Women’s Basketball Strengthening & Conditioning

Strengthening and conditioning are foundational for all athletes, but each sport has its own fitness focus and injury concerns.

Haylee Borgstrom, MD, a Mass General Brigham sports physiatrist, specializes in the nonsurgical treatment of sports injuries at Massachusetts General Hospital. 

She discusses the unique strengthening and conditioning needs of basketball players assigned female at birth (AFAB).

What are strengthening and conditioning?

“Strengthening is what you’re doing in the weight room, and conditioning is what you’re doing on the court,” says Dr. Borgstrom. “But there is some overlap between them.”

In a conditioning program, basketball players typically:

• Build cardiovascular endurance through aerobic exercise, which is activity that raises your heart rate 
• Agility work to improve athleticism 

In a strengthening program, they typically:

• Build muscle strength 
• Improve neuromuscular control

Why are strengthening and conditioning important in women’s basketball?

“As in most sports, a good strengthening and conditioning program not only prevents injuries but also improves performance,” says Dr. Borgstrom.

Basketball strengthening and conditioning programs aim to optimize strength and aerobic capacity so athletes can stay healthy while performing at their highest level.

Athletes typically focus more on performance, but trainers and medical professionals may focus more on injury prevention.

“With a good strengthening and conditioning program, ideally, you can accomplish both of those goals,” says Dr. Borgstrom.

The role of strengthening in injury prevention

“There’s more and more research coming out about the importance of a good strengthening and conditioning program, particularly the strengthening piece, to prevent injuries,” says Dr. Borgstrom.

In a sport like basketball, where players need conditioning for the endurance required during games, conditioning can overshadow strengthening. However, in injury prevention programs (IPPs), strengthening is essential. 

“In the medical community, we know how important strengthening is for injury prevention, but that doesn’t always translate to the athletes and coaches,” says Dr. Borgstrom. “So, getting buy-in on strengthening from training staff and coaches is key.”

Common injuries in women’s basketball

Certain injuries are more common in basketball players AFAB than players assigned male at birth (AMAB) due in part to physical differences.

“The anatomy of the pelvis and hip girdle, for example, is different in a woman. These anatomical differences cause different injury patterns in basketball players AFAB,” says Dr. Borgstrom.

Common basketball injuries in players AFAB include:

• Anterior cruciate ligament (ACL) injury or tear, which is an injury to one of the ligaments that connects the tibia (shin bone) to the femur (thigh bone)
  
• Ankle injury, especially to the ligaments on the outside of the ankle
• Hip injury, including sprains and strains 

“The common injuries show us where we need to focus more of our attention when it comes to strength training in female athletes,” says Dr. Borgstrom.”

Women’s basketball strength training

Dr. Borgstrom says athletes AFAB tend to be more quad-dominant. Quad dominance means they focus on developing the muscles on the front of the thighs rather than areas like the hamstring and gluteus, the muscles on the buttock and the back of the upper leg. 

“This has been shown to increase the risk of injuries like ACL tears,” she says.

She recommends that women basketball players focus more on strengthening muscles of the posterior chain. The posterior chain includes:

• Back muscles
• Gluteus muscles (glutes)
• Hamstrings
• Hips

Focus particularly on the glutes and the hip abductors, which are smaller muscles on the outside of the hip. 

“Strengthening the posterior chain muscles is the cornerstone to preventing injuries in the entire lower extremity, including foot, ankle, ACL, and hip injuries,” says Dr. Borgstrom. “Really focusing on the smaller glute muscles decreases the risk of all these injuries.”

Focus on efficient strength training

It’s essential to create a thorough, high-yield strengthening program. 

“There are only so many hours in the day, especially when you’re playing at the collegiate level or higher where you’re practicing three 3 or more hours a day,” says Dr. Borgstrom. “The strength program needs to be efficient.”

Dr. Borgstrom says a focused 20-minute strengthening program is enough for most basketball players. Serious basketball players at the college level or higher will need a more extended program. 

Fuel fitness with nutrition

Many serious athletes, especially at the college level, have very busy schedules that include a lot of travel. It can be challenging to get proper nutrition. 

“You can’t forget about the nutrition piece in optimizing performance and preventing injury,” says Dr. Borgstrom. “If you’re not fueling appropriately with food, you’re not going to get the benefits of your hard work.”

There are also complicating nutrition issues that are more common in women athletes. 

“A quarter of female athletes have disordered eating patterns. Not a true eating disorder, necessarily, but they’re just not fueling appropriately,” says Dr. Borgstrom. “Some of these eating issues are inadvertent, but body image issues are also common, which can affect eating.”

Dr. Borgstrom recommends that women’s basketball programs incorporate team sports dietitians and nutritionists when possible. She wants to see nutrition and overall health made into team priorities.

Season vs. off-season conditioning and strengthening

Dr. Borgstrom offers a few key considerations for in-season versus off-season fitness.

“During the season, there’s typically less focus on injury prevention and strengthening because there’s only so much time, and much of it is dedicated to sport-specific practice,” she says. 

Another concern is that a lot of athletes lose weight during the season, which conflicts with the goal of building and maintaining muscle. Weight loss is a good indicator that an athlete isn’t fueling enough to maintain strength for their best performance.

And while off-season training is important, all athletes need time off where they’re not doing sport-specific activities, says Dr. Borgstrom. She recommends that basketball players AFAB focus on building muscle mass and cross-training in the off-season. 

Cross-training, where athletes do different sports or activities than their primary sport, helps avoid overuse injuries. It also helps maintain mental health and prevent burnout.

“The off-season is an important time to take a mental break from your sport,” Dr. Borgstrom says. “Everyone needs an off-season.”