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....................

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.

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.

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.

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 (http://basketballmedicine.blogspot.com/2007/06/eyes-have-it-part-ii.html ), 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.

Basketball ---> Medicine

www.LSUsports.net

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!!

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.