Improve your Basketball Performance with Chiropractic
Improve BasketBall Performance with Chiropractic
What you need to know
Common Movements
What happens to the body in training and competition games
The pre-season phase is a fundamental part of the basketball season aiming at increasing players’ physiological and physical characteristics for the upcoming in-season phase pre-season phase is characterised by a higher training volume compared to the in-season phase due to the higher number of training sessions and the absence of official matches In one 48-minute game, a single player may travel a distance greater than 6000 m via a variety of short, moderate- to high-intensity exertions that include sprints and quick changes of direction as well as powerful jumps NBA, 60% of all game-related injuries (and 64.6% of all injuries) affect the lower extremity. Typical Body Movements Basketball is an inherently vertical sport, requiring 35 to 46 jumping and landing activities per game, which is 2 to 4 times greater than soccer and volleyball. he multidirectional nature of basketball requires constant acceleration and deceleration, forcing athletes to change directions or activities every 2 to 3 seconds
Common Injuries
Achillies Tendon
The prevalence of Achilles Tendon ruptures among all sports is highest in basketball, and basketball play is actually the cause of 42.6% of all Achilles Tendon ruptures among individuals under age 60 in the United States. The mechanism of injury for Achilles Tendon ruptures involves forced dorsiflexion of the ankle with simultaneous contraction of the gastrocnemius-soleus complex. Achilles Tendon ruptures and partial ruptures are almost exclusively treated with surgical repair. This is especially true in high level athletes who desire to return to competition due to the ability of surgery to better restore dorsiflexion and plantarflexion peak torque in comparison to nonoperative treatment. Post-operatively, an athlete may be placed in a splint or cast for the first 1-2 weeks to immobilise the Achilles Tendon. Shortly thereafter, a functional rehabilitation process that involves early modified weightbearing will begin.
What type of Injuries Happen In Basketball
High participation rates in basketball have led to a large number of injuries, especially considering that basketball poses one of the highest risks of injury in team sports, with injury rates reported between 7 and 10 injuries per 1000 athletic exposures 58-66% injuries are in the lower extremity ankle sprains account for 25% of all injuries considering the increased risk of recurrent sprain, concomitant injury to the talus and peroneal musculature, and the development of chronic ankle instability with subsequent osteoarthritis that can follow initial ankle sprains
Risks Of Basketball Injuries
Because basketball is a contact pivot sport, its associated injury rate is not negligible The joints at most risk are the knee (19.1% of all injuries, 13% of game injuries), the ankle (16.9% of all injuries, 20.9% of game injuries), the lumbosacral spine (9.0% of all injuries, 7.2% of game injuries), and the feet and toes (7.9% of all injuries, 5.0% of game injuries The number of decelerations and the total distance can be considered risk factors for injuries in professional basketball players. Unloaded players have greater risk of injury compared to players with higher accumulated external workload. Workload management should be considered a major factor in injury prevention programs. Patellofemoral inflammation is the most significant injury regarding lost competition days, while ankle sprain is the most common injury among professional male basketball players The quadriceps group was the most commonly injured structure (contusions and strains) and had a significantly higher game-related injury rate than other structure The hamstring muscle group was the most frequently strained. Strains were more likely to occur in the preseason
Back Pain In Basketball
How the Neck, Back and Low back are affected with Basketball
A study into basketball athletes found that 77% of the athletes reported low back pain, followed by neck pain (63%) and thoracic spine pain (46%) . This is where Chiropractors can really help by reducing the risk factors of poor spinal and muscle hygiene Furthermore, the trend of spinal curvature changes in basketball players, when compared to that in non-athletes, suggests an effect of regular basketball training on the degree of curvature of thoracic kyphosis and lumbar lordosis This is why we take posture screens at Health Wise Chiropractic to assess each players kyphosis and lordosis Basketball is an asymmetric sport that involves repetitive unilateral movements . Therefore, the practice of this sport may promote pain and/or injury to the spine due to the number of throws and dribbles during a practice session or game
Ankle Sprains and injury in Basketball
