Holiday Assist Award - 2008

http://www.zonkergreetingz.com/basketball.html

This Year's Winner of the Holiday Assist Award goes to Dwayne Wade.

Read this article from ESPN.com and you'll understand why.

I've said before that while basketball is just a game, it is also a way to learn life skills, like how to work with others, develop trust, and reveal your true nature.

Happy Holidays to You and Your Family.

And Kudos to Flash.
This assist is even better than his pass to Kobe vs. Greece.

Low-Rider

Recently, Nike and Kobe Bryant introduced their latest basketball shoe.

What's so special about them? They're not the usual high-tops we're used to seeing.
In fact, the low cut design brought back the argument about what type of shoe is best for basketball. Many experts have said that high tops are better at reducing ankle sprains (the most common injury in basketball), while others have said that high-tops limit performance.

During a recent interview with ESPN.com , Mr Bryant brought up lots of reasons for his decision to go to this new model.

• Soccer players cut harder and put more torque on their ankles than basketball players do, but they play in shoes lower cut than his new one.


• "High Tops were becoming more restrictive" and he wanted to make the shoe "as snug as possible" .


• "I've rolled my ankles a lot of times wearing high tops". Like his severe Right Ankle Sprain in 2005 .
  


• "If you come down on somebody's foot - there's nothing you can do about that"


• The current design "cuts the weight of the shoe"


• "gives your foot a little more freedom to change directions"

When asked how it will translate to the average, chubby, middle america basketball playing guy ? "the shoe will actually make you faster" and make you jump higher.

So what do I think? (Thanks for asking)

He's right about several things:

• Soccer players do cut hard and wear even lower-cut cleats.


• If you land awkwardly on someone else's foot, there's a good chance you'll turn your ankle regardless of the type of shoe you're wearing.


• A lighter shoe can help you jump (relatively) higher and move (somewhat) faster. Although I doubt it's going to significantly affect how tired you get on the court.

But Here's One Thing That Nike And Kobe Are Not Discussing - as reported in The Canadian Press , Kobe may be wearing a new low-cut shoe but "Bryant is sticking with plain old athletic tape for ankle support").

Why's that important? Taping ankles and/or wearing ankle supports has been shown to reduce the risk of ankle injuries (especially in athletes who have already injured their ankles before).

Just like the professional soccer players he watches and admires, Mr Bryant has a professional trainer at his disposal who will wrap his ankles before every practice and game.

Do you? Didn't think so.

Take Home Message Number 1
If you want to play in Kobe's low tops, either get someone to tape your ankles (will provide support for a limited time, depending on the type of tape and how it's applies) or put on an ankle support (will provide continuous support) before you hit the court.

Take Home Message Number 2
Regardless of what some people wear, they'll still sprain their ankles. Like Kobe says in his interview, "if you get crossed up, that's your fault" .

Nutritional Supplement Use in the UK

Journal of the International Society of Sports Nutrition, December15, 2008

In an article published earlier this week in the Journal of the Internation Society of Sports Nutrition , researchers from Kingston University in London reported on nutritional supplement use among young (ages 12-21) elite athletes in the United Kingdom.

Athletes take supplements for different reasons: to improve their health, enhance their performance, round out their diet, and increase their energy.

One concern I have is that many young athletes take the wrong supplements, in the wrong amounts, at the wrong times.

In this study, young elite athletes most often reported taking (in descending order) energy drinks, vitamin C, multivitamins, whey protein, creatine, echinacea, caffeine, iron, ginseng, and melatonin. Often, though, they weren't able to correctly match their reason for taking a supplement with the supplement needed to reach their goal .

Take a look at the graph above.

When asked about the source of advice to take three of the most popular supplements (creatine, whey protein and energy drinks) most young athletes reported they took them without advice from others. While it's comforting to see that the second most reported source of advice was their coach, the coaches themselves, while well intentioned, might not be giving out correct advice.

What about health care provider's advice? Nutritionists were the 3rd most common source of advice (after NONE and coaches). Team doctors and general practitioners? Way behind even fellow athletes and friends.

This needs to change. Athletes, especially those who are still growing, need credible, reliable advice on ways to safely optimize their health and performance. Doctors are partly at fault, because most are not up to date with current evidence-based sports nutrition. Hopefully, health care professionals can work to translate the latest research results to the everyday player so that s/he can make informed decisions about what, and what not, to put into their bodies.

Want more information? Just search this blog using the keyword NUTRITION.

You can also get more resources by going back to this blog post.

*********************************************************************

Looking more critically at the article, it's notable that the response rate (those who sent back their answers) was only 1/4 of the 1,674 athletes who received the questionnaire. For our interests, it's also important to know that basketball players were not studied here ("Game On"?) . I also don't know what constitutes "energy drinks" in the UK (are they hydration drinks, recovery drinks or something like Red Bull - ugh). I've asked the lead author to answer this last question. Will let you know when I do.

Around the World

I've been blogging here for about a year and a half now, trying to help young basketball athletes improve their health, fitness and performance.

Until this past week, however, I didn't know who was actually reading this blog.

Thanks to some technical assistance (Thanks, Jessica!) and a neat program called Sitemeter, I've recently discovered that this blog is not only getting hits from across the United States, but from across the world as well.

The picture above is a graphical representation of today's most recent visitors, including:

* Someone from Houston Texas (where I did my residency training) who read about ankle injuries.
* A person in Rochester, NY who wanted more information about plyometrics.
* A reader from Badalona Spain who was interested in learning more about mouthguard use.
* Someone who has (or knows someone) with patellofemoral syndrome from Bogota, Columbia.
* A Canadian who read about miserable malalignment syndrome.

When I first started this blog, I hoped it would at least help people across my home state of North Carolina. In fact, a little less than 2/3 (65%) of hits are coming from the United States. The rest come from Canada, the UK, South America, etc. It's opened my eyes about both the power of the internet as well as the international interest.

So please (por favor, 請, tevreden, παρακαλώ, svp, bitte, пожалуйста), wherever you play ball - jump on in and join the discussion! You've got friends here from around the world.

Keep It Clean !

At 7'7" (7'9" in shoes), Kenny George had a huge presence on the basketball court. (That's him, making 6'9" Deon Thompson look like Mugsy Bogues) .

