Introduction
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Physical education teacher James Naismith invented basketball in 1891 as a noncontact sport wherein teams competed to throw a ball into opposing peach baskets.
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Since then, basketball has become increasingly physical with regular contact between players expected, resulting in one of the highest overall injury rates among noncollision sports.
Epidemiology
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Most basketball injuries are sustained in the lower extremity with contact mechanisms accounting for a majority of acute injuries ( Table 72.1 ).
TABLE 72.1
EPIDEMIOLOGY OF BASKETBALL INJURIES IN THE UNITED STATES
NCAA Women
NCAA Men
WNBA
NBA
Rate of Injury
(AE = Athlete Exposure)
G = Game
P = Practice
G: 7.68/1000 AEs
Practice: 3.99/1000 AEs
G: 9.9/1000 AEs
P: 4.3/1000 AEs
G: 24.9/1000 AEs
G: 19.3/1000 AEs
Common Injuries
(% of Total Injuries)
Ankle ligament sprains (24.6% G, 23.6% P)
Knee internal derangements (15.9% G, 9.3% P)
Concussion (6.5% G, 3.7% P)
Ankle ligament sprains (26.2% G, 26.8% P)
Knee internal derangements (7.2% G, 6.2% P)
Concussion (3.6% G, 3.0% P)
65% NBA injuries and 66% WNBA injuries to lower extremity
NBA injuries only: lateral ankle sprain (13.2%), patellofemoral inflammation (11.9%), lumbar strain (7.9%), hamstring strain (3.3%)
Mechanism of Injury
Player contact (46% G, 31% P)
Other contact—balls, standards, ground (24% G, 18% P)
No contact (29% G, 47% P)
Player contact (52% G, 44% P)
Other contact—balls, standards, ground (24% G, 18% P)
No contact (22% G, 36% P)
Overuse and inflammatory conditions (tendinitis, bursitis, synovitis) accounted for greatest amount of time lost from practices and games in both leagues (22% NBA, 27% WNBA)
Data from Agel J, Olson DE, Dick R, Arendt EA, Marshall SW, Sikka RS. Descriptive epidemiology of collegiate women’s basketball injuries: National Collegiate Athletic Association injury surveillance system, 1988-1989 through 2003-2004. J Athl Train . 2007;42(2):202-210; Deitch JR, Starkey C, Walters SL, Moseley JB. Injury risk in professional basketball players: a comparison of Women’s National Basketball Association and National Basketball Association athletes. Am J Sports Med . 2006;34(7):1077-1083; Dick R, Hertel J, Agel J, Grossman J, Marshall SW. Descriptive epidemiology of collegiate men’s basketball injuries: National Collegiate Athletic Association Injury Surveillance System, 1988-1989 through 2003-2004. J Athl Train . 2007;42(2):194-201; Drakos MC, Domb B, Starkey C, Callahan L, Allen AA. Injury in the national basketball association: a 17-year overview. Sports Health . 2010;2(4):284-290.
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The five most common injuries in pediatric ED visits are ankle sprains, finger sprains, finger fractures, knee sprains, and facial lacerations.
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US high school basketball players are over two times more likely to sustain an injury in practice than in game.
General Principles
Biomechanical Principles
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Basketball requires a high degree of vertical movements, requiring 35–46 jumping and landing activities per game, over twice those of soccer or volleyball.
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A combination of both single- and two-footed jumps and landings
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A high demand of lateral movement and shuffling, particularly while defending
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Recent rule changes at the professional and collegiate level including shortening the shot clock and implementation of the charge circle have led to a faster pace of play, which places higher demands on individual participants.
Equipment and Safety Issues
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Sudden cardiac death (see Chapter 35 )
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Male basketball players have the highest incidence of sudden cardiac death among all NCAA athletes, with black males at a higher risk than white males
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An emergency action plan must be in place, including readily available AED and early defibrillation.
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A high rate of facial injuries in basketball including eye, oral, dental, and nasal trauma (see Chapter 47 , Eye Injuries in Sports and Chapter 48 , Maxillofacial Injuries)
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Facial protective equipment, including protective goggles and mouth guards, are used by some but are not required.
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A hard protective face mask recommended for at least 2–3 weeks after a nasal fracture.
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Common Injuries
Concussions (See Chapter 45 , Head Injuries)
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The third most common form of basketball injury at the NCAA level (see Table 72.1 )
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Immediate evaluation may require escorting the player to the locker room owing to close proximity of the sideline to the court.
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Do not return a symptomatic player to the competition.
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Follow the return-to-play protocol as per internationally recognized guidelines.
Finger Injuries
Frequently caused by direct trauma from the ball, opponent, or rim of the basket
“Jammed Finger”—Collateral Ligament Injury
Mechanism: Forced ulnar or radial deviation of finger, resulting in partial or complete tear of collateral ligaments; most often PIP
History/examination: Tenderness at the involved joint; check for stability with varus and valgus stress testing with the involved joint at 30 degrees of flexion; ensure that the MCP is flexed to 90 degrees because an extended MCP will tighten collateral ligaments.
Diagnostic considerations: Obtain radiographs if concerns for fracture
Treatment: Stable—buddy tape to adjacent finger, may return to play; Unstable—refer to hand surgeon
Jersey Finger
Mechanism: Forced extension of the DIP joint during active flexion causing rupture of flexor digitorum profundus tendon (e.g., finger caught on opponent’s jersey or rim of basket); most commonly the fourth finger because of relative flexor weakness ( Fig. 72.1 )
