Back in 2015 I undertook research looking into the rates of ankle and knee injuries in basketball, and potential strategies to reduce risk of injury.
The research process was invaluable. Unfortunately (or fortunately!) the growth of Zone 34 Sports Physiotherapy along with roles with Australian Boomersand Sydney Kings basketball teams led to the difficult decision to cease research and not publish a paper.
Rather than letting all the work hide away on a hard drive, here are some of the findings on the rates of ankle injuries. The tabs below show the differences in injury rates between levels of play, and sex.
If anyone is keen to embark upon a systematic review on Ankle Injuries in basketball and complete what I started, please get in contact!
David Hillard
basketball.physio
Basketball is the second most popular team sport worldwide, with an estimated 1.1 million players in Australia and 450 million worldwide. Epidemiological studies have found that the most common injuries in basketball players are in the lower extremities, with lateral ankle sprains being the most common diagnosis [1,2, 3, 4].
Basketball related ankle sprains often lead to relatively minimal time loss, with players often returning to playing before full recovery from their pathology and rehabilitation. This lack of recovery can be detrimental to a player’s longevity and performance since the rate of recurrent ankle sprains is up to 60% , and the primary injury may lead to a sequelae of associated pathologies such as chronic instability, chondral defects or peroneal tendinopathy [5,6,7].
In elite level basketball, injuries may have further impact on athlete development and team performance. Podlog et al. [2015] have shown an inverse correlation between games missed to due to injury or illness, and team success in the NBA.
Lateral Ankle Sprains
In studies that include lateral ankle sprains as sub-classification of basketball related ankle injury, lateral ankle sprains accounted for 84-95% of all ankle injuries.
Other kinds of ankle sprains include medial (deltoid ligament) sprains, and high ankle (syndesmosis) sprains.
Determining injury rates via "Athlete Exposures"
The majority of studies define one athlete Exposure (A.E.) as one athlete participating in one training or game regardless of the duration of the session.
Some studies report in units of hours. For example ten athletes completing a 90 minute training session is equivalent to 15 hours for that session.
Ankle sprains occur more frequently in games when compared to trainings. [9, 10]
This can be explained by trainings often being a mixture of low, medium and high intensity drills. Not all training drills will involve contact or reactionary movements. Fatigue may also have a role to play in injuries during match play.
Comparing injury rates between levels of play
There is a trend for increase in injury rates from high school (1.00 per 1,000 AEs; CI, 0.66-1.34) to college (1.34 per 1,000 AEs; CI, 1.30-1.38), and a further increase from college to professional level (3.90 AEs per 1,000; CI, 2.84-4.96)
(Figure 1).
What does this mean???
Professional players tend to injure their ankle more frequently then college players, and high school players have the lowest rate of injury.
Figure 1. Hillard, unpublished data
Are males or females more likely to sprain an ankle?
There was an inconsistent pattern comparing injury rates between sexes across the levels of play. Females have a higher rate of injury in hgih school and professional level of play, but a lower risk of injury compared to males at collegiate level. The IRR in High School was 1.28 (?need to calculate CI?), College 0.81, and Professional 1.49).
Ankle injuries rates shown in the table were higher in females professional players compared to their male counterparts however this was based on a small sample of studies. A very recent study by Baker et al (2020) showed a rate of lateral ankle sprains in the WNBA of 1.2 /1000 A.E.
Future meta analysis including more recent papers will assist in confirming if their is any singificant diference in ankle sprains between males and female basketballers.
Hillard, unpublished data
Limitations in focussing on Time Loss injuries
Studies that report time loss injuries only will underestimate the rate and burden of basketball injuries. Many knee and ankle conditions exist that will cause pain and reduced function, but may not lead to time loss.
Further epidemiological studies that include non time loss injuries will allow for future reviews and synthesis of data to gain a better understanding of the prevalence knee and ankle pain in basketball.
REFERENCES
- FIBA , About FIBA.
- Basketball Australia, Annual Report 2013/14.
- McCarthy, M.M., et al., Injury profile in elite female basketball athletes at the Women’s National Basketball Association combine. Am J Sports Med, 2013. 41(3): p. 645-51.
- Pappas, E., et al., The Epidemiology of Pediatric Basketball Injuries Presenting to US Emergency Departments: 2000-2006. Sports Health, 2011. 3(4): p. 331-5.
- Cumps, E. and E. Verhagen, Prospective epidemiological study of basketball injuuries during one competitive season. ankle sprains and overuse knee injuries. Journal of Sport Science and Medicine, 2007. 6: p. 204-211.
- Attenborough, A.S., et al., Chronic ankle instability in sporting populations. Sports Med, 2014. 44(11): p. 1545-56.
- Taylor, J.B., et al., Prevention of Lower Extremity Injuries in Basketball: A Systematic Review and Meta-Analysis. Sports Health: A Multidisciplinary Approach, 2015. 7(5): p. 392-398.
- Podlog, L., et al., Time trends for injuries and illness, and their relation to performance in the National Basketball Association. Journal of Science and Medicine in Sport, 2015. 18(3): p. 278-282.
- Ingram, J.G., et al., Epidemiology of knee injuries among boys and girls in US high school athletics. American Journal of Sports Medicine, 2008. 36(6): p. 1116-1122.
- Dick, R., et al., Descriptive epidemiology of collegiate men’s basketball injuries: National Collegiate Athletic Association Injury Surveillance System, 1988-1989 Through 2003-2004. Journal of Athletic Training, 2007. 42(2): p. 194-201.
- Baker, H. et al,, Injury in the Womens National Basketball Association (WNBA) from 2015 – 2019. Arthroscopy, Sports Medicine and Rehabilitation.
If you have had a recent ankle sprain please consult a health professional. A Sports and Exercise Physiotherapist will be able to help diagnose your injury, tailor the rehabilitation and ensure it is safe to introduce more challenging drills.
If you would like a telehealth video consult or detailed return to sport rehabilitation plan please email david@basketball.physio
For more ideas on rehabilitation take a look at the Recover pages
