Posts tagged basketball
Pre Season Y Balance Scores Did Not Accurately Predict Future Injury

Pre-participation movement screens have gained popularity among sports teams and health professionals over the past decade. Their aim is to determine the likelihood of an individual sustaining a future injury by testing them through a battery of movements. Clinicians may utilize a composite of individual tests to identify risk for a specific injury (ex. ACL tear) or use a commercially available stand alone test designed to screen for all injuries (ex. FMS or Y Balance). One of the determining factors in these stand alone tests is examining symmetry of movement patterns, comparing one side of the body to the other or to an established “norm” of movement. These tests have been under scrutiny as recent research has challenged the validity of these tests suggesting these tests may not be able to accurately identify individuals at risk for future injury.

The Y- Balance Test is a common pre-participation movement screen determining lower extremity injury. Individuals are asked to move their leg in 3 planes while in single leg stance on the opposite leg. Previous research has shown a difference in reach distance from side to side may indicate a risk of future injury. A recent article out of the Sports Journal looked at a homogeneous group of 169 male collegiate basketball players over 2 seasons (Brumitt et al. 2019). During the study, all athletes were given a pre season Y balance test and then followed through the seasons. The authors found no association between preseason Y-Balance scores and future time-loss from their sport or lower quadrant non contact injury during the upcoming seasons. These results add to the growing evidence questioning the validity of these stand alone movement screens. Injury prevention for specific injuries such as ACL tears and composite testing of individual tests may provide better risk reduction test batteries.

Return to Professional Basketball after Surgery

“In life there are no guarantees” and this is certainly the case with return to sport after surgical procedures.  Unfortunately, the commonly held belief is surgical repairs of muscles, tendons, ligaments, etc. guarantees a return to sport at prior levels of play and competition.  The odds of returning to competitive levels of sport can be improved dramatically through pre and post operative Physical Therapy.   A new review article highlights the lower than expected odds of returning to high level basketball competition after orthopedic surgery.  

We assume professional athletes have a greater likelihood of returning to sports following surgery given their athletic gifts and high levels of resources directed at their care including money, time, and medical staffs.  A recent review article of close to 350 NBA basketball players was conducted to determine the likelihood of these athletes returning to high level play after surgery (Minhas et al. Am J Sp Med. 2016).  The return to sport ranged from 70% in achilles repairs to 98% after hand/wrist surgeries.  Across all procedures older (>30 years old) and heavier (BMI >27) athletes were 3 times less likely to return to sport.  In addition, those undergoing arthroscopic knee surgery or achilles tendon repairs suffered the greatest reduction in performance at both a 1 and 3 year follow up.    Athletes at greatest risk of decreased performance should work closely with a Physical Therapist to facilitate an optimal return to sport.  

Prevention of Basketball Injuries

Basketball has one of the highest injury rates in sports with articles reporting up to 7-10 injuries per 1000 athlete exposures (Dick et al. J Athl Train. 2007).   As expected, the majority of these injuries occur in the lower extremity, in particular within the knee and ankle.  Authors report both overuse (tendinopathy) and traumatic (sprain, strain) injuries account for the high injury rate noted in this sport.  Of all the lower extremity injuries the literature has focused on ACL sprains in the knee and lateral ankle sprains in athletes.  Ankle sprains account for up to 25% of all injuries and have a poor prognosis with many athletes demonstrating balance impairments up to 6 months after the injury (Doherty et al. JOSPT. 2015).  Basketball places unique demands on its' athletes requiring a change of direction every 2-3 seconds during game play (Mathew et al. J Sport Sci. 2009).  These dynamic movements can play stress on the passive structures of the knee and ankle if an athlete is not trained to deal with these loading patterns.  In the last 10 years, there has been a greater focus on the impact of prevention programs in basketball to determine the ability of these programs to limit the number of knee and ankle injuries in athletes.  

A recent systematic review of the available evidence on basketball injury prevention programs was published in Sports Health.  Taylor et al. reviewed 10 studies available on the prevention of lower quarter injuries including ACL injury and ankle sprains.  The authors noted these programs significantly reduced the incidence of lower quarter injuries (Odds Ratio .69), ankle sprains (OR .45), but failed to show a significant reduction in ACL injuries.  This impact on ACL injury is unlike with the proven benefits of ACL prevention among youth soccer athletes.  Athletes wishing to maximize their performance and reduce injury risk should incorporate a combination of strengthening and balance exercises to enhance their body's ability to reduce abnormal loading in basketball.