Fatigue is a contributing factor in many of the injuries that occur on the basketball court. As players run low on energy, their form deteriorates, their reaction time slows, and they lose stability in certain joints. This leaves them much more susceptible to injury than they are when they're fresh.

A study performed at the University of Kentucky demonstrated how fatigue can put players at risk. Nineteen Kentucky women's basketball and volleyball team members took part in the study. Researchers had the players perform a series of running and rapid stopping drills. They measured the women's muscle activation patterns and ground reaction time at several points during the workout. The investigators found that muscle activation during rapid stopping was delayed when players became fatigued, rendering the knee less stable and more prone to injury.

If it's true that fatigue contributes to injuries, we should expect to see more injuries occur early in the season, when many players are not in great shape, and late in games, when players become exhausted. Although such patterns have not yet been well studied in basketball, analysis of other endurance team sports has yielded strong evidence of a fatigue-injury connection. For example, a study of injuries in the United States Hockey League found that game-related injuries were more frequent during the third period, and practice-related injuries occurred most often during the first third of the season.

Two ways to beat fatigue

What can women basketball players do to prevent fatigue in games and thereby increase their chances of staying healthy? The most obvious way is to delay fatigue is to maximize one's physical endurance through on-the-court and off-the-court conditioning. Jogging regularly or doing some other form of cardiovascular exercise consistently throughout the off-season is especially effective. The higher a player's endurance level is at the beginning of the pre-season, the lower her chances will be of getting injured then or at any point during the season.

Nutrition is the other big piece of the puzzle. Carbohydrate is the body's main energy source for high-intensity sports like basketball. Players can increase their endurance level quite a bit simply by getting plenty of carbohydrate from healthy foods like whole grain cereals and breads every day, and especially on game days. At the college level, and even more so at the high school level, insufficient intake of carbohydrate and total calories among female basketball players is practically an epidemic.

A second way to delay fatigue through nutrition is to sip from a carbohydrate-electrolyte sports drink frequently throughout games. There are two nutrient-related causes of fatigue in basketball games. One is carbohydrate depletion and the other is, of course, dehydration. As little as a 2% loss in body fluids will negatively impact cardiovascular performance. Basketball players can easily lose twice this amount during a game. Drinking water is better than drinking nothing, but water does not contain the electrolyte minerals (especially sodium) that are also lost in sweat, so it only does half the job of preventing dehydration. Sports drinks do a much better job of hydrating the body because they contain electrolytes.

Sports drinks also contain carbohydrate. The average female basketball player cannot store enough carbohydrate in her body to last through a complete game. So for maximum performance - and injury prevention - it is essential that players consume carbohydrate during games. By doing so, they can slow down the use of the carbohydrate supplies that are stored in their muscles, thereby delaying fatigue and extending endurance.

A quality sports drink can supply the fluid, electrolytes, and carbohydrate a player needs to maintain performance late in games. Drinking water alone will not do the job. In a study performed by researchers at the University of South Carolina, athletes who consumed a sports drink during a game were able to continue playing 45% longer than athletes who drank only water. These and other studies reinforce the importance of consuming carbohydrates during a game.

The new rules of refueling

Most sports drinks are very similar. However, a new generation of sports drinks based on breakthrough research may change our idea of what constitutes the ideal sports drink. These new drinks contain protein in balance with carbohydrate, which can make a big difference in performance. In a University of Texas study, athletes participating in moderate- and high-intensity workouts were given water, a conventional carbohydrate sports drink without protein, or a sports drink containing carbohydrate and protein in a 4 to 1 ratio (ACCELERADE). The results were quite dramatic. The athletes consuming the carbohydrate protein sports drink had a 24% improvement in endurance as compared to those who used the carbohydrate sports drink and a 54% improvement as compared to athletes who only drank water.

The addition of protein increases the muscles' fuel efficiency by speeding carbohydrate uptake, sparing stored carbohydrate and delaying muscle fatigue. The result is an improvement in endurance.

Players should get in the habit of drinking about 12 ounces of a sports drink about an hour before a game and to drink 7-10 ounces every 15 minutes during a game. By combining sound everyday and game nutrition with a steady commitment to endurance conditioning, especially during the off-season, players can greatly reduce fatigue late in games and thereby also reduce their risk of getting injured.