The 2008 Big South Conference Defensive Player of the Year was a shot-blocking machine who improved his game enough to start getting looks from NBA teams (like they say - "you can't coach height").

This past Summer, he returned from Pete Newell's Big Man Camp in Las Vegas with a skin infection. While it may have started with a small cut or an abrasion, the infection was caused by MRSA (Methicillin-Resistant Staph Aureus) an antibiotic-resistant bacteria that can cause life-threatening illness. Complications from the infection led to the partial amputation of his right foot, eventually knocking this giant of a man off the court.

Life for him will go on. As his coach said, “There's much more to Kenny than just basketball" and I hope that he finds success and enjoyment in whatever field he eventually enters.


I also hope that YOU learn from this unfortunate story and make the effort to reduce your risk of contracting this serious disease, which can be found in locker rooms and gym bags. In fact, participation in contact sports (and yes, basketball is a contact sport) increases the risk of getting this type of infection. Sometimes Community Associated MRSA (CA-MRSA), can spread from teammate to teammate quickly.


So what can you do? As the Centers for Disease Control recommend, you should always:

* Keep your hands clean by washing thoroughly with soap and water or using an alcohol-based hand sanitizer.
* Keep cuts and scrapes clean and covered with a bandage until healed.
* Avoid contact with other people’s wounds or bandages.
* Avoid sharing personal items such as towels or razors.

The National Federation of State High School Associations has this to say about CA-MRSA.

And last, but certainly not least, the American Academy of Pediatrics has a good webpage about MRSA at http://www.aap.org/new/mrsa.htm

Take a few minutes to go there, learn more about what you can do, and take the steps to reduce your risk of going through something like Kenny George had to endure.

MRSA infection changed his life.... don't let it change yours.

One Step at a Time

ESPN

Baby steps.

That's the way someone usually learns how to walk.

You know, take a step forward; fall down; get back up and try again.

For most of us, we accomplish this before our first birthday and never give it a second thought.

For others, life sometimes brings the challenge back around again.


Wayman Tisdale had an incredible career as a basketball player- The first college Freshman to ever be named an All-American, a member of the 1984 gold medal-winning US Olympic team, the 2nd player taken in the NBA Draft.


After 12 years in the NBA, he retired in 1997 to pursue his next career as a jazz musician. But basketball was such an integral part of who he was that he could never separate himself from his past athletic accomplishments. Many of his album titles reflect his love of the game ( Power Forward (1995) , In The Zone (1996), Hang Time (2004) ) and his music often flows like a well-orchestrated run.


Last year, he was diagnosed with cancer and eventually had to have his right leg amputated above the knee. And there he was, lying in a bed with a different body and a new challenge. The way he responded demonstrated both the person he is and the lessons he learned from playing basketball.

As a basketball player, he was already familiar with the need to train his body and took to his rehabilitation with the same intensity he often showed on the court - learning to use an artificial leg 3-4x faster than the average amputee.

In an ESPN.com article, he discussed how he also used the inner strength and resolve he developed during his basketball career to deal with his disease and his new physical challenges, specifically recalling, "I had some coaches that literally didn't want me to make it, and one in particular was Bobby Knight. At the time, I frowned on that … I look at it today that had I not persevered through a lot of the stuff he put me through, I probably wouldn't be here today. I thank God for that dude because he pushed me."

I'm a big believer that basketball can help young athletes learn lessons and gain experiences that will help them later in life. It's obvious that Mr Tisdale is a talented, creative and motivated individual who became stronger through time on the basketball court. Trying to make the 1984 US Olympic team despite having a coach who was anything but supportive could have been a disaster, but he didn't let a difficult situation get the best of him.

So the next time you have a coach who gets on your nerves, try to look at the situation not as a problem but as an opportunity.
S/he yells at you/picks on you/doesn't give you the playing time you feel you deserve?
Keep your head up and keep working hard through it.

It's a chance for you to grow by overcoming adversity.
One step at a time.

B*U*R*P

An Espn.com article last month described Derrick Favors (one of the top-ranked high school players in the country) as his team's "meal ticket" .

Unfortunately, he and his teammates were never taught what type of meals they should, and should not, eat before games.

The article describes what happened to him and his teammates before a state tournament game last year where they lost in the first round.

They "had a transportation issue before that first-round game. The bus was late by 90 minutes or so. The Hornets arrived about 30 minutes before tipoff, and perhaps worst of all, somebody -- a parent, a fan, nobody seems sure -- decided to try to help by buying dinner. Those bacon cheeseburgers were good."

Ah, if only they had read my post from last year ("You Are What You Eat"- August 2007) and gone to some of the websites about nutrition for basketball players, they would have known that you don't eat greasy bacon cheeseburgers any time before an important game or practice.

What you eat before games depends upon how long you have to digest the food. Carbohydrates are the best and most easily digested types of pre-game meals. A little protein can be added if you've got a while before gametime.

And the bacon cheesburgers?

"four players suffered cramping problems during the game, Favors landed in foul trouble, and the Hornets -- who averaged 83 points per game last season -- scored six points in the fourth quarter".

Moral of the story? You are (and might play like) what you eat.

Moral #2: Bacon cheesburgers should NEVER be (or be eaten by) your meal ticket.

Pete Newell (1915-2008)

The world basketball community mourns the passing of Pete Newell this past Monday.

For those of you who don't know about him, Coach Newell left his mark in many ways, including an NCAA Championship in 1959, coaching the USA Olympic Team to a Gold Medal in the 1960 Olympics, and developing the now world famous Pete Newell's Big Man Camp and the more recent Pete Newell Tall Women's Basketball Camp where 4's and 5's come to improve their game.

As Bill Walton said, "He was a caring, loving, selfless man who was a coach of not just basketball but life.

May he rest in peace and may his teachings live on in the players and coaches he touched.

Don't Stretch Like Your Grandmother

AP Photo/Kevin Sanders

A recent article in the New York Times' "Play" magazine section gave a good overview about how out of date warm-up stretching practices are at all levels of sport, including basketball.

The article, available at

http://www.nytimes.com/2008/11/02/sports/playmagazine/112pewarm.html?_r=3&oref=slogin&oref=slogin&oref=slogin

discusses the importance of using a dynamic, movement-based warm-up routine to improve performance and (possibly) reduce the risk of injury.

Want to learn some good pre-game and pre-practice stretches?

