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Sunday, August 18, 2019

Basketball: Managing Injury Risk



"Basketball isn't a contact sport; it's a collision sport." 

 Risk is inherent with many activities. Mitigate risk by asking "what if" and following through. Here's a quick overview with some references provided. I label opinion as such. 

Adventure photographer Jimmy Chin (his Alex Honnold cover above) uses the equation:
CONSEQUENCE x PROBABILITY = RISK

In Deep Survival, Laurence Gonzales describes snowmobilers who ignore AVALANCHE (sign) warnings and fly up the side of a mountain. The consequence of entrapment in an avalanche was death and the probability was real. 

 Share the message that we care by emphasizing safety with players and families. In basketball activity, we can spot and reduce risks. 
ENVIRONMENTAL
SURFACE
PLAYER
PLAY 

Environmental. We don't live in the Neanderthal "water makes you weak" era. Understanding that players experience risk from dehydration to heat injury allows us to set guidelines. 

Keep it simple. Use the chart above from the National Weather Service and NOAA. Risk rises dramatically at the interface of temperatures of 88 degrees and above with relative humidity of fifty percent. This doesn't account for asphalt effects with outdoor courts. I don't think practicing at anything over 88 degrees makes sense and near that limiting running matters. Players need to bring plenty of water and get regular breaks. 

 Surface. Likewise, if courts are wet, anything more than walking (cutting, running) carries unacceptable risk. 

Player factors. It only makes sense that the more 'exposures' or hazards undergone, the greater the potential for risk (by increasing the probability). I don't think this is simple linear probability. The New York Times informs us about risks in growing athletes, enhanced by overuse, dehydration, vitamin D deficiency, impaired nutrition, lack of recovery, and single sport play. Vitamin D deficiency is high worldwide. 

I take vitamin D supplements periodically. Do you? 

Injuries. Most coaches are required to receive and demonstrate concussion education familiarity. The CDC offers free online concussion education via their HEADS UP program. 

 Basketball places athletes at risk via numerous exposures. There's a suggestion that mouthguards may prevent or reduce the severity of concussions. On balance, I think they make sense, even if the benefit is small. 

 Dynamic stretching has value. Studies show that "In contrast to static stretching, dynamic stretching is not associated with strength or performance deficits, and actually has been shown to improve dynamometer-measured power as well as jumping and running performance." Additionally, "dynamic stretching may be better suited for athletes requiring running or jumping performance during their sport such as basketball players or sprinters."

 Studies of taping ankles show a lack of durable limited ankle range of motion. Lace-up ankle braces reduce ankle injuries. I share two quotes below. 

 "The rate of acute ankle injury (per 1000 exposures) was 0.47 in the braced group and 1.41 in the control group (Cox hazard ratio [HR] 0.32; 95% confidence interval [CI] 0.20, 0.52; P <.001)."

 "Use of lace-up ankle braces reduced the incidence but not the severity of acute ankle injuries in male and female high school basketball athletes both with and without a previous history of an ankle injury."

 Drills. I do not teach Euro step because I have concerns about knee injuries in girls. We do not teach players how to take charges via drills or use contact layups with pads for similar reasons. 

Game play. When I speak with officials pre-game, I ask them to keep the players safe. Some coaches and programs don't emphasize good technique and continually set illegal backscreens or moving screens that put players at risk. I prefer to think this is from lack of knowledge than malevolence. 

Lagniappe: via Chris Oliver @BBallImmersion  Zone overload action. 
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