Kawhi Leonard's latest rest day in a high-profile game shows the NBA has a problem that's not going away soon

• Kawhi Leonard sat out of a high-profile, nationally televised game to rest, once again raising the issue of when NBA players should take a night off.
• Though science backs resting players and NBA teams are adopting "load management," there are critics who argue it's bad for the game and business.
• Resting in the NBA won't go away any time soon because of the 82-game schedule. There have been calls to reduce the schedule, but doing so would also mean reducing revenue.
• There are greater concerns about the state of youth basketball, which is taking an increased physical toll on young athletes, meaning load management won't simply be for veteran players.
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The NBA world is once again in an uproar over when players should rest.

The topic reared its head this week, as Kawhi Leonard sat out a high-profile, nationally televised game between the Los Angeles Clippers and Milwaukee Bucks.

The game was the first night of a back-to-back for the Clippers. Leonard also sat out the first night of a back-to-back the previous week.

Rest has been a hot-button issue in the NBA for years. In 2012, the NBA fined the San Antonio Spurs for sending home their star players without proper notice before a high-profile game against the Miami Heat. In 2017, the issue was inflamed when the Golden State Warriors and Cleveland Cavaliers sat their star players for nationally televised games in back-to-back weeks.

Leonard has been the most cautious player in the NBA with his body. Last season, the Toronto Raptors coined the term "load management," resting Leonard for 22 games as he worked his way back from the quad injury that cost him all but nine games the year before. Leonard then topped the NBA in minutes in the playoffs and led the Raptors to a championship. Many believed the Raptors' plan was a success.

Leonard's rest day drew familiar criticism on Wednesday. ESPN's Doris Burke said it was "ridiculous" that Leonard would sit out of a high-profile game so early in the season. She said the NBA has a problem on its hands.

Others called the decision unfair to fans who were attending the game and TV networks paying for the game. As Burke noted, NBA TV ratings were down last year. Leonard, one of the league's biggest stars, sitting out a marquee game on national TV would not help.

Others defended Leonard and the Clippers. The NBA on Wednesday said the Clippers informed the league of the decision to sit Leonard and that Leonard qualified as an injured player (more on that later).

Many argued that Toronto's success last season was proof that Leonard should stick to his plan and more teams should adopt it.

John Hollinger, a former executive with the Memphis Grizzlies, wrote on The Athletic that teams have "grudgingly" adopted load management because "the evidence from medical and training staffs became overwhelming that it was a better way to manage a basketball team."

And though the data backs up that it's smart, it's unlikely to make the issue go away.

When and what type of rest is allowed?

After defending the Clippers' decision to rest Leonard on Wednesday, the league then punished them on Thursday, fining the Clippers $50,000 for "inconsistent" statements regarding Leonard's health. The fine came after head coach Doc Rivers said Leonard "feels great" and shot down the idea of Leonard dealing with an injury. The NBA said it determined Leonard was dealing with an injury, saying Leonard has "an ongoing injury to the patella tendon in his left knee" and would be sitting out back-to-backs.

The fine raises the issue about when and what type of rest is okay.

The NBA does make a distinction. There are designations for a player resting for rest's sake or a player resting for an injury or to prevent re-injury.

Teams (and the NBA itself) don't have much of a say in that distinction. As The Ringer's Ryen Russillo noted, teams are trying to be "player-first" in an increasingly player-driven league. Even if a team tried to shoot down a player looking to rest, that player could, in turn, say they are dealing with an injury and can't play. Who is to tell a player how he feels? Denying players rest only worsens relationships.

ESPN's Rachel Nichols argued on "The Jump" that the league shouldn't allow players to simply rest if they're healthy. Nichols argued, "Because if it's just rest, then why are we having an 82-game season?"

The scheduling conflict

In 2017, Commissioner Adam Silver noted that there is a scientific argument for resting players.

"We also have to be realistic that the science has gotten to the point where there is that direct correlation that we're aware of between fatigue and injuries," Silver said (via USA Today). "And as tough as it is on our fans to miss one of their favorite players for a game, it's far better than having them get injured and be out for long periods of time."

In that statement, Silver made a tacit admission that the NBA has a bigger problem on its hands - the schedule.

There have been near-constant calls in recent years to re-examine the NBA's 82-game schedule. However, reducing the schedule - which some think would allow players more rest and create more meaningful games - would also mean reducing revenues, likely a non-starter with owners and many players.

