Thursday, December 20, 2007

Happy Holidays

So, how has your season been so far?
What would you ask from Santa to improve your game? (He knows if you've been bad or good....)
In case you don't find that extra vertical jump, quicker first step, faster hands, or better shot in your stocking, then get out there and work on it yourself.
Looking forward to helping you improve your health, fitness and performance in 2008.
Happy Holidays to you and yours.

Wednesday, December 12, 2007

To Sleep, Perchance to Start - Part 2

Pure Sport
In my last post, I talked about the importance of sleep. Now, let's see if you're getting enough sleep.
You are likely getting enough sleep to help you play better basketball if you can answer NO to all of the following questions:

1) Does your mom or dad have to wake you up in the morning?

2) Do you usually need an alarm clock to wake you?

3) Once you wake up, do you still feel tired during the morning?

4) Do you feel slow throughout the day?

5) Do you often take naps during the day?

6) Do you need to drink soda, caffeine to wake up or stay up?

7) Do you sleep in late during the weekends?

If you answered NO to all of these questions, then congratulations! You're one of the lucky few who are probably getting enough sleep. No need to read on. Good Night.

If you answered YES to any of the questions above, then keep reading....

How to Get a Good Night's Sleep


Try to keep a regular bedtime

Keep the lights down low

Keep things quiet

Take a warm bath before bed

Use a comfortable bed with plenty of room

Read a book before bed

Keep the room slightly cool

Exercise early in the day or afternoon

Drink caffeine after lunch

Eat chocolate after lunch

Watch TV right before bedtime

Surf the internet before bedtime

Play video games before bedtime

Take late or long afternoon naps

Exercise late in the day or at night

Try these suggestions out and remember that it can take a few weeks to get into a good routine that you can keep doing on a regular basis. If you do get enough sleep, you'll find that you're more awake, alert, happy, and maybe even on the starting 5.

Wednesday, November 28, 2007

To Sleep, Perchance to Start - Part 1

Clement Micarelli

A parent recently wrote to me asking me to cover the importance of rest for young basketball players, so let's start with the most important type of rest - sleep.
Shakespeare once wrote, "to sleep, perchance to dream", but I say "To sleep, perchance to start". I can't overemphasize the importance of getting a good night's sleep.
Sleep is important because it:
Helps you grow - Want to grow taller? Growth hormone is made while you're sleeping. Exercise and sleep help your body grow.
Helps you repair injuries - sprained your ankle? Got a bad floor burn? Deep sleep helps your body recover from injuries to play another day.
Helps you make memories - Can't remember your plays? Not doing as well in school as you'd like? A good night's sleep can help!
Helps you stay healthy and fight infections - Sleep helps strengthen your immune system.
Let's you DREAM! - Make that game winning shot, first in your dreams, then on the court.

Did You Know?
The average 8-13 year old basketball player needs between 9-11 hours of sleep each night!
How Much Sleep Do You Need? How Can You Get Enough Sleep?
I'll write about this in my next post.
Sweet Dreams....................

Sunday, November 18, 2007

A Tough Night for Alex Miller

Sara D Davis/ AP Photo

Wishes for a full recovery go out to senior leader and point guard Alex Miller who sustained multiple injuries during the UNC Women's game this past Friday night. One of the injuries was relatively minor: the other might have ended her season.

In the first half, she jammed finger(s) on her left hand while taking a pass in the backcourt. She went to the bench, got some buddy taping of her fingers, and re- entered the game.

In the second half, on a drive to the basket, she sustained a serious knee injury (a patellar tendon tear). While it's not an ACL, MCL, LCL and/or meniscus tear , it will likely keep her off the court for a while. This type of injury is relatively infrequent, but can occur in jumping athletes, especially those who have had a history of patellar tendonitis.

This weekend, she'll be dealing with pain, frustration, fear, anger, and a whole lot of emotions. I suspect that she'll get the support she needs from friends, family, and teammates to process this, and I hope that she will be able to come to the realization that, even if she may not practice or play with the team again this year, she can still teach, still support, still lead, and still be a factor in her team's success.

Monday, November 12, 2007

Patellofemoral Pain Syndrome - What You Can Do

In my last post, I reviewed some of the common reasons that basketball players develop patellofemoral pain syndrome (PFPS), otherwise known as miserable malalignment syndrome.

So what can you do (besides playing less, icing the knee, and taking ibuprofen) to improve this condition? It really depends upon the underlying cause(s) for this condition, but here are the most common non-surgical interventions:

1) Orthotics (Shoe Inserts) - for players who have flexible flat feet (foot hyperpronation). While you can buy them off the shelf, you'll get the best fit with custom molded models from your local orthotist or physical therapist.

2) Quadriceps Strength Training - In cases where there is an imbalance of these muscles (located on the front of the thigh), closed kinetic chain exercises (where the foot is in contact with a surface) to strengthen the quadriceps (with a special focus on the vastus medialis) can improve symptoms.

3) Stretching - A tight iliotibial band can pull the patella off to the side, while tight hamstrings can increase the pressure on the kneecap by pulling it back up against the femur/thighbone. Tight achilles tendons can also worsen foot hyperpronation. Stretching these muscles regularly should be an important part of any intervention to decrease PFPS.

4) McConnell Taping - This taping maneuver, usually performed and then taught by a physical therapist or athletic trainer, can be used to keep improve the alignment of the kneecap during activity. It helps decrease the pain of PFPS, but is NOT a replacement for appropriate rehabilitation and maintenance exercises.

5) Knee Braces & Sleeves - may help decrease pain in patients who don't want to take the time to tape before playing. While this may provide some symptomatic relief, it should never take the place of a good stretching and strengthening program.

These interventions will help most, but not all people. Rarely surgery is needed to release tight tendons and/or realign bones.

While most people try out different things to see what works best, I'd recommend you see a health care provider who knows about this condition, can perform a good musculoskeletal exam, and can prescribe a targeted treatment program for you to follow. Then, it's up to you.

Sunday, November 11, 2007

Miserable Malalignment

Les Miserables

This month's Physical Medicine and Rehabilitation Clinics of North America, contains a review article about PFPS (Patellofemoral Pain Syndrome).

If you've been around basketball players long enough, you've known lots of people who have had this type of kneecap pain. In fact, PFPS accounts for 1 out of every 4 knee injuries treated in a sports medicine clinic.