Take a look at this video:

http://video.nytimes.com/video/2008/10/31/sports/playmagazine/1194830066044/stretching-the-truth.html?partner=permalink&exprod=permalink

Even though it's done as a tennis warm-up, many of the stretches are useful before playing basketball.

While static stretches (like the ones the Hot Pink Grannies team is doing above) are great to do after practice and games, those in the know are incorporating dynamic routines. Now that you know, be sure you warm up the "new" and improved way.

Better be ready. Those Grannies got game.

Cipro No-Go

ptclinic.com

Recently, the Federal Drug Administration added an important warning to the prescribing information for ciprofloxacin, an antibiotic commonly used to treat sinus, bladder, and other infections.

The warning, available at http://www.cipro.com/html/pdf/cipro_prescription.pdf (page 10), states that the use of ciprofloxacin (as well as other drugs called "fluoroquinolones") is "associated with an increased risk of tendinitis and tendon ruptures in all ages".

This risk is further increased for older patients (usually >60 years), those taking corticosteroid drugs, and those involved in "strenuous physical activity" (which includes playing basketball).

What does this mean for you?

Ciprofloxacin, while an effective antibiotic for the treatment of some infections, may also increase your risk of a tendon injury. Since young basketball players are already at an increased risk for injuries to tendons at the knee and heel, there's no reason to further increase your risk for injury by taking this medicine if another equally effective antibiotic is available.

This only applies to medicines that you swallow. Eye drops or ear drops are not associated with an increased risk of tendon injuries.

So the next time your doctor prescribes ciprofloxacin or another fluoruquinolone antibiotic medicine to treat an infection, remind them that you don't want to increase your risk of tendon injury and see if they can prescribe another medicine.

Hoops at the House

No, I didn't vote for Barack Obama because he plays basketball, but it didn't hurt.

You can learn a lot about a person by the way they act on the court.
Are they a good teammate? Do they have a shoot-first or pass-first mentality? Are they more interested in their own stats than winning? Do they yell at their teammates (or themselves) when things go wrong?

Michelle Obama, our new First Lady, knew this when she asked her brother to report to her how the then-Mr Obama acted when they played pickup ball. The report then was good, and the rest is history.

Now that President-Elect Obama is heading to Pennsylvania Avenue , chances are good that there will be a lot more ball played at the White House. And if they want to play some real pickup (even 4v4) they'll need to get rid of the horseshoe pit and add some length (and another rim) to the the old White House basketball court .

Looking forward to hearing more about the pickup games to be played there and, if asked, will be happy to serve my President (and country) if he needs 1 more for a game.

Take Your Shot

There's not much that can keep Dwayne Wade from playing basketball.
He's got a reputation for getting knocked down and getting back up each time.
Last Winter, though, he got hit by something worse than a bruised quad - the Flu.
And that wasn't the first time a virus infection took its toll on D-Wade. He suffered a similar fate back in 2006.

Since Flash is smart enought to wear pads under his uniform to reduce his risk of injury, I hope that he's also smart enough to get a flu shot at the start of each season.

So what about you?
Do you take steps to reduce your risk of catching a cold or flu during basketball season?

Here's a good article from 2006 written by Dr Tom Brickner , a team physician here at UNC.

Read it.
Think about it.
Then talk to your local doctor about getting a flu shot.

Don't like shots? You might be able to use an inhaled flu vaccine.
Again, talk with your doctor about the pros and cons of it before you decide.

And don't forget to wash your hands.
Often.

The Big D

No, this post is not about Dallas.

It's not about defense either (although defense does win games).

It's about Vitamin D.

You know, the vitamin that's found in fish, eggs, and fortified milk.

The vitamin that may reduce your risk of osteoporosis.

Here's the news.

Last week, the American Academy of Pediatrics doubled the recommended dose of vitamin D for infants, children and adolescents from 200 IU (international units) to 400 IU.

If you can't get enough in your daily diet (and by spending 10+ minutes outside in the sunlight each day), then you should take a vitamin that has the new, increased amount in it.

But how is this going to help my crossover? My jumper?

It's not.

But it may decrease your risk for osteoporosis as an adult (women are 4 times more likely to develop brittle bones as men) and it may also help prevent infections, autoimmune diseases, cancer, and diabetes.

That should be a good enough reason for you to make sure you're getting enough of the Big D every day.

New Website from the American Academy of Pediatrics

As a member of the American Academy of Pediatric's Council on Sports Medicine and Fitness, I just wanted to let you know that the council has recently come out with a new and improved website design.

At http://www.aap.org/sections/sportsmedicine/ , athletes and their parents can go to the Policies and Publications section where they'll find lots of credible, reliable information about the care of the young athlete.

The website is also listed on my LINKS section under Sports Medicine Resources.

Hope you enjoy it.

Moo

An article in the October issue of the Journal of the International Society of Sports Nutrition reveiwed the potential use of milk as an alternative to other commercial recovery drinks.

It reminded me of a study I heard about a couple of years ago that found chocolate milk to be as good a recovery drink as some sports drinks on the market.

This review article by Brian Roy, a Canadien researcher contends that:

Milk increases "muscle protein synthesis, leading to an improved net muscle protein balance" (which, when paired with resistance exercise, will help build muscle tissue ).

"Low-fat milk has been shown to be as effective, if not more effective, than commercially available sports drinks as a rehydration beverage".

Low-fat milk "is a safe and effective post exercise beverage for most individuals, except for those who are lactose intolerant."

So how does milk help you gain muscle mass and recover from exercise?

It contains carbohydrates (lactose) in amounts similar to many commercially available sports drinks (glucose, maltodextrin).

"Milk contains casein and whey proteins in a ratio of 3:1 which provides for slower digestion and
absorption of these proteins resulting in sustained elevations of blood amino acid concentrations."

The whey protein in milk also contains a large proportion of branched chain amino acids which have an integral role in muscle metabolism and protein synthesis.

Finally, "milk also has naturally high concentrations of electrolytes, which are lost through sweating during exercise".

While the author admits that "More research is need to better understand how milk promotes recovery after exercise and to better understand the physiological mechanisms through which it acts", I think that drinking low-fat milk after a workout (but not before a practice or game!) might provide a more natural alternative to some of the commercial recovery drinks. And don't
forget that the calcium and vitamin D found in milk is especially important for adolescent female athletes.

