Damian Lillard #0 and Giannis Antetokounmpo [608x342]
Damian Lillard #0 and Giannis Antetokounmpo [608x342] (Credit: Stacy Revere/Getty Images)

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Injuries were a key storyline during Sunday's NBA playoff action. When Damian Lillard joined Milwaukee Bucks teammate Giannis Antetokounmpo on the sideline for Milwaukee's Game 4 loss due to an Achilles strain suffered Friday, he became the fourth 2024 All-Star to miss a game in the first round of the playoffs.

LA Clippers Kawhi Leonard forward missed Game 1 of his team's series against the Dallas Mavericks, and his availability for the rest of the series is now in question after he was ruled out ahead of Sunday's Game 4 in Dallas, which the Clippers won.

The NBA has been focused all season on getting stars on the court as much as possible to fight the stigma created by players and teams embracing load management. That worked well in the first half of the season, when All-Stars played far more than they have in recent campaigns. But injuries have mounted over the course of the schedule, shaping the postseason picture.

Although the Bucks have been hit harder than any playoff team, going this entire series without Giannis, they're not alone. The four injured All-Stars don't include the Miami Heat's Jimmy Butler and New Orleans Pelicans' Zion Williamson. Butler and Williamson are key contributors for their teams, who have gone a combined 1-5 in their series.

Let's look at how this year's playoff injuries compare to past years and what they mean looking forward to the remainder of the bracket.

Playoff injuries remain high

We're three years removed from blowing away the record for most All-Stars to miss a game due to injury or illness during the playoffs with 10 in 2021. That year's playoffs followed a compressed regular season that began in late December, barely more than two months after the bubble conclusion of the COVID-19 pandemic-interrupted 2019-20 schedule.

Before 2021, no more than six All-Stars missed games due to injury or illness in that year's playoffs. The NBA again surpassed that total with eight in 2022 before dropping back down to five last season.

It's early, but 2024 is on a troubling pace for playoff injuries. The four All-Stars who have already missed games match the third-highest total in the first round, trailing 2013 and 2022 (six apiece). And the 11 games those All-Stars have collectively missed are only one game shy of the total for the entire 2023 playoffs. With New York Knicks forward Julius Randle out for the season following shoulder surgery, we're guaranteed to surpass that figure.

Playoff star injuries were once relatively rare. Through the 1980s and 1990s, an average of 1.5 All-Stars per year missed games during that season's playoffs due to injury or illness. That mark doubled to around three per year in the 2000s and 2010s before doubling again to more than six per year in the 2020s.

It's not just stars, as I noted when writing about playoff injuries back in 2021. By any measure, they're way up in the past decade at the same time NBA teams have begun to think more proactively about managing the games or minutes played by their best players.

Stars played more in first half, not in second half

The NBA has taken credit for its steps to encourage stars to play more regular-season games via the "player participation policy" limiting the scenarios under which qualifying recent All-Stars can rest, as well as adding a 65-game minimum for major individual awards.

"We talked a fair amount about the new player participation policy this year, which has been discussed a lot throughout the year, the 65-game threshold for being eligible for certain awards," NBA commissioner Adam Silver said following the league's board of governors meetings earlier this month. "I think the view in the room was that it's working. In fact, there was a presentation on star player participation this year, and in fact, games missed by star players was down roughly 15 percent in the regular season this year."

Looking at the group of players who qualified for the player participation policy -- anyone named All-Star or All-NBA within the past three seasons, including this year's new All-Stars -- they missed an average of 16 games this year due to injury, non-COVID illness, load management or rest. In 2022-23, a group identified the same way missed an average of 18.4 games, meaning a 13% decline -- in the same ballpark as Silver cited.

However, as Tom Haberstroh of Yahoo Sports noted, this reduction came entirely in the first half of the schedule. Qualifying players missed fewer than 11% of their teams' games due to injury, non-COVID illness, injury management or rest in October or November, a dramatic improvement from the 20% they missed in this portion of the 2022-23 schedule. By this March and April, the rate of games missed by stars had ballooned to 29% -- even higher than the same period in 2023, when it was just 26%.

Stars also logging heavy minutes

After playing more during the regular season, stars are again being asked to do more so far in the playoffs. An incredible 14 players have averaged at least 40 minutes per game in the playoffs, including Lillard, who edged over that mark by virtue of Milwaukee's Game 3 overtime loss in Indiana.

In last year's first round, just four players topped 40 MPG. One of them was Leonard, who played the first two games of the Clippers' first-round loss to the Phoenix Suns before suffering a meniscus tear that required season-ending surgery. In 2022, far more players -- 11 -- averaged 40 MPG in their first series. Still, you have to go back to 2013-14 to find the last time this many players saw 40 MPG of action during the opening round.

The good news in terms of wear and tear is the possibility of short series. Ahead of Monday's night final two Game 4 matchups, just two series -- Cleveland-Orlando and Dallas-LA Clippers -- are tied 2-2, guaranteeing at least six games. With a win Monday, the Boston Celtics can join two other teams with a chance to close out in Game 5 at home, while the Oklahoma City Thunder will be looking to join the Minnesota Timberwolves with first-round sweeps.

Nonetheless, nagging issues are already starting to become a factor in the postseason. Tyrese Haliburton was downgraded to questionable ahead of Game 4 due to back spasms before playing, and Luka Doncic is playing through right knee soreness.

So far, injuries have had the most impact on the Eastern Conference playoffs. Before the season, the five best title odds in the East belonged to Milwaukee, Boston, Philadelphia, Miami and Cleveland. Of that group, only the Celtics currently lead their series, with injuries a major factor. Although the 76ers are relatively healthy now, the time Joel Embiid missed locked them into a difficult first-round matchup against the No. 2 seed Knicks.

Hopefully, the four All-Stars currently out are the last key players sidelined by injury this postseason. History tells us that probably won't be the case, and whoever stays healthy will have the best chance of bringing home a championship.