In 1979, it was named "miserable malalignment syndrome" because it was felt to be due to several factors that led to improper tracking (and rubbing) of the patella (kneecap) as you run and/or jump.

There are many potential causes of this condition, including:

* femoral anteversion
* squinting patellae (see photo above)
* patella alta
* increased Q angle
* imbalance of the quadricep muscles
* tibial external rotation
* foot hyperpronation
* poor dynamic alignment (how the thigh, knee, and shin bones line up when in motion)

So what can you do about PFPS?

There are a bunch of interventions, that can help, as long as you know which one(s) to use.

In my next entry, I'll talk about a few things that can help reduce kneecap pain and make you less miserable.

Thursday, November 1, 2007

New Injury Prevention Link Added

Just added another injury prevention website to the toolbar on the right.
The Coalition to Prevent Sports Eye Injuries was created to help reduce the number of avoidable eye injuries that occur in today's sports environment.
What does this have to do with basketball?
As I mentioned in a previous post ( ), basketball accounts for almost 1/3 (29%) of all sports-related eye injuries.
Take a few minutes to go to their website and learn how you can protect your vision while you protect the ball.

Monday, October 29, 2007

Basketball ---> Medicine

Here's a real case of Basketball Medicine!

I just read a release from the LSU Women's Basketball program that Katy Antony has passed up her senior season so that she can focus on being accepted into medical school. Kudos to Ms. Antony for making this hard decision, and kudos to her coach, Hall-of-Famer Van Chancellor, who supported her decision to leave the team.

Playing college basketball and pre-medical studies usually don't mix well. The time commitments of these two pursuits almost always force a student-athlete to leave one behind. While there are a few special people and special circumstances where Division 1 college basketball players make it into medical school, you can't fault this smart (National Honor Society President and High School Valedictorian) and talented (a former 2003 Louisiana Miss Basketball and Gatorade Louisiana Player of the Year) young lady for her decision to concentrate on her pre-medical studies.

I hope that her basketball experience and lessons learned on the court will help her in medical school and residency programs.

And hey, if she decides to enroll at UNC's School of Medicine, I call first dibs on her for our intramural team!!

Monday, October 22, 2007

The 2% Solution

The most recent edition of the Journal of the American College of Nutrition includes a supplemental review of hydration and physical performance by Bob Murray, PhD. In a nutshell, this article tries to summarize how dehydration affects physical performance.

The main points to remember:
  1. The current scientific consensus is that dehydration equal to 2% or more of your body weight will negatively effect athletic performance.
  2. Most dehydration occurs from water lost through sweat.
  3. There's a substantial variation in the sweating rates between individuals. That is, no two people sweat at the same rate.
  4. Each person's sweat rate changes depending upon their exercise intensity, length of exercise, and environment (how hot it is in the gym or out on the playground).
  5. There is no current evidence that hyperhydration (drinking more than you need) provides any performance advantage over just staying well-hydrated during a game.

So what's the 2% solution? What should you do to stop dehydration from ruining your game?

Go back to my previous post on how to prevent dehydration during a game or practice.

In addition, if you're playing ball outside on a hot day, try to find a shady spot to hang out when you're not playing, preferably one with a good breeze that will help cool you down even more.

Wednesday, October 17, 2007

Concussions in Basketball

JESSICA KOURKOUNIS : For the Chronicle

Just came back from a lecture at the hospital entitled "Management of Neurosurgical Problems in Contact Sports". The presenter was a neurosurgeon affiliated with high school and college teams, as well as the NBA team in his state.

The first part of his lecture was on concussions in team sports and he noted how common it is in sports such as football, hockey, and soccer.

I was surprised that he didn't mention basketball.

As we've seen in recent studies, concussion, though not nearly as common as ankle and knee injuries, has become an important basketball-related injury.

Whether it's taking an elbow to the face, banging noggins while going for a loose ball, or hitting your head on the floor or against a basketball support, high school and college basketball players (more often girls than boys) sustain concussions.

While they may not require a hospital admission, concussions can cause long-term problems like headaches, dizziness, sleep problems, behavior changes, memory difficulties, learning disabilities, and more.

So what's a coach to do? As players get larger and the game gets more physical, we're going to see more head injuries, including concussions.

Go to helmets? Nope.
Wear mouthguards? Nope. (while mouthguards SHOULD be worn to prevent tooth and mouth injuries, there's no conclusive evidence that shows they prevent brain injuries).

The first step is to recognize that concussions DO occur in basketball and CAN cause problems if players are not identified and given help to recover.

In my future posts about this topic, I'll cover pre-season testing, on the court management, and how to know when an athlete is ready to return to play.

For a good overview about concussions in youth sports, take a look at this .

Saturday, October 13, 2007

Wear Your Mouthguard

Sad to see Mike Copeland go down early last night at UNC's opening night scrimmage. Reports are that an elbow to the face loosened a couple of his front teeth.

I've always pulled for him since he came to Carolina and worked hard with Strength and Conditioning Coach Jonas Sahratian to overcome some past injuries.

For a 20-minute exhibition scrimmage, it was an intense game, especially in the paint. If this is how they compete in a scrimmage, imagine what it's going to be like during practice! Games might be tame by comparison.

While intense competition in practice is nothing new for this team, I have one suggestion for Mr. Copeland. If you're going to be going up against Deon Thompson, Alex Stephenson, and Tyler Hansbrough in practice everyday, please, please wear your mouthguard.

Sunday, October 7, 2007

Best of Luck...

to Sean May, who will be undergoing microfracture surgery of his right knee later this week.

Dr. David W. Altchek will perform the surgery on Tuesday, Oct. 9, at the Sports Medicine and Shoulder facility at the Hospital of Special Surgery in New York City. Mr. May is expected to be on crutches for up to eight weeks afterwards and full recovery likely will take six to 12 months.
Quoted in the Bobcats press release, their team physician said “We are hopeful that this procedure will allow him to resume his career and be the player that he wants to be.”
Me, too.

Wednesday, October 3, 2007

Passing Plyometrics

When people talk about plyometrics, most of us think about working on a basketball player's vertical jump or lateral speed, but did you know that plyometrics can also improve your (team's) passing?