For the full article (including nutritional information for milk compared to varous sports drinks) go to http://www.jissn.com/content/pdf/1550-2783-5-15.pdf

Best Wishes for a Quick Recovery

My prayers and best wishes go out to Antawm Jamison of the Washington Wizards who injured his right knee in the first half of his team's pre-season game last night.

I was fortunate to meet Mr. Jamison, a former National Player of the Year at UNC , this past Summer when we provided some education, measurements and testing during his annual All-Star Basketball Camp in Charlotte for area children.

Watching him during the camp and learning more about his charitable endeavors off the court, I learned that he's not only an exceptional basketball player, but a good man as well.

I hope he recovers soon.

Ankle Taping: Good News/Bad News

Those of you who have read some of my past entries know that ankle sprains are the most common injuries in basketball.

Research has shown that, once you sprain your ankle, you are more likely to injure that ankle again.

Research has also shown that ankle taping can decrease the risk of having a second (or third, or fourth or...) ankle injury.

While many players tape up before each practice or game, others do not because they worry that this might impair their performance on the court.

In this article from the Journal of Sports Science and Medicine, researchers from Spain compared the effects that ankle taping had on the vertical jump and the balance of 15 active young men (average age = 21 years).

They found no significant difference in their vertical jump or balance when their ankles were taped or not taped. This information might make people more likely to tape their ankles and not worry that it will impair their performance.

At the same time, however, they also found that the ground reaction force (the force of impact when the body lands) of the vertical jumps was significantly greater on the knees when the subjects had their ankles taped.

This is likely due to the fact that the ankle taping made the ankles "stiffer" and less able to absorb the landing force. In this way, more force was transferred to their knees to act as shock absorbers.

I would like to see a similar study performed with some of the more common ankle braces, which are likely to be less tight than a freshly wrapped ankle. And, to make it more applicable to real-life basketball athletes, the testing should have been performed after letting the subjects play basketball for 15-30 minutes (during which tape jobs often loosen up). And, while we're on the subject of improving the study, it should also include younger athletes of both genders and more tests (agility, speed, etc.)

The take home message? This does not lead to an all-or-none decision for or against taping ankles. For those who worry that ankle taping might decrease their vertical jump and adversely affect their balance - fear not. But for those whose main concerns are patellar tendonitis, Osgood-Schlatter and other knee overuse injuries, keep in mind that taping ankles may play a role in your knee pain.

Roll 'Em!

I love it!

More and more information that used to be available only on VCR tapes or DVDs is now being streamed via the internet.

Research has shown that the risk of repeat ankle injuries can be decreased by taping or wearing an ankle brace. Similar support can be given to other injured joints that can help reduce pain and increase function.

A recent Web Alert from the American College of Sports Medicine let me know about a nice resource online that can give health care providers a refresher course on taping joints.

It's available through Mueller Sports Medicine, a company that supplies taping materials, braces and other protective devices for use by athletes.

http://www.muellersportsmed.com/taping/taping.html

It's a nice review for athletic trainers, therapists and other people who frequently tape up athletes, featuring Mueller products.

Like the disclaimer on the video says - "The information contained in this program.....should not be used as a substitute for professional medical advice, diagnosis or treatment of a medical condition".

What Female Basketball Players Kneed to Know

http://www.usatoday.com/sports/gallery/acl/flash.htm

Basketball season starts in 6-8 weeks.

Just enough time for you to do something important.

In previous blogs, I've discussed various knee injuries, including the Anterior Cruciate Ligament (ACL) injury, a serious knee injury for which female athletes are 3 to 6 times more likely to suffer than their male counterparts.

Here's some more information from a recent article in The American Journal of Sports Medicine that examined knee injuries among boys and girls on High School teams in the United States.

• Knee injuries were three times more likely to happen in a game than in a practice (not surprising, since practice is usually less intense and takes place in a more "controlled environment" than games).
• The highest rates of knee injuries for girls in the study were seen in soccer and basketball.
• Female high school basketball players were almost twice as likely to sustain a knee injury compared to the male players in the study.
• Almost half of the knee injuries to girl basketball players caused them to lose more than 3 weeks of their season (or end their season or their career).
• More than 1/3 of all knee injuries suffered by the female high school basketball players required surgical repair.
  

So what do female basketball players "kneed" to know?

Although not as combative a sport as football or wrestling, playing basketball puts the female athlete at a higher than normal risk for a knee injury that can end her playing career. While female players can't hope to avoid contact in what is becoming a high-contact sport, and they can't change the way they are built, they can significantly reduce their risk of suffering an ACL injury by spending the next 6-8 weeks working on an ACL injury reduction program.

For a list of some of the available programs, scroll down some and click on the PEP Program or the Girls Can Jump links in the Injury Prevention section found on the right hand side of this blog.

If you're a female basketball player, it's no longer an option. It's something you "kneed" to do.

Don't Forget to Bring the Cooler !

basketballhoopsunlimited.com

Summer (with its heat and humidity) is almost over, but it's always a good time to think about ways to improve your performance.

For those of you living (and playing ball) in hot, humid climates, here's an interesting study from the United Kingdom that appears in the September 2008 issue of Medicine & Science in Sports & Exercise, the official journal of the American College of Sports Medicine.

Researchers wanted to examine the effects of drinking a cold liquid (instead of one at room temperature) on an athletes body temperature, heart rate, and endurance in the heat.

They took 8 young men (average age =22) and had them pedal on a bicycle to exhaustion in a hot and humid environment, once while drinking a warm (98.6 degrees fahrenheit) liquid and once while drinking the same amount of liquid at a cooler temperature (~39 degrees) .

They found that compared with the warmer liquid, drinking a cold drink before and during exercise in the heat reduced physiological strain (kept the body cooler) and increased the athletes' endurance capacity by more than 20%.

So what does that mean for you? The next time your team is scheduled to play a tournament outside or in a hot gym environment, it might be worth the cost and effort to store your drinks

(water, sports drinks) in a cooler. Don't like to be the one to carry the cooler(s)? Then you can ride the Cooler Train (above). It might help you get where you want to go.

Another Use for a Pillow

Want to improve your agility?
Want to reduce your risk of an ankle or knee injury?
Work on your balance.

Among the many skills a basketball player requires, good balance helps you move quickly in different directions, react to changes on the court, and avoid injury.

