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Basketball season can subject players to a world of injuries

February 15, 2000

THE BASKETBALL seasons -- professional, college, high school and amateur -- are at or beyond the halfway point, and the injuries are mounting.

Among the early season concerns were strains and bruises to the head, shoulder, back, wrist, fingers, hamstrings, knee, ankle and Achilles tendon, as well as stress fractures. But now doctors are seeing an increase in over-use injuries because of the hard surfaces the players must run.

Professional teams have the luxury of playing on a flat floor that's built on risers -- a much softer and more forgiving surface than those in most area gyms. These soft-touch floors, ongoing conditioning and proper nutrition allow the pros to play more than 80 games a year without suffering perpetually sore joints.

Basketball players routinely bang their heads and joints while going after loose balls. This contact can result in cuts that should be cleaned immediately and iced down. Any injury to the nose, cheek or jaw should be iced to reduce swelling or bleeding, then X-rayed to rule out a fracture. Occasionally, a player suffers a blow to the eye resulting in a corneal abrasion, ruptured globe or eye rim fracture. These injuries should be examined by an ophthalmologist as soon as possible to evaluate the extent of the damage. Goggles can be worn to protect the eye from injury.

Perhaps the most frightening common injury is a concussion. If you suffer one, you must not return to play too early because there is an increased risk of suffering another concussion from a lesser blow to the head. Immediate symptoms are disorientation and head pain and perhaps nausea and memory loss. If symptoms persist, the player must be examined by a doctor as soon as possible.

Sometimes a player suffers from shooter's shoulder. This occurs when a player goes up for a shot with his arms straight up and an opponent knocks the arms backward. The result may be a partial or full shoulder dislocation. Once the shoulder is back in place, the treatment is to strengthen the rotator cuff muscles as well as the shoulder blade muscles with a strengthening and flexibility program. The shoulder is a slow-healing joint, and rehabilitation may take several months.

People with long legs are likely to have one leg that is slightly longer than the other. This discrepancy can result in low back or hip pain. Measuring leg lengths and placing a heel lift under the shorter leg can help correct the problem. Tall people also often have long backs and need more muscle to stabilize the spine. Rebounding involves a lot of body torquing and twisting that can result in a severe strain and even a ruptured disk. A lower back stretching and strengthening program is essential throughout the season.

Almost all experienced basketball players have either broken or dislocated a finger. If your finger swells after being hit by a ball, then it should be iced immediately until the swelling subsides. An X-ray should be done to rule out a fracture. If a dislocation is present and a fracture is ruled out, putting traction and downward pressure on the dislocated finger often corrects the dislocation immediately.

Hamstring pulls are common among basketball players because of sudden deceleration when a player pulls up for a shot or slows down to complete a lay-up. The treatment is rest, followed by a regular stretching program.

Therapeutic electro-stimulation or ultrasound can expedite the healing process. To prevent another hamstring injury, a sports cream such as Ben-Gay or Flexall can be applied to keep the muscle warm. Many players wear rubber thigh sleeves under their shorts to keep their thighs warm and to give support. They're available at your local sporting goods store for $10-$15.

Knee injuries are less common in basketball than in football, but they can be severe. Basketball involves a lot of planting of the foot to make a sudden change in direction while running. This may cause an injury to the anterior cruciate or other supporting ligaments and cartilage of the knee.

The treatment of arthroplasty versus total knee reconstruction is usually up to an orthopedic surgeon with a strong sports medicine background. A knee brace is part of the initial equipment for anyone who has undergone an anterior cruciate ligament repair, and full recovery usually requires six months or more of vigorous physical therapy. The knee brace is normally covered by health care insurance. Eventually, a well-repaired knee can do without a brace.

Because it is a jumping sport, basketball often aggravates jumper's knee, known as patellar Tendinitis, in which the tendon sheath beneath the knee becomes inflamed. To ease this, rest is recommended until the acute pain subsides. Then the knee is iced frequently for 20 minutes at a time while it is tender.

Anti-inflammatory agents such as 400 to 800 mg of Advil or two Aleve also will help. They should always be taken with food, and alcohol should be avoided. Next, the quadriceps, thigh and hamstring muscles need strengthening with leg extension and leg curl machines.

A Cho-Pat support strap can be worn just below the knee over the patellar tendon.

The stress of leaping also can cause a pulled muscle in the calf. Rest for a few days is recommended as well as the use of anti-inflammatory agents. Then a stretching program can begin: wall push-ups for 10 to 20 seconds at a time, five repetitions at least six to eight times a day.

Ankle sprains occur often and usually result from stepping on another player's foot.

Ankle injuries should be evaluated by a doctor for possible fracture. As with other injuries, rest, ice, compression and elevation are recommended, followed by a range of motion exercises. You can begin putting weight on the ankle once you can walk with a normal heel-to-toe gait.

Taping or bracing also may support your ankle during recovery. An ankle sleeve is available for about $10.

Basketball players can suffer Achilles Tendinitis from two causes: turning the foot over while running, known as overpronation, and straining the Achilles tendon while jumping. Repeated bouts of Achilles Tendinitis can result in scar tissue, and then, all of a sudden, a routine activity such as a jump shot can cause the tendon to rupture.

To remain active in sports, these ruptures usually require surgery. The alternative is to wear a cast for approximately eight weeks. Full recovery usually takes six months to a year.

Foot pain requires special attention, as there is a high incidence of stress fractures in the small foot bones. The most serious stress fracture involves the fifth metatarsal behind the little toe. This may require surgery and eight to 12 weeks of recovery.

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