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THE WHOLE ATHLETE

SKILL × PERFORMANCE HEALTH

Bridging Skill Development with Performance Health

Kevin Wilson, Doctor of Physical Therapy

Head Strength & Conditioning Coach, Toronto Tempo (WNBA)

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KEVIN WILSON

DPT · MScPT · CSCS · RSCC

Head Strength & Conditioning Coach, Toronto Tempo (WNBA)

Co-Owner, Align’d Body Mind, Milton, ON

Founder, Canadian Basketball Performance Network (CBPN)

WNBA

Toronto Tempo

Head S&C Coach

NBA

LA Lakers · OKC Thunder

Strength Coach

NBA GLOBAL

Basketball Without Borders

S&C Coach, Los Angeles and Singapore camps

CANADA

Canada Basketball

Junior Academy

CEBL

Canadian Elite Basketball League

NBL CANADA

National Basketball League of Canada

UK

British Basketball League

SCOTLAND

Scotland Basketball

A quick bit about me so you know where this comes from. I’m Kevin Wilson, a Doctor of Physical Therapy and strength coach. I’m currently the Head Strength and Conditioning Coach for the Toronto Tempo in the WNBA, and before that I worked in the NBA with the Lakers and the Thunder. I’ve worked with Canada Basketball at the youth level, with the NBA’s Basketball Without Borders camps in Los Angeles and Singapore, and across leagues here and overseas: the CEBL, NBL Canada, the British Basketball League, and Scotland Basketball, including their U16 team. Outside of team sport, I co-own Align’d Body Mind, a multidisciplinary clinic in Milton, and I founded the Canadian Basketball Performance Network. Everything in this talk is the stuff I wish every skill coach I’ve worked with knew.

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Four Pillars, One Athlete

TODAY’S GAME PLAN

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01

The whole athlete

Sleep, stress, the menstrual cycle, iron and energy: what “lazy” might really be

02

Load management

Measuring load, a simple ACWR, a WNBA schedule stress-test, and smart rest

03

Strength training

Core principles, and what off-season vs. in-season looks like at every age

04

Nutrition

How fuel shows up in skill, macronutrients made simple, and needs by age

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Before you call it lazy, ask why

LOOK BENEATH THE SURFACE

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BIO

Sleep, iron status, fuelling, the menstrual cycle, illness, growth spurts

PSYCHO

Stress, anxiety, confidence, motivation, fear of re-injury

SOCIAL

School and exams, family, work, money, team dynamics, travel

“Low effort” or “out of shape” is an observation, not a diagnosis.

The same factors that limit training also limit learning: focus, decisions, retention.

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Stress is load, too

PSYCHOSOCIAL LOAD

Slimani et al., 2018 (meta-analysis, soccer); Kellmann et al., 2018; Soligard et al., 2016

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What the research shows

Negative life events, high life stress, daily hassles and trait anxiety predicted injury in soccer players
Psychological interventions (stress management, imagery, goal setting) reduced injury rates in senior players
Recovery is physical, psychological and social

How it shows up on the court

Slower reads and decisions, more turnovers
Poor focus; corrections that don’t “stick”
Higher RPE for the same session
Withdrawn, irritable, or suddenly “not trying”

Exam week is a heavy week. Count it in the plan, not just on the court.

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Sleep is part of the load equation

THE CHEAPEST RECOVERY TOOL

Walsh et al., 2021; Watson et al., 2020; Chan, Yung & Mok, 2024

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43%

lower in-season injury risk for each extra hour of sleep, in NCAA Division I men’s basketball players

Watson et al., 2020, as summarized by Chan et al., 2024

Elite athletes are especially prone to short sleep (under 7 hours) and broken sleep, driven by late games, travel, stress and screens.

Recommend an individualized approach, based on each athlete’s own sleep needs, rather than one number for everyone.

Add “How did you sleep?” to every check-in.

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Individual, not average

THE MENSTRUAL CYCLE

McNulty et al., 2020 (meta-analysis); Mountjoy et al., 2023 (IOC REDs consensus)

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On average: small

Performance is only trivially lower around the period on average, with big differences between athletes.

For the individual: real

Cramps, fatigue, poor sleep, mood changes and heavy bleeding can change what a given day should look like.

Red flag

Missing or irregular periods are not “normal for athletes.” They can signal under-fuelling (REDs). Refer.

