt. Christmas Day viewership hit a 15-year high. Four days later, MVP frontrunner Nikola Jokic hyperextended his knee and missed 16 games.
There are multiple theories as to what’s causing these injuries: the pace of play, the 82-game schedule, constant switching on defense, load management, and the proliferation of the three-point shot. But what are NBA stars—and their trainers— doing to prevent them? Several high-profile trainers and doctors gave Complex a glimpse into how NBA fitness has evolved in recent years.
(According to the NBA’s player participation policy (PPP), a “star player” is defined as someone who has been an All-Star or on an All-NBA team in any of the previous three seasons.)
Athletic Gaines sports performance coach James Mayhew—Draymond Green’s trainer since 2020—tailors his training program around his belief that the faster pace of play is responsible for the bulk of soft tissue injuries.
“When you're driving faster on the road, accidents are going to be more catastrophic than when you're driving slow,” Mayhew tells Complex.
According to NBA.com’s Second Spectrum data, from January 1 to February 1 of this year, NBA teams ran an average of 4.27 miles per hour in each game compared to 4.22 miles per hour in 2016 during that same time period.
A commuter might walk .05 mph faster to get to work on time and not notice it. But when, say, Anthony Edwards barrels down the lane .05 mph faster before drastically shifting his weight to one leg to execute a Eurostep, it impacts his body differently. “The brakes on a Ferrari have to be way better than the brakes on a Toyota Prius,” Mayhew says. “Because when you’re going 115 mph, and need to [turn] the corner, those brakes need to be really, really good or else that car is going to go out of control.”
Mayhew endorses deceleration exercises such as depth drops, where a player lands softly from an elevated platform with their knees bent and hips back—this gets their muscles and tendons accustomed to jumping and landing while keeping the kinetic chain in alignment to prevent injury. Even though Draymond Green has a history of foot injuries, the 35-year-old has played in 82.4% of Warriors games this season.
“Most of the time, injuries do not happen on acceleration,” Mayhew says. “They're happening when guys are trying to slow down, when they're landing, and when they plant. So, making sure guys are aligned, in terms of hip, knee, ankle, all in one line, is a huge component in sports performance training.”
“Alignment” refers to what is known as a player’s “kinetic chain.” Dr. Jason Snibbe, a board-certified orthopedic surgeon with over 20 years of experience and a former medical consultant for the Los Angeles Lakers and L.A. Clippers, explains the kinetic chain as an interconnected system of joints, muscles, and body parts working in unison to produce movement. A simple pull-up jumpshot is actually a force on the player’s feet as he plants that goes through his knees, then through his hips, through his back, and his arms to propel him up in the air to shoot. If one link in the chain is weak or damaged, the entire system can go haywire.
“We don't just say, ‘Oh, he has a knee injury, let's just get the muscles around the knee stronger.’ We look at the whole body,” Dr. Snibbe tells Complex. “For example, let's say an athlete has very stiff hips. If you have stiff hips, you actually have a much higher incidence of ACL injury or a meniscus injury because your hips don't move normally and you stress out your knee.”
According to data compiled by Complex from Basketball Reference and FOX Sports’ injury database, 96.2% of all missed games by star players as of February 6 were due to injuries to lower body areas such as the groin, knee, Achilles, calf, and ankle.
With that data in hand, Mayhew puts Green through corrective exercises that focus on thoracic spine mobility, hip mobility, and knee and ankle alignment, movements that will fortify the “kinetic chain.” He also prepares Green to adapt to the faster game. During training sessions, the four-time NBA champ performs sprint-to-stop exercises, where he runs at full speed before coming to a complete stop, and lateral bounds, which involves Green explosively pushing off one leg and landing on the opposite leg while moving laterally.
NBA stars are also training smarter, microtargeting areas through shorter, more precise workouts. “To prevent njuries [means] shortening our training sessions and simplification,” Chris Johnson, founder of JusHoop, explains to Complex. “We can’t do everything. If you’re a professional, we should know exactly that one improvement area and then build the house around it.”
Johnson has over 20 years of experience training elite NBA talent from legends like LeBron James and Dwyane Wade to next-generation stars Tyrese Maxey and Darius Garland. Last year, he spent five months with Atlanta Hawks rising star Jalen Johnson as he recovered from a torn labrum in his left, non-shooting, shoulder.
Before they got started, Chris consulted with Jalen’s physical therapists, the Hawks’ medical team, and other close confidants to plot his road to recovery.
With Jalen not cleared for full-body contact training, Chris developed a training regimen that treated Jalen’s recovery limitations as focus areas. On days Jalen could only use his left hand, they focused training sessions on ballhandling. Some days, he couldn’t use his right hand at all, so Chris prioritized 20 minutes of focused repetition on passing. More than anything, they cut back on the length of these sessions.
So far, the program is working. After averaging just 54 games per season over the last three seasons, Johnson has been one of the Hawks’ most durable players, missing just six of the team’s first 60 games. He also secured his first All-Star selection and shattered the team’s record for triple doubles in a season.
The conventional wisdom around strength training has also changed over the years. It’s plausible to think players are focusing on powerlifting when Giannis Antetokounmpo is bulldozing grown men, and LeBron James is deadlifting at 41. But, Dr. Snibbe believes lifting heavy weights leads to injuries. Most NBA players now aim for higher reps with lighter weights to develop muscle tone and strength. They’re also prioritizing flexibility as a tool for injury prevention, which is why LeBron mixes in yoga with his wife when he’s not doing weighted squats.
“I have seen a lot more pilates and yoga implemented,” says Travelle Gaines, a sports performance coach and the founder of Athletic Gaines. “There's also been more emphasis on recovery, sleep, and hydration.”
Before injuries forced him to miss most of this season, few players were as durable as Trae Young. Over his first seven seasons in the NBA, Young played in 88% of the Hawks’ games, including a 76-game campaign in 2024-25. Gaines, who has been training Young since the point guard’s high school years, notices the changes in Young’s body throughout the season and updates their training program accordingly. Young is only 27 years old but has been playing competitive hoops for nearly all of them. That adds up. Now warm ups go longer and there’s more attention to recovery.
Young and Gaines are not alone; trainers claim the ratio between training and recovery has shifted in recent years from 90/10 to 70/30. NBA stars also often wear health technology devices such as a lower back massager on the bench to squeeze out as much recovery time as possible. In addition, players are returning quicker from injuries thanks to advancements in surgical procedures.
So, can NBA trainers put an end to the league’s injury crisis? That would mean there was a crisis to begin with.
Even with star players missing 30.68% of available games due to physical injuries as of February 6, according to data compiled by Complex, Gaines doesn’t consider this a crisis. After all, injuries have always been part of the game, and, as Gaines points out, the league's best are taking better care of their bodies to the point where they are extending their primes.
“A lot of the prominent players are now getting older,” Gaines says, “and the older you get, the more susceptible your body becomes to injury.”