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Multicomponent warm-up for basketball players

Can warm-up programs consisting of multiple components effectively reduce the incidence of ankle sprains and knee injuries in basketball players?

Basketball is a popular court-based team sport in which players experience extensive intermittent activity during training and gameplay, performing accelerations, decelerations, jumps, and changes in direction interspersed with periods of low to moderate intensity activity. The repeated execution of these explosive basketball movements imposes extensive mechanical stress on the lower extremities, exposing players to potentially damaging forces when cutting, jumping, or suddenly decelerating during training and game situations.

Why are injuries Common among Players?

The most frequent activities during which injuries have been documented in high school basketball include general play, rebounding and defending in both male and female players. In addition, dynamic loading during jumps and planting of the feet, lateral bending, and twisting during basketball movements can expose players to exorbitant shear and compressive forces that may predispose players to lower-back pain. On top of these scenarios, collisions, falls, or incorrect catching can also lead to head, wrist, hand, and finger injuries among basketball players.

Although different body regions are prone to injury, most injuries sustained by basketball players have been documented in the lower extremities. More precisely, ankle and knee injuries are among the most commonly encountered in various samples of basketball players.

Emilija Stojanović PhD and former international-level basketball player, led an international multidisciplinary scientific team that conducted a study to assess the effects of a novel multicomponent neuromuscular warm-up program on lower-extremity injury incidence in male and female basketball players.

The novel multicomponent neuromuscular warm-up protocol for trained basketball players
Table 1. The novel multicomponent neuromuscular warm-up protocol for trained basketball players.
Note: Drills 1-6 and 17-18 involve players completing each set from the baseline to the halfway line, then jogging or walking back to the baseline to commence the next set; Drills 10-16 were performed within a small area (3 m x 3 m).

Our Study

The experimental design was adopted to compare injury incidence between players exposed to the injury prevention warm-up program and those exposed to a typical warm-up program (technical skills with static stretching) across an entire basketball season. Four teams consisting of 57 players (male: n = 42; female: n = 15) were allocated to the intervention group and four teams consisting of 55 players (male: n = 43; female: n = 12) were allocated to the control group.

The initial part of the novel warm-up program consisted of six running exercises combined with active stretching to activate the cardiovascular system and neuromuscular pathways relevant to basketball. The second part of the warm-up program consisted of 10 specific preventive exercises focusing on plyometrics, core and leg strength, and balance. In addition, each exercise in the second part of the warm-up program contained three levels of increasing difficulty to provide variation and progression options. Players progressed to the next level of a specific exercise when it was performed without difficulty for the prescribed volume. The third part of the warm-up program consisted of two agility drills, with a focus on the quality of movement, emphasising core stability, hip control, and proper knee alignment throughout the warm-up. The neuromuscular warm-up program lasted for approximately 20 minutes. It did not alter the overall duration of each training session compared to what is typically performed following a usual warm-up.

Incidence of Injury

The study observed a 71% lower overall lower-extremity injury incidence rate in the intervention group compared to the control group. Regarding specific diagnoses, lower ankle sprain (74%) and knee injury (68%) incidence rates were apparent in the intervention group compared to the control group. Furthermore, considering injury mechanisms, a 74% lower overall non-contact lower-extremity injury incidence rate was evident in the intervention group compared to the control group.

Completion of the activities contained in the neuromuscular warm-up program, as well as in previous studies reporting benefits when following similar programs, may have lowered non-contact ankle sprain incidence rates by promoting adaptations that reduce landing forces, alter joint position senses, better regulate sway in single-limb stances, activate various muscle groups, and/or improve dynamic stabilisation. Multicomponent exercises may also optimise intrinsic risk factors via reductions in muscle, ligament, and contact forces, thus enabling the ankle to maintain stability or correct deviations when landing on an opponent’s foot during contact scenarios.

Multicomponent Warm-up Program

This multi-team study demonstrated a novel multicomponent warm-up program resulted in fewer non-contact lower-extremity injuries, particularly ankle sprains and knee injuries, compared to a typical warm-up program in regional-level male and female basketball players. A multicomponent warm-up program applied prior to on-court team training sessions across a full season promoted favourable effects in lowering the incidence of ankle sprains compared to typical warm-up programs in regional, male and female basketball players. 

In addition, the intervention group undertaking a multicomponent warm-up program experienced a tendency toward a lower knee injury incidence rate than the control group. Data concerning overall non-contact lower-extremity injury incidence revealed a higher incidence rate in the control group, supporting the efficacy of multicomponent neuromuscular warm-up programs in lowering non-contact lower-extremity injuries. These findings may assist basketball coaching and medical staff in developing suitable injury prevention strategies in a practically feasible and consistent manner.

Implications of the Multicomponent Warm-up Program

A multicomponent warm-up program applied prior to on-court team training sessions across a full season promoted favourable effects in lowering the incidence of ankle sprains compared to typical warm-up programs in male and female basketball players. In addition, the intervention group undertaking a multicomponent warm-up program experienced a tendency toward a lower knee injury incidence rate than the control group. 

Data concerning overall non-contact lower-extremity injury incidence revealed a higher incidence rate in the control group, supporting the efficacy of multicomponent neuromuscular warm-up programs in lowering non-contact lower-extremity injuries. These findings may assist basketball coaching and medical staff in developing suitable injury prevention strategies in a practically feasible and consistent manner.

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Journal reference

Stojanović, E., Faude, O., Nikić, M., Scanlan, A. T., Radovanović, D., & Jakovljević, V. (2023). The incidence rate of ACL injuries and ankle sprains in basketball players: a systematic review and meta-analysis. Scandinavian Journal of Medicine & Science in Sports, 10.1111/sms.14328. https://doi.org/10.1111/sms.14328

Emilija Stojanović is an assistant professor at the Faculty of Medical Sciences, University of Kragujevac, Serbia. Her tertiary studies and athletic experience as a high-level basketball player (with over 300 matches in the Serbian and French basketball leagues, FIBA U16 and U18 Women's European Championships, and Balkan Championship U18) have been both challenging and rewarding, significantly shaping her research focus. Underpinned by Emilija's desire to advance practices in basketball, her research has focused on improving the exercise prescription process and optimizing training adaptations for health, fitness, and performance.