What coaches can do

Make it normal to mention · let athletes opt in to sharing, privately · adjust for symptoms like any other symptom · have a female staff member or clinician athletes can go to · involve parents and a physician for minors

For those coaching female athletes, the menstrual cycle deserves a direct, normal conversation. On average, the research says the effect on performance is small: McNulty and colleagues’ 2020 meta-analysis found performance was only trivially lower in the early follicular phase, around the period, but with big differences between individuals, so they recommend a personalised approach. That’s the point: averages don’t play; individuals do. Cramps, fatigue, poor sleep and mood changes can absolutely change what a given practice should look like for one athlete. And one red flag: missing or irregular periods are not a normal side effect of training hard. They can be a sign of low energy availability, REDs, and that’s a referral. Practically: make it normal to mention, let athletes opt in privately, adjust for symptoms the way you would for any other symptom, make sure there’s a female staff member or clinician they can talk to, and for minors, loop in parents and a physician.

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Tired isn’t always unfit

IRON AND ENERGY

Sim et al., 2019; Mountjoy et al., 2023 (IOC REDs consensus)

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15–35%

of female athletes are iron deficient, vs. 3–11% of male athletes

Signs: lethargy, fatigue, low mood, poor work capacity. Risk rises with menstruation, low energy intake, plant-based diets and heavy training.

UNDER-FUELLING (REDs)

Not eating enough for the work being done (low energy availability) harms health and performance.

It affects male and female athletes. Busy schedules, growth spurts and skipped meals before practice all add up.

Don’t diagnose or supplement. Persistent fatigue → physician bloodwork + sports dietitian.

Here’s a classic “lazy” trap. Iron deficiency is common in athletes: a 2019 review estimated roughly 15 to 35 percent of female athletes and 3 to 11 percent of male athletes, and some studies of young elite athletes report even higher. Symptoms include lethargy, fatigue and low mood, and when it progresses to anaemia, work capacity drops. Risk goes up with menstrual blood loss, low energy intake, plant-based diets and heavy training. Closely related is under-fuelling: the 2023 IOC consensus on Relative Energy Deficiency in Sport describes how not eating enough for the training load harms both health and performance, in male and female athletes. Key point for coaches: we don’t diagnose and we don’t hand out iron. The same review found that supplementing athletes who weren’t deficient didn’t improve performance. If fatigue is persistent and unexplained, refer to a physician for bloodwork and to a sports dietitian. For minors, that conversation goes through the parents.

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What the youth guidelines say

THE DEVELOPING ATHLETE

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Recommendation	What it means on the court	Source
Sample other sports	Delay basketball-only specialization until about age 14	DiFiori et al., 2018
Build in rest	Regular days off, and time away from organized basketball each year	DiFiori et al., 2018
Develop athleticism	Strength, movement skill and fitness for every youth athlete, not just the elite	Lloyd et al., 2016
Respect maturation	Growth spurts change tolerance to load; individualize, don’t age-group	Lloyd et al., 2016

Development is the goal. Load is the tool. Burnout and overuse are the cost of getting it wrong.

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What is Load Management?

WHY BRIDGE THE GAP

Gabbett, 2016; Gabbett, 2020

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1

High load, built gradually

Athletes accustomed to high training loads tend to have fewer injuries than those training at lower loads.

2

Fitness is protective

Well-developed physical qualities are associated with lower injury risk across many sports.

3

Under-training is a risk too

Too little load leaves athletes unprepared for the spikes that games and tournaments bring.

It isn’t the load that hurts athletes. It’s the jump in load they weren’t prepared for.

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You already control the load

THE SKILL COACH’S DIALS

General guidance: actual cost depends on duration, intensity and the athlete

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Turn it up or down with

Court size and number of players
Work-to-rest ratio and total duration
Live defence vs. no defence
Jump, cut and contact density
Full-court vs. half-court

Typical relative cost

Form shooting, free throws

Low

5-on-0 walkthrough

Low

Shell, closeouts

Moderate

1-on-1, 2-on-2 live

High

Full-court transition

Very high

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Two sides of load

LOAD MANAGEMENT

Bourdon et al., 2017; Soligard et al., 2016

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EXTERNAL LOAD

What the athlete did

Minutes, sessions, games
Jumps, accelerations, decelerations
Distance, sprints, contacts

INTERNAL LOAD

How the athlete felt it

Rating of perceived exertion
Heart rate
Soreness, sleep, mood, stress

The same drill can be easy for one player and brutal for another. Track both.

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It’s not just sitting the star

WHAT LOAD MANAGEMENT REALLY MEANS

Soligard et al., 2016; Chan, Yung & Mok, 2024

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1

PRESCRIBE

Plan the week: hard days, easy days, progressions

2

MONITOR

Record what was done and how it felt

3

ADJUST

Modify, progress or rest based on the data and the athlete

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Session RPE: one question, one number

THE FREE TOOL

sRPE was the most-used internal load measure across basketball injury studies (Chan, Yung & Mok, 2024)

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6

RPE (0–10)

×

90

minutes

=

540

arbitrary units (AU)

“How hard was that whole session, 0 to 10?”