One popular exercise used to both evaluate and improve balance is the single leg balance test.

While you can go online to find lots of different programs to improve your balance, people often tell you that you need special equipment, like a BOSU, wobble board, or balance disc.

While these are all useful for more advanced balance and proprioceptive training, not everybody has access to a health club or can afford to buy them to use them at home.

One solution is laying there on your bed.
Yep, your friendly neighborhood pillow.

If you've already perfected your single leg balance on the floor (with hands on hips, eyes closed and supporting knee slightly bent x60 seconds) then you're ready to use your pillow.

Place it on the floor and perform a single leg balance exercise with your foot on top of it.
If that's still too easy, try 2 pillows. That should give you a good start.

Working on your balance using pillows at home is an easy and inexpensive way to improve your performance and reduce your risk of injury.

Just don't forget to wash the pillow cover once in a while or else you might start dreaming of sweaty feet.

Breathe Easily

If you or someone you know is a basketball player who has asthma (like Dominique Wilkens, shown above), here's useful website that I recently read about.



Azma.com, gives you the chance to check out the allergy and air-quality levels for any zip code in the United States. They also have a place where you can sign up for asthma alerts by e-mail on the days that your local ashtma index level might be a concern.



Unless it's severe, asthma shouldn't stop someone from playing basketball. But it's important to know that playing basketball with asthma CAN cause significant breathing problems. In fact, an article from the Journal of Allergy and Clinical Immunology (volume 113, nuber 2, Feb 2004) found that basketball was the sport most often associated with deaths in athletes with asthma (13 over a period of 7 years).

So what can you do? If you have asthma, work with your doctor to create an asthma action plan that uses medicine to control your asthma and/or rescue you from an attack, make sure you take the time to warm up before playing, and avoid triggers (like high pollen counts, smoke, and poor air-quality) that might cause an asthma attack.

Take care of your asthma, then take it strong to the hoop.

When Muscles Break Down Too Much

from http://www.technion.ac.%20il/

After a talk I gave to a group of basketball players on their way to an international tournament, a young lady came up to me and asked me if I knew about rhabdomyolysis. She had been diagnosed and treated for it in a hospital and was worried that it might happen again. I told her that, while I was familiar with it, I needed to do a little research first before getting back to her.

Here's what I found:

Exertional rhabdomyolysis is a rare illness that happens when a person has an intense physical activity that breaks down their muscles. While there is always a little muscle breakdown that occurs with heavy exercise, this is much more severe. The muscles cells break apart and the injured muscles release myoglobin, creatine kinase and other muscle cell contents into the blood stream.

Mild and moderate cases can cause high levels of sodium, potassium, phosphorous and calcium in the blood. This can lead to pain and swelling of the muscles, stomachache, nausea and back pain. In more severe cases (very rare), the myoglobin gets into the urine, causing it to become a dark tea or brown color. When the myoglobin is this concentrated, it can injure the kidneys. In fact, if left untreated really severe cases can lead to clots in the blood, kidney failure and even death.

Now this doesn't happen very often. Most players can push themselves during workouts and games without having to worry about it. But there are some things to avoid if you want to decrease the chance of this happening to you.

Things that INCREASE a person’s risk for exertional rhabdomyolysis/make it MORE likely to happen include:

* high temperatures and humidity levels,
* poor physical conditioning
* not drinking enough fluid
* taking certain medicines like aspirin
* cocaine or alcohol abuse and/or
* recent viral illness (cold, flu).
* Having Sickle cell trait

Things that REDUCE the risk of exertional rhabdomyolysis/ make it LESS likely to happen include:

* Limiting exercise that pushes you to the brink of your ability
* Limiting exercise in higher than average temperatures
* Making sure that you consume enough carbohydrates and that you have sufficient rest periods to enhance the body’s ability to convert the carbohydrate to glycogen
* Keeping well hydrated at all times

If you're a basketball player with a history of kidney disease, heat exhaustion and/or previous case of rhabdomyolysis, you should see a doctor (and get blood and urine testing) if you experience brown discoloration of your urine, have back or stomach pain, or pain and swelling in your legs or arms that comes after a period of high intensity exercise. You might need intravenous (IV) fluids and be admitted to the hospital to make sure you recover well and future exercise might need to be adjusted to keep it from happening again.

Again, I don't want to keep anyone from playing the game. Just use the recommendations above to reduce your risk, use your common sense and, if you think you might be suffering from this condition, get help from your doctor.

A "Tri" for an Eye

A recent Parade Magazine article , encouraged readers who play sports to wear protective lenses designed for their particular sport. In a previous blog entry on this subject, I only mentioned the use of polycarbonate lenses.

If you're playing basketball and need to wear protective eyewear like Rec-Specs, you might consider trying out a newer material, called Trivex.

Trivex is somehwat stronger, clearer, and lighter than polycarbonate.

Most importantly for basketball players, Trivex lenses reportedly decrease the distortion that occurs when objects are viewed away from the optical center. This might make objects in your peripheral vision more clear, improving your on-court vision.

Would it help enough to justify its higher cost (Some websites list Trivex about $25 to $40 more expensive than polycarbonate)? There's no good data on that yet.

But if it's important to you, you might consider using Trivex instead of polycarbonate lenses the next time you need new sport glasses.

Things That Go Bump in the Knee

A colleague of mine who is doing good work for youth basketball in the U.S. asked me some questions about Osgood-Schlatter Disease recently.

In response, I sent him a handout which he will soon publish in an interview script. If you already receive his newsletter, wait for my next post, but if you don't, then read on to learn more about a common condition that is close to my heart (and both my knees, as I had it back when I was 12).

What is it?
Osgood-Schlatter Disease (OSD) is a common overuse injury that causes pain, swelling and tenderness just below the kneecap. The tender point is the “tibial tuberosity”, where the kneecap tendon attaches to the tibia (shinbone).
Knee pain from OSD worsens with activity, kneeling, and trauma to the tender point below the knee. The tender point may start to stick out, causing a bump in the bone below the kneecap. While the pain is a temporary condition and generally improves with rest, the bump below the knee may remain.

Who gets it?
It occurs in children (especially gym rats) who participate in sports that require lots of running and jumping (like basketball) while they are going through their growth spurts. In boys, this usually occurs between the ages of 13 to 15 and in girls, it usually happens between the ages of 10-12. The pain occurs gradually over time as the young athlete continues to play and grow.

