Mechanisms of Achilles Tendon Rupture in National Basketball Association Players

Abstract

A systematic search was performed of online databases for any Achilles tendon (AT) injuries occurring within the National Basketball Association (NBA). Video was obtained of injuries occurring during competition and downloaded for analysis in Dartfish. NBA athletes (n = 27) were identified with AT rupture over a 30-year period (1991–2021). Of the 27 NBA athletes found to have AT ruptures (mean age: 29.3 [3.3] y; average time in the NBA: 8.5 [3.8] y), 15 in-game videos were obtained for analysis. Noncontact rupture was presumed to have occurred in 12/13 cases. Eight of the 13 athletes had possession of the ball during time of injury. The ankle joint of the injured limb for all 13 athletes was in a dorsiflexed position during the time of injury (47.9° [6.5°]). All 13 athletes performed a false-step mechanism at time of injury where they initiated the movement by taking a rearward step posterior to their center of mass with the injured limb before translating forward. NBA basketball players that suffered AT ruptures appeared to present with a distinct sequence of events, including initiating a false step with ankle dorsiflexion of the injured limb at the time of injury.

Biomechanics and situational patterns associated with anterior cruciate ligament injuries in the National Basketball Association (NBA)

“…Only 23.7% of the injuries examined were non-contact. This is a significantly lower prevalence than multiple other studies,16 17 37 38 but similar to a recent study on NBA athletes 18. This lower prevalence could be due to different definitions of ‘contact’ between studies.…”

“…That could potentially be attributed to differences in video quality, and to the fact that their study did not quantifiably measure biomechanical angles using formal tools. A more recent study on NBA athletes identified IC knee flexion angle to be slightly greater than this study (21.3° vs 12.6°) 18. However, that study measured some kinematics at the time of whole foot ground contact, rather than any ground contact like this study.…”

“…A recent study by Petway et al evaluated the kinematics of ACL injuries in NBA players from 1975 to 2022 18. Petway et al obtained 35 videos for review, of which 5 were excluded since they involved direct contact to the knee.…”

“…However, previous studies that evaluated basketball injuries included players of different competitive levels and sexes 16 17. Additionally, other studies provide limited data on playing situations and biomechanics over time 18. There is a need for comprehensive analysis of ACL tears specifically within National Basketball Association (NBA) players as they have an elevated risk for ACL injuries due to the fast pace of the game, unpredictable movement patterns and decreased recovery between competitions 19 20…”