Ask about 30 minutes after

so the last drill doesn’t dominate the answer.

Ask privately

(a form or text), so players don’t copy each other.

Count everything

practice, games, other teams, skills trainers.

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This week vs. what they’re used to

ACUTE:CHRONIC WORKLOAD RATIO

Weiss et al., 2017 (n = 13, one season); range guidance from Chan, Yung & Mok, 2024

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ACUTE

Total load, last 7 days

÷

CHRONIC

Average weekly load, last 4 weeks

=

ACWR

Below 0.8

Under-loaded, detrained

0.8 – 1.3

The range most often cited

1.3 – 1.5

Caution

Above 1.5

Spike: plan carefully

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The tournament-weekend spike

WORKED EXAMPLE: A U15 CLUB PLAYER

Illustrative numbers. Youth players who got hurt often had low 3–4 week loads before a high 1-week load (Benson et al., 2021)

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NORMAL WEEK

3 practices × 90 min × RPE 6 = 1,620

1 game × 40 min × RPE 7 = 280

1,900 AU

Chronic load (4 steady weeks)

TOURNAMENT WEEK

2 practices × 90 min × RPE 6 = 1,080

5 games × 40 min × RPE 8 = 1,600

ACWR 1.41

2,680 ÷ 1,900: a spike

ADJUSTED WEEK

1 light practice × 60 min × RPE 4 = 240

Same 5 games = 1,600

ACWR 0.97

1,840 ÷ 1,900: back in range

You can’t change the tournament schedule. You can change the practices around it.

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From the All-Star break into the grind

NEW YORK LIBERTY, SUMMER 2025

Schedule: 2025 New York Liberty schedule (Sports Illustrated, 2024); Swish Appeal, 2025

17

Sa

19

ASG

Su

20

M

21

Tu

22

IND

W

23

Th

24

F

25

PHX

Sa

26

LA

Su

27

M

28

DAL

Tu

29

W

30

MIN

Th

31

F

1

CON

Sa

2

Su

3

CON

M

4

Tu

5

DAL

W

6

Th

7

F

8

DAL

Sa

9

Su

10

MIN

JULY

AUGUST

7 games in 13 days, incl. a back-to-back and a 4-game road trip

Home game

Away game

All-Star Game (ASG)

No game

Ten games in 20 days, coming straight off a mid-season break. What does that do to the ratio?

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The spike is built in the valley

MODELLED ACWR FOR A STARTER, JUL 6 – AUG 10

Real 2025 Liberty schedule; loads are illustrative sRPE (game 450 AU, practice 220, day after game 60). Rolling 7-day ÷ 28-day average weekly load.

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1.39

0.36

All-Star break

Spike

0.8–1.3 range

Here’s the model. The schedule is real; the loads are illustrative session-RPE values for a starter: about 450 units for a game, 220 for an in-season practice, 60 for a recovery day. The orange line is “no plan”: five days of complete rest over All-Star, then straight back into the full schedule with normal practices. The ratio collapses to 0.36 during the break, because acute load vanishes, and then, with chronic fitness eroded, the return to games drives it to 1.39 by July 28, right as the road trip starts. The dashed blue line is managed: a couple of moderate sessions during the break to keep chronic load up, then practices swapped for walkthroughs during the congested stretch and a minutes cap on the second night of the back-to-back. Same games, same opponents, and it stays between 0.66 and 1.22. The lesson: the spike is built in the valley. What you do during the break decides how hard the return hits.

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Three small changes flattened the curve

SAME GAMES, DIFFERENT PLAN

Modelled values from the previous slide (no plan → managed). Illustrative, not team data.

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1

Keep the break loaded

Two moderate sessions during the All-Star break instead of five days off, so chronic load doesn’t erode.

2

Trade practice for walkthroughs

On non-game days in the 7-in-13 stretch, film and shootaround replace full practice.

3

Cap minutes on night two

A planned minutes limit on the second game of the back-to-back.

Lowest point

0.36

→

0.66

Highest point

1.39

→

1.22

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Rest is a dial, not a switch

RESTING PLAYERS APPROPRIATELY

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1

Swap to lower-cost skill work: form shooting, film, free throws

2

Reduce volume: fewer reps, shorter session, minutes cap

3

Reduce intensity: half-court, no live defence, no contact

4

Protect a tissue: no jumping, or ball-handling only

5

Full rest day

MOVE DOWN WHEN

ACWR above 1.5, or returning from a long break
Several poor nights of sleep
Unusual soreness or fatigue
Illness, or a heavy exam week
Pain that changes how they move: refer to a physio

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A weekly log anyone can run

SKILL COACH TOOLKIT

Example entries. A shared spreadsheet or a free form works fine.

