Establishing Phase Definitions for Jump and Drop Landings and an Exploratory Assessment of Performance-Related Metrics to Monitor During Testing.

ABSTRACT: Harry, JR, Simms, A, and Hite, M. Establishing phase definitions for jump and drop landings and an exploratory assessment of performance-related metrics to monitor during testing. J Strength Cond Res 38(2): e62-e71, 2024-Landing is a common task performed in research, physical training, and competitive sporting scenarios. However, few have attempted to explore landing mechanics beyond its hypothesized link to injury potential, which ignores the key performance qualities that contribute to performance, or how quickly a landing can be completed. This is because a lack of (a) established landing phases from which important performance and injury risk metrics can be extracted and (b) metrics known to have a correlation with performance. As such, this article had 2 purposes. The first purpose was to use force platform data to identify easily extractable and understandable landing phases that contain metrics linked to both task performance and overuse injury potential. The second purpose was to explore performance-related metrics to monitor during testing. Both purposes were pursued using force platform data for the landing portion of 270 jump-landing trials performed by a sample of 14 NCAA Division 1 men's basketball players (1.98 ± 0.07 m; 94.73 ± 8.01 kg). The proposed phases can separate both jump-landing and drop-landing tasks into loading, attenuation, and control phases that consider the way vertical ground reaction force (GRF) is purposefully manipulated by the athlete, which current phase definitions fail to consider. For the second purpose, Pearson's correlation coefficients, the corresponding statistical probabilities ( α = 0.05), and a standardized strength interpretation scale for correlation coefficients (0 < trivial ≤ 0.1 < small ≤ 0.3 < moderate ≤ 0.5 < large ≤ 0.7 < very large) were used for both the group average (i.e., all individual averages pooled together) and individual data (i.e., each individual's trials pooled together). Results revealed that landing time, attenuation phase time, average vertical GRF during landing, average vertical GRF during the attenuation phase, average vertical GRF during the control phase, vertical GRF attenuation rate, and the amortization GRF (i.e., GRF at zero velocity) significantly correlated with landing performance, defined as the ratio of landing height and landing time ( R ≥ ± 0.58; p < 0.05), such that favorable changes in those metrics were associated with better performance. This work provides practitioners with 2 abilities. First, practitioners currently assess jump capacity using jump-landing tests (e.g., countermovement jump) with an analysis strategy that makes use of landing data. Second, this work provides preliminary data to guide others when initially exploring landing test results before identifying metrics chosen for their own analysis.

Australian netball injuries in 2016: An overview of insurance data.

OBJECTIVES: The objective of this study is to profile the netball-specific sporting injuries from in a national community-level insurance claim database. DESIGN: An audit of insurance injury claims. METHODS: An electronic dataset containing successful injury insurance claim data from the 2016 netball season was retrospectively coded. Data were de-identified and coded to meet the Orchard Sports Injury Classification System. Descriptive data reported included age, injury date, activity type, anatomical injury location, nature of injury, weather conditions, indoor/outdoor surface, quarter injury occurred, and open text for injury description. RESULTS: The dataset contained 1239 claims that were approved for payment by the insurance company. The overall incidence rate was 2.936 successful injury claims per 1000 participants. The average age of players with claims was 34years. The majority of successful claims came from players aged 22 to 29years (n=328; 27%) and 30-39years (n=279; 23%) age groups. Of the successful claims for injury, most occurred during matches (n=1116; 92%), and were for injuries to the knee (n=509; 42%) and ankle (n=356; 29%) and for sprains/ligament damage (n=687; 57%) or fractures (n=182; 15%). CONCLUSIONS: Netball injuries profiled by an injury insurance dataset of successful claims mostly occurred to the knee and ankle. Sprains and ligament damage were the most common type of injury. This study strengthens the evidence for national injury prevention policies and strategies. Findings from the current study could be used in future to expand into mechanisms of injury, and injury diagnoses.

Use of Dynamic Ultrasound Imaging for Assessment of the Fibular Collateral Ligament of the Knee.

