Five Common Basketball Injuries

THE ORIGINS OF BASKETBALL: TWO PEACH BASKETS

The game of basketball was invented in 1891 by Dr. James Naismith, a YMCA teacher who was asked to create an indoor activity for the cold months of the year. His first version of the game used two wooden peach baskets and a soccer ball. Scoring was fairly rare, but when it did happen the players had to climb a ladder or use a long pole to get the ball out of the basket — so that play could continue.

It’s from this simple beginning — a make-shift game for kids to play when it was raining or snowing outside — that today’s high-scoring, high-speed, and intensely physical sport of basketball has evolved. As the game has become professionalized, with eight-figure salaries on offer, the athletes playing basketball have become larger, faster and stronger. And even with ever-improving training regimens and state-of-the-art facilities, injuries are common: occurring at a rate of 6-14 injuries per 1,000 hours played.

THE MOST COMMON BASKETBALL INJURIES

According to the American Orthopaedic Society for Sports Medicine (AOSSM) Sports Trauma and Overuse Prevention (STOP) program, the most common basketball injuries (considering recreational as well as professional venues) are ankle sprains, jammed fingers, knee injuries, deep thigh bruising, facial cuts, and foot fractures. According to a study based upon a 17-year overview of injuries in the NBA:

“Professional athletes in the NBA experience a high rate of game-related injuries. Patellofemoral inflammation is the most significant problem in terms of days lost in competition, whereas ankle sprains are the most common injury.”

While lower limb injuries — e.g. ankle sprains, patellofemoral pain syndrome and other knee injuries, and leg/foot stress fractures — are the most common ones among NBA players, injuries to the hips, head/face, and wrist/hand join the list of common fairly basketball injuries.

Whether you’re playing a pick-up game at the neighborhood recreation center, or contesting for an Olympic gold medal, or on contract with a professional team, or just shooting lay-ups and free-throws in your own driveway — you’re equally susceptible to the occasional jammed finger or rolled ankle.

MUSCLE GROUPS INVOLVED IN PLAYING BASKETBALL

Not surprisingly, it’s the muscles and joints most frequently used while playing basketball that are the ones that are most susceptible to injury. So which muscles are these, exactly? Basically, they’re the muscles involved in running quickly, jumping high, stopping and starting and cutting on a dime, and passing, catching and shooting the ball.

When sliding side to side, or crouching to defend a player, or lowering the hips into a squat at the beginning of the shooting motion — the quadriceps (thighs) and gluteal muscles (hips/buttocks) are primarily involved. Any kind of jumping — to launch a jump-shot, or contest for a rebound, or leap to block a shot or intercept a pass — requires also the engagement of the calf muscles. The explosiveness of a quick first step utilizes the calves, hamstrings, and quadriceps in tandem.

Shooting, defending, and passing the basketball also involve the muscles of the arms and shoulders: the triceps, biceps, deltoids, and rotator cuff. The triceps in particular factor into the ability to shoot effectively from a distance (say from 3-point range). And the chest and back muscles — the pectoralis and trapezius — also are centrally involved in these movements.

Also of vital importance are the muscles of the core: It’s the strength of the abdominal, oblique, psoas, pelvic floor, and lower-back muscles that provide an efficient foundation for changing directions quickly, and making sharp cuts. A strong core also allows for a stable defensive stance, and an overall sense of balance and ease of movement.

Given that pretty much every muscle group of the body is involved in playing basketball, a strength training program that addresses each of these muscle groups will, in a general way, help to prevent injury.

COMMON BASKETBALL INJURIES: TREATMENT & PREVENTION

Now let’s explore some specific injuries that are common for basketball players, including tips on how best to prevent them along with basic treatment strategies. We’ll begin with the most common of all basketball injuries: the ankle sprain.

1. BASKETBALL INJURIES TO THE FOOT AND ANKLE.

An ankle sprain happens when you twist, roll, or turn your ankle in an awkward way, which results in the stretching or tearing of one or more of the ligaments in the ankle. Such an injury typically results in pain, swelling, and stiffness (i.e. limited range of motion) in the ankle — and can take days, weeks, or months to fully heal, depending upon the severity.