An ankle ligament sprain is the most common injury in high school and collegiate athletics, accounting for 22.6% of all injuries Studies indicate that basketball players change motion every 2.0 to 2.82 seconds and jump up to 35 to 46 times per game. These activities have been linked with ankle injuries. The most common activity at the time of injury was rebounding followed by general play, defending, and shooting Guards experienced the highest rate of ankle injuries in competition, followed by forwards and centres We found that most ankle injuries in collegiate basketball resulted in a time loss of less than 7 days How long do ligaments take to heal once injured? Ligamentous healing takes 6 weeks to 3 months, and despite rehabilitation, up to 30% of patients may have mechanical laxity up to a year after the injury. The most common activity at the time of ankle injury is rebounding (34.4% of all ankle injuries) followed by general play, defending, and shooting. Studies have suggested that ankle sprains were the most common injury overall and knee internal derangements were the most common injury causing athletes to miss more than 10 days of participation Among all ankle sprains, lateral ankle ligament sprains are reported to be the most common, compromising 80.2% of all ankle sprains among professional basketball players. Lateral ankle sprains are also much more likely to be produced by a contact mechanism such as stepping on another player’s foot or general contact with another player (71.2%). Lateral ankle sprains are caused by excess inversion of the ankle joint which creates stress on the anterior talofibular ligament, calcaneofibular ligament, and the posterior talofibular ligament. Medial ankle sprains are much less common than lateral sprains, only compromising 7.8% of all ankle sprains in professional basketball players. Like lateral ankle sprains, medial sprains are also more likely to be caused by a contact mechanism (63.0%). However, medial ankle sprains were the most likely ankle sprain type to be caused by a noncontact mechanism (37.0%) The medial ankle is primarily supported by the deltoid ligament. Sprains of this ligament are typically caused by excessive eversion and dorsiflexion of the ankle joint. Due to the large biomechanical forces that must be present to cause damage to the deltoid ligament, fibular or medial malleolus fractures may also be present which may lead to a more severe injury that is difficult to recover from. Like lateral ankle sprains, medial sprains are also typically treated nonoperatively Proprioceptive control is the expression of the effectiveness of the stabilising reflexes in controlling vertical stability. Single stance stability should be based on proprioceptive control (minimizing the visual and vestibular contribution) to guarantee the safety of basic movements such as walking, running, jumping, and performing refined motor skills while keeping the fluency of movements. After an ankle sprain, low ankle dorsiflexion ROM of ankle joint is a risk factor for developing patellar tendinopathy in basketball players as well as impaired bilateral balance . This loss of function increases the risk of re-sprains . In basketball, 60% of the participants experienced recurrent ankle sprain, 28% perceived ankle instability with a history of ankle sprain and 30% suffered from persistent symptoms after an ankle sprain
Prevention Tactics in Basketball
Athletes who did not perform a general stretching as part of their warm-up protocol were 2.6 times more likely to have ankle injury than athletes who stretched Neuromuscular training, such as hopping with a low centre of gravity concentrating on squats, standing on one leg, and training using a balance board, has been reported to be effective in preventing ankle sprains For prevention, it is imperative to reduce knee joint loading during sport-specific tasks like sidestep cutting .Kinematics and kinetics during sidestep cutting manoeuvres have been thoroughly examined to be effective. The Effectiveness of Neuromuscular Warmups for Lower Extremity Injury Prevention in Basketball Available evidence supports the effectiveness of neuromuscular warmups for prevention of lower extremity injuries in basketball. Poor adherence to warmups and study design flaws impact the strength of the evidence. More research is needed to identify the necessary and sufficient components of basketball warmup routines Static stretching—which has long been a key facet of traditional warmups in many sports —can lead to improvements in range of motion and have other performance benefits
Knee Injuries in Basketball
Jumpers Knee- Patellar Tendon Problems
Among male and female players, lower limb (LL) injuries predominate in the ankle (21.9%), which is the most frequently injured site, followed by the knee (17.8% Patellar tendinopathy is a clinical diagnosis, characterised by focal pain at the inferior pole of the patella and load-dependent symptoms, with increased loads resulting in a greater degree of pain. It most commonly affects athletes participating in jumping sports, where the extensor mechanism experiences high, repetitive loads. The prevalence of patellar tendinopathy is high, with 11.8–14.4% of recreational volleyball and basketball players reporting symptoms. In elite players the prevalence is even higher, with 32% of elite men’s basketball players and 45% of elite men’s volleyball players experiencing symptoms When jumping, adequate ankle joint range-of-motion is of importance since the ankle is responsible for absorbing 37% to 50% of the total kinetic energy during the landing phase. Additionally, decreased dorsiflexion is moderately correlated with higher ground reaction forces during a drop landing task A study found that peak patellar tendon force approaches 7 times body weight during horizontal landing and 5 times body weight during vertical landing in a stop-jump task Studies have shown that individuals with patellar tendinopathy demonstrated significant differences in lower extremity movement patterns in jumping and landing tasks in comparison to healthy individuals Risk for patellar tendinopathy is thought to be greatest during the eccentric phase of landing (The patellar tendon is elongated and loaded while the knee is flexing during landing. Eccentric loading can results in force magnitudes three times those observed during concentric loading)