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Day	Session	Min	RPE	sRPE	Sleep
Mon	Team practice	90	6	540	8 h
Tue	Skills session	60	5	300	7 h
Wed	Off	0	–	0	9 h
Thu	Team practice	90	7	630	6 h
Sat	Game	40	8	320	8 h
Week	Acute load			1,790

3-QUESTION CHECK-IN

1

How hard was today, 0–10?

2

How did you sleep?

3

Anything sore or hurting?

Every Sunday: this week ÷ 4-week average. Flag big jumps or drops.

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Strength Training:��Every skill rep is also a load rep.

The body doesn’t know whether a jump came from a shooting drill, a conditioning circuit or a game. It just counts it.

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The best injury prevention we have

STRENGTH TRAINING

Lauersen, Andersen & Andersen, 2018 (meta-analysis); Stricker et al., 2020 (American Academy of Pediatrics); Lloyd et al., 2016

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~66%

lower sports-injury risk with strength training, across 6 trials and 7,738 athletes aged 12–40

Dose-dependent: more strength training volume, fewer injuries.

For young athletes too

Children and teens of all ages can benefit, with qualified supervision and good technique
Builds strength, movement skill, bone health and confidence
It doesn’t stunt growth; poor supervision and technique are the real risks

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Five rules that apply at every age

STRENGTH TRAINING PRINCIPLES

Lloyd et al., 2016 (NSCA long-term athletic development); Stricker et al., 2020; Sport for Life, 2019

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1

Technique first

Earn load with quality movement: squat, hinge, push, pull, carry, land

2

Progressive overload

Small, steady increases in load, reps or complexity, never big jumps

3

Individualize

Program by training age and maturity, not birth year

4

Periodize

Change the goal with the season: build, convert, maintain

5

Recover

Adaptation happens between sessions: sleep, food, spacing

Strength fades if you stop. The in-season goal is to keep what the off-season built.

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Build, convert, maintain

OFF-SEASON VS. IN-SEASON

Cuthbert et al., 2021 (meta-analysis); Lloyd et al., 2016

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OFF-SEASON

BUILD

Most strength sessions of the year
General strength, muscle, fix weak links
Higher volume, lower skill density
Planned time off first

PRE-SEASON

CONVERT

Turn strength into power and speed
Jumps, landings, change of direction
Conditioning ramps up gradually
Court load rises, so lifting volume drops

IN-SEASON

MAINTAIN

Fewer, shorter sessions
Keep intensity, cut volume
Time sessions away from games
Never stop completely

When weekly volume and load are kept similar, how often you lift matters less, so in-season sessions can be split into short “micro-doses” around games.

Here’s the universal shape of a training year, whether it’s a U13 club team or the WNBA. Off-season is build: the most strength sessions of the year, general strength and muscle, fixing weak links, after some planned time off. Pre-season is convert: turning that strength into power and speed with jumps, landings and change of direction, while conditioning ramps up gradually and lifting volume comes down as court time goes up. In-season is maintain: fewer, shorter sessions, keep the intensity, cut the volume, schedule them away from games, and never stop completely, because strength fades. A 2021 meta-analysis by Cuthbert, Haff and Comfort found that when weekly volume and load are similar, training frequency matters less for strength, which supports splitting in-season work into short micro-doses that fit around a congested schedule.

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Same principles, different dose

WHAT IT COULD LOOK LIKE BY AGE

Practical framework informed by Lloyd et al., 2016; Stricker et al., 2020; Sport for Life, 2019. Adapt to the athlete.

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Age	Focus	Off-season	In-season
6–9	Movement through play: hop, land, crawl, throw, balance	Multi-sport play; short movement games most days	10–15 min movement warm-up each practice
10–13	Learn the lifts with bodyweight and light loads	2–3 short sessions a week	1-2 short sessions or a strength warm-up
14–17	Progressive loading by training age and maturity; add power	2–3 sessions a week	2 sessions (30–40 min)
18+ / pro	Individualized, periodized strength and power	3–5 sessions a week	1–3 sessions, micro-dosed around games

Ages are a guide: training age and maturity decide the step, not the birth year. Every age: qualified supervision, technique before load, rest days between hard sessions.

