By: Dr. Brian DeVeaux, PT, DPT, OCS, CSCS
From the viewpoint of a Strength and Conditioning Specialist as well as a basketball lover, I can say that basketball is beneficial for many reasons. Aside from the fact that it’s a great way for players of any age to burn calories and build muscle, it improves concentration and builds confidence. However, if you are an avid player or a member of a team, basketball—like any other sport—comes with its own risk of sport specific injuries. Your best bet is to go into it knowing the exact injuries that players are susceptible to and ways in which those injuries can be prevented. Therefore, increasing the amount of years you can play comfortably and avoiding an injurious event that could hinder one from enjoying the sport well into their advanced years.
One of the more common basketball injuries is a sprain or rupture of the Anterior Cruciate Ligament of the knee otherwise known as the ACL. The ACL is a ligament inside the knee that keeps the shinbone from sliding forward. Injury takes place when a player lands on an extended knee, makes a lateral pivot while running, collides with another player, suddenly slows down or changes direction (sidestep/cutting) and with hyper flexion (when a limb flexes beyond the normal limit).
When the ACL is injured, the tissues around the knee swell up and become painful. While the pain goes away, the knee remains unstable and tends to shift or give way while playing sports or twisting and turning at the knee. 80,000 ACL injuries occur annually within the US with roughly 50,000 requiring surgery, over 70% of those injuries are sports related.
Female athletes are more likely than male athletes to acquire this type of injury. Some reasons include:
- Females land from a jump with less hip and knee flexion (danger zone is less than 45 degrees bent).
- Females tend to depend on ligaments to protect knees after jumping and use their muscles less efficiently.
- And while no official evidence has yet to be documented, some say that shoe wear may be a factor, possibly shoe to surface interface.
Research shows the best way to avoid ACL injury is to eliminate the three main problems that lead to non-contact injuries. These are ligament dominance, leg dominance and quad dominance. I call these The 3 D’s.
THE 3 D’s THAT INCREASE THE RISK OF ACL INJURY:
1. Ligament Dominance: when an athlete relies more on their ligaments vs. their muscles (specifically their hip muscles) or perform athletic tasks like cutting or landing from a jump. This is apparent when an athlete as “knocked knees” while squatting or landing from a jump or if they land stiff. It’s bad because it loads up all the ligaments, especially the ACL.
2. Leg Dominance: when an athlete relies on one leg more than the other while performing athletic tasks and can be seen if they lean to one side with a squat or landing. It’s bad in that it stresses the leg to the point that an injury can occur.
3. Quad Dominance: when an athlete calls on their quadricep muscles (the front of their thighs) before their gluteus maximus (butt/hip) muscles. This is harmful in that it increases the shearing force on the ACL and the possibility of injury.
The good news is that, over time, training techniques have improved and are now created with injury prevention in mind. As long as we understand the muscular and anatomical deficits behind the injury, we can personalize an athlete’s training program to strengthen his/her weakness. Below, I included the types of training one might engage in when protecting and strengthening the ACL. Not only is this a useful guide for athletes, but coaches can benefit from it as well.
ACL INJURY PREVENTION:
- Neuromuscular Training: reduces ACL injuries in female athletes, under the condition that it includes plyometrics, balance and strengthening. Training sessions must be performed more than once in a week and over a period of at least six weeks in a row. Some types of training that young female basketball players can engage in are: jump training programs/plyometrics, progressive resistance weight training for the lower extremities, as well as athletic conditioning and technique training with particular regard to basic basketball specific movement patterns that commonly lead to injuries.
- Ligament Sprains and Internal Derangement of Knee Prevention: interventions such as taping, bracing and neuromuscular training.
- Structured Warm-up Programs: must contain agility, balance, strength and playing technique exercises and designed to improve knee and ankle control during landing and pivoting movements.
- Practice Techniques such as cutting and landing movements and balance training.
- Wobble Boards or Mats: should be trained on from 12 years of age and onwards.
- Preventive Training: must include strength and power exercises, neuromuscular training and agility exercises; and be integrated into a dynamic warm-up routine.
Dr. Brian DeVeaux is a Physical Therapist at Peak Performance, Lynbrook, New York. He received his Doctorate degree in Physical Therapy from Touro College and is an Orthopedic Clinical Specialist. In addition, Brian holds a Bachelor degree in Health Science, is a certified Strength and Conditioning Specialist and holds an Olympic Weight Lifting Certification. He works on the constant development and growth of Peak’s Sports Outreach Program in the Lynbrook office.