Among NBA players, it’s the Golden State Warrior’s Stephen Curry whose frequent ankle sprains — resolved at least in part via surgery and an intensive and ongoing training regimen (focused in large part on core strengthening) — have been most impactful. When Curry is healthy, his impact on a given game is almost immeasurable. But there was a time when his career was genuinely in jeopardy, because of the seriousness and frequency of this most common of basketball injuries.

Treatment for ankle sprains: The basic RICE protocol: rest, ice, compression, and elevation. If the symptoms don’t resolve within a few days, an x-ray and evaluation by a physician may be required. Once the immediate symptoms have diminished, physical therapy exercises can support a full recovery.

Prevention of ankle sprains: Along with core strengthening (Steph Curry’s #1 strategy), proper equipment is vital. Wear indoor basketball shoes that prevent slipping, and provide adequate support for the ankles. Ankle braces and/or taping can be used for additional support, particularly if you’re prone to ankle sprains.

Other foot/ankle injuries: Stress fractures are another common basketball injury, particularly in the foot and lower leg (tibia). These are treated initially via immobilization and temporary ceasing of weight-bearing activities; with return to play happening only once the fracture has healed completely.

2. BASKETBALL INJURIES TO THE HIP AND THIGH.

Deep thigh bruising (contusion) is another common basketball injury, typically caused by an opponent’s elbow or knee inadvertently striking a player’s thigh muscles. However, among NBA players it has been the quadriceps tendinopathy suffered by Kawhi Leonard which has been the thigh injury with the greatest impact on the league. Conflict regarding the treatment (or mistreatment) of this injury during the 2017-18 season resulted eventually in Leonard being traded from the San Antonio Spurs to the Toronto Raptors.

Treatment of thigh bruising: As with ankle sprains, the initial treatment includes rest, ice, compression, and elevation (RICE). Once the acute symptoms have subsided, light training with physical therapy can bridge a player’s journey back to full activity.

Prevention of thigh bruising: Injuries such as this often can’t be prevented. However, having a comprehensive yoga or stretching program — along with weight training — can lesson the impact of the injury. Also, compression sleeves and/or girdles with thigh pads can be worn for additional protection.

3. BASKETBALL INJURIES TO THE KNEE.

As mentioned above, patellofemoral pain syndrome — pain felt behind the kneecap, where the kneecap (patella) meets the thigh bone (femur) — is one of the most common knee injuries among basketball players. The pain is generally the result of excessive joint pressure due to poor kneecap alignment, which affects the joint surface behind the kneecap.

Treatment for patellofemoral pain syndrome: Once again, the initial treatment is rest (avoiding activities that cause pain), ice, compression, and elevation. Once pain and inflammation is reduced, correcting the biomechanical imbalances that created the problem is the next step toward full recovery.

Prevention of patellofemoral pain syndrome: Normalize muscle balance and establish proper biomechanics, through physical therapy, yoga, or pilates. Wearing a therapeutic compression sleeve or knee brace can also be beneficial.

Other knee injuries: Unfortunately, more serious knee injuries — while not as common as patellofemoral pain syndrome — are not entirely uncommon among basketball players, so are worth mentioning. The Boston Celtic’s Kyrie Irving suffered a fractured kneecap, and complications from this injury prevented him from joining his team in the 2018 NBA playoffs. And the New York Knicks 7-foot 3-inch all-star forward Kristaps Porzingas suffered a torn ACL (anterior cruciate ligament) in February 2018 — which is an injury that can take up to a year or more to fully resolve. Both of these players are leaders of their team, and so their absence was deeply felt.

The best strategy for preventing a serious knee injury is to maintain balanced strength in the muscles of your legs, which support the knees. Commit to doing a yoga, pilates or stretching routine prior to practices and games, to maintain proper biomechanics. (The yoga pose Hero Pose (virasana) is particularly excellent for overall knee health.) A knee brace can provide additional support and protection.