A 25-year-old male college student reported an immediate sharp pain in the lateral aspect of his left knee while playing recreational basketball. He sought a direct-access consultation by a physical therapist. Due to the superficial nature of the fibular (lateral) collateral ligament (FCL), static and dynamic ultrasound imaging was used to visualize the FCL. Complementing the clinical examination findings, use of dynamic imaging strengthened the differential diagnosis of multidirectional laxity and supported the clinical decision of referral. Subsequent follow-up magnetic resonance imaging confirmed tears of the anterior cruciate ligament and FCL.J Orthop Sports Phys Ther 2019;49(3):210. doi:10.2519/jospt.2019.8460.

Epidemiologic comparison of injured high school basketball athletes reporting to emergency departments and the athletic training setting.

CONTEXT: Basketball is a popular US high school sport with more than 1 million participants annually. OBJECTIVE: To compare patterns of athletes with basketball-related injuries presenting to US emergency departments from 2005 through 2010 and the high school athletic training setting from the 2005-2011 seasons. DESIGN: Descriptive epidemiology study. SETTING: Data from the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission and the High School Reporting Information Online database. MAIN OUTCOME MEASURE(S): Complex sample weights were used to calculate national estimates of basketball-related injuries for comparison. PATIENTS OR OTHER PARTICIPANTS: Adolescents from 13 to 19 years of age treated in US emergency departments for basketball-related injuries and athletes from 13 to 19 years of age from schools participating in High School Reporting Information Online who were injured while playing basketball. RESULTS: Nationally, an estimated 1,514,957 (95% confidence interval = 1,337,441, 1,692,474) athletes with basketball-related injuries reported to the emergency department and 1,064,551 (95% confidence interval = 1,055,482, 1,073,620) presented to the athletic training setting. Overall, the most frequent injuries seen in the emergency department were lacerations and fractures (injury proportion ratios [IPRs] = 3.45 and 1.72, respectively), whereas those seen in the athletic training setting were more commonly concussions and strains/sprains (IPRs = 2.23 and 1.19, respectively; all P values < .0001). Comparisons of body site and diagnosis combinations revealed additional differences. For example, athletes with lower leg fractures more often presented to the emergency department (IPR = 6.53), whereas those with hand fractures more frequently presented to the athletic training setting (IPR = 1.18; all P values < .0001). CONCLUSIONS: Patterns of injury differed among high school basketball players presenting for treatment in the emergency department and the athletic training setting. Understanding differences specific to clinical settings is crucial to grasping the full epidemiologic and clinical picture of sport-related injuries. Certified athletic trainers play an important role in identifying, assessing, and treating athletes with sport-related injuries who might otherwise present to clinical settings with higher costs, such as the emergency department.

Suggestions from the field for return to sports participation following anterior cruciate ligament reconstruction: basketball.

The purpose of this paper is to outline the final, functional phases of rehabilitation that address exercises, drills, and return-to-play criteria for the sport of basketball, following anterior cruciate ligament (ACL) reconstruction. ACL injuries can be debilitating and affect the quality of life for recreational and elite athletes alike. Tears of the ACL are common in both male and female basketball players, with a higher incidence rate in females. Incidence of a retear to the existing graft or contralateral knee within 5 years of ACL reconstruction with patellar tendon autograft in young (less than 18 to 25 years of age), active basketball players can be as high as 52%. Reducing the number of ACL injuries or reinjury, of which there are an estimated 80 000 per year at an associated cost of over a billion dollars, can have significant potential long-term fiscal and health benefits. Following surgical reconstruction of the ACL, implementing a tailored rehabilitation protocol can ensure a successful return to sport. When searching the literature for such protocols, clinicians may struggle to find specific exercises, drills, and return-to-play criteria for particular sports. The intent of this manuscript is to present such a rehabilitation protocol for basketball.

Clinical assessment of ankle injury outcomes: case scenario using the foot and ankle ability measure.

