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CHAPTER 17:
Basketball

When James Naismith invented basketball more than 100 years ago, he didn't foresee 7-foot, 270-pound players who run like deer. Because today's athletes are bigger, stronger, and faster, they injure themselves more often than their nineteenth-century counterparts did. Naismith also probably never thought his game would become the most-played sport worldwide. Basketball is played by nearly 40 million people in the United States alone.

      Basketball has evolved from an outside set-shooting game to an under-the-basket dunking contest. As big players jockey for rebounds, they make a great deal of contact. A player driving to the hoop may collide violently with an opponent or, if he is knocked off balance, come down on a hardwood floor. In addition, the game is played in a confined space, so there are many things to run into. The pole holding the basket, the scorer's table, and the bench are all close to the court and represent dangerous obstacles for fast-moving players.

      Overuse injuries are magnified in basketball because of the hard surface the players must run on. Most gyms have hardwood floors laid directly on concrete. If there is a wooden base underneath, the court is slightly less rigid. In either case, the floor does not give sufficiently to cradle the impact on the foot as a player pounds up and down the floor.

      Professional teams play on a floor built up on risers. This is a much softer, more forgiving surface that allows professionals to play more than 80 games a year without suffering perpetually sore joints.

HEAD INJURIES

Basketball players can bang their heads going after loose balls, or a player can take an elbow to the head, usually while rebounding. These clashes cause cuts and bruises, which should be cleaned and iced down; concussions; and broken noses, cheeks, and jaws.

      If you suffer a concussion, be careful about returning to play ball. You are at increased risk of another concussion from a lesser blow to the head.

      Any nose, cheek, or jaw suspected to be broken should be iced down with pressure applied to reduce swelling and bleeding. Then it should be x-rayed.

      Occasionally, a basketball player will be poked in the eye, resulting in a scratched cornea. The immediate treatment is to patch the eye shut. Then have an eye specialist check on the extent of the damage. Goggles can be worn to protect the eye from further injury.

SHOOTER'S SHOULDER

When you go up for a shot with your arm straight up and an opponent knocks your arm backward, you may end up with a partial or full shoulder dislocation. The same thing can happen when you go up for a rebound with your arms stretched over your head.

      Once the shoulder is back in joint, the treatment is to strengthen the rotator cuff muscles with an exercise program. Rest may ease your pain, but your shoulder muscles will still be weak. Without restrengthening, the shoulder will likely go out on you again. The shoulder is a slowhealing joint, and rehabilitation may take several months.

BASKETBALL BACK

People with long legs are more likely to have one leg that is slightly longer than the other. This discrepancy can lead to lower-back pain. Measuring your leg lengths and putting a heel lift in the shoe of the shorter leg can correct this problem.

      Tall people also have long backs and need more muscle to stabilize the spine. A basketball player who comes down off balance from a rebound commonly strains a muscle and may even rupture a disc. All the jumping and twisting exerts tremendous torque on the back, and a player's muscles may not be adequately developed to absorb all the shock.

      A back exercise program is therefore important for basketball players. A lower-back stretching program should be incorporated into the exercise routine, and both arching and flexing exercises should be used to strengthen the back.

WRIST INJURIES

Sprained and even broken wrists commonly result from players falling to the floor. They instinctively put out their hands to stop their momentum, and the wrist absorbs the shock.

      It's difficult to distinguish a sprained wrist from a broken wrist without an x-ray. Because there are so many tendons and bones in the wrist, it's one of the hardest areas of the body in which to diagnose an injury. If you damage your wrist, see a sports doctor who knows the difference between the two injuries.

      A basketball player may break the small navicular bone just behind the base of the thumb. This fracture may take from eight weeks to eight months to heal by itself. If it doesn't heal, surgery will be needed to help the bones knit back together.

FINGER FRACTURES

Almost all veteran basketball players have broken a finger. This injury typically occurs when a deflected pass hits the end of a finger, or a tendon can rupture and a piece of bone can break off with it. If your finger gets hit by a ball, ice it down until the swelling subsides. If the pain persists, see a doctor and have the finger x-rayed to see whether it is broken.

DISLOCATED FINGER

If the ball hits your finger and moves it sideways, a dislocation may result, commonly in the joint closest to the hand. Immediately pulling on the finger usually puts it back in joint and relieves the sharp pain. However, you should have the finger x-rayed because it may also be broken, and you can lose the motion in an untreated broken finger.

      The swelling may take four to eight months to go down. Don't be alarmed. The finger may always be a little bit bigger than it was, and you may lose some mobility, but not enough to throw you off your game.

HAMSTRING PULL

Hamstring pulls are common among basketball players because of their sudden acceleration, for example, as they drive to the basket.

      The treatment is rest and ice, followed by a stretching program. When you can stretch the injured side without pain as far as you can stretch the healthy one, you are ready to return to action.

