Can Karl-Anthony Towns and Joel Embiid handle life as a guard?

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Karl-Anthony Towns held the ball while Rudy Gobert, the two-time Defensive Player of the Year, guarded him tightly. The pair of 7-footers weren’t wrestling in the paint like traditional centers would. On this late November night, they were 25 feet away from the basket, and Towns was stuck.

Enter Jeff Teague, the Timberwolves’ nominal point guard. He shuffled over to Towns and instead of asking for the ball, the 6-foot-3 ball-handler set a screen -- that’s right, set a screen -- for the 7-foot center. That misdirection prompted another. Using the pick would have meant Towns had to dribble to his right in the direction of his dominant hand. Instead, Towns juked right-to-left, dribbled hard past the arc with his opposite hand and abruptly shifted into reverse for a stepback 3-pointer, displaying the quick footwork of a ballerina set in fast-forward.

“Karl is the modern-day NBA big,” said Minnesota Timberwolves president of basketball operations Gersson Rosas on the latest Habershow podcast. “He was one of the major reasons, if not the major reason why I took this job.”

Towns is currently taking more 3-pointers and making a higher percentage of those shots than Stephen Curry did in his 2014-15 MVP season. But it’s not just the shooting that jumps off the page. Watch the NBA on any given night and you’ll witness seven-footers like Towns running pick-and-rolls, shooting 3-pointers and zipping around the floor like they’re six-footers. 

Giannis Antetokounmpo, whose towering dimensions appear to be designed in an NBA laboratory, has pounded out more dribbles this season than Devin Booker and Bradley Beal, per NBA.com player tracking data. LeBron James is the size of Karl Malone and leads the NBA in assists. Luka Doncic, behind James on the assist leaderboard, stands 6-foot-7 and 230 pounds, roughly the same as Xavier McDaniel -- only heavier.

Other skilled giants like Nikola Jokic, Joel Embiid and Anthony Davis often play outside-in, not inside-out. It’s clear that the guardification of NBA bigs has taken over the sport. What’s not clear is whether their enormous bodies can handle it.

* * *

Athletes around the world are bigger, faster and stronger than previous generations. Last month, Eliud Kipchoge of Kenya ran a sub-2-hour marathon, clocking in four minutes faster than the world record set a decade ago. The average weight of NFL offensive linemen in the 1970s was 249 pounds compared to today’s weigh-in of 315 pounds. In 1999, Tim Isaac became the first man to bench press over 800 pounds (802 to be exact). Today, that record is 1,102 pounds, belonging to a man named Tiny Meeker.

Oddly enough, the NBA hasn’t gotten appreciably bigger or taller, on average. The average NBA player, according to Basketball Reference tracking, is actually an inch shorter and seven pounds lighter than they were in 2010-11. But NBA players have gotten markedly more athletic, allowing giants to move like hummingbirds. 

In the eyes of Dr. Marcus Elliott, the load management conversation has skipped over this critical piece of the puzzle. The founder of P3 Peak Performance labs in Santa Barbara, Calif., Elliot and his sports science team are at the core of a global movement trying to keep professional athletes healthy. What Elliott sees from his vantage point is a fundamental shift in how NBA players are moving.

“The game has just gotten so much faster and more athletic,” Elliott says. “You can’t do apples to apples to the NBA 20 years ago.”

Elliott isn’t basing his opinion on anecdotal evidence. Over the past decade, the P3 staff has assessed the biomechanics of hundreds of NBA players -- 58 percent of the players on opening-night rosters, P3 says -- and one trend keeps popping up. 

“All of the athletes are improving their athleticism, but the rate that our bigs are improving is much faster than the guards and perimeter players,” Elliott says.

As part of the biomechanical assessments that P3 delivers to its NBA clientele, P3 leads off with an “Athleticism” score that measures an athlete’s ability to move vertically and laterally. Recently, P3 crunched the numbers and analyzed how these scores have changed over time for two groups: “bigs” and guards/wings. Before 2016, the average “big” received an Athleticism score of 62. Since 2016, however, the average big’s Athleticism score jumped to 69, an increase of seven points. Over the same window, guards and wings have improved their Athleticism score by just three points, less than half that of their towering teammates.