4. BASKETBALL INJURIES TO THE WRIST AND HAND.

It should come as no surprise — given all the passing and catching of the basketball, not to mention attempted steals, etc. — that jammed fingers are one of the most common injuries. Instead of landing snug in the palm of your hand, the ball hits the tip of a finger, jamming the finger into one of its joints, creating pain and swelling. Happily, the solution is usually pretty simply, and recovery time modest.

Treatment of jammed fingers:  Apply ice, and then “buddy tape” the injured finger to the adjacent finger. This helps protect the finger while it heals, and may also allow you to return to the game, if the injury isn’t serious. If pain and swelling haven’t resolved after a few days, an x-ray and evaluation by a trainer or physician may be required.

Prevention of jammed finger: Preventing jammed fingers is about mindfulness as much as anything else. Follow the ball visually all the way into your hands before doing what you’re going to do next, i.e. dibbling, shooting, or passing. When you don’t have the ball, keep your vision wide and soft, maintaining awareness of all the players on the floor, as well as the ball. This will make it less likely that you’ll be surprised by the ball arriving in your hands.

Other injuries to the wrist and hand: The Phoenix Sun’s Devon Booker  — who once scored 70 points in a game — recently had surgery to repair the fifth metacarpophalangeal joint in his right hand. There are also hand injuries that basketball players pick up in ways that are only tangentially related to actual basketball activity: Lebron James, for instance, injured his hand via punching a blackboard, out of frustration after losing a game in the 2018 playoffs. And the Boston Celtic’s Marcus Smart (not very smartly) punched a glass frame, cutting his hand seriously and just narrowly missing severing a couple of tendons.

5. BASKETBALL INJURIES TO THE HEAD AND FACE.

Cuts are the most common basketball injury to the head and face. In the game where he broke the NBA record for made 3-point shots, shooting guard Klay Thompson accidentally knocked heads with his Golden State Warriors teammate Damian Jones, resulting in a cut on his forehead that required stitches. Luckily, most such cuts are not serious.

Treatment of cuts: Clean and disinfect the cut, and apply “butterfly” sterile tape to temporarily suture it. If the cut is deeper, it may require stitches. Apply ice if there is pain or swelling. As with any head injury, be on the lookout for concussion symptoms. If an NBA player is experiencing these, he’ll be placed in the league’s concussion protocol.

Prevention: Cuts to the head or face resulting from collisions can’t really be prevented, though training to enhance proprioception might increase your chances of avoiding such collisions.

GENERAL RECOMMENDATIONS FOR PREVENTING BASKETBALL INJURIES

Here are some general recommendations for preventing basketball injuries. Abiding by these guidelines will allow you to enjoy the game more fully, and increase your chances of remaining injury free:

-Always warm up thoroughly before playing a game or training.

-Build core strength, via yoga, pilates, and/or physical therapy.

-Along with exercises for strength, power, speed and agility, include proprioceptive (the sense of the relative position of neighboring parts of the body) and neuromuscular (relationship between neural firing in the brain and movements of body) training.

-Don’t skimp on your endurance training. According to one study of high school basketball players, nearly 60% of game-related injuries occurred during the second half of the game — which points to fatigue as a predisposing factor for injury.

-Always use good technique when shooting, dribbling, passing, or defending.

-Be intelligent about your gear: Invest in well-fitting high-top basketball shoes and/or ankle supports.

-To prevent or heal injury, use a compression sleeve — e.g. from Mueller Sports Medicine to increase circulation and decrease inflammation in the ankle, knee, wrist, elbow, hip, thigh, or shoulder.

-Clean the courts thoroughly before and during play, checking for slippery spots or debris.

-Attend to any injuries immediately, to intelligently initiate the healing process.

We’d love to support you in resolving any basketball injuries you might have, and in creating a physical routine to help keep you injury free, and maximize your performance.