However, ESPN's Brian Windhorst pointed out on "The Jump" on Wednesday that the league's best players have already taken matters in their owns hands and reduced the schedule with rest. If players want to increase their chances to be healthy in the postseason, they'll take some nights off from November to March.

How does the NBA deal with the idea that teams and players are willing to throw out games for ones that matter down the line?

There have been calls to eliminate all back-to-backs, but it's likely not a feasible option. The NBA has worked to decrease the number of back-to-backs, but eliminating them altogether would mean further stretching a regular season that already runs from October to April. 

Some people in the NBA world have called for making sure national TV games don't involve teams playing in any back-to-backs. That is a fix that could be made with some re-jiggering of the schedule, though it wouldn't be without its challenges. National TV games fall on Tuesdays, Wednesdays, Thursdays, and Fridays, plus Saturdays and Sundays late in the regular season. Excluding those days for some teams might mean lumping some back-to-backs closer together during portions of the season. It could be done, but it adds another layer of complexity for the league.

A larger concern about the state of basketball

In July, ESPN's Baxter Holmes detailed in length (in a two-part story that is worth reading) the growing concern about youth basketball, specialization (youth athletes who focus on one sport nearly year-round rather than multiple sports), and the damage being done to the bodies of teenagers.

Holmes reported that those involved in all levels of basketball, from high school to college to the NBA, have found players' bodies are breaking down at a younger age because of the amount of basketball being played.

Studies have shown, according to Holmes, that those who specialize in one sport are 125% more likely to suffer injuries because of overuse.

"What our orthopedics are telling us is they're seeing wear-and-tear issues in young players that they didn't used to see until players were much older," Silver said at a press conference in 2017.

Marcus Elliott, the found of P3, a training center that specializes in advanced athlete assessment, told Holmes of the high school athletes they study: "They shouldn't be peaking at 16 or 17. But I can tell you from a data standpoint, you can make a case for it. And you talk to the individual athletes, a whole lot of them will tell you, 'Oh, when I was a senior in high school is when I was jumping my best. I was moving my best' ... It should happen at 23, 24, 25, but with most of these kids, that's not the case."

According to Holmes, young NBA players are missing more games than ever before. As American players continue to come through these same pipelines, it's an issue generating more awareness.

Former NBA point guard Earl Watson chimed in on Leonard's load management and pointed the finger at youth basketball.

"Kids are playing basketball year-round now, all day," Jay Williams said on ESPN's "Get Up" of why load management exists

NBA players, in general, are playing more, too. Some people chide today's players as being softer and unable to withstand the rigors of the NBA schedule. Those critiques ignore two key factors: both the game and training has grown.

The evolution of offense in the NBA has changed the way the game is played. The game is now played from 30 feet out instead of 20 feet out. Players like Stephen Curry command defensive attention when they cross half-court. NBA offensive and defensive schemes or more intricate than ever before. Hollinger wrote that the stopping and starting of offense and defense wear on players' bodies more than hard fouls of the 1980s.

Today's players also aren't taking the term "offseason" to heart. Most players take only a few weeks off before getting back in the gym and training, often playing basketball all summer long.

"When the season ended, Michael [Jordan] left and played golf and didn't pick up a basketball again until probably a little bit before training camp [in September]," Wally Blase, a former Chicago Bulls athletic trainer, told Holmes. "He might have played pickup ball with some friends, but he wasn't working eight hours a day at some gym with some shooting coach."

It will take something drastic for change to happen

None of these are small-scale issues.

Changing youth basketball will not be easy, especially with no governing body.

The NBA won't alter its schedule unless it sees drastic repercussions from resting, like far lower TV ratings and declining profits.

Teams will adopt load management, even if some players are outwardly resistant to it. Giannis Antetokounmpo, in response to Leonard sitting out vs. the Bucks, said he would not voluntarily sit out of games. Yet Yahoo's Chris Haynes reported that the Bucks are actively trying to get Antetokounmpo to rest more often.

The Clippers play a back-to-back on Wednesday, November 11 and Thursday, November 12. The Wednesday game is on national TV. It's a safe bet that Leonard will miss one of those games.

The Los Angeles Lakers have four back-to-backs before 2019 ends, two of which involve nationally televised games. Will LeBron James and Anthony Davis play in each of those?

Don't be surprised if rest and load management dominate the conversation throughout the year.

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