      To prevent another hamstring pull, you can apply a sports cream, such as Ben-Gay®, before playing to keep the muscle warm and fluid. Many players now wear rubber thigh sleeves under their shorts to keep the thigh warm and give it some support.

KNEE INJURIES

Knee injuries are less common in basketball than in football, but they do occur and can be severe. Usually they result from the player taking a blow to the knee from the side. Since a sneaker doesn't fix your foot to the floor, the foot can rotate, which reduces the impact somewhat.

      You can also injure a knee by suddenly changing direction while running. This may cause an anterior cruciate ligament (ACL) tear or a cartilage tear. An ACL tear requires reconstructive surgery, and it may take six months or more of strenuous physical therapy before you recover fully. Initially, a knee brace will become a part of your standard basketball equipment. Eventually, a well-repaired knee can do without a brace.

      A moderately severe knee injury may not be immediately evident. You may have a sizable cartilage tear and have no problem with your knee for quite a while. Then the next time you stress the knee, it gives out on you.

      As a jumping sport, basketball often leads to jumper's knee, a condition where the tendons that hook into the top and bottom of the knee become inflamed. To ease this tendinitis, rest until the acute pain subsides, and ice your knee intermittently while it is tender. Pain-killing antiinflammatory agents may also help. Then you need to strengthen the tendons and muscles of the knee using the Leg Extension and Leg Curl exercises described in the strength-training program in Chapter 1.

      All knee injuries should be treated by a doctor. The knee is not a joint that lends itself to self-treatment. You may be able to do a prescribed rehabilitation program at home, but there is no standard program for all knee injuries. If your knee hurts for more than a few days, or if you feel pain after two playing sessions, see a doctor.

CALF PULL

The stress of leaping can cause a muscle pull in your calf. Rest for a few days and ice the calf muscle often during this time. Then begin a stretching program using Wall Push-ups. Stretch the muscle for 20 seconds at a time, doing five repetitions at least six to eight times a day, to lengthen the calf muscle.

ANKLE SPRAIN

The ankle sprain is the basketball player's bête noire. It usually results from a player stepping on another player's foot while coming down from a jump or while running up the court.

      Anything but the most minimal ankle sprain should be seen by a doctor and x-rayed to check for a possible fracture. Treatment includes the traditional RICE formula described in Chapter 4, followed by early range-of-motion exercises. You can bear weight on the ankle once you can walk with a normal heel-to-toe gait. Muscle-strengthening exercises are important in preventing another sprain. Taping or bracing the ankle may also help support the ankle while you are recovering.

ACHILLES TENDINITIS

Basketball players can suffer Achilles tendinitis from two causes: turning the foot over while running and straining the Achilles tendon while jumping.

      Two useful stretching exercises are the Wall Push-up and the Heel Drop in Chapter 12.

      Repeated tendinitis can weaken the Achilles tendon and cause scar tissue to form. A player may go up for a jump shot one day and all of a sudden the tendon ruptures. Each year I see about a half-dozen basketball players with Achilles ruptures, which is one of the most severe injuries in sports. It is likely that surgery will be needed to repair the ruptured tendon, and full recovery may take six months or more.

STRESS FRACTURES

Basketball players must pay heed to foot pain. They have a high incidence of stress fractures, the injury that shortened Bill Walton's career. If you experience a sudden pain in the front part of the foot while running, it may be a stress fracture. If both the top and bottom of the foot hurt and the foot swells up, have it x-rayed to see whether any bones have cracked.

      The most common stress fracture among basketball players occurs in the bone behind the little toe. An informal survey of team doctors in the National Basketball Association found that, of all lower-body fractures, more than half were to the fifth metatarsal, behind the little toe. A Penn State study revealed that NBA players come down on their feet with as much as 14 times their own body weight after a lay-up. The NBA is now studying the connection between such high-impact landings on hard floors and stress fractures.


How to Improve Your Game

Like other running sports, basketball requires superb conditioning. You must be able to exert a burst of speed to get by the person guarding you and also have the endurance to run the court for an entire game. You can perform running drills that combine these facets.

      Endurance running drills are just long, slow runs, from three to five miles a day, that get your heart into the training range. This gives you the strong base of aerobic conditioning that is necessary for stamina. Once you have built up your base level, start interval training. Repeated sprints of varying distances with short rests in between will give you the speed and quick recovery you need for basketball.

      You also need to develop a good first step and side-to-side agility. Here are drills to make you more agile and to improve your lateral movement:

      Basketball is, of course, a jumping sport, so you need to strengthen your legs. In particular, work on your calf muscles to increase your vertical leap. Plyometrics are good rhythmic drills that increase calf muscle strength to improve jumping ability. Following are three plyometrics exercises:

      I can't emphasize enough the value of an overall strength training program for basketball players. Your legs must be strong to jump high, and your upper body needs to be strong for boxing out and rebounding. Professional teams now work on strength training in the off-season as well as during the season. Most teams also take a strength coach with them on the road. The strength coach hooks up with a local health club that allows the players to work out there.




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