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Basketball is a contact sport that requires a wide variety of skill development. In conditioning, players need aerobic and anaerobic training. Aerobic conditioning involves endurance. Anaerobic conditioning deals with shortburst activity. No one program trains both the aerobic and anaerobic cardiovascular systems.

AEROBIC CONDITIONING

For basketball players, stationarybike riding is great, stairsteppers are good, and the new elliptical trainers are terrific for a lowimpact exercise. Most health clubs have elliptical trainers now, which are a combination of crosscountry machine and stairstepper.

The machines that have both upper and lowerbody components put the strongest demand on the heart.

ANAEROBIC CONDITIONING

For anaerobic training, basketball players need sprint work, which can be done on or off the court. One way to make it a little easier is to incorporate interval training into conditioning.

For example, riding a stationary bike at a certain pace and then increasing the speed and resistance to make it vigorous for 30 to 60 seconds. This will tax and improve anaerobic metabolism.

Both aerobic and anaerobic conditioning are especially helpful during playoff time or at higher altitudes, particularly for players who play a large percentage of the game.

Additionally, there is no question that conditioning helps with injury prevention. Betterconditioned athletes are going to suffer fewer injuries. Finally, if an athlete is better conditioned and he suffers an injury, it probably is going to be a less severe injury and his recovery is going to be faster.

Unfortunately, the pros do not always buy into this because some of them are so blessed with their capabilities and metabolism that they do not feel they need it. But Michael Jordan used to spend hours working out and training and making his body the best and most resilient it could be.

It is less the gift and more the work, especially as one gets older.

STRENGTH TRAINING

Professional basketball players need strength training as much as football players. When most players come fresh out of college, they have not matured in terms of muscle mass. Their games change dramatically when they add a new layer of muscle.

Basketball players probably need more strength and tone than bulk and mass. This is where conditioning philosophies differ. Some conditioning coaches believe that to be fast you have to move weights fast. I feel there is a safe, sensible way to weight train. It involves moving weights slowly with gradual weight increases to build strength  maybe adding more sets as well as strength increases. I prefer to see what an athlete can do with 12 to 15 repetitions and good form rather than how much they can maximally lift in one repetition.

OTHER USEFUL TRAINING

To a certain degree, fitness comes from playing the sport itself, but athletes can always improve their balance and agility through training. For instance, certain martial arts like tai chi can really help with balance and coordination. As gifted as these athletes are, their lower extremities are not always so coordinated, especially after an injury.

If a normal, uninjured ankle is in a cast for three weeks, not only is there a decrease in strength and flexibility but also a loss in proprioception (the finetuned coordination around a joint). This is especially true after an injury. Proprioception can be retrained through balance drills. Also, an advanced training method called plyometrics is big right now. It involves conditioning stretch reflexes, which can help a rebounder on a second and third jump for a loose ball. Although it can improve the efficiency and quickness of a jump, this type of exercise should be done under professional supervision.

FLEXIBILITY TRAINING

Flexibility is a very neglected area, especially in tall players who are not the most flexible people. Jumper's knee, or infrapatellar tendinitis, is very common in basketball and is caused by a tight quadricep (front thigh) muscle. Stretching helps jumper's knee and also helps prevent other injuries like Achilles tendinitis and hamstring tears. It may also prevent ankle sprains, which are the most common acute injury in basketball.

GETTING STARTED

Any person beginning a sport should have a thorough preparticipation screening exam. This is especially true for growing kids or people returning to a sport from injury. A good exam can make a big difference in injury or reinjury rates. For example, most people who sprain their ankle try to walk it off, or, if it starts to feel better, they try to run on it. They come into the doctor's office claiming that they feel great and want to go out and play. However, physicians often run them through a few simple tests, which reveal they are not ready to play.

Finally, most people never see the amount of work that the pros put into conditioning  for every minute a player is on the court, he is spending an hour conditioning and honing his skills. If kids or weekend warriors could see this, maybe it would be easier to convince them of the need to work harder on conditioning and rehabilitation. From the moment a pro gets hurt, he has a doctor there evaluating it, a trainer working on it, and he is getting daily attention.

Nicholas A. DiNubile, M.D., is a member of Professional Team Physicians.