This article in the most recent edition of the National Strength and Conditioning Association's Performance Journal discussed plyometric training of the upper body.
The author recommends throwing a medicine ball upwards while lying on a bench (make sure someone is spotting you!) and performing clapping push-ups (where you clap your hands together at the height of your pushup and catch yourself before your hands hit the floor).

While he doesn't mention it, the thought occurred to me that these exercises might be useful in improving basketball passing velocity (chest pass).

A little research led me to a 2006 article from the Japanese Journal of Physical Fitness and Sports Medicine which concludes that "plyometrics, by using the drop jump and medicine ball throw, are effective training methods for improving jump, footwork and chest pass ability in competitive basketball players".

While I can't comment on the accuracy of these findings (anybody out there able to translate Japanese?), it shouldn't be too hard to add these two plyometric exercises to the routine of an older teenager.
It just might improve their passing ability.

Wednesday, September 19, 2007

That Hurts! - Part 2

In my last entry , we reviewed the injuries to women collegiate basketball players.

Now, let's look at the men's injuries.

In their recent Journal of Athletic Training article researchers reveiwed 16 years of NCAA injury surveillance data for men's basketball to identify the types and locations of injuries these athletes sustained.

They found that:

* Approximately 60% of all injuries were to the lower extremity, with ankle sprains being the most common injury overall (26%).

* 1 out of every 4 ankle sprains was a repeat ankle injury ((Please see my previous posts about ankle injuries and their rehabilitation and get yourself into an appropriate program so this doesn't happen to you!).

* Other common injuries included knee injuries (10%), thigh and hip bruises (3.9%) and concussions (3.6%).

* A player was more than twice as likely to sustain an ankle or knee injury in a game than during practice and was 3 times as likely to sustain a concussion in a game as in a practice (This is not surprising since practices are a more controlled and *sometimes* less intense setting than games).

* A trend of increasing incidence of injuries to the head and face was noted over the course of the study with an average increase of 6% each year.

Like the women, the men's college game is getting more and more physical. As the athletes get bigger and stronger, and the court stays the same dimensions, physical contact has become the "dominant cause of player injury".

The authors of this article felt that "the increased in head and facial injuries may indicate that officials need to assess the increased tolerance for physical contact", that is, call the game closer. We also need to encourage the use of mouth guards, but that's another blog entry .

Tuesday, September 18, 2007

That Hurts! - Part 1

Last month, I spoke about the Perils of Pre-Season, the increased injury rate in pre-season college basketball practices noted in an article from the latest edition of the Journal of Athletic Training.

This month, let's take a closer look at the types of injuries found during men's and women's college basketball play between 1988-2004.

Ladies First .

In this study, researchers reviewed data from the NCAA's Injury Surveillance System to look at the types of injuries sustained by female college basketball players in Divisions I, II and III.

The first interesting piece of information is the number of programs fielding teams. Between 1988 and 2003, the number of varsity women's basketball teams increased 34% from 766 schools to 1026. This likely reflects the significant increase in participation by female athletes and bodes well for the future of the sport.

Now to some of the findings:

Over the 16 years of the study, the rate of injury in a game situation was almost twice as high as the rate in practice. (This is not surprising since practices are a more controlled and *sometimes* less intense setting than games).

More than 60% of all game and practice injuries were to the lower extremities (hips, thighs, knees, ankle, feet).

In both games and practices, ankle injuries were the most common injuries. Of these, 30% were identified as being a repeat injury to an already injured ankle. (Please see my previous posts about ankle injuries and their rehabilitation and get yourself into an appropriate program so this doesn't happen to you!).

Other common game injuries included knee injuries (contact and non-contact) and concussions. Yep, that's right, concussions were 3 times more likely to occur in games vs. practices. This demonstrates that women's basketball is a fast-paced, physical game where heads, elbows and knees often collide.

Anterior cruciate ligamen (ACL) injuries accounted for 8% of game injuries - with more than half of them happening without contact. (There are many risk factors that cause female basketball players to have a 3-6 times greater incidence of ACL injuries. While some factors cannot be changed, there are neuromuscular training programs that have proven to be effective in reducing ACL injur risk and every basketball coach should know about them and integrate them into their players' training).

One other concerning finding was the increasing trend in the rate of stress fractures in the bones of the lower leg and foot. While this could be due to improvements in the technology used to diagnose these injuries, it can also be due to poor footwear (when are players going to stop wearing smaller versions of men's shoes and put on a well-made women's basketball shoe?) poor nutrition (anorexia, low calcium and vitamin D intake, etc.), and insufficient recovery time between games and training sessions.

The authors state that "As the size of players and the speed of the women's game continue to increase, basketball will complete the evolution from a finesse sport to more of a high-risk contact sport". I think that this has already happened and coaches, parents, and trainers need to work together to help reduce the risk of injury for these players so that they can continue to play, and learn from, the game.

Friday, September 14, 2007

Wishes for a Speedy Recovery

Just wanted to send out wishes for a speedy recovery to Greg Oden of the Portland Trailblazers.

First it was hand surgery at Ohio State, then it was inflamed tonsils during the NBA Summer League and now, it's cartilage damage in his right knee.

He underwent microfracture surgery yesterday and may miss this entire season. Many times, an athlete feels that s/he is defined by what is done on the court, and can become depressed and angry when an injury prevents them from playing.

I hope that Mr Oden understands that his job now is the same as it is for any injured basketball player - to rest, recover, and work hard in rehabilitation so that when he returns to the court, he'll be in better shape and better able to contribute to his team.

Sunday, September 9, 2007

Names, Not Numbers

Last week, to honor Coach Roy Williams' induction into the Basketball Hall of Fame, the Raleigh News & Observer published a special keepsake poster in their Sports Section.

Unfortunately, they missed a golden opportunity to recognize the essence of what Coach Williams is about. By focusing on "his" number of wins, numbers of NCAA tournament appearances and winning percentage, the paper did him a disservice.

If they really wanted to illustrate his impact, they should have written the names of every player he's ever coached in the background of his photo.
While I understand that a coach is usually evaluated by his won/loss record, the true measure (and example) of a great coach is not the numbers of wins or losses; it's the positive effect they have had on the people around them.

Friday, August 31, 2007

The Perils of Pre-Season

In articles from the most recent issue of the Journal of Athletic Training , researchers examining 15 years of college basketball injury data found that pre-season practice injury rates were about 2 and 1/2 times higher than in-season practice rates.

