August 29, 2023
Inside the Stephanie Talbot journey back to basketball: Part 4
'I'm definitely stronger'
Stephanie Talbot feels like a basketball player again. She still has several months of rehab ahead, but she’s back on the court and her schedule resembles her pre-injury routine.
“I feel like my life is back to normal,” she told The Next. “I’m training every morning — Monday, Wednesday, Friday I do my weights, and then Tuesday, Thursday, Saturday, we moved my running to a separate session because it was getting so long.” At six months post-surgery, the focus of her rehab has transitioned from general athletic activity to basketball performance.
Basketball performance means Talbot’s rehab will more closely resemble things she’ll do in a game. Her earlier recovery work was more generalized, focused on basics like mobility, balance, strength or aerobic conditioning. To optimize Talbot’s return, her trainer and physio can compare her current level of performance to the specific demands needed to compete on the basketball court.
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Breaking down the game of basketball
What are the specific demands of basketball? As a simplified example, one way to break down basketball could be into upper-body, lower-body and cardiovascular components. The upper body is essential for things like dribbling, passing and shooting. Months away from the court can impact a player’s handles, timing and perception.
The lower body components include running, cutting, jumping and landing, particularly when rebounding or diving for a loose ball. In basketball, running occurs at variable speeds, and both the speed and direction change rapidly within possessions. Jumping and landing for a set shot typically occurs from two feet, but for a layup, it’s frequently from one leg. Training for each of these scenarios should be incorporated.
Running distances are limited to the size of the court, allowing for short sprints on a fast break or slower-paced movement through set plays. Basketball games include mandatory time-outs and breaks between periods, when players essentially have a brief rest period. This limits the total time an athlete can run continuously. These running factors are taken into consideration for the cardiovascular needs for basketball performance.
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What are Talbot’s specific needs to address these basketball components to return to high performance?
For the upper body, Talbot’s strength is better than before her injury. She started training her upper body a few days after surgery and noted, “I’m definitely stronger. I could never do chin-ups before, and now I can.” As for dribbling, passing and shooting, Talbot wasn’t ready to touch a basketball in the early months. Getting a ball into her hands was the first step. Training started with set shots and layups and progressed to jump shots and moves to the basket.
Of higher priority are lower-body and cardiovascular demands, which initially decline after surgery. These can’t be adequately trained during the early healing stages. Talbot’s physio conducted baseline assessments of balance, strength and power and will re-test her periodically to assess progress. They’ll compare her surgical leg to her non-injured leg and use those measurements to develop her training program.
Talbot’s trainer added reaction and change of direction drills. She’ll run to a spot on the court, he’ll call out “jump shot” or “layup,” and she’ll complete the play as directed. Sometimes he’ll compete against her. “It would be a race, and that stuff is all right because it’s competitive and I’m trying to beat [him]. If I’m not trying to beat someone, it’s hard to get going sometimes.” At this phase, she said, “it’s a little bit more interesting then just running back and forth between cones, which was boring.”
Running and landing from jumps, such as with rebounding or diving for the ball, are key, especially for the type of play Talbot typically demonstrates. In the 2022 WNBL season, she averaged 7.4 rebounds per game with the Adelaide Lightning. Muscles produce force in two ways: They accelerate movement while shortening in length, a concentric movement, or they decelerate movement while elongating, an eccentric movement. The eccentric brakes are Talbot’s strength training priority right now. “The only thing I still struggle with are the eccentrics and the deceleration. I’ve been doing a bit of rebounding work, so landing double leg I’m fine and single leg I’m fine, but landing on the affected leg is stiff because I don’t have the eccentric strength yet.”
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At The Next’s last check-in with Talbot, she shared the only training that made her sweat was on the ski ergometer. Ski erg training requires the athlete to pull down on cords attached to pulleys while bending at the trunk. The feet remain on the ground. Since there’s no impact, it’s a great option for cardio work soon after knee surgery. It allows for training in intervals, alternating short bursts of hard work with rest breaks. This is different from steady state training, working at a lower intensity for a longer period of time. Interval training and steady state training both increase heart rate and challenge the cardiovascular system, but they target different energy systems.