Why does it happen?
During running, jumping and landing, the front thigh muscles (quadriceps) pull on the kneecap and the kneecap tendon. If the amount of activity is too great, it can start to pull the tendon off the raised area of the tibia/shin bone where it attaches, causing inflammation of the growth cartilage, pain at the site and a bony bump under the knee. During rapid growth (a growth spurt), tendons can become tighter, leading to a loss of flexibility and more pull where they attach to the bones.

How long does it last?
The pain of OSD can come and go, depending upon the degree of injury and the player’s activity level. While OSD can last months to years, it is a temporary condition that improves with a decrease in activity and usually goes away when a child has finished their growth spurt.

How do you know it’s OSD?
On a visit to your local doctor, they should examine your knees and hips for strength, swelling, stability, pain, and range of motion. They’ll look for the tenderness (and bump) below the knee. They may also get an x-ray of your knees (and hips). No blood tests or advanced imaging (CT scan, MRI) are usually needed. If the history, physical exam, and x-ray findings all suggest OSD, then the diagnosis is made.

What can you do about OSD?
Once the diagnosis is made, then you can decide upon the best treatment plan for you. While it can be extremely frustrating, the best treatment is REST.

In milder cases, you can use a knee pad to protect the tender point, making sure you stretch the thigh muscles frequently, and use ice and non-steroidal anti-inflammatory medicines (like ibuprofen) after a game/practice to reduce the pain and swelling. You can also try wearing a patellar strap to decrease the tension on the tender point area. In most cases, playing with mild OSD should not cause it to last any longer or cause damage. But if the pain makes it hard to just get through everyday life activities like walking or climbing a set of stairs, then your body is telling you something and you need to listen to it and stop playing for a while.

If you do the above, but the pain doesn’t go away, your doctor might put you in a knee brace or on crutches to rest your leg. That doesn’t mean you should stop exercising – I’d suggest you consider staying in shape by swimming, doing aquatic therapy, or bicycle riding (if OK’d by your local doctor). Once the pain is gone and you’re cleared by your doctor, make sure that you also work to improve your strength, flexibility, balance, and conditioning before you return to playing.

DON’T keep playing through severe pain. This might worsen the condition and even cause the bone to break off at the tender point. Playing with pain and swelling in your knee will also make you more likely to sustain a different injury in the knee, hip or ankle.
In the very rare case where the pain continues even after your growth spurt is over, a bone doctor can perform surgery that fixes the problem and takes away the pain.

What can you do to prevent it?
Stretching the quadriceps muscle on the front of the thigh helps to reduce the pull of the muscle on the kneecap and tender point. You can also work to strengthen and stretch the hamstring muscles on the back of your thighs (which, by the way, can also help you run faster). Making sure you warm your muscles up well before exercise and stretch and cool down afterwards can also help. Remember, it’s the repetitive stress on the knee during a growth spurt that causes this condition and makes the pain worse. The best treatment for this condition is a temporary reduction in playing and practicing.

Protein Problem?

I was just reading an article about the misconceptions that high school athletes have about protein supplement use.

The article, scheduled to be published next month in the Journal of Strength and Conditioning Research, asked high school football players about the importance of using protein supplements when training to improve athletic ability.

As they predicted these athletes had many inaccurate beliefs about using protein supplements, including:

"Protein supplements are necessary to gain weight through weight lifting" - FALSE - you can gain muscle mass while weight training from protein in a food or a supplement.

"Protein supplements are better than a high-protein food for gaining weight through weight training" - FALSE - There's no advantage of protein found in supplements over protein found in food.

"Protein supplements are a good source of energy during a workout" - FALSE - Carbohydrates (mostly) and fat (in some cases) are what keeps you going during a workout or game. Protein is a muscle building block, not a fuel.

"Taking protein supplements will stop me from gaining unwanted fat on my body" - FALSE - If you take in too many calories (either as carbohydrate, fat, or protein) you will store those extra calories as fat.

So how best to get the protein you need?

According to the authors of this article, strength athletes need between 1.6 and 1.7 grams of protein for every kilogram (2.2 pounds) of body weight. Most adolescent boys eat this much in an average day. If you want to take a protein shake after a workout, that's OK, but you're paying $$ for the convenience.

Are there any dangers in taking too much protein?

The jury is still out, but some of the potential bad effects of too much protein include:

• excess fat gain


• dehydration


• gout


• kidney damage


• diarrhea


• bloating


• colon cancer

What should I eat?

Try to use high-protein, low-fat foods like:

• cheese made with skim milk


• skim milk


• low-fat yogurt


• chicken


• turkey


• fish

Who should I talk to if I want more information?

I'd go with an expert like a registered dietician who has special training in sports nutrition. Don't know where to find one? Look here.

Back in the Game

Melissa Majchrzak/NBAE /Getty Images

A recent article in the journal Practical Pain Management reported that 15% of basketball players have lost time from play due to low back pain.



While this is nowhere near the rates for ankle, finger, and knee injuries, it's still worth taking a closer look.


Basketball is a game of quick actions and reactions, and when your back "is out of whack" so is your game - it can adversely affect your shot, your defense, your ability to box out, you name it.


Here are some of the most common back injuries in basketball:

muscle sprain/strain - a pulled muscle or ligament (attaches bone to bone) in your back.

delayed-onset muscle pain - muscle soreness from overuse that is usually worst about 2 days after exercise.

contusions - bruises from getting elbowed or hitting something hard (the floor, another player)

disc herniations - more common in older (30+) players, these injuries can cause shooting electrical shock-like pain in the back and down the leg while also causing weakness and/or numbness in the legs.

piriformis syndrome - occurs when a tight muscle in your buttocks irritates a nerve that causes pain to shoot down your leg (similar to pain from a disc herniation).

sacroiliac joint pain- soreness in the low back where the tailbone and hip bones join together.

stress fractures - tiny breaks in the backbones caused by muscle weakness and overuse .

spondylolysis/spondylolisthesis - fractures of the backbones that lead to slippage of one backbone over the other .

So what can you do?


The best step is to do what you can to prevent a low back injury from ever happening. Work on maintaining and increasing your aerobic conditionining, flexibility and strength (not just in your back but in your hips, legs, shoulders, and abdomen). Make sure you wear proper shoes and play on safe surfaces.