As the authors comment, this may be due to the fact that pre-season practices are physically more intense, focusing more on conditioning while in-season practices focus more on strategy and game preparation.

However, another potential reason is that players may (unfortunately) not be in shape at the start of pre-season, thinking that this is the time to "get their legs and wind back". In the unprepared player, untreated muscle imbalances, decreased strength, lower cardiovascular conditioning and endurance, and other deficiencies likely increase their risk for a pre-season practice injury.

So what are you waiting for? Don't just get ready for the season by going to the gym to shoot or play in a pick up game. Get a thorough pre-season evaluation now from a physician, physical therapist, athletic trainer, or certified strength and conditioning coach, finish rehabbing any existing injuries, work on neuromuscular training programs to prevent future injuries, work on strengthening your core as well as your arms and legs, and ramp up your cardiovascular conditioning program.

This will increase your chance of becoming a starter, while decreasing your chance for a pre-season injury.

Friday, August 24, 2007

You Are What You Eat

A recent article by Nancy Clark got me to thinking about some of my favorite basketball nutrition articles and resources.

Here's a short list that I've also added to my link section (lower right hand corner of this blog) .

While these links provide good general information, none of it takes the place of having a sports dietitian work with you to optimize your nutrition.

Fueling the Fastbreak- Article by Jen Ketterly, MS, RD

Basketball Nutrition Handout - from the Australian Institute of Sport
Better Nutrition Equals Better Hoops - from the Gatorade Sports Science Institute

A healthy eating and active living Web site for kids ages 9-12 and their families, from the International Food Information Council.

Website for Sports, Cardiovascular and Wellness Nutritionists section of the American Dietetic Association. If you want to work with a Registered Dietitian in your area that specializes in sports nutrition go to .

Bon Apetit.

Wednesday, August 22, 2007

Jump! - Plyometrics in Youth Basketball - Part 2

Last month, I promised to continue my discussion about the use of plyometrics in youth basketball.

In this entry, I offer some suggestions about appropriate times to train, amount of training, length of training, and some useful and credible resources.

Like most pre-season programs that cause neuromuscular changes, you should start plyometric training at least 6 weeks before the start of practice.

A good youth plyometrics program is based upon these 5 principles:

1) Sufficient warmup – Any good workout should start with a dynamic warm-up to get the muscles ready for training.
2) Appropriate overload – Work first with simple body weight exercises that are enough to challenge you. Don't use heavy weights or deep jumps.
3) Gradual progression – Don’t try to do too much too soon. If you do, you’re just asking for a good case of Osgood-Schlatter Disease or Sever’s Disease. Start with less intense exercises and then gradually progress to more advanced ones.
4) Cool-down Period and
5) Adequate Rest- Most experts recommend 2 or 3 days of rest between plyometric training to enable your muscles to recover and grow from the previous workout. This usually works out to twice each week on non-consecutive days.

Make sure that when you do plyometric exercises, you:
Use soft training surfaces.(Jumping on concrete or asphalt can lead to knee, ankle, and hip damage).
Use non-skid training surfaces.
Use jumping boxes that will not move.
Wear proper shoes.
Keep the jumping area free of clutter.

Learn and practice proper landing form on all jumps because landing with stiff, straight legs puts pressure on the ligaments and bones and not the muscles. This can cause injury and reduces the effectiveness of your training.
Plyometric drills should be performed when your legs are fresh and before lifting weights.
When it comes to plyometric drills, more is not necessarily better.

For more information about plyometrics, read Progressive Plyometrics for Kids by Faigenbaum, Falkel and Chu and Jumping into Plyometrics by Donald Chu, PhD.

Jump to it!

Wednesday, August 15, 2007

Time Out

For this week, at least, the doctor is out.

I'm away on vacation but will return next week to post information that will help you improve the health, reduce the injuries, and enhance the performance of youth basketball athletes.

How about you? Do you have any timeouts left this summer?
If you do, I encourage you to use them and take some time to relax before the new school year (and season) begins.

Tuesday, August 7, 2007

Trojan Teeth

Nice smile.
Hope he keeps it.

In a just-published article in the Journal of the American Dental Association, researchers reported on the incidence of dental injuries in athletes playing for the University of Southern California Trojans from 1996-2005.

Those of you who read the blogs last month about mouthguard use can guess which sport had the highest dental injury rate for both men’s and women’s athletics.

Yep, it was basketball.

During the years this study took place, USC fielded 19 teams in 15 different sports. Compared with football, soccer, baseball and all other sports, men’s and women’s basketball had the highest dental injury rate.

While this study is limited by the small number of athletes followed, it does report two important findings.

We already know the first finding - that there is a higher incidence of dental injuries in basketball for both boys and girls. This has been found in different studies from different countries.
The other interesting finding is related to the effect that mouthguard use might have on basketball athlete’s dental safety.

In 2000, (in the middle of this study) the USC women’s basketball program instituted a team-wide policy requiring all players to wear a mouthguard during practices and games.

When the authors reviewed their data, they found that this policy corresponded to a 2/3 reduction in the incidence rate of dental injuries for the women players.

While the number of players is too small and the study is not set up to prove the point, this would support the theory that wearing mouthguards while playing basketball does reduce your risk of serious dental injury.

Basketball players historically have complained that mouthguards bother them when they play. Some felt (and still feel) that it limits their game, too. But modern-day mouthguards don’t have to be uncomfortable and they may even make some players feel safer and play quicker and more aggressively.

So did wearing mouthguards affect the USC Women’s team performance?
During the first 4 seasons studied (before mouthguards were required) they had a record of 55-58. Their record over the next 6 years was 93-86. Not much difference in the won/loss columns but probably a significant difference in dentist bills.

So what will OJ Mayo do as he starts his Freshman year at USC? If he’s smart, he’ll wear a mouthguard and take care of his bubblegum card smile.

What will YOU do the next time you or your players take the court?

Friday, August 3, 2007

Take Him/Her to the Hospital !!

In a recently published report from the United States Centers for Disease Control (CDC), basketball was, yet again, the most common sport to cause an injury that sent a child or adolescent (between the ages of 5 and 18 years) to a hospital emergency department.

While the article ( available at ), focuses on brain injuries from sports participation, the authors (see table 1) estimate that, between 2001-2005, there were over 380,000 emergency room visits for youth basketball-related injuries. That's more than football, more than bicycling, more than baseball, soccer, or any other sport listed.

