Epidemiology and Impact on Performance of Lower Extremity Stress Injuries in Professional Basketball Players

Abstract

Background:Professional basketball players in the National Basketball Association (NBA) subject their lower extremities to significant repetitive loading during both regular-season and off-season training. Little is known about the incidence of lower extremity bony stress injuries and their impact on return to play and performance in these athletes.Hypothesis:Stress injuries of the lower extremity will have significant impact on performance.Study Design:Case series.Level of Evidence:Level 4.Methods:All bony stress injuries from 2005 to 2015 were identified from the NBA. Number of games missed due to injury and performance statistics were collected from 2 years prior to injury to 2 years after the injury. A linear regression analysis was performed to determine the impact of injury for players who returned to sport.Results:A total of 76 lower extremity bony stress injuries involving 75 NBA players (mean age, 25.4 ± 4.1 years) were identified. Fifty-five percent (42/76) involved the foot, and most injuries occurred during the regular season (82.9%, 63/76), with half occurring within the first 6 weeks. Among players who sustained a fifth metatarsal stress fracture, 42.9% were unable to return to professional play. Players who sustained stress injuries had reduced play performance, specifically related to number of games played (P = 0.014) and number of steals per game (P = 0.004). Players who had surgery had significantly better performance at 2 years than those who were managed nonoperatively, independent of the type of injury (β = 4.561; 95% CI, 1.255-7.868).Conclusion:Lower extremity bony stress injuries may significantly affect both short- and long-term player performance and career length. Stress injuries result in decreased player performance, and surgical intervention results in improved performance metrics compared with those treated using conservative methods.Clinical Relevance:Stress injuries result in decreased player performance, and surgical intervention results in improved performance metrics.

Comparison of Non-Contact and Contact Time-Loss Lower Quadrant Injury Rates in Male Collegiate Basketball Players: A Preliminary Report

“…As a result, there may be a greater chance for repeated physical contact (e.g., blocking out for rebounds) and there may be greater exposure to certain injuries due to repetitive jumping (e.g., jumper's knee or bone stress injuries). 29,30 Starkey 9 reported National Basketball Association (NBA) forwards had the highest game-related injury rate of 21.7 per 1000 AEs, followed closely by NBA guards at 21.3 per 1000 AEs, and finally NBA centers at 21.0 per 1000 AEs. However, it is important to note that this injury rate was for games only, included injuries for the entire body, and did not differentiate injuries based on MOI.…”

Definition of the lower extremity overuse: A review

“…Activity-related lower limb overuse, insidious onset Campanelli, 2015 Excessive strain and load on joints, which may lead to the development of overuse Multi-factorial injuries of the lower limb associated with intensive weight bearing exercise Foch, 2015 Increased muscle strain over the period of many runs Fullem, 2015 Injury due to harder training Galloway, 2013 Pathologic condition that is dominated by an incomplete or maladaptive repair process Goffar, 2013 Overuse injury due to required extended periods of walking and marching under heavy loads. Kerr, 2016 Repetitive nature of the activity -overuse Khan, 2018 Bone stress injuries Koch, 2016 Being a training or match injury when symptoms developed or aggravated usually caused by repeated micro-trauma without a single, identifiable event responsible for the injury Kollock, 2016 Overuse injuries due to large amounts of physical training Kristenson, 2016 Injuries with insidious onset and no known trauma mechanism Malliou, 2014 Chronic mechanism of injury (overuse = gradually onset).…”

“…Case-control study 2 (++) Fullem, 2015 Clinical review 4 Galloway, 2013 Clinical review 4 Goffar, 2013 Cross-section study 3 Kerr, 2016 Descriptive epidemiology study 3 Khan, 2018 Case series 3 Koch, 2016 Prospective cohort 2 (++) Kollock, 2016 Meta-analysis 1 (+) Kristenson, 2016 Follow up-study 3 Malliou, 2014 Cross-section study 3 Pensgaard, 2018 Prospective cohort study 2 (+) Reinking, 2015…”

Anatomic Characteristics of Tissues Attached to the Fifth Metatarsal Bone

“…3 Therefore, in this study, zones 2 and 3 were treated as Jones fractures. Because the area where Jones fractures occur has a poor blood supply, 22,33,36 basketball, 17 soccer, 6,7 and American football 37 players with such injuries have been reported to have low rates of return and healing. Furthermore, the high rate of male injury 23 and refracture 7,42 and reports of injury on both sides 4,21 have recently been regarded as problems.…”