If you sustain an injury, see a local health care provider who can perform a history and physical exam and additional tests (x-rays, ultrasound, bone scans, CT or MRI scans or other tests) to help make the correct diagnosis.


Treatment and rehabilitation will depend on the diagnosis, but generally, relative rest is an important part of any recovery program. Therapy from an athletic trainer or physical therapist may include ice packs early on and heating pads later in the process. Over the counter medicines like ibuprofen (or steroid injections in more severe cases) can help reduce some of the inflammation and pain, allowing you to tolerate soft tissue mobilization (therapeutic massage), stretching, and strengthening programs.


You can maintain your cardiovascular fitness by doing aquatic therapy (aqua jogging, for example) elliptical trainers, and/or recumbent bicycling.


Above all, make sure that you are fully recovered, in good cardiovascular shape, and strong and flexible as this will help you perform at your best and avoid further injury when you get back in the game.

"The Best" Sport

A recent poll of over 200 professional athletes from a variety of sports by ESPN Magazine showed I'm not alone in my belief that basketball is "the best" sport in the world.

Here are some of their results:

WHO IS THE BEST CURRENTLY ACTIVE ATHLETE?
1. LeBron James (22)

2. Tiger Woods (19)

3. Kobe Bryant (7)

4. Dwight Howard (4)

5. LaDainian Tomlinson (2)

WHO'S THE GREATEST RETIRED ATHLETE?
1. Michael Jordan (53)

2. Bo Jackson (17)

3. Deion Sanders (7)

4. Carl Lewis (4)

5. Muhammad Ali (2)

WHAT SPORT HAS THE BEST ATHLETES?
1. Basketball (78)

2. Football (42)

3. Baseball (12)

4. Hockey (8)

5. Gymnastics (6)

For the full results, go to http://sports.espn.go.com/espnmag/story?id=3424124

No Excuses

Welcome to June.

School's (almost) out, the gyms get hotter, and it's time to start your summer workout sessions.

For those times you think about doing something else, take a moment and (re)consider how important it is to improve your game.

Who are you doing this for?

Your parents? Your coach? Your brother/sister/aunt/uncle/grandparent/friend, etc.?

Nope, it's got to be for you. Something that you want to do.

Take a look at this video and know that I've heard all these excuses before.

So get out there, work hard, rest up, eat well, and then get out there again.

No excuses.

The Bad and The Ugly (More Effects of Steroids)

I'm not one to use scare tacticts to influence people's behavior. It's my mission to give you information, and your choice to take that information and make your own decisions.

So, for those of you who might know someone considering using steroids to help them become better basketball players, please let them know about some of the following side-effects associated with steroid use:

• decreased height (as I mentioned in my last post)
• acne (your face & back won't turn green, but might have more zits and hair)
• hair loss/baldness
• hair growth on the back
• high blood pressure (increasing your risks for heart attacks and strokes)
• depression
• difficulty controlling your aggression ('roid rage)
• diarrhea
• sleep problems
• increased risk of tendon and ligament injuries
• and more!

Oh, and did I mention that it's illegal?

So what's the best way to get stronger, faster, leaner, better?

It's simple (but hard to do in this day and age) -- you need to exercise, eat healthy foods, and give your body enough sleep and rest to build itself up.

Want more information about steroid use in youth sports? Try these websites:

http://www.taylorhooton.org/

http://www.100percentme.co.uk/home.php

http://www.usantidoping.org/misc/clean_sport.aspx

http://steroidabuse.com/

The Short End of the Stick

I just read an article discussing the recent increase in use of steroids by young athletes. These players take illegal medicines to make them stronger in the hopes that this will help them become better players, college prospects, and NBA draft picks.

Some young players, the article says, start this as early as middle school !

While there are many (many) reasons not to use steroids in the pursuit of better performance on the basketball court, here's another one for aspiring young basketball players to consider:

The use of steroids has been linked to shortened stature.

What does this mean in English?

On top of all the other side effects it can cause - USING STEROIDS CAN MAKE YOU SHORTER as an adult. (It won't shrink you, but may cause you to grow less than you should).

Last I checked, most basketball players want to be taller, not shorter.

Keep that in mind when someone suggests using steroids as a way to get stronger.

Fathers and Daughters

Kate Robertson @ Stone River Reflections

This past week, during a clinic visit for a boy I see, I got to meet his 13 year-old sister, who accompanied him and his parents to the hospital.

During the visit I discovered that the father of this family still plays basketball 3 times a week and, when I asked if his sister played, she told me that basketball was "our thing".
He takes her to games and they spend time talking and being with each other.
A nice for both of them to share their enjoyment of the game and each other.

So here's to the fathers that pass the ball (and their love for the game) to their daughters.
Just another way that basketball brings people together.

Skate-ing Away

Quick - Name the only person to be in the UNC Men's Basketball Team picture for 3 National Championship teams (1982, 1993 and 2005).

Give up?

It's Mark Davis, the team's Head Athletic Trainer for the past 31 years. Nicknamed "Skate" by former Tar Heel player Jimmy Black, Mr Davis recently announced his retirement.

While the team is still in the good hands of Dr Timothy Taft (team physician) and Jonas Sahratian (Strength and Conditioning Coach), Carolina Basketball will be hard pressed to find someone to fill Mr Davis' chair (and sweater vest) at the end of the team bench.

It's true that coaches and players get most of the attention, but athletic trainers are an equally important part of any good basketball team, especially those college and professional programs that have to make it through a long, grueling, and physical season of practices and competitions. Athletic trainers are often the hands-on providers in the management, prevention, recognition and rehabilitation of injured athletes.

Long hours, working with athletes in pain, and miles (and miles) of tape are all part of an athletic trainer's life. But so is helping players get back in the game and being a central part of any succesful team.

If your own NBA dream doesn't pan out, you might find your professional calling as an athletic trainer.

It may even help you make it to the NBA (or, in Mr Davis' case, to multiple Final Fours and Championship rings).

Enhanced Water = Enhanced Calories

With all the recent advertising for "Enhanced Water" ( water products with added flavor, color, vitamins and/or minerals) I just wanted to make sure that you know what you're buying/using.