If you look at all ages, basketball is still the sport associated with the most emergency room visits (over 600,000 during that same time period).

For the dubious distinction of causing brain injuries (concussions and worse), youth basketball ranks 3rd, behind bicycles and football, two sports where the use of helmets is mandated.

Don't get me wrong, I consider basketball to be the best sport on the planet and would encourage all young athletes to learn, practice, and enjoy it.

But the next time you think about going out to play, keep in mind that it is a high-speed, contact sport that can send you to the hospital so you should take every opportunity to rehabilitate, train, and use protective equipment to reduce your chance of being the one seen in the local emergency room.

Monday, July 30, 2007

Jump! - Plyometrics for Youth Basketball

You've heard and seen the ads.
Want to jump higher? Try this!!
Guaranteed to increase your vertical jump by 3-6 inches!!!
Learn the secret behind (insert celebrity athlete's name here)'s athleticism!!
Behind the explosion of products and programs designed to increase your vertical jump, there's a common thread: Plyometrics

What is Plyometrics?

Plyometrics is the use of dynamic movements that involve a rapid stretch of a muscle (eccentric muscle contraction) that is immediately followed by a rapid shortening of a muscle (concentric muscle contraction).
It's a type of exercise that helps muscle fibers learn to contract with more strength and speed which is especially helpful in an explosive sport like basketball.

What's more, childhood may actually be the best time to start plyometric training because a child's neuromuscular system may "learn" it's plyometric lessons more quickly than an adult who trains in a similar fashion.

Why is Plyometrics so Popular?

There are many potential benefits to plyometric exercises, including:

What are Some Different Types of Plyometric Exercises?

When most people think of plyometric exercises, they imagine someone doing jumps over hurdles or off of tall jump boxes while they wear special shoes.

But plyometrics can be as simple as skipping rope or doing jumping jacks. There are hundreds of exercises with thousands of variations that can be used to design an effective plyometrics program: cone hops, backward hops, single leg jumps, double leg jumps, power skipping, hurdle jumps, box jumps, alternate leg bounding... you get the picture.

Dangers of Plyometrics

Because of its emphasis on quick, repetitive eccentric/concentric muscle contractions, plyometrics tends to cause more muscle damage than some other types of exercises. Too much plyometrics (in amount or intensity) for a teenager can lead to muscle soreness and decreased performance. Too much plyometrics for a younger athlete can lead to tendon injuries.

So what should you look for in a good plyometrics program? More to come.......

Friday, July 27, 2007

IN MEMORIUM: George Edward "Skip" Prosser (1950-2007)

I was sad to hear that Skip Prosser, head basketball coach for Loyola (Md.), Xavier University, and, most recently, Wake Forest University, died yesterday of an apparent heart attack at the age of 56.

Don't know whether or not he had a family history of heart disease, but I can only imagine the toll that the physical, psychological, and emotional stressors of being a Division 1 Coach took on him.

He chose to be an ACC basketball coach and the lifestyle, risks, and rewards it brings, and he heard a great deal of criticism in recent years. I don't know how much this may have contributed to his untimely death, but the next time you feel like publicly second-guessing or putting down a hard-working coach, please remember that they're human beings who feel the sting of harsh words and ill actions just like anyone else, and temper your expression with the knowledge that, after all, it's just a game.

May God Rest his Soul.

Friday, July 20, 2007

Injury Prevention Links

Just added links to several good injury prevention programs, including ones to help reduce anterior cruciate ligament (ACL) tears, concussions, sudden cardiac death, and dental injuries.
Scroll down to the bottom of the right blue bar and read what they have to say.
The body parts you save may be your own!

Monday, July 16, 2007



Now that you know how important it is to wear a mouthguard when playing basketball, let's talk about the 3 most common types of mouthguards you can purchase:

Types of Mouthguards

Ready-Made, Stock Mouthguards – these fit loosely over the teeth and the wearer usually needs to keep his/her mouth closed to keep in place. This can interfere with speaking (not to mention breathing) and can limit your effectiveness out on the court. While they are the least expensive, these are considered to be the worst fitting and least protective kind of mouthguard.

Boil and Bite Mouthguards – most commonly found in sporting good stores, these mouthguards are first put in hot water and then placed in the mouth so that it can be shaped to fit your teeth. When shaped correctly, they provide better protection than the stock mouthguards but they may not provide as much shock-resistance as custom made mouthguards.

Custom-made Mouthguards – These Mouthguards are custom-made in your dentist’s office and, when made properly, provide the best fit, comfort, speech and breathing. They also fit better over braces.

How to Know if You've got the Right Mouthguard

The right mouthguards should:

  • Fit properly and feel comfortable

  • Be easy to clean

  • Not make it difficult to speak or breath

    How to care for your mouthguard

  • Rinse your mouthguard before and after each use.

  • When not wearing it, keep your mouthguard in a sturdy container that allows air in through holes or vents.

  • Don’t leave your mouthguard out in the sun or hot water.

  • Don’t chew or cut pieces off your mouthguard.

  • Bring your mouthguard with you to your dentist appointments to check that it still fits.

  • Check it regularly and replace it when it's old (2-5 years), outgrown, or cracking.

For more information about mouthguards, go to

Tuesday, July 10, 2007

Watch Your Mouth!

Under the basket, players are pushing and shoving for position to rebound a shot that’s just gone up. The ball hits the rim, bounces out and….. WHAM!!

Someone gets hit in the mouth with an elbow.

The referee blows his whistle and play comes to a stop while the trainer and coach runs out onto the floor to check on the player, hands held over bloody mouth, looking down on the floor for the tooth that’s been knocked out.

According to the American Dental Association an athlete is 60 times more likely to suffer harm to the teeth when not wearing a mouthguard. Since 80% of traumatic dental injuries occur to your top front teeth, mouthguards are important for athletes who don’t want to look like Leon Spinks or Bobbie Clarke. And for those of you who think this only relates to boxers and hockey players, studies have shown that basketball dental injuries are now 13 times higher than football (probably because high school football players have been required to wear mouthguards since the 1960’s).

Mouthguards act as a layer over your top (“maxillary”) teeth to protect them from impacts that might break or crack them and protect your lips and tongue from cuts from your teeth or braces.

