BASKETBALL INJURIES - DEFINITION AND ANATOMY

BASKETBALL INJURIES
- Definition and Anatomy -
Basketball is one of the most popular sports, and it is also one of the highest contributors to sport and recreation-
related injuries. [1] As the sport grows, in terms of number of participants and intensity, so does the number of
injuries. In 2006 FIBA (Fdration Internationale du Basketball Association) has estimated that 11% of the worlds
population plays basketball.
So far, there is not a great deal of data to be found on the injury of basketball players in European countries. Studies
concerning the epidemiology of basketball injuries have been very popular in the USA. When we compare injury data
between USA and European players, we have to bear in mind that the game of basketball as played in the USA is
different from its European counterpart, which is partly caused by the different rules maintained by the NBA (National
Basketball Association) and FIBA. [2]
The game of basketball is physically and mentally demanding. Basketball is characterized by intermittent bouts of
high-intensity activity that occurs in the context of an endurance event. [3, 4, 5] Though players rarely reach maximal
running speeds when playing, they often overcome movement momentum to change direction or to
accelerate/decelerate. Technically basketball is considered as non-contact sport, but there is usually a high level of
physical interaction between players on opposing teams, suggesting that basketball evolves into a semi -contact
sport. [2, 6] The contact is responsible for 52.3% of the game-related injuries in male and 46.0% of injuries in female
collegiate players. [6]
Definition of Injury
There is a notable variability in used injury definitions among researchers. One of the broad injury definitions define
injury as any muscular-skeletal complaint newly incurred due to competition and/or training that received medical
attention regardless of absence from competition or training. [7] The advantage of this definition is possibility to
assess full spectrum of injuries from mild contusions to fractures and not only those which result in time lost from
participation, bearing in mind that athletes sometimes compete despite an injury. [6] Although in practice researchers
more often apply the time loss" definition.
Type of Injuries
The types of injuries experienced by basketball players reflect the physical demands of the game. [8]
An acute (traumatic) injury was defined as being a basketball accident with a sudden, direct cause/event responsible
for the injury. In general, sprains (injuries to ligaments) are the most common type of acute injury. In college
basketball sprains were experienced 37.1%, and in professional basketball sprains often accounted for about 27.8%.
Other common injuries are contusions and strains (injuries to muscles). [8]
An overuse injury refers to an injury resulting from repeated micro trauma without a single, identifiable event
responsible for the injury. An athlete sustained an overuse injury when he/she suffered a physical discomfort which
caused pain and/or stiffness of the musculoskeletal system, and which is present during and/or after the basketball
activity. [7, 2] It appears that overuse injuries account for between 12.8% and 37.7% of all injuries. Tendinopathies,
particularly patellar tendinopathy, are the most common overuse injury. [6]
A significant proportion of these injures remain difficult to treat, and many individuals have long-term pain and
discomfort, which cause significant loss of performance and decreased functional capacity.
Anatomical Location
Basketball requires repetitive jumping interspersed with running and rapid change of direction, and this pattern is
indicated in the lower limb being more affected by injury than the upper limb. Regarding the distribution of injuries by
body region, the lower limb accounts for 46.4% to 68.0% of injuries, while head and neck injuries were responsible for
5.8% to 23.7%. Upper-limb injuries account for 5.6% to 23.2% of injuries, and spine and pelvis injuries for 6.0% to
14.9%. [6]
The most common lower-limb injuries in basketball occur at the ankle and knee. In collegiate basketball, the ankle
and knee were the affected respectively 28.8% and 12.0% and in NBA basketball on the top injury locations were the
ankle (14.3%) followed by patellofemoral complex (12.5%). [8] While a European player during one season sustained
15.0% of ankle injuries and 23.01% of knee injuries. [2]
Compared with adults, children more seldom sustain lower extremities injuries 19.8-26%. As well, reversal finding is
repeated in upper extremities data with studies reporting between 11-72%. Fingers are the body part most often
involved in the injury, and the injury is usually associated with improper pass and reception. The young athlete may
be particularly vulnerable to sport injury due to the physical and physiological processes of growth. Injury risk factors
unique to the growing athlete include: susceptibility to growth plate injury, the adolescent growth spurt, limited
thermoregulatory capacity, and maturity-associated variation between players. The more frequent and intense
training and competition of young athletes today may create conditions under which these risk factors may exert their
influence. [9]
Ankle
In basketball, ankle injuries are among the most
common injuries sustained and the high
prevalence of ankle injuries is supported by
findings from many epidemiological studies. [2, 8,
10] Empirically and anecdotally, ankle sprains
are synonymous with the game of basketball.
