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| Photo Credit: Seattle Pediatric Sports Medicine I'm front-right, and I need to work on my landing. |
Working in pediatric sports medicine, I notice clusters of injuries which coincide with the change in sports seasons. This is, of course, a generalization, but it seems that there are patterns. Some examples: shoulder overuse injuries in swim and baseball season, concussions as football gets underway, "shin splints" in cross country runners who may have ramped up too quickly, and ankle sprains with soccer and basketball.
So now that the sports seasons are changing and I'm expecting to start seeing basketball players in the clinic, I thought it was time to hop on my soap box suggesting the use of a dynamic warm-up as an injury prevention tool. It has recently come to my attention that some of the local high schools are so overbooked on their gym time that the athletes are expected to warm-up on their own before they're allowed access to the court. The team does not warm up together unless the captain organizes the group beforehand. To me, that means it isn't mandatory. It isn't a priority. If teams only get 2 hours of on-court time per day, they'll use the time to focus on sport-specific activities, no time wasted on preparing their bodies. I get it, but I don't approve. I think you might end up with a team that knows a few extra plays, but you also might have a few more injured players on the bench. Is it worth it? There's quite a lot of research on the benefit of ACL injury prevention programs, including the 2018 National Athletic Trainer's Association Position Statement written by an awesome group including my mentor, Dr. Lindsay DiStefano, which can be found here. (That paper includes the components you should include in your injury prevention program... no worries ... they're going to be briefly summarized below.)
I've previously mentioned that an injury prevention program is the same thing as a performance enhancement program here. Most of these programs are targeting prevention of ACL injuries, but there is no reason to believe they couldn't help prevent other injuries, as well. The Seattle Pediatric Sports Medicine Group's ACL Injury Prevention Program and the FIFA 11+ programs were both designed to be used as a dynamic warm-up. Note that I'm using three different names for the same thing: Dynamic warm-up, if used properly, is the same thing as an injury prevention program, which is the same thing as performance enhancement. (There are many other programs out there, but these are the two I'm most familiar with and have seen teams use most frequently. Ignore that they're set on a soccer field... it doesn't matter!).
Let's back up for a moment. What is a dynamic warm-up? A dynamic warm-up is a progressive increase in the intensity of exercise placed at the beginning of a training session to prepare the body for the work it will do. It targets increasing the cardiovascular system and getting the blood flowing as well as progressively increasing the use of the musculo-skeletal system and the nervous system to optimize the body for movement. There are numerous publications that recommend doing this for a variety of reasons. Like this article for injury prevention, and this one to optimize power. You've probably learned that you shouldn't skip meals leading up to Thanksgiving Dinner (though many people wrongly think this means more room for extra desserts, you're better off having some breakfast earlier in the day and regular eating the day before. You're welcome.) Why would you go from sitting in school all day long to sprinting up and down the basketball court without preparing your body?
Great, so now that we've determined that you're going to include a warm-up in your teams' practices and before games, why not decide how to design the warm-up for optimal performance? This really can't be just about going through the motions. It needs to be intentional. It needs to be focused. This is a great opportunity to develop a plan that team captains can lead early in the season so you can help teach individuals who might need more help with some of the movement patterns.
No more sitting in a circle stretching and chatting about last night's episode of Grey's Anatomy. Focused, purposeful movement. There are SO MANY activities you can include if you're not able or willing to use one of the programs already designed for you due to the amount of time they may take. I urge you to consider one of those programs, but alternatively, take the components from those programs and use them interchangeably. If you structure your practices so you know what things you're going to work on, you can also structure your warm-ups so you know what you're going to work on in that time. What good is running a play for your shooter if they're not yet getting off the floor with their jumps? What good is spending an hour teaching your team how to get a pass into the post if your center doesn't understand the benefit of getting low (in their squat pattern) to back down their defender and take it to the hole. I'll say it one more time for the people in the back, injury prevention IS performance enhancement and a dynamic warm-up is an easy way to fit this into your daily routine. If you help develop your athletes into just that - better athletes - they'll have more skills available to them to apply to whatever sport they're playing.
Components you should consider using in your warm-up.
1) mobility/flexibility (walking stretches)
2) strength (of the hips and core as well as the upper body) which can be done using:
3) movement patterns (squat, lunge)
4) jumping (plyometrics)
5) balance
6) agility (cutting/change of direction)
According to the NATA position statement, you should be using at least 3 of the above categories. The prepared programs use all of them.
I don't have data to support this claim, but in general, I would say that most of the injured teenage girl athletes I see in the clinic do not jump or land in an "optimal fashion". They're generally strong, but need to be stronger for the demands of the sport they're playing. They often can't squat without falling over and I don't think I've seen any who can control a single leg squat. As a coach, if you don't know how to teach these things to your players or why they're important, you could ask a local physical therapist to come in and screen your athletes and give you some pointers. Or call me and we can chat about them! Seriously... any time. If this post prevents one high school basketball player from injury, I'll be happy. Or if this post changes the way a coach organizes their practice to include more of the above components, I'll be elated.
As a reminder -
Every jump shot is, in fact, a jump and a landing.
Most rebounds are, in fact, a jump and a landing.
Jump-landings are, in fact, related to the squat. If you do it on one leg, it's more related to a single-leg squat.
Defensive stance and the "triple threat" position are, in fact, related to the squat.
If you are standing on one leg for any reason - landing from a rebound, trying to save a ball from going out of bounds - you need to be able to balance. Most teenagers can easily stand on one foot on a firm surface and balance steadily without a problem. But if they have had an ankle sprain, it gets much more difficult. If they're turning their head - like they would for an outlet pass or to avoid a defender - it gets much more difficult.
I'll go back to the discussion of getting the high school girls into the weight room another day, but for now, strength training could be as simple as a few sets of squats and a few lengths of the court with walking lunges and a few side planks - all with body weight - to focus on movement patterns and strengthening. That could easily be a huge part of their warm-up before playing basketball. (If you're preparing for a strength training workout, the dynamic warm-up should more closely mimic the motions of the exercises to be completed, but for a sports practice, there's a ton of variety available that will be relevant and beneficial).
Last thought on these warm-ups. Something that makes my mind go nutty is watching a team practice where they spend a good 15 minutes warming up, and then the coach has them circle up and stand still to discuss the upcoming practice, ultimately cooling them back down. Prepare your team's mindset before the warm-up so you can transition right from the warm-up into business. You can't avoid it during games when you substitute a player from the bench and they've been sitting for the whole first half. That player is cold and has to use the game to warm up. Hopefully the energy of the game has kept the blood pumping a bit. Hopefully they do some jumping up and down on the sidelines when your team makes a great play, to keep them warmer. But on a daily practice routine, you can keep them warm and ready to go.
Any questions? Let me know if I can help.
Here's to a great basketball season with zero injuries for your team. And lots of offensive rebounds. Those are my favorite.
(Go Cheshire Rams! Go UConn Huskies!)
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