Last week, sports fans witnessed arguably the most gruesome knee injury – both visually and medically – in recent history when the Clippers’ Shaun Livingston’s knee folded up like a lawn chair on a seemingly harmless play (be forewarned; this video is not for those with uneasy stomachs). Given Livingston’s age (21) and “fragile” 6-7 frame, many supporters of the NBA’s new age minimum restrictions are quick to assert that this injury would not have happened if Livingston had been forced to wait longer to enter the NBA. Dan Wetzel of Yahoo Sports wrote a detailed piece on the topic.

As a strength coach who has worked extensively with basketball players, I can say without wavering that this couldn’t be further from the truth; chronological age had nothing to do with Livingston’s injury. Physical maturity, training experience, and – presumably – ignorance of previous injuries and imbalances did. What seems to be lost in the details is that the Clippers guard also had a stress reaction in his lower back and pre-existing ankle problems; any of the best coaches and physical therapists in the business will all tell you that dysfunctions are almost never isolated.

Stress reactions are commonly the result of repeated hyperextension of the lumbar spine secondary to poor core stability and hip mobility (not to mention that the typical NBA spine is a LOT longer than that of the Average Joe). As part of this dysfunction, the gluteal muscles fail to fire sufficiently, and they lack the strength and activation level to decelerate “knock-knee,” internal rotation forces in landing – just like the one that ended Livingston’s season. When you lack mobility at the hips and ankles (most basketball players have terrible ankle mobility due to high-top sneakers and ankle taping), the knee (a joint that should just be a stable hinge) develops instability to create mobility. He could easily have developed chronic hip or knee pain; a traumatic injury got him first. Put a 1983 Buick engine in a 2007 Ferrari body, and you’ve got the typical NBA athlete.

When it comes to injuries, the basketball culture is reactive, not proactive. Unlike sports like football, hockey, and baseball that have embraced dedicated off-season conditioning programs (not to mention resistance-training from an early age), the basketball community – from the youth leagues right up to the NBA – has yet to appreciate how valuable a role strength and conditioning can play in preventing injuries like Livingston’s.

Rather than preventing the injuries by participating in dedicated off-court off-season training programs, most basketball players go right back to playing street ball, AAU hoops, or NBA summer leagues – all the while reinforcing the imbalances they’ve developed. Everyone wants to compete, but nobody wants to train or even rehab. Apparently, alley-oops and crossover dribbles are a lot more “sexy” than lifting weights and doing flexibility drills – at least until you rupture an ACL, MCL, PCL, patellar tendon, and lateral meniscus on a lay-up.

Karl Malone was notorious for his rigorous off-season lifting regimen, and he was quite possibly the most durable player in the history of the league. Entering the NBA at a young age wasn’t a problem for Lebron James – and it should come as no coincidence that he was resistance training for years before his arrival to the NBA at age 18. I had a 15 year-old, 192-pound high school shortstop front squat 300 for an easy single on Friday, then vertical jump 28.5 inches and box squat 355 today with a bit left in the tank. Do you mean to tell me that he won’t be ready for professional sports physically in three years? Please!

The NBA doesn’t need to institute age restrictions; it needs to take the initiative to develop a culture – independent of age – where players start training smart and taking care of their bodies.

Want to learn more?  Check out The Ultimate Off-Season Training Manual.