ACL injuries in Basketball
Among athletic patients, individuals participating in basketball, soccer, and football have the highest incidence of ACL injury, often requiring surgical intervention Currently, there is no gold standard for rehabilitation after ACL reconstruction At all participation levels, the risk of anterior cruciate ligament (ACL) injury is exceedingly high among athletes involved in jumping, pivoting, and rapid change of direction The primary role of the ACL is to resist anterior tibial translation. This increase in anterior translation laxity is maximal at 20° to 40° of knee flexion, and thus ACL tears are best diagnosed near knee extension The ACL also serves as a secondary restraint to external and internal tibial rotation, in conjunction with the medial collateral ligament and surrounding posteromedial structures.The bundles serve unique roles throughout the entirety of the knee range of motion (ROM)—the AM bundle is tight in flexion and is primarily responsible for restraining anterior tibial translation, whereas the PL bundle is tight in extension and more responsible for rotational stability. Patients with ACL injuries that display severe deficits in quadriceps strength and gait symmetry have worse outcomes after ACLR
Return to play for Basketball after injury
Signs of quicker return to play are : younger age, higher competition level, reduced time until surgery, and absence of cartilage injury were associated with return to preinjury sports participation It has been advised that the return to sport process be separated into 3 phases; return to participation, return to sport, and return to performance Current suggestions include pain 80% limb symmetry index (LSI) for quadriceps force production with isometric assessment and >70% with isokinetic assessment
Treatment with Chiropractic and Rehab in Basketball Injuries
Some acute basketball injuries sustained during participation can be treated by protection, rest, ice application, compression and elevation – the PRICE principle The majority of lateral ankle sprains do not require surgical intervention and can be treated nonoperatively. The first step in lateral ankle sprain management is to acutely minimise the degree of swelling and inflammation in the ankle. This is most effectively achieved by employing the RICE protocol (rest, ice, compression, and elevation), particularly for the first 24-48 hours. For more severe sprains, such as Grade 2 or 3, immobilisation with a wrap or bracing device may also be employed for the first few days to weeks to minimise pain and further injury. weeks 2-3, low intensity, low impact exercise may be started (e.g. exercise bike) along with isolated proprioceptive training and light muscular strengthening. Gradually, the use of an elliptical machine may also be incorporated as the athlete progresses and begins to get more range of motion and stability in the ankle. Straight light running is then begun and usually becomes asymptomatic in the first 3-4 weeks. However, sport specific movements such as cutting, planting, and jumping may be painful for months post-injury. Moreover, the use of an ankle stabilising brace or wrap is also particularly important in an athlete’s return to play. An athlete’s rehabilitation can vary widely with a medial ankle sprain and may take upwards of 3-6+ months.
Youth Training Recommendations for Basketball
Training recommendations for kids The most frequent neuromuscular deficits in federated youth basketball players are related to instability, the most frequent being ankle instability, followed by lumbo-pelvic instability, dynamic postural instability and dynamic knee valgus. An estimated 12 million student-athletes between the ages of 5 and 22 years sustain a sport-related injury annually, leading to an estimated 20 million lost days of school and generating approximately $33 billion in injury-related medical costs Recommendations include (1) limiting training/competition in a single organised sport to no more than 8 months per year (2) participating in fewer hours per week of organised sports than the athlete’s age (3) participating in organised sports for fewer than 16 hours per week (4) taking 1 to 2 days off per week from organised sports participation, (5) participating in at least 1 hour of unorganised sport—or free play—for every 2 hours of organised sport participation
Treatment and Rehab Suggestions for common Ankle Sprains and fractures in basketball
The most common bones to experience a stress fracture in the ankle are the navicular bone, talus, and the lower tibia and fibula.
Lateral low ankle sprain
What happens: Excess inversion of the ankle joint which creates stress on the anterior talofibular ligament, calcaneofibular ligament, and the posterior talofibular ligament.
Treatment :RICE protocol (rest, ice, compression, and elevation), particularly for the first 24-48 hours and then chiropractic management which may include soft tissue work, joint adjustments , shockwave and more. For more severe sprains, such as Grade 2 or 3, immobilization with a wrap or bracing device may also be employed.
Return to play :Proprioceptive training, muscle strengthening in first 1-2 weeks post sprain. At 2-3 weeks can introduce straight line jogging and running as tolerated. Braced, sport specific activities incorporated in weeks 3-4. Full return to play expected at 6-8 weeks
Medial ankle sprain
What happens: Excessive eversion and dorsiflexion of the ankle joint which creates stress on the deltoid ligament.
