BASKETBALL INJURIES - Prevention

BASKETBALL INJURIES

- Prevention -

Although some may perceive sports-related injuries to be unavoidable and simply a part of the game, these occur in predictable patterns and many are preventable through the implementation of targeted interventions. As detailed previously, the two most problematic injuries in basketball are related to the ankle and knee. As a result, numerous studies had been conducted to evaluate different intervention strategies and different protective equipment in preventing injuries of these body parts.

There is no standardized intervention program established to prevent lower limb injury.  The common traits of alternative effective protocols include a combination of the following elements: 1) preseason conditioning, 2) education, and 3) proprioceptive balance training programmes (functional training). The use of protective equipment in injury prevention is still partially inconclusive and requires further assessment. [1]

1) Preseason conditioning
Preseason conditioning is used to develop flexibility, strength, power, sport-specific fitness and training technique (e.g. to learn how to avoid common injury mechanism). The benefit appears to be optimized when the preventive programme is continued throughout the playing season.

Using a sample of female soccer, volleyball and basketball players, it was found that 6 weeks of preventive intervention (three sessions a week) decreased the number of serious knee injuries over the next sporting season. [1] Furthermore there is evidence that showed significant reductions in ankle sprain also, after introduction of preventive programmes in volleyball. Similarly preventive programmes in football (soccer) produced a 50-75% reduction in injuries in general and a significant reduction in ACL injuries. [1]

2) Education
Education to athletes, coaches and sports federations is very important. Effectiveness of injury prevention strategies and safety promotion in sports depends on the compliance to advice from sports medicine specialists. Important challenge is to convince coaches and athletes to accept existing knowledge and to put it into practice. They sometimes show scepticism in the field with questions ‘‘Are the exercises really worth doing? It takes 20 min; is it necessary to do this program every training session?'' These and similar doubts should be decreased showing evidence based data that prevention of some injuries is possible

3) Proprioceptive training
Proprioceptive training has been used to prevent ankle sprains since this form of prophylaxis was first proposed in 1965. Most functional training protocols consisted of stability and postural control exercises. [2] It is a unique method of training, because it stimulates multiple planes of ankle movement on a weight bearing foot, an activity that would occur infrequently otherwise. Proprioceptive training often involves the use of devices such as tilt boards, ankle disks, balance boards, and so on, which demand use of the muscles that pronate and supinate the feet. [3] It was shown that proprioceptive training was more effective prophylactic measures for ankle sprains in basketball than orthosis. [3, 4]

Marc Gasol has his ankle taped before the game
Spain center Marc Gasol has his ankle taped before the game

The prophylactic devices
The prophylactic devices, like taping and bracing/orthosis, is the most common preventive method used among athletes. The similarity of these devices is to wrap the ankle joint from the foot segment to the shank segment. Some studies suggested that these devices provided a mechanical support to resist the ankle inversion moment, but some suggested that it instead improved the proprioception and joint position sense and thus maintained a proper anatomical position during landing. Bracing and taping may have negative side effects (uncomfortable if not fitted properly, skin irritation, relatively high costs, etc.). [5]

The effectiveness of these devices in reducing the ankle sprain injury rate was reported in numerous studies and its main merit is the improvement of the proprioceptive function of a previously injured ankle. [2, 5] Randomised clinical trials have reported that orthosis reduces the incidence of ankle sprains in previously sprained ankles, but not in previously uninjured ankles. The use of external support should be recommended for a period of 12 months after an ankle sprain, because the risk of reinjures is increased during the first year and the ligaments need about a year to heal properly and to regain their normal strength and proprioceptive ability after an ankle injury. [3]

Pragmatists argue that the potential benefits of knee taping and bracing are related to enhancing sensorimotor control rather than providing mechanical constraint, but the evidence to support this remains contradictory. There is some evidence to show that knee bracing can enhance sensorimotor control in subjects with a history of knee injury, but the effect is lessened with more demanding functional tasks, and the clinical benefits of such small changes have also been questioned. It was found that the application of an elastic bandage can enhance joint positional sense in knees with an ACL tear, and it supports the use of knee bracing in preventing re-injury. Generally there is no consistent evidence of effectiveness for knee bracing in reducing knee injury in adult and adolescent athletes. [2]

When to start prevention of injuries?
Many preventive programs are targeted toward athletes aged from 15 to early twenties. It is possible that the implementation of injury prevention programs would be more beneficial at an earlier age; according to some authors we should put most effort into prevention from 12-14 years. From a motor learning aspect even age 6-12 might be important in relation to develop ‘‘good habits'' (good warm-up routines and movement patters) and to establish correct playing technique.

For more detailed information you can download the fact sheet "Preventing injuries in Basketball" here

References:

1. Abernethy L, Bleakley C. Strategies to prevent injury in adolescent sport: a systematic review. Br J Sports Med 2007 41: 627-638

2. Fong DTP, Chan YY, Mok KM, Yung PSH, Chan KM. Understanding acute ankle ligamentous sprain injury in sports. Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology 2009, 1:14

3. Stasinopoulos D. Comparison of three preventive methods in order to reduce the incidence of ankle inversion sprains among female volleyball players. Br J Sports Med 2004 38: 182-185

4. Cumps E, Verhagen E,  Meeusen R. Prospective epidemiological study of basketball injuries during one competitive season: Ankle sprains and overuse knee injuries J Sports Sci and Med 2007; 6: 204-211

5. Cumps E, Verhagen E,  Meeusen R. Efficacy of a sports specific balance training programme on the incidence of ankle sprains in basketball. J Sports Sci Med 2007;6:212-219

6. Myklebust G, Steffen K. Prevention of ACL injuries: how, when and who? Grethe. Knee Surg Sports Traumatol Arthrosc 2009;17:857-858

7. Caine DJ, Harnmer PA,Shiff M. Epidemiology of injuries in Olympic sports. 2010. Blackwell Publishing Ltd

8. Starkey C. Injuries and Illnesses in the National Basketball Association: A 10-Year Perspective Journal of Athletic Training 2000;35(2):161-167

9.  McKay GD, Goldie PA, Payne WR, Oakes BW. Ankle injuries in basketball: injury rate and risk factors. Br J Sports Med 2001;35:103-108

10. Alentorn-Geli E, Myer GD, Silvers HJ,  Samitier G,  Romero D, La´zaro-Haro K, Cugat R. Prevention of non-contact anterior cruciate ligament injuries in soccer players. Part 1: Mechanisms of injury and underlying risk factors. Knee Surg Sports Traumatol Arthrosc 2009: 7:705-729

11.Scanlan A, MacKay M. Sports and Recreation Injury Prevention Strategies: Systematic Review and Best Practices.


Prepared by: Dr. Jelena Oblakovic-Babic


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