How much can wearing a mouthguard help you? A 2002 article found that college basketball players wearing custom mouthguards had only 1/3rd as many mouth injuries as players who did not.

So why don’t more basketball players make like Dee Brown and get their ‘guards’ on?
It’s probably a combination of several factors:
  • While most football players consider mouthguards as part of their basic equipment, young basketball players often don’t get introduced to mouthguards until somebody (they or their teammate) gets hurt.
  • Most basketball coaches (and leagues) don’t require their players to wear mouthguards and don’t teach their players about them.
  • Not many players know that mouthguards will help prevent injuries, and even those who do may not actually wear them. A 2003 study of Australian basketball players found that only 30% of them were aware of mouthguards as protective devices and less than 2% actually wore one.
  • Mouthguards that don’t fit well can make it hard to breath and communicate, two important parts of playing basketball.
  • Even when they fit well, mouthguards take some getting used to, so the earlier a player starts with a mouthguard, the more likely they’ll feel it’s part of their basketball gear.
That said, the evidence points to the need for the youth basketball community, including parents, coaches and league officials, to consider mandating mouthguard use in both boys' and girls' basketball. As the game becomes even more physical, we are likely to see more dental injuries. We know they reduce the risk of injury, now we just have to increase knowledge about them and access to them.

In my next blog entry, I’ll cover the advantages and disadvantages of the 3 most common types of mouthguards and talk about how you can tell when you’re wearing the right kind so that you can show off your moves, and all your pearly whites, on the court.

Friday, July 6, 2007

Coming Back from an Ankle Injury

In a previous post (An Ankle a Day - June 22, 2007) , I mentioned that ankle sprains are the most common injury resulting from playing basketball.

Here, I’d like to talk a little about some important, but often overlooked, parts of a good rehabilitation program designed to not only return an injured basketball player to competition but to decrease his or her risk of further injury.

Since research has shown that basketball players with a history of ankle injury are almost 5 times more likely to sustain an ankle injury than those who have never been injured, it's important to take the extra steps to make sure you appropriately rehabilitate and protect your ankles before you get back in the game.

In the old days, basketball players were told to take some Non-Steroidal AntiInflammatory Drugs (NSAIDs) and Rest, Ice, Compress, and Elevate (RICE) their injured ankles for the first 24-48 hours after injury. That's still good advice because this first aid for ankle sprains will reduce the swelling (and pain, and amount of time you miss). After that, they were told to slowly "get back into it" and return to play when they could manage it.

Here's the problem with just returning when you feel ready -- the damage from an ankle sprain not only causes swelling, pain, stiffness and bruising,
but it also decreases the body's ability to avoid future injury.
  • When ligaments and muscles are overstretched, they become less strong, and less able to support the body.
  • When there's pain and swelling around the ankle, the muscles that move and support the ankle are used less often and can weaken, again becoming less able to support the joint and more likely to be re-injured.
  • The body's ability to respond and right itself from a fall onto uneven surfaces (like someone else's foot) depends on the athlete's balance (which can decrease from disuse) and proprioception (your ability to feel a joint's position). These split-second reactions depend upon your body's ability to provide quick and accurate information about where it is in space and an overstretched or injured muscle,tendon, and/or ligament doesn't provide it as well as an uninjured or fully rehabilitated one.

So, if you're one of the walking/running/jumping wounded who have sprained your ankle and completed your RICE program, you might want to add these to your rehabilitation regimen:

1) Get it Checked Out - If you're a couple of days past injury and you still can't bear weight on your akle, you should get it checked out by a health care provider to make sure that it's not something more serious.

Once you know that you're dealing with a sprained ankle, and know that it's safe to begin some serious rehabbing, you should find a physical therapist or athletic trainer and get a home instruction program that includes...

2) Range of Motion - You should have full ankle range of motion in all directions (think of being able to write the entire alphabet, in cursive, using your big toe as a pen) before returning to play.

3) Strength - You should have returned to (almost) full strength of your ankle, knee, and hip muscles on the side that was injured. Some experts like to especially focus on ankle dorsiflexion and eversion muscles that place the ankle in a more stable position.

4) Balance and Proprioception - You should work on your static and dynamic balance and proprioception before getting back on the court.

5) Ankle Supports - Some studies have shown ankle supports (stirrups, laceups, etc.) to be the most effective intervention to prevent severe sprains in unstable ankles.

While I wouldn't recommend it over professional help, you can find some basic ankle rehab exercises from the American Orthopaedic Foot and Ankle Society here .

One last tip - When you do return to practice, try out the offensive drills first before you go to defensive drills. That way, you'll know where you're (supposed to be) going and be more in control of your body than when you have to react to other people's moves on defense.

Include the extra steps above in your ankle rehab program and you'll be less likely to reinjure yourself when you step back onto the court.

Wednesday, July 4, 2007

Happy Fourth of July!

Hope you have fun celebrating the Red, White, and Blue..

Monday, July 2, 2007

Why This Blog?

Basketball is a beautiful game.

It’s something that I’ve enjoyed throughout my life.
And I’m not alone.

Almost 450 million people play basketball somewhere on the planet.Whether it’s in front of millions of people at the NBA or World Championships or just shooting hoops on a makeshift court, people are loving the game.

My love began when I started playing in an instructional league at the age of 5.I got the “Jones” then and there.Now, almost 40 years later, I recognize that, while it offers physical, social, and other benefits, playing basketball can lead to injuries in the young and old.

Injuries cause pain, can cost thousands of dollars in medical care and rehabilitation, and can change the course of your life. Some may say it’s “the price you pay to play”, but many of these injuries can be prevented if the right training, equipment, and treatments are used.

As a physician at a large academic medical center, I’ve become aware of the wealth of research about injury prevention, health enhancement, and performance training that’s out there but has not been discovered and utilized by the vast majority of parents, coaches and players in our country.
This blog will help change that.

Youth Basketball Medicine will offer credible, reliable information about treatments, equipment, nutrition, training programs and more that will help improve the health, fitness, and performance of young athletes so that they can enjoy, and learn from, the game of basketball.

Last month (June 2007), I covered hydration issues, ankle injuries, speed training, eye protection, and the risks of overtraining.

Thanks to CR, SW and others for their feedback and support.

Let me know what YOU want to see me cover in the upcoming months.

