ACL Injury Epidemic – The Solution Starts with Coach Education & a Change away from Peak by Friday Mindset

ACL injuries have become a politicized issue, as evidenced by Wendy Parker’s latest column. While pundits and activists battle, the larger issue is muddied: the rhetoric has no effect on changing the epidemic of injuries. Rather than writing about rehabilitation or prevention programs, the injury issue creates a gender war.

The epidemic boils down to two issues: (1) Lack of education and dissemination of information to coaches and (2) the Peak by Friday mentality.

The female body differs from the male body, especially after puberty. These differences, according to most experts, affect or even cause the disparity of injury rates between males and females. To suggest otherwise is foolish based on what is known currently.

However, researchers have amassed plenty of evidence to suggest that anatomy is not the sole reason for the disparity. I am uninterested in the arguments of the male vs. female body because there is little that I can do to change someone’s anatomy. The other issues, however, can be impacted by training and skill development and therefore interest me.

Are injuries a result of poor coaching? Yes. Are they a result of poor parenting? Often. However, in most cases, these coaches and parents are not malicious. There is no intent to harm. There is ignorance. There is a void in the education of coaches, especially in terms of movement-related skills. As I wrote recently, basketball coaches, even at the NCAA or WNBA (or should I say especially at the NCAA and WNBA levels), are not movement experts.

Youth coaches typically volunteer their time and are not Coaches, but parents who work, raise children and coach as a hobby or to spend time with their sons or daughters.  Rather than blaming these coaches, as a semi-recent New York Times article appeared to imply, we need to cherish these parents who volunteer, as there would be far less opportunity for children, especially females, to play sports without the volunteer coaches. Rather than chastising these coaches, we need to nurture and provide them with resources. If we are to place blame, the blame should fall on the organizations who sponsor and generate income from the leagues, camps and tournaments that fail to nurture coaches and provide coaching resources.

At the high school level, we also have part-time coaches. They teach or work another job and coach for a small stipend. Even if they had the interest, the stipend they receive would barely cover the cost of attending a great conference to learn more (and I am not talking about Nike Clinics).

These are our coaches at the developmental levels: volunteers, amateurs and part-time coaches. However, these are the years of growth and development. The developmental years are the time when athletes develop practice habits, techniques, skills and mechanics. If these are developed incorrectly or inefficiently, these athletes must re-learn their habits, techniques or skills at a later age or they simply fall out of the competitive stream because they can no longer compensate for their deficiencies.

In the United States, our professional coaches, for the most part, coach at in the NCAA and WNBA. We should place higher demands on these coaches, as they earn an income commiserate with high expectations. However, to my knowledge, not one women’s college basketball coach attended the Boston Sports Medicine and Performance Group conference despite it falling during a relatively dead period (first weekend of June). How many colleges are within a two-hour drive of Northeastern University? There were no fewer than three presentations directly related to ACL injury prevention, and several others that were relevant, yet nobody attended. Why? Because basketball coaches specialize in basketball. They are hired to win games, not to keep their players safe.

The second problem is that this mentality seeps into the lower levels, and our expectations for coaches at every level center on winning. Good coaches win; bad coaches lose. We cannot differentiate one’s coaching ability from their record.

Therefore, coaches take a Peak by Friday approach to their teams; they concentrate on the next game, not on their athletes’ development. If you ask most coaches to spend 10-15 per minutes at practice on movement skills – skills that enhance performance as well as reduce injury risk – they will say that they are too busy. No coach is fired because he or she has too many players suffer ACL injuries, but plenty are fired for losing too many games.

To make inroads into the ACL epidemic, and to improve the quality of coaching and play in general, we need to raise our expectations of our coaches. At the grassroots, recreation levels, this is difficult because most organizations are thankful to have anyone without a criminal record offer to coach. However, if this is our expectation when finding or recruiting new coaches, what should we expect? Finding coaches is often a difficult process, and volunteering for a youth team can be a thankless task as every parent in the stands suddenly knows more than the coach. However, what can leagues and organizations do to improve the coaching experience? When a league finds a great coach, how can it keep the coach rather than watching him or her leave when his or her daughter or son finish playing in the league? These are the questions that need to be asked.