“A decade ago, if we had a 7-foot guy come in that had decent skills, that’s an NBA player,” says Elliott. “Now, if we have a 7-foot guy who comes in and he’s not athletic, we don’t know if we have an NBA player.”

Elliott remembers when Andre Drummond came into P3’s lab several years ago and shocked the staff with his other-worldly metrics. They analyzed his movements in every direction and his scores were remarkably consistent with NBA athletes who weighed 100 pounds lighter than him. He was, in essence, a big who moved like a guard.

“Drummond was a unicorn, but there are a lot more of these unicorns now,” Elliott says. “They’re not really unicorns anymore.”

Before Drummond, it was Derrick Favors, who at one point ranked near the top of P3’s leaderboards in just about every category.

“Pretty athletic big that we got in 10 years ago,” Elliott says of Favors. “These guys stood out. Now, it’s status quo. We expect them to be athletic and move laterally and be overall big movers. They were the exception 10 years ago.”

Now, it’s the rule.

* * *

What is driving the athletic surge in tall players? Elliott points to two factors: the increasingly global nature of the NBA and sheer economics that have incentivized players to pay closer attention to training.

As the NBA sets up academies in India and Africa, the selection pool of NBA athletes is ever-expanding. The league’s international bridges were evident when Antetokounmpo and Doncic trained together this offseason at P3’s sports science lab. Antetokounmpo, or “The Greek Freak,” is the son of Nigerian immigrants and a native of Athens. Doncic, meanwhile, is a 6-foot-7 point guard from Slovenia and the son of a professional basketball player who was born in a small town on the Solvenian-Italian border with a knack for churning out pro soccer players. If not for the international explosion of the sport, it’s entirely possible this season’s two MVP frontrunners could have put the ball to their foot rather than in their hand.

With international exposure of the league growing and TV deals in China, Europe and North America leading to a salary cap boom, NBA players are richer than ever. The average NBA player makes $7.7 million compared to $2.9 million in 2000, while the top NBA salary is Stephen Curry’s $40.2 million compared against Shaquille O’Neal’s $17.1 million in 1999-00. The increased wages make the NBA an even more desirable goal for the best athletes in the world, while also giving the ones that do make it more resources to sharpen their athleticism. The record income then trickles to secondary trainers, nutritionists and chefs, whose primary jobs are to keep players in top shape. 

“The overall selection pool has gotten so much bigger and the incentive to have a career is so much bigger,” Elliott says.

That career is also more demanding on the body. After hovering around 90 possessions per game for much of the late 1990’s and early 2000’s, league-wide pace this season exceeded 100 possessions per game for the first time since 1988-89. The rise of the 3-pointer and emphasis on pick-and-roll defense has required bigs to be more perimeter-oriented. 

“When we started assessing NBA players back in 2009, if you asked most NBA bigs, what they wanted to improve, 10 out of 10 would say their vertical jump,” Elliott says. “The majority of bigs we get in now say they want their lateral movement to improve.”

That mobility comes at a cost. To Elliott, the constant chatter about load management and minutes restrictions overlooks a key point: what’s happening in those minutes. Players are objectively covering more ground in today’s NBA than in years past. Last season, players collectively ran 3,139 more miles than they did in 2013-14 despite the season length and game regulation time being held constant.

But Elliott thinks that only scratches the surface.

“That’s a pretty big change,” Elliott says, “but I really think where you’re going to really see the load of these guys is these ballistic accelerations, both negative and positive,” Elliott says. “How fast they stop, how fast they change direction, how fast they go. It’s these super high intensity stop-and-go’s that are really destructive.”

* * *

As a leader in the space, Elliott has grown tired of the complaints about load management. He jokes that it’s become a dirty phrase now. 

The NBA’s most influential media voice, Charles Barkley, hates it. Michael Jordan reportedly told his Hornets players they’re paid to play 82 games. When asked if rookie R.J. Barrett was being overworked, New York Knicks head coach David Fizdale said “we gotta get off this load management crap” and referenced Latrell Sprewell averaging 42 minutes per game one season (Sprewell averaged 43.1 in 1993-94).