Wednesday, June 27, 2007

New Links

Just added a new set of links to the blog (scroll down to the blue bar on the right).
In addition to links to youth basketball and sports medicine organizations, there's now a list of charitable organizations that use basketball to promote health, peace, and well-being.
They all do good work and could use your support.

Friday, June 22, 2007

An Ankle a Day....

OK, maybe Sports Medicine doctors don't see an ankle injury each day, but it's pretty close.

Ankle injuries (mostly sprains) are the most common basketball injury and can range from a "tweak" that you walk off to a career ending event.

Take a look at this clip a few times and then read on for a few things to learn from it.

  • While guards and wings like to "break ankles" with a good crossover driblle during transition or on the perimeter, most ankle injuries occur in the paint, where people are jumping and landing while going for rebounds, blocked shots, etc.

  • The vast majority (about 85%) of ankle sprains occur when you land awkwardly or on top of someone else's foot and roll your foot over the outside border. This inversion injury can stretch or tear ligaments (tissue that joins bone to bone) and cause significant pain. In this instance, the player lands on someone else's foot and suffers an inversion sprain.

  • Immediate management of the injury includes getting off the floor to be evaluated. If you hear a pop, roll your ankle the other way (eversion), or can't walk or bear weight on the ankle, it's probably a more serious injury. If an athletic trainer, physical therapist or physician is present, they can assess the tenderness and stability of the ankle ligaments by performing a series of maneuvers. You can see some of this on the video.

This should be done quickly, because as soon as any swelling starts, it will become more difficult to figure out any specific tender points (because the entire side of the ankle will be tender!)

  • Whether you're in a pickup game or in the middle of the NBA Finals, you should take immediate steps to keep the ankle from swelling (too much). This means starting the R.I.C.E program that includes Rest, Ice, Compression, and Elevation. In the video, you can see this player (Kristen Rasmussen of the Adelaide Lightning) limping off the court while her foot is in a compression boot.

  • Another important point is that once you sprain your ankle, you become 5 times more likely to sustain another injury to that same ankle. I'm guessing that "Raz" had previously sprained her ankle(s) as she can be seen to be wearing black ankle supports under her basketball shoes (more about this in a future post).

The good news is that ankle injuries, when treated appropriately, can be overcome. Ms. Rasmussen was able to return later in the season and she's currently playing for the WNBA's Connecticut Sun.

In a future blog post, I'll go over some of the important, but often overlooked, parts of a good rehabilitation program designed to not only return an injured basketball player to competition but to decrease his or her risk of further injury.

Thursday, June 14, 2007

The Eyes Have It -Part II

In my last entry (The Eyes Have It), I stressed the important contribution that vision plays in the game of basketball.

But did you know that basketball carries one of the highest risks for sports-related eye injury?

Here are the facts:
* The US Consumer Product Safety Commission has reported that, each year in the United States, more than a quarter of a million children under the age of 15 sustain a sports-related eye injury.
* Basketball and baseball are the two sports associated with the most eye injuries in athletes between the ages of 5-24 years old.
* Basketball accounts for almost 1/3 (29%) of all sports-related eye injuries.
* One in ten college basketball players will sustain an eye injury each season.
* More than half of basketball related eye injuries are cuts or scrapes to the eyelid while another 1/3 are bruises to the area around the eyes. Eleven percent are scrapes to the cornea, the clear tissue that covers your eyeball.
* About 7% of sports-related eye injuries require a trip to the emergency room and some even result in permanent loss of sight.

These statistics are not meant to stop you from playing basketball.
But they should get your attention.

So what can you do to reduce your risk of getting poked in the eye when everyone’s reaching/battling for the ball?

According to the Joint Policy Statement from the American Academy of Pediatrics and the American Academy of Opthalmology:
* All athletes and their parents should be made aware of the risks associated with participation in sports. (Just did that!)
* Any athlete with worse than 20/40 corrected vision in one eye MUST wear eye protectors when playing. (Think about it, if you injure your “good” eye, you might never be able to drive a car, let alone drive down the lane).
* Safety sports eyewear should meet the requirements of the American Society for Testing and Materials (ASTM) Standard F803 (just look at the label) for basketball players.
* Safety eyewear should be replaced when it no longer fits correctly, is damaged, or is yellowed with age (because it might no longer be strong enough to protect you).

A few other thoughts:

While contact lenses can improve your vision, they don’t provide any extra protection for your eyes. Appropriate eye protectors should still be worn over them.
Regular “streetwear” glasses that do not have non-breakable polycarbonate lenses can actually increase your risk of a severe eye injury since they are more likely to shatter.
When worn correctly, protective eyewear can reduce the risk of serious injury to your eyes by 90%.

So do your best James Worthy and Kareem Abdul-Jabbar impression and drive the lane with no fear, knowing that you’ve got your eyes covered.

For more information and resources about eye protection and youth sports, go to:

The Coalition to Prevent Sports Eye Injuries

Protective Eyewear for Young Athletes;113/3/619.pdf

Promoting the Use of Protective Eyewear for Children in Sports

Tuesday, June 12, 2007

The Eyes Have It

“He’s got eyes in the back of his head”
“She’s got great court vision”

You often hear talented basketball players described this way.
But how important is it to have good vision when you’re playing hoops?

Well, you can play basketball well without being able to smell, taste, or hear.
You can even play basketball well without being able to walk or run,
but just try to play basketball with your eyes closed.
Not happening.

Vision plays an important part in balance (Try standing on one leg with your eyes open and then with your eye closed), coordination and speed (DON’T try running a suicide sprint on the court with your eyes closed) and hand-eye coordination (Throw a ball up and catch it with your eyes open, and then with your eyes closed).

Because of the constantly changing position of the ball and players, a basketball athlete needs to have excellent vision to reach his/her potential.

Different positions place different demands on your sight during a game. While guards usually play facing the hoop, a post player who plays with his/her back to the basket and turns to shoot has only a few milliseconds to find and lock in on the rim or backboard. Players who hang out around the 3-point line need better depth perception than those who are shooting mostly lay-ups.

So what can you do? A good first step is to get a sports vision specialist (usually an optometrist or ophthalmologist) to perform a sports vision assessment. This not only includes the basic eye chart testing for visual acuity, but might also include measures of dynamic (in motion) visual acuity, peripheral vision, depth perception, tracking, and visual memory. While you’re at it, a basic test of color vision wouldn’t hurt.

