A Guide for Basketball Injury Prevention

What is the role of a coach? To teach? To develop? To provide a positive, fun experience? What about a safe experience? Is there more to providing a safe environment than making sure the floor is not wet or that no balls roll across the middle of the floor? Is a coach responsible for preventing injuries?

Some programs have athletic trainers who support the coaches and work with players to prevent injuries. Some programs rely on coaches to function as coaches, strength coaches, athletic trainers, bus drivers, etc. Regardless of responsibility, every year, an injury ends numerous teams’ seasons prematurely. Many injuries are freak accidents or just unlucky. However, many injuries are preventable through training and off-season strength and conditioning work. Common ankle or knee injuries occur because basketball places tremendous force on these joints, the tendons and ligaments which stabilize the joints and the muscles which move the joints. The constant landing from jumps, stops and starts and quick changes of direction compromise the muscles, especially when fatigued, which leads to injury.

Pure strength is not the answer; simply bench pressing and squatting will not necessarily alleviate injuries. Nor will common weight training which trains muscles in only one plane. Sport specific training is important, as it prepares the body for movements and forces applied during competition.

In-Season: Dynamic Warm-up
Basketball demands more than a static stretch. A dynamic warm-up includes sport specific range of motion exercises under muscular control. It has two benefits: first, players get loose; and, second, the movements mimic different basketball movements; “they are used to develop fundamental movement skills and therefore are helpful in establishing motor patterns that are going to directly carry over to speed development and jumping ability,” (Chu, Donald. Jumping into Plyometrics).

While coaching professionally in Sweden, I was astounded by the pre-game warm-ups of our opponents. Players did group exercises, stretching and light plyo-metric exercises. Before shooting or running through lay-up lines, they were thoroughly warm through these movement preparation exercises. I found these warm-ups foreign then, but now believe they helped contribute to the considerable lack of injuries suffered during the season there.

A dynamic warm-up may include some or all of the following:
Jogging, Skipping, Running backward, High Knees, Butt Kicks, Carioca, Multidirectional Lunges, Ankle Walks, Heel Walks, Heel-to-Toe Walks, Shuffles, Marches, etc.

Off-Season Injury Reduction through Plyo-metrics
One hundred-thousand female athletes will injure their ACL’s this year; female athletes between the ages of fifteen and twenty-five are at the greatest risk; and only thirty percent of injuries are contact injuries. With these numbers, can a coach afford to leave his player’s health and the team’s success to fate?

Plyo-metrics is not a panacea for all ACL injuries. However, when used properly, plyo-metric exercises can reduce injuries by strengthening the muscles used to jump, land, plant and cut (the actions responsible for 70% of ACL injuries) and to teach athletes proper form.

According to the American Academy of Orthopaedic Surgeons:
Women don’t bend their knees as much as men do when landing from a jump; the pressure on the knee joint is increased. The knee is exposed to higher force per pound of body weightâÂ?¦Women also turn and pivot in a more erect position, which also strains the ACL.

Plyo-metric exercises, like a depth jump, teach athletes to land properly: the landing should be from toe to heel, with weight shifting back, not out. Incorrect technique, which leads to injury, occurs when the knees bend forward, so the knees are in front of the toes and there is very little flexion in the hip. Proper form requires greater hip flexion, as the knees stay behind the toes and the shoulders are over the toes with a straight back. Hips are pushed back as the athlete lands, so she lands with her butt down. In this position, the hamstrings are activated and the force is dispersed over a greater area, utilizing the hip and knee joints, not just the knee.

According to research published in the Journal of Athletic Training (2004), plyo-metric training is valuable in learning to recruit hip adductor activity which aids in joint stabilization when landing or cutting:

“The increased preparatory adductor activity and abductor-to-adductor co-activation represent preprogrammed motor strategies learned during the plyometric training. These data suggest the role of hip-musculature activation strategies for dynamic restraint and control of lower extremity alignment at ground contact. Plymometric exercises should be incorporated into the training regimens of female athletes and may reduce the risk of injury by enhancing functional joint stability in the lower extremity,” (Chimera, et al., 25).

Beyond simply incorporating plyo-metric training into one’s basketball training regimen, coaches must be aware of their role in developing traits and habits in female players that will reduce the likelihood of ACL tears. This means incorporating movement training into practices, especially for younger players. Young players who develop good habits are less likely to suffer an injury later; however, if young players fail to develop good habits, they may never learn to move properly and will be susceptible to injury throughout their career.

Modified Depth Jumps
“Depth jumps use the athlete’s weight and gravity to exert a force against he ground. Depth jumps are performed by stepping out from a box and dropping to the ground, then attempting to jump back to the height of the box,” (Chu).

In this workout, the modified depth jump is used to teach correct landing posture. Most ACL injuries and ankle sprains occur when landing from the jump. Therefore, instead of doing a true depth jump, the athlete will drop from a box and land, working on a toe to heel landing, pushing the hips down and back. Knees should remain behind the toes and the hips, knees and feet should be in a straight line. Working from a two-foot box and progressing, the athlete learns to land properly and absorb the force the landing imparts onto his body.

Ice Skater
The athlete stands on her right foot with left foot behind her right foot, like an ice skater’s stance. She pushes off and hops laterally, landing on her left foot with her right foot behind her left. This works on balance and strengthens the ligaments and muscles involved in lateral movement, especially decelerating movements where injuries occur most frequently.

Lateral Slides with Resistance Bands
Using bands around the ankles can help strengthen the hip abduction muscles, leading to greater activation and stabilization of the lower leg during movement.

Wobble Board Squats
Using a wobble board (or other unstable surface) while doing squats increases the activation of the ankle musculature and works on the player’s balance and proprioception, in addition to the leg strength built through the squats, as well as the proper movement habits instilled through learning to squat properly.

While it may be unfair to expect a coach to wear every hat, in many cases, that is exactly what happens. Instead of bemoaning the responsibility, a coach must embrace the challenge and work to reduce the risk of injury to his/her players through in-season and off-season efforts.

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