To Elliott, the focus on minutes misses the point. 

“There’s this constant back and forth about ‘when we played …’ ‘when we played,’” Elliot says. “I don’t think that people have given enough attention to how different the game is compared to when they played 20 years ago. These athletes are so much more ballistic and across the board more athletic. These are amazing systems driving super, super hard.”

The pace-and-space era of the NBA is putting increased demands on the bigger athletes. To Elliott, taller players face more injury risk simply because their bodies haven’t been optimized for movement patterns. A 7-footer can get by at younger levels simply by being tall, rather than being an efficient mover. But once they get in the NBA, those movement patterns can catch up to them.

“I still think that NBA athletes are a ways away from being optimized,” Elliott says. “We don’t get many athletes that have as much slack in their system as NBA athletes do. That’s one of the reasons that the game is going to get that much more powerful and more ballistic. NBA players have more slack in their physical development in almost all the professional athletes that we assess.”

Elliott says that track athletes that come through P3 are at 99 percent of where they could be athletically, leaving only 1 percent of space to improve, or “slack” as he calls it. Each percentage point can be the difference between college and Olympian grade. “They don’t make it out of high school at 90 percent.”

NBA players, on the other hand, aren’t nearly as mechanically optimized, settling in at typically 80 percent in his view. “It’s still a skill-dominant sport,” Elliot says.

The slack can be costly. Elliott recently presented new research at Harvard Medical School that studied the biomechanics of 481 NBA subjects and used granular kinetic data to predict whether a player would have a significant knee injury (ACL, MCL and meniscus) that would require surgery in the next year. The P3 machine-learning algorithm was able to predict 70 percent of those major knee injuries simply by looking at how a player moves.

“The load being placed on them is so close to what they’ll be able to manage,” Elliott says, “If they have a screw loose, something probably breaks.”

Elliot wouldn’t reveal the names of his NBA subjects in the study. But it’s safe to say that high-profile knee injuries in recent years to DeMarcus Cousins (torn ACL), Kristaps Porzingis (torn ACL) and Zion Williamson (torn meniscus) were likely due, in part, to some underlying breakdown in the kinetic chain -- whether it was how aligned joints were when the player landed or the balance of force between right-to-left and left-to-right. Simply put, injuries are not 100 percent a product of bad luck.

“Doesn’t matter what size your engine is, if your brakes and suspension are crap, you’re toast,” says P3’s director of biomechanics, Eric Leidersdorf, who has the build of a high school soccer player. “You can have an engine like mine or an engine like Zion Williamson’s, it won’t matter at that point.”

For years, Elliott has wanted to get LeBron James in his P3 facility, just to witness the kinematic system that’s allowed James to perform at this level for so long. Now officially listed at 6-foot-9 and 250 pounds, James is the ultimate guard in a big’s body. In his age-35 season, James is averaging a career-high 11 assists per game while averaging 25.6 points and 7.4 rebounds. His durability is the stuff of legend, never missing more than 10 games in any stretch of his career until last season when he suffered a groin injury on Christmas. (James was playing on by far the fastest team of his career, pace-wise). 

But more important than genetics, James famously invests seven figures per year on body optimization strategies and personally employs a staff that includes a professional biomechanist, multiple chefs and masseuses. He regularly uses cryotherapy, hyberbaric chambers and NormaTec recovery sleeves to stay healthy.

It’s a lesson that Elliott hopes will inspire other premiere athletes to take extra care of their bodies, especially the bigs that have progressed largely because of their size.

“The speed of the game and the load on these players, something has to give,” Elliott says. “It’s a game that’s so hard on these players’ systems, playing 82 games at this speed that it’s played now, it’s so hard on these guys’ systems. When mechanics are messed up, they’re not going to survive.”

Elliott doesn’t see the NBA slowing down anytime soon. When asked what kind of impact those ramped-up velocities will have on the largest of human bodies, Elliott isn’t so sure.

 “I don’t know long-term,” Elliot says, “what it’s going to do.”

Follow me on Twitter (@TomHaberstroh), and bookmark NBCSports.com/Haberstroh for my latest stories and videos and subscribe to the Habershow podcast.

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