The Oklahoma City Thunder guard has carried his team on his shoulders during a record-breaking season. But is such excellence sustainable?

Russell Westbrook doesn’t breathe; he takes air hostage. While such lines have been in the past reserved for Hunter Pence signs or Chuck Norris jokes, Westbrook has displayed such sangfroid for Oklahoma City Thunder that he has become a serious contender for the NBA’s MVP award. He might also have become the most interesting man in basketball.

Perhaps more appropriately, Westbrook takes the ball hostage, playing the game with the heat of a thousand suns. This fury has driven him to break the NBA record for triple-doubles in a season. But in the NBA, over-exertion of stars has become a significant concern. Like other high-energy players – Derrick Rose of the Knicks or Dennis Schroder of the Hawks – Westbrook never seems to coast, playing exclusively at full speed, at least on offense.

But does playing basketball at a relentless intensity lead to injury? Westbrook has had three knee surgeries, something that the Thunder surely factor into determining how they manage his minutes.

Russell Westbrook has played one of the NBA's all-time great seasons Read more

Acknowledging he has observed but never met Westbrook, Lachlan Penfold, the former director of physical performance and sports medicine for the Golden State Warriors, believes that Westbrook might just be different. “What you do have are ‘physical wonders’– athletes that seem to have the physical ability to continually play at a high level for a long period of time, without suffering major injury or physical degradation.”

For Penfold, the concern is sustainability, especially later in a career. “As his body stops being able to recover as well, is he able to modify how often he plays at that intensity – either within a game, or also which games he goes hard?”

“What may undo him are the mental and emotional factors, both his ability to control that fierce competitiveness as well as how much it burns him out mentally. There can be a reasonable toll on someone from a mental perspective. There is only so long you can carry a chip on your shoulder before it starts to weigh you down,” he says.

Information on a player’s speed and distance traveled is now readily available to teams and fans, thanks to the motion-tracking data collected by the SportVu cameras positioned in every NBA arena – and this makes a more granular analysis of the question possible.

SportVu data may help to decode how speed of play is related to injury risk. Gary Vitti, the now retired athletic trainer of the Los Angeles Lakers, quoted in an ESPN article on injuries in the NBA, had this to say on the topic: “From [SportVU cameras in every NBA arena], you have an average speed for every player in the league, so let’s see who’s getting hurt. Is it fast guys or is it slow guys? Because I think it’s fast guys. I think the slow guys don’t get hurt much. That would be a key piece of information for us.”

“He [Westbrook] is pretty intense, a machine,” says Erwin Valencia, director of training and conditioning for the New York Knicks. Westbrook not only plays at a high intensity but figures into a very high percentage of the Thunder’s possessions, something analytics experts calls usage rate. Westbrook leads the Thunder this season with a usage rate of 41.7%, the highest in the history of the NBA (Westbrook’s 2014-15 season is third on the all-time list).

For NBA sports medicine experts, injuries can’t simply be attributed to the ‘injury bug’, random events that strike players down without rhyme or reason. Some believe that to prevent injury, you must first predict them. That was the principle of an article presented at last year’s Sloan Sports Analytics Conference, an annual gathering of sports science and analytics experts. The researchers, a group of analytics experts from outside the NBA, used machine learning to analyze injuries from the 2014 and 2015 seasons and attempted to determine the factors behind them.

Perhaps most significantly were the factors that did not seem to contribute to injuries, such as the number of back-to-back games and the number of games played during the two weeks used in the paper’s model. This would appear to refute those that have pushed for fewer back-to-back games as a means to reduce injuries in the NBA.

The factors that the researchers found most relevant to injury risk were: the average speed at which a player ran during games; the total number of games played in a career; the average distance covered by a player; the average number of minutes played; and the average number of field goals attempted. The article concludes: “These findings support the hypothesis that individual workload and playing style can place additional strain on a player’s body.”

For players with a high-speed playing style, like Westbrook, this calculation may point to a higher risk of injury. All of his relevant numbers are among the highest in the NBA: an average speed of 4.08mph, 81 games played (only six more NBA players played every game this season); 34.8 minutes per game (18th in the NBA); 2.36 miles covered per game (27th in the NBA); 24 field goal attempts per game (most in the NBA).

The study concludes that resting the 20% of players above a certain risk threshold could prevent 60% of injuries in the NBA. Because minutes played is one of few factors highlighted that coaches can control – it’s harder to change field goal attempts or someone’s average speed – the study recommends that coaches lower injury risk by decreasing the number of minutes played instead of resting players for entire games late in the season.

Balancing intensity with proper recovery is also important. “However, if Westbrook is able to look after himself well through his health, diet, lifestyle then it will be fascinating to see how long he can ‘maintain the rage’,” says Penfold, “what you also find is that players develop a fitness capacity over each season, so that the effort required to get through a season becomes less and less as they become accustomed to the physical demands needed and their body develops both an adaptation and resilience to these stresses.”

“If a player wants to sustain a high intensity over the season the key is incorporating recovery,” says Valencia of the New York Knicks. “Since you can’t, and don’t want to, control intensity during games, a team has to reduce individual and work at practices and pre-games.” According to Valencia, this taper of minutes and volume is planned out early in the season and is not random.

Inevitably, players will reach a point in time when the demands become harder and harder to recover from. “That will be the interesting point for him,” says Penfold, “will he listen to his body [and team advisers] about recovery, rest, etc, or will he keep raging into the night?”

The future of Westbrook and Thunder could hinge on the answer.