Humans have three systems for creating energy in our bodies. As Talbot progresses in her recovery, her cardio training will get more specific to the energy pathways needed to play basketball. Which system is used depends on the duration and intensity of the activity.
Let’s say you want to heat up a pot of soup. The fastest method requires the least energy from you: Turn the knob on your stove. Building a pile of sticks and rubbing them together to ignite a flame would take longer and require much more energy to achieve the same goal.
A similar concept applies to how the cells in our bodies create fuel. The outcome is energy in the form of ATP (adenosine triphosphate), which our muscles need in order to function. A low-intensity activity can be sustained for a long duration of time using aerobic glycolysis to make ATP. This process requires oxygen and is the method used to run a marathon. A baseline level of aerobic fitness is essential for all basketball players. As intensity of exercise increases, oxygen supply is insufficient and alternative pathways are needed.
With moderate intensity and duration, anaerobic glycolysis is used to make ATP without oxygen. This could occur during a game segment where both teams are going back and forth in transition without slowing for half-court set plays. ATP is created quickly, but lactic acid is made as a byproduct. Lactic acid limits how long the body can tolerate work at this intensity.
At the highest intensity, the phosphagen system uses energy stored in the muscles and lasts only a few seconds. Sprinting from one end of the court to the other for a fast break could use this system. Athletes can train each energy system individually, so focusing on the ones needed for basketball are prioritized in Talbot’s training. She shared, “I was doing a sprint session … running the length of the court every 20 seconds, so I’d get about a 10-second break in between … I feel like no matter how fit you are running, sprints are always hard.” This paper from Morrison et al. defines the energy systems and provides training recommendations for each.
Talbot isn’t doing any long runs, but her trainer programs moderate duration and intensity interval runs and sprint intervals. “We only do the longer stuff once a week and the shorter stuff more often … Last week I did a workout of 6x800m runs, and then this week I did a pyramid where I ran for four minutes, took a two-minute break, three-minute run, two-minute break, two-minute run, two-minute break, and then I did that again. So it’s all broken up. It’s not like I’m just going for a 5K run.” Basketball stops play approximately every five minutes, so these interval sessions closely mimic on-court running.
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WNBL season about to begin
Looking forward, Talbot hopes to return to playing in early 2024 with the Adelaide Lightning. In June, she signed a four-year contract with the Lightning, whose preseason training is scheduled to begin on Sept. 11. Talbot will start the season as an assistant coach, taking advantage of this opportunity to learn basketball from a different perspective. “The coach has started bombarding me with plays and ‘Do you like this one?’ ‘What do you think about this?’ Talbot said. “It’s not something I ever thought I would do post-career … But I think it’s like, assistant coach slash working with players, I think it’d be good and I’ll learn stuff. See the game in a different way.”
The WNBL regular season kicks off on Nov. 1. In Part 1 of this series, we discussed why returning early isn’t recommended. Nine months post-surgery is on Dec. 1. So far, the most offense versus defense Talbot has played is against her trainer. “We played one-on-one. Not properly, but I got bumped a bit and that was fun.” A January return to full competition, assuming all testing progresses according to plan, is probable.
After the WNBL is the 2024 WNBA season, where Talbot is under contract to play for the Los Angeles Sparks. Talbot’s injury occurred three weeks after signing a two-year deal with LA. Talbot also expects to play in the 2024 Summer Olympics in Paris with the Opals. She previously won a bronze medal with Australia at the 2022 FIBA World Cup and competed in the 2020 Tokyo and 2016 Rio de Janeiro Olympic Games. So far, everything is on track for her to be back on the court for all of these events — to show the world that she’s a basketball player again.
Want to learn more about Stephanie Talbot’s return to basketball? Browse the entire series here.
Written by Dr. Abby Gordon
Abby Gordon is a Board-Certified Sports Physical Therapist at Seattle Children's Hospital. She was the Team Physical Therapist for the Seattle Storm from 2015 to 2022 and the Travel Coordinator and Equipment Manager for the Connecticut Sun from 2007 to 2010. After four seasons working as a team manager for the UConn Huskies Women's Basketball team, she graduated from the University of Connecticut in 2007 with a Bachelor's in Exercise Science and in 2014 with a Doctorate in Physical Therapy. She writes about WNBA Injuries and Sports Medicine Issues in Women's Basketball for The Next.