Ankle sprains were reported, with most involving
the lateral ligaments 92.8%. Trauma to the
deltoid ligament complex was reported in 6.4%
instances, while the distal ankle syndesmosis
was involved in 0.8% injuries.
Landing on someone else's foot been identified
as the first major inciting event causing ankle
sprains, which is mainly the result of jumping
tasks. In second place, ankle sprains were
brought on by sudden changes of direction. [2,
10] It was reported that 66.7% of athletes who injured their ankles had a history of ankle sprain and follow-up of ankle
injuries after 6 to 18 months have shown that residual ankle symptoms occur in 40% to 50% of cases. [6]
Knee
Among knee injuries which have been recognized as being common and of high importance in basketball are
Jumper's knee and anterior cruciate ligament (ACL) damage.
Jumper's knee mostly affects the proximal end of the patellar tendon in basketball players and account for
approximately 70% of patellar tendon injury. [6] In the literature, this overuse condition of the patellar tendon has
been referred to as jumper's knee', patellar tendonitis', patellar tendinitis', patellar tendinosis', patellar tendon
disorder', patellar apicitis', patellar enthesitis', partial rupture of the patellar tendon' or patellar tendinopathy'. [11]
Because of its insidious nature, patellar tendon disorder may be the "silent endemic" among professional basketball
players. All players are vulnerable, particularly those that are aerial players by nature. [6] This condition is the leading
cause of players missing practices and games, but in multiple, small increments rather than the season-ending
magnitude as some other injuries. [8] In a survey independent of applied treatment strategy, one-third of the athletes
presenting with patellar tendinopathy were unable to full practice their sport for >6 months. [10] Overuse of the
patellar tendon can lead to pain, tenderness and functional deficit. Patellar tendinopathy, as a typical overuse injury,
is related to intensity of training, jumping performance, and ankle and knee joint dynamics. [11]
Anterior cruciate ligament (ACL) damage is a knee injury, which is often of serious nature, because it can be season-
ending or, at times, career-ending. Female basketball players have 3-7.8 times increased risk to suffer an ACL injury
in comparison to male counterparts when they compete at the same level of competition.
ACL injuries have been reported as non-contact injuries in 65.2 % of male and 80.1% of female college players. Even
though majority of ACL injuries were from noncontact mechanisms, after video analysis of 39 ACL injuries it was
shown that one half of the ACL injuries in women involved the player being pushed or collided with before the time of
injury. A majority (71.8%) occurred while the injured player was in possession of the ball, and over half (56.4%)
occurred while attacking. For female players, 59.1% of ACL injuries occurred during single-leg landings, while in male
basketball players 35.3% occurred during single-leg landing. [6]
Teeth
Although dental injuries are thought to account for only 1% of basketball-related injuries, they are of concern because
they can be permanent, disfiguring, and expensive. [6] The use of mouth guards is commonly used preventive
strategy in contact sports. Studies on adults have shown that mouth guards can prevent injury. [12]
Severity of Injury
Athletes of all ages and everyone who works with them, whether they be parents, coaches, team managers or sports
medicine personnel need to know answer to questions: What is the time lost from injury and when the player will be
ready to back on court?
The number of days the athletes will not be able to undertake their normal training programme or will not be able to
compete also serve to assess severity of injury. Injuries are usually classified as minor (1 to 7 days), moderate (8 to
28 days), severe (>28 days), and career-ending injuries. [7]
Knee injuries appear to be responsible for the most time lost, and they required surgery more often than other
injuries. In intercollegiate players on average, knee injuries caused 18.3 days to be missed [6]
Ankle injuries also cause substantial time to be missed. It was reported for intercollegiate basketball players reported
that ankle injuries caused, on average, 5.5 days to be missed, while for high school players reported a mean of 7.6
days. Among high school athletes it was found that 35.4% of ankle injuries caused >1 week to be missed. In a
sample of Australian players, it was noted for 43.3% of ankle injuries for which >1 week was missed. [6]

Ankle injuries are among the most common injuries in
basketball
References:
1.Scanlan A, MacKay M. Sports and Recreation Injury Prevention Strategies: Systematic Review and Best Practices.
2. Cumps E, Verhagen