Once you have more information about your visual strengths and areas that need improving, there are exercises you can perform to improve your passing, catching, and shooting.

In my next entry, I’ll talk about steps you can take to protect your eyes from injury while you’re playing

Wednesday, June 6, 2007

and Drink Some More !!

In my last post I talked about pre-hydration, or making sure you have enough fluids before training or competing.

While it's important to be well hydrated when you step onto the court, it's just as important to make sure you stay hydrated during your practice or game (to optimize your performance) and to re-hydrate yourself afterwards (to make sure your body recovers easily and is ready to go the next time).


During a game or workout, you should drink 8-12 ounces every 15-20 minutes to keep yourself hydrated.
If you're playing half-court for less than an hour, drinking water is the best (and least expensive!) option.
If you're playing more than an hour, you might consider using a sports drink to help provide some energy (in the form of sugar/carbohydrates) and replace some of the sodium you sweat away.


The first 30 minutes after the game is the best time to rehydrate (not to mention the best time to restore your carbohydrates, and provide your body with some protein to help build your stressed muscles back up).

Focusing on rehydration, your post-game liquid consumption really depends upon how much you've failed to replace during the game (see above).

Weigh yourself before the game and then again afterwards (uniform off!).
For every pound of weight you've lost, you've fallen 16 ounces behind in your liquid consumption and you need to drink that much after the game or practice to make it up.

While water will help with the rehydration, many people suggest using a recovery drink that also includes protein and carbohydrates to help your body better recover.


Kris Osterberg MS, RD, gave an interesting poster presentation at the recent 2007 Annual Meeting of the American College of Sports Medicine.

A former college basketball player, her research focused on how well hydrated NBA basketball players were before and after Summer League games in Salt Lake City, Utah and Las Vegas, Nevada.

It wasn't pretty.

Over half of the players showed up under-hydrated before the games and didn’t make up for this during the game even though they could have as much water or sports drink as they wanted…. Now that’s just sad.

Why is that sad? Well, research has shown that dehydration (as little as 2%) can decrease an athlete’s endurance and performance. This has been shown to be the case in many different sports, including basketball. So here are these NBA Summer League players, trying to get noticed by scouts or make the team, and they’re already putting themselves at a disadvantage because they didn’t drink enough liquids before the game.

While you might want to model your crossover dribble or post-game after some of these players, don’t follow their poor pre-game hydration habits!! Maybe they didn't know any better, but you should.

What can you do? Prehydrate.

Step One
About 2-3 hours before your game or practice, drink 12-16 ounces of fluid (water, or a sports drink but NOT an energy drink-more on this in a future post).

Step Two
About 20 minutes before your game/practice drink another 8-12 ounces of fluid.
Remember, these are general guidelines and you should talk to your doctor or sports nutritionist about what amounts are right for you. But if you follow recommendations along these lines, you’ll improve your (and your team’s) performance when you step onto the court.

Monday, June 4, 2007

Too Much of a Good Thing

Today, the American Academy of Pediatric published a clinical report entitled Overuse Injuries, Overtraining, and Burnout in Child and Adolescent Athletes.

This press release covers most of the important points and should be required reading for all parents, coaches and athletes.

If you or your child’s organized basketball experience includes any one of the following terms…..

  • year-round
  • multiple teams (at the same time)
  • parental pressure
  • traveling team
  • weekend tournaments

… you should click on the links above and consider their advice.

Sunday, June 3, 2007


Want to know how to improve your speed on the court?

I just read the June 2007 edition of the National Strength and Conditioning Association’s Performance Training Journal which focuses on Speed Development.

How important is speed in basketball? While it may not be as important during a half-court game, the ability to get up and down the court quickly during a full-court run can significantly affect fast break points (scored and allowed) and mean the difference between winning and losing the game.

Here are 4 take-home points from this issue.


To get the most out of a training session, perform speed drills before you get tired (try to perform them at the beginning of practice (but after a dynamic warmup!) or prior to weight training workouts) so that you can practice high-quality movements at top speed. Use a stop watch to record sprint times to motivate yourself to improve, as well as let you know when you’re getting stale. When your sprint times start going up, it means you're getting tired/stale and it’s time to stop this session and move on to something else.


Some of the more popular speed training programs focus on straight-line sprints run over 50-100 yards, but if you want to increase speed for basketball, the author suggests training at distances commonly run during play.
Think about it…. when was the last time you saw a basketball player run 100 yards in a straight line during a game? So when you train for speed, limit your sprint conditioning drills to the distance between the end lines on the court.


Training for basketball should also focus on the footwork and agility needed to turn linear (forwards/backwards) speed into lateral (side-to-side) and diagonal speed.


Once you’re comfortable running sprints using high-quality movements at top speed, you can progress your training to include sprints (forward, lateral, diagonal) against resistance. Resisted sprinting can be used not only to increase speed but to also to improve acceleration, an important trait to possess in a sport with so many starts and stops. You can find some suggestions about different ways to add resistance to your sprints by reading the article on page 12 of this issue.

To read the articles in this issue, click here .

To learn more about the National Strength and Conditioning Association, click here.

Friday, June 1, 2007

Why This Blog?

Basketball is a beautiful game.
The flow: the movement: the constantly changing challenges: the chance to work with others while you lose yourself in the game.

It’s something that I’ve enjoyed throughout my life.
And I’m not alone…almost 450 million people play basketball somewhere on the planet.

Whether it’s in front of millions of people at the NBA or FIBA Championships or just shooting hoops on a makeshift court, people are loving the game.

My love began when I started playing in an instructional league at the age of 5.
I got the “Jones” then and there.

Now, almost 40 years later, I recognize that, while it offers physical, social, and other benefits, playing basketball can lead to injuries in the young and old.

Injuries cause pain, can cost thousands of dollars in medical care and rehabilitation, and can change the course of your life. Some may say it’s “the price you pay to play”, but many of these injuries can be prevented if the right training, equipment, and treatments are used.

As a physician at a large academic medical center, I’ve become aware of the wealth of research about injury prevention, health enhancement, and performance training that’s out there but has not been discovered and utilized by the vast majority of parents, coaches and players in our country.

This blog will help change that.

Youth Basketball Medicine will offer credible, reliable information about treatments, equipment, nutrition, training programs and more that will help improve the health, fitness, and performance of young athletes so that they can enjoy, and learn from, the game of basketball.