In previous posts, I've written about the importance of drinking enough liquids to keep yourself properly hydrated before, during and after practices and games.

Research shows that, for people who work out less than an hour, drinking PLAIN WATER is all you need to do.

WHY DRINK ENHANCED WATER?
Enhanced waters might be used for people who just don't drink enough and would drink more of a liquid with some flavor (although in this case, you could also get some flavor by adding a little bit of juice to PLAIN WATER).

If you need to add weight, enhanced waters will give you added calories that PLAIN WATER will not.

Enhanced waters also provide between 10-100% of the daily recommended intake of some vitamins. But that shouldn't be the only reason you drink them. While drinking enhanced water can help you meet your fluid needs, I'd rather see people getting their vitamins and minerals through eating healthy foods.

And if you're looking to lose weight, remember that enhanced water = enhanced calories
The 32 ouncer that Shaq pushes (above) contains 200 calories
32 ounces of PLAIN WATER? = NO Calories.

Basketball Medicine - Eastern Style

No, not the Eastern Conference.

Eastern (in this case, Chinese) Medicine.

An article in today's Shanghai Daily , reports that Yao Ming of the Houston Rockets (and, hopefully, the Chinese Olympic team) will be returning to China for a 10-day course of herbal remedies and other Traditional Chinese Medicine (TCM) treatment.

Yao and the Chinese team hope this will reduce swelling and speed the healing of his left foot stress fracture for which he underwent surgery early last month.

While I wouldn't recommend this treatment for everybody, there are a couple of important points in this story.

1) It's important to investigate the use of different approaches to care to help recover from an injury. No one approach is best for everyone.

2) In a related article, it was reported that doctors in both Chinese medicine and his NBA team doctors have discussed and agreed to this treatment - If you're going to go to multiple providers to try different approaches, try to keep all the providers in the loop.

I hope that this combination of Eastern and Western medicine helps him recover and compete well in the upcoming Olympic Games.

No Lo(go) Contendere

Today, I learned that the NCAA has pleaded "No Lo(go) Contendere" to the claims that the too slick NCAA Logos placed on the floors during the first two rounds of the this year's tournament could/would lead to player injury.

Kudos to the NCAA for responding to the concerns of coaches, players, and fans. Their decision to pull the Logos from the arena floors for the rest of the tournament was the right thing to do.

Slippery Logo = Unsafe Court

I thoroughly enjoyed watching the first and second rounds of the Men's NCAA Basketball Tournament at the RBC Center in Raleigh, NC this past weekend.
But while it was great to see the teams competing, it was disturbing to see several players slipping and falling when they tried to change direction or accelerate on the midcourt area that was covered by the largest NCAA logo I have ever seen.

I can't argue with the need to publicize the NCAA and its tournament, but when the logos applied to the court surface start to pose a hazard to the players, then it's time to re-evaluate their use. Keep using them, and you run the risk of a serious injury to one or more athletes.

I hope that the NCAA seriously considers removing these types of logos from the floor for the remainder of the tournament. The players safety should come before the need to have yet another reminder that we're watching an NCAA tournament game.

Work = Play (Better)

Watching Danny Green dunk, score and defend during the latest installment of the UNC-Duke men's basketball rivalry, I couldn't help but think back to a summer morning, almost 2 years ago.

I was observing a mid-morning summertime workout run for a few UNC basketball players, including Danny(pictured above).

While most UNC students were away on summer break (or sleeping in at home) that day, he and others were down in the depths of the Dean Smith Center, completing what was then a daily series of sprints, agility drills, and weight lifting. Day in and day out, they would come in ths morning to increase their strength, stamina, and fitness. They would then come back in the afternoon and evening to work on their skills.

I remember thinking to myself that this is what it takes to be a great basketball player... not just the gifts of size and ability, not just practicing on the court, but the constant dedication to improve yourself.

Remember That - Becoming the best basketball player you can be takes time and effort. Daily care of your body (sleeping and eating right), making the time to work out off the court (and recover from it) and learning new skills and knowledge on the court all combine to make you a better and more valuable teammate.

So, as the weather gets warmer, and you start to think about how you'll be spending your time off from school, take a few moments.
Think about what you want to accomplish.
Think about how you can get there.
Then make the decision to put in the work it will take.

Regardless of how his team does in the upcoming ACC and NCAA tournaments, Danny Green and his teammates will be spending their upcoming Summer mornings in the Smith Center, working out, and getting ready for the next season.

Where will you be?

Don't Get Stressed Out

Jason Sipes for the Altoona Mirror

In their recent article in the journal Current Opinion in Pediatrics , doctors from the Hospital for Special Surgery in New York wrote about lower extremity (leg) stress fractures in young athletes. These fractures occur when a young athlete's bones can't keep up with their increased activity level and stress.

Here are some take-away messages from their article:

1. Stres fractures are one of the most common overuse injuries in young athletes.
2. As young athletes play more(more practices, games, tournaments, camps) of the same sport (stressing the same muscles and bones in the same way) with less time to rest and recover, stress fractures are more likely to occur.
3. Stress fractures of the tibia (lower leg) and foot are more common in sports involving sudden stops (like basketball).
4. The most well-established risk factor for stress fracture is a sudden increase in training intensity.
5. Other risk factors include uneven leg length, abnormal knee alignment, stiff knee movements, and abnormal foot bones or alignment.

So What's a Young Basketball Player to Do?

Here are some general recommendations (in no particular order of importance)

• Wear well-padded and appropriately sized basketball shoes when you practice or play.




• When/if possible, get off the concrete and play on some well-supported wooden gym floors.




• Maintain a healthy body weight for your height (too-thin girls with low lean body mass and decreased bone mineral density are at increased risk for stress fractures).




• Avoid drinking diet sodas (the phosphoric acid can weaken your bones).




• REST! Give your bones (and body) enough time to recover from the microscopic injury they get when you play hard and long.




• Listen to your body! If your knees, shins or feet start to ache, decrease the amount and/or intensity of your schedule to prevent things from getting worse.




• If the pain does not go away with rest, see your doctor or sports medicine specialist. They may get an MRI to look for signs of early stress fracture(s).




• REST ! Did I say that before? Yes, but it needs to be emphasized that this is the best treatment for stress fractures. It's better to treat this condition with "aggressive rest" early on than to let it progress to something that's going to keep you off the court for months to come.