Small-sided games, injuries, and too many games

Coaches: are US athletes experiencing wear and tear from playing too many games, and if so, does heavy use of SSGs exacerbate the problem?

— Paul Cortes (@pcortes64) July 22, 2015

After reading the above on Twitter, I knew that 140 characters would be insufficient. However, to answer the question accurately requires two additional questions:

1. Who are U.S. athletes? Are we referring to NBA players and their injuries? Overuse injuries with high-school players?
2. How are the small-sided games (SSGs) used? Are these replacing other training-form practice activities? Replacing other game forms? Added to traditional practices and games? Used as free play?

Injuries are a multi-factorial problem, especially overuse injuries such as patellar tendonitis, a frequent injury among basketball players. Often, there is not a single answer; a recent article about injuries in the NBA identified four potential causes: Lack of sleep, low calcium intake, overtraining/overplaying, and lack of basic strength. These four issues, which cover four very broad categories (sleep, nutrition, training, and strength), likely fail to capture all the potential issues related to injuries: What about the type of shoe or amount of cushioning? Does ankle bracing increase risk of knee injuries/patellar tendonitis? With the amount of travel and activity, does dehydration play a role?How do SSGs fit?Small-sided games can be used in four basic ways:

1. Replace full-sided games
2. Replace training-form activities
3. Added to the traditional practice
4. Added to the normal game schedule

Each of these uses present different answers to the original question of wear and tear.I advocate for small-sided games primarily as a replacement for other activities. With young children, I believe small-sided games should replace full-sided games, which is why I developed the Playmakers Basketball Development League. Why are 7-year-olds playing 5v5 basketball on a regulation court with 10' hoops? This, to me, is the most important change that we can make. Would replacing full-sided games with small-sided games increase wear and tear? When I studied 3v3 vs. 5v5 games, I found the physical activity demands to be similar. However, there are reasons to suggest that small-sided games would reduce wear and tear. When Canada Basketball conducted a pilot study, it found that parents were less involved when the players played 3v3 compared to 5v5. Therefore, moving to SSGs could reduce the overall time on the court and the length of the seasons because it is not real basketball. The change could push the start of the competitive stage of basketball to later in a child's development, much as t-ball tends to delay the start of competitive baseball (all-star teams, traveling teams, private coaches, etc).For older players, I argue to replace training-form activities with small-sided games. Could these activities lead to more wear and tear? Yes and no. The SSGs likely are more intense than standard drills. However, SSGs likely cause more variable movements than a standard drill. If I play 1v1 for 5 minutes, I may not make the same move twice. However, if I do a standard drill for 5 minutes, I am likely trying to make the moves as similar to each other as possible on each repetition. Therefore, the physical demands may be higher in the SSGs, but specific and repetitive demands may be greater in a drill. Is the problem general or specific fatigue? Is the problem general or specific overuse? These are interesting questions.I do not advocate for adding SSGs to a traditional practice. In my experience, practices are a zero sum: The coach and team is allotted a certain amount of time. To add something new means eliminating or shortening something else. I also find that by adding SSGs, I can eliminate more things, including conditioning, because the practices are intense, and there is less down time. Therefore, total time on court is reduced. If you shorten a practice from 2 hours to 90 minutes because of SSGs, maybe players get 30 minutes of additional sleep, or they have more time to seek out a healthier dinner, or you have time to lift weights prior to practice to increase strength. My intention has never been to suggest that you take your normal 2 hour practice and add 30 minutes of SSGs to create a 2.5 hour practice.As for adding games to the normal game schedule, I do believe that children should play more in unstructured activities as opposed to additional, specialized training. Which increases wear and tear more, a player going to a private coach for 2 hours per week in addition to his or her normal team practices, or a player playing 2 hour of pickup games? Again, an interesting question. I do not, however, believe that players should play all of the games currently on their schedule and add more SSGs. Personally, I think high school players would benefit from a longer break in the spring and ease into spring/summer basketball with pickup games or a SSG league rather than additional 5v5 leagues and tournaments. Several high school coaches have used the Playmakers League as their spring league, which would reduce the wear and tear compared to the typical practices and games of a normal spring schedule.I am biased, as I see SSGs as solutions to problems, not the cause of the problems. There are, of course, unanswered questions. However, with a multi-factorial problem such as overuse injuries, it is hard for me to see the SSGs at practice or instead of more typical leagues and tournaments as the cause of the injuries. Instead, the biggest cause, to me, is the lack of an appropriate offseason, as players never stop playing formal, organized basketball. There needs to be a time in the year when players do not play organized basketball or train for basketball. This time could be spent playing other sports, lifting weights, playing pickup games, and/or other similar activities, but should not involve league play, tournaments, or private on-court training. Give the body and mind a break.Rather than add SSGs to the current practices and game schedule, replace current practices with SSGs. This could mean replacing fake fundamentals with SSGs in practices or replacing 5v5 leagues with 3v3 leagues for young children. These changes should not increase the wear and tear, but could lead to a decrease in varying ways.By Brian McCormick, PhDDirector of Coaching, Playmakers Basketball Development LeagueAuthor, The 21st Century Basketball Practice and Fake Fundamentals