Treatment: ICE protocol with 1-2 weeks of immobilisation via cast or walking Rboot with no weightbearing and non-operative management. If fractures are present or the joint is chronically unstable, fixation and deltoid ligament reconstruction may be necessary.
Return To Play : Low intensity and low impact exercise with concurrent proprioceptive training and light muscular strengthening in weeks 2-3. Introduce straight line running in weeks 3-4. Sport specific movements may be painful for months post-injury and use of ankle stabilizing braces are recommended. Full return to play expected at 3-6+ months.
High ankle sprain
What Happens:Forceful external rotation of the foot and ankle while the leg is in a planted position, creating a strain on the syndesmosis when the talus generates a separating pressure in the lower tibia and fibula.
Treatment : RICE protocol, immobilisation via cast or walking boot, and non-weightbearing or limited weightbearing for 1-2 weeks.Focusing on stabilising syndesmosis by limiting external rotation. If a severe syndesmotic disruption or a fracture is present, surgical screw fixation or suture button is recommended. Otherwise, manage with chiropractic care is appropriate.
Rehabilitation timelines may vary substantially. Begin proprioceptive and muscle strengthening exercises early in the acute and subacute phases. Begin full weightbearing and straight-line jogging/running as the athlete can tolerate it. When the athlete can hop on one foot and run in a straight-line with no pain, begin modified intensity sport specific training. Full return to play expected in 6-8+ weeks.
Stress fracture
What happens: Overuse of the foot and ankle by engaging in frequent, repetitive motions that cause inflammation and microscopic trauma that progresses to a small fracture over time.
Treatment : RICE protocol and non-weightbearing on crutches for 1-2 weeks. Non-operatively, a stiff soled show, walking boot, or orthotic brace is used to stabilize the foot/ankle and allow for good alignment and healing. Operative management for elite athletes includes screw fixation with possible bone graft.
Return to play: Bone stimulating devices such as shockwave therapy at health wise chiropractic may be used to promote bone healing. Once the ankle pain is resolved, begin strengthening exercises like banded resistance training, proprioceptive training, and straight-line jogging. Slowly introduce this increased activity over a 4-6-week timespan. Average return to play is expected in 3.8 months with operative management or 5.6 months with non-operative management.
Jones fracture
What happens:Significant adduction of the foot with a simultaneously lifted heel.
Treatment:RICE protocol and if the fifth metatarsal fracture is nondisplaced, a conservative approach can be taken with 6-8 weeks of non-weightbearing in a short leg cast. Surgical intervention in elite athletes may include the use of intermedullary screw fixation, low profile plating, or tension band constructs.
Return to play:One-week post-surgery, modified weightbearing activities may begin along with general lower extremity body weight exercises like leg lifts. In weeks 2-6, full weightbearing, stretching, and resistance band exercises can be started when the athlete no longer experiences discomfort or pain. In weeks 6-8, light activity and functional weightbearing activities are started, but high impact activity should be avoided. By week 8, sport-specific training can likely begin, but the progression to full activity should be gradual. Full return to play expected in 8-10+ weeks.
Weber Type A fracture
What happens: Excessive adductive force upon a supinated foot.
Treatment :RICE protocol and utilisation of a walking cast until the fibula has healed if managed non-operatively. If displaced fractures are present, ORIF is recommended.
Return to Play: Full return to play is expected in 8 weeks.
Weber Type B fracture
What Happens: Forced external rotation on a supinated foot.
Treatment RICE protocol and operative vs. nonoperative management is determined by the degree of fracture displacement or ankle instability. However, both options may offer similar outcomes.
Return to play:Full return to play is expected in 8 weeks.
Weber Type C fracture
What Happens:Excessive external rotation on a pronated foot.
TreatmentRICE protocol and likely operative management with ORIF.
Return to play:Full return to play is expected in 8 weeks.
Achilles tendon rupture
What happens:Forced dorsiflexion of the ankle with simultaneous contraction of the gastrocnemius-soleus complex.
Treatment:RICE protocol and operative management in all athletes.
Splint or cast for 1-2 weeks post-surgery. Begin functional rehabilitation program with modified weightbearing soon after. Light stretching, muscle strengthening exercises, and full weightbearing started at 6 weeks as tolerated. At three months, more intense muscle strengthening and proprioceptive training can be initiated (isokinetic exercises, balance board, stair climbing, and isotonic plantar and dorsiflexion exercises).
Full return to play is expected in 6 to 9 months.