When a league finds a great coach, why not offer him a position overseeing other coaches? As a volunteer position, he or she may not be able to invest many hours, but why not create a mentor system for experienced and novice coaches?

These questions do not address ACL injuries specifically. However, ACL injuries are a symptom of a larger problem. If we do not raise our expectations of leagues, and leagues fail to nurture and retain good coaches, how can we expect these leagues to implement the available neuromuscular training programs? If we do not address the Peak by Friday mentality first, how do we ensure the adherence to these programs once introduced?

Writing about ACL injuries is a hot-button topic now, so articles attract eyes, and eyes translate to dollars. Writing about coach education or the win-at-all-costs mentality lacks the same hotness. ACL injuries are the acute injury, but the coach education and preparedness is the chronic problem. When a player injures her ACL, the injury sparks new interest and articles. However, there is no event to spark the same interest in general coach training.

If we really want to make a difference, we need to start young. Sport coaches need to look beyond sport-specific skills to the general movement skills that form the foundation of all sports skills. With physical education cuts and a reduction in free, spontaneous play, sport coaches must fill the void and ensure the proper execution and training of these general skills.

Will this help win games? At 7 or 8 years-old, who cares?

These sport coaches need the tools to change their approach, and developing and disseminating these tools fall to the organizations and leagues. I am amazed that leagues do employ a Technical Director or some other position to oversee the quality of the coaching. In Europe, I was the Head Coach of a professional team, but in that capacity, I was also in charge of the underage coaches. We met about philosophy and drills and teaching concepts. I attended practices.

Of course, this was a professional position – I was doing my job. However, why is there no quality control? On TV, I hear advertisements for the Jr. Jazz and their 10,000 players. If you raise the cost of the league $3, you could pay a Technical Director $30,000/year to attend practices, lead clinics, mentor coaches, identify mentor coaches, etc. What if each league gave a Coach of the Year award based not on record, but a professional’s objective evaluation of the coach’s teaching style, feedback, learning environment, etc.?

These ideas appear impossible to implement. Why? The reason that leagues do not implement these ideas is because they derive no benefit. Parents are not choosing leagues based on the coach training that the coaches receive. Parents generally do not know what to look for or what questions to ask. Leagues thrive based on marketing like most businesses. If people thought critically about their beverage choices, would Coke be a thriving international company? No. Instead, we buy the easiest product to find, the one with which we are most familiar, regardless of its effect on our health.

We make the same choices when we choose leagues, teams, etc. Since familiarity trumps effectiveness in our choices, leagues derive no benefit from adding expenditures to improve the league.

Youth sports is a business. Ultimately, parents dictate the business through their choices. Business will chase the dollars. If parents insist on quality coaching, leagues that can demonstrate the quality of their coaching through certifications, mentorships, etc. will derive benefit from these efforts.

What if a league, rather than charging coaches to attend a Saturday clinic or asking them to volunteer more of their time to attend the clinic, paid the coaches to attend or gave the coaches free gear or products to assist with their coaching? Would more coaches be interested in coaching clinics if they were paid to attend or given gifts for attending? Rather than creating another impediment in finding coaches, use the clinics as a reward for volunteering. Change the narrative.

Eventually, when we see some of these changes implemented with recreation leagues, YMCAs, middle school leagues, AAU, NJB, BCI, etc., we will create the environment where the neuromuscular training programs which have been shown to be effective in reducing the incident rate of ACL injuries can have an effect. Before we shift the philosophy or mentality of the coaches and establish long term development and coach preparedness as the expectation not the exception, these neuromuscular training programs will remain sporadic and the injury rate will remain the same.

YBCA tentatively has scheduled a clinic on October 11 at the University of Utah. More information to follow.

 By Brian McCormick
Brian McCormick Basketball
Author, Cross Over: The New Model of Youth Basketball Development
Director of Coaching, Playmakers Basketball Development League


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