Table 2.

Recommendations for youth basketball participation

Topic	Recommendation	Strengtha
Personal engagement	Promotion of personal engagement should be a priority in youth basketball. Sport programs that invest in providing opportunities for youth to connect with others, build relationships, and take on challenges and leadership roles promote overall personal development, well-being, and talent development	B
Multisport engagement and delayed specialization	Youth should be provided opportunities and be encouraged to engage in diverse sports and delay single-sport specialization. Multisport engagement through childhood and adolescence is associated with reduced risks of overuse injury, and facilitates prolonged participation, psychosocial development, as well as long-term talent development. World-class athletes in basketball and other sports often delayed single-sport specialization until age 16 years or later. It is recommended that specialization for basketball be delayed until this age. However, given that the age of high-school entry in the USA is typically age 14 years, the working group recognizes that specialization may occur at this time. However, specialization prior to age 14 years is discouraged	B
Varied settings	Youth should be provided opportunities and be encouraged to engage in both organized, coach-led basketball activities and peer-led play. Peer-led basketball play allows youngsters to experience largely self-determined, intrinsically motivated activity, be creative and challenge themselves. It may contribute to individual growth and long-term talent development	B
Rest and time off	Coaches and parents should ensure sufficient rest and time away from organized basketball practices and competitions. It is recommended to ensure a minimum of one day of rest each week and multiple months per year away from organized basketball. Proper daily sleep, rest days, and off-periods provide physical recovery, reduce injury risks, and further psychological recharging	C
Competition density and cumulation	Cumulative, high-density competitions should be avoided. High-density competition scheduling may increase injury risk and fatigue, and lead to loss of motivation. Parents, coaches, event directors and administrators should be cautious in designing basketball events. The working group recommends a maximum of two games per week per player through childhood, and a maximum of three games per week through late adolescence. The working group also recommends reducing game duration for tournaments or events during which multiple high-density competitions are scheduled (i.e., reduce the number of minutes per game). “Rest games,” where some players are rested while their teammates compete, together with larger roster sizes, will allow teams to participate without overloading individual players	C
Injury prevention programs	Neuromuscular injury prevention programs should be implemented and evaluated. Such programs have been shown to reduce lower extremity injury. However, further evaluation of basketball-specific programs is warranted	B
Sport readiness	Parents and coaches should adjust demands to the individual player’s development. Individuals develop at different rates. Moreover, through adolescence in particular, physical, motor, cognitive, emotional, and social development may proceed asynchronously within one player. Carefully adjusting expectations and demands to the individual player’s development furthers a rewarding experience, progress in learning, motivation, and a healthy life balance	B

^aEach recommendation in this table has been classified using the Strength of Recommendation Taxonomy system (SORT) defined in Table 1 [27]. Recommendations of strength B are based on inconsistent or limited-quality patient-oriented evidence and recommendations of strength C are based on expert opinion consensus