So what does that look like across ages? This is a practical framework, not a prescription, built from the NSCA’s long-term athletic development statement, the AAP’s 2020 report, and Canada’s Sport for Life framework. Ages 6 to 9: movement through play, hopping, landing, crawling, throwing, balance; off-season is simply multi-sport play, and in-season it lives in a 10-to-15-minute movement warm-up. Ages 10 to 13: learn the lifts with bodyweight and light loads, two or three short sessions a week in the off-season, one or two short sessions or a strength-focused warm-up in-season. Ages 14 to 17: progressive loading guided by training age and maturity, adding power; two or three sessions off-season, one or two 30-to-40-minute sessions in-season. Adults and pros: individualized and periodized, three or four sessions off-season, one or two in-season, often micro-dosed around games. The ages are a guide. A late-maturing 15-year-old with no lifting history starts where a 12-year-old would.

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Heavy early, fresh by game day

SAMPLE IN-SEASON WEEK: YOUTH CLUB, WEEKEND GAMES

Example only. Adjust to the schedule, the athlete’s training age, and the session RPE you’re logging.

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MON

Off

Recovery, sleep, food

TUE

Practice + strength

Main lifts, 30 min

WED

Practice

Skill focus, high quality

THU

Practice + power

Jumps, med ball, 15 min

FRI

Light

Shootaround or off

SAT

Game

Fuel and hydrate

SUN

Game

Log RPE after

Heaviest work early in the week, furthest from games.

Nothing new late in the week: no new exercises or big jumps in load.

Midweek game? Drop to one short session and shift the rest.

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Fuel shows up in the skill numbers

NUTRITION AND SKILL

Dougherty et al., 2006 (older, but the key youth basketball study); Thomas, Erdman & Burke, 2016

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Skilled boys aged 12–15, combined shooting %

53%

Hydrated

45%

2% dehydrated

60%

Carb-electrolyte drink

Sprint and defensive drill times also got worse when dehydrated.

Under-fuelled players often

Fade late in practice
Lose focus and make poorer decisions
Rate sessions harder (higher RPE)
Recover slowly for the next day

Ask: “What did you eat since lunch?”

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What each one does

MACRONUTRIENTS 101

Thomas, Erdman & Burke, 2016; Desbrow, 2021

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CARBOHYDRATE

4 kcal per gram

Main fuel for high-intensity play and for the brain

Rice, pasta, bread, oats, potatoes, fruit

PROTEIN

4 kcal per gram

Builds and repairs muscle and tendon; supports growth

Meat, fish, eggs, dairy, beans, tofu

FAT

9 kcal per gram

Long-lasting energy, hormones, absorbing vitamins A, D, E, K

Nuts, seeds, olive oil, avocado, fish

FLUIDS

0 kcal

Temperature control, focus, and shooting accuracy

Water; sports drinks for long or hot sessions

No “bad” macronutrient. Young athletes need all three, and enough total energy to grow.

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The floor for everyone, not the athlete target

BASELINE NEEDS BY AGE

Health Canada, Dietary Reference Intakes tables (macronutrients and water). General-population values.

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Age	Carbohydrate	Protein	Fat	Protein RDA	Total water
9–13	45–65%	10–30%	25–35%	0.95 g/kg	Boys 2.4 L · Girls 2.1 L
14–18	45–65%	10–30%	25–35%	0.85 g/kg	Boys 3.3 L · Girls 2.3 L
19 and up	45–65%	10–35%	20–35%	0.80 g/kg	Men 3.7 L · Women 2.7 L

Percent columns = share of daily calories (the acceptable range).

Total water includes water from food, not just drinks; sport adds sweat losses on top.

Kids and teens need at least 130 g of carbohydrate a day just for the brain.

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Five questions, then the right referral

ASK BEFORE YOU ASSUME

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Ask privately

1

How have you been sleeping?

2

What did you eat today?

3

What’s going on at school or home?

4

How’s your energy been lately?

5

Is there anything I should adjust today?

Then refer

Pain or injury → physio / athletic therapist

Persistent fatigue, cycle changes → physician

Fuelling, weight concerns → sports dietitian

Stress, mood, anxiety → mental performance / counsellor

Under 18 → always loop in parents

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Six things to take to practice

1

Ask before you assume: sleep, stress, fuel, iron and the cycle all look like “effort.”

2

Every skill rep is a load rep. Track session RPE × minutes.

3

Use the ACWR to spot jumps and drops. The spike is built in the valley.

4

Strength train at every age: build off-season, maintain in-season.

5

Fuel and fluids show up in the skill numbers. Ask what they ate.

6

Modify before you rest, and refer what’s outside your lane.

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References

SOURCES

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Available Upon Request