PATIENT SCENARIO: A 20-y-old male Division 1 college basketball player sustained a grade 2 inversion ankle sprain during preseason that is preventing him from practicing and competing. CLINICAL OUTCOMES ASSESSMENT: The Foot and Ankle Ability Measure (FAAM) was administered to the injured athlete as an evaluative tool to provide the clinician with valuable subjective information on the patient's self-reported function. The FAAM consists of 2 subscales: the activities of daily living (ADL) subscale and the sports subscale. Together the 2 subscales contain 29 questions (21 questions on the ADL and 8 on the sports subscale), which assess self-reported function and disability in the foot and ankle. CLINICAL DECISION MAKING: The addition of the self-reported functional measures provides the clinician with more quantitative data to make clinical decisions than is possible with typical clinical exams. Self-reported functional assessments should not replace thorough clinical examination or sound clinical judgment; instead they should be an adjunct to them. CLINICAL BOTTOM LINE: In addition to our objective assessment tools, the FAAM provides clinicians with a tool that can be used to assess function and disability through our patients' self-reported responses. When used for evaluative purposes the FAAM can measure an individual's changes in function and disability over time.

Assessment and follow-up of muscle injuries in athletes by bioimpedance: preliminary results.

Mono-frequency (50 kHz) whole-body and segmental bioimpedance is measured before sport training in 14 high performance athletes. The athletes are classified in two groups according to the team sport: football and basketball. Bioelectrical impedance vector analysis (BIVA) method is used to obtain the individual whole-body impedance and 6 segmental impedance vectors in the main muscular groups in the lower-limbs. The whole-body vector is analyzed in the tolerance ellipses of the reference population. Individual impedance vector components are standardized by the height H of the subject, (R/H and Xc/H) to obtain the impedance vector (Z/H) of each segment. The hypotheses of the study are: 1) Not all the sports have the same pattern of bioimpedance vector by muscle group. 2) In elite well trained athletes their muscle groups are symmetrical (right and left sides), thus each athlete is its own reference for future comparisons. 3) We expect a change in the two components of bioimpedance vector (R/H and Xc/H) in front of a muscle injury. In order to compare the differences between the complex Z/H vector (R/H, Xc/H) we use Hotelling's T2 test. Preliminary results show a significant difference (P < 0.05) in bioimpedance vectors between groups according to the team sport, and also between normal muscle condition and after muscle injury producing hyper-hydration.

Longitudinal assessment of noncontact anterior cruciate ligament injury risk factors during maturation in a female athlete: a case report.

OBJECTIVE: To present a unique case of a young pubertal female athlete who was prospectively monitored for previously identified anterior cruciate ligament (ACL) injury risk factors for 3 years before sustaining an ACL injury. BACKGROUND: In prospective studies, previous investigators have examined cross-sectional measures of anatomic, hormonal, and biomechanical risk factors for ACL injury in young female athletes. In this report, we offer a longitudinal example of measured risk factors as the participant matured. DIFFERENTIAL DIAGNOSIS: Partial or complete tear of the ACL. MEASUREMENTS: The participant was identified from a cohort monitored from 2002 until 2007. No injury prevention training or intervention was included during this time in the study cohort. FINDINGS: The injury occurred in the year after the third assessment during the athlete's club basketball season. Knee examination, magnetic resonance imaging findings, and arthroscopic evaluation confirmed a complete ACL rupture. The athlete was early pubertal in year 1 of the study and pubertal during the next 2 years; menarche occurred at age 12 years. At the time of injury, she was 14.25 years old and postpubertal, with closing femoral and tibial physes. For each of the 3 years before injury, she demonstrated incremental increases in height, body mass index, and anterior knee laxity. She also displayed decreased hip abduction and knee flexor strength, concomitant with increased knee abduction loads, after each year of growth. CONCLUSIONS: During puberty, the participant increased body mass and height of the center of mass without matching increases in hip and knee strength. The lack of strength and neuromuscular adaptation to match the increased demands of her pubertal stature may underlie the increased knee abduction loads measured at each annual visit and may have predisposed her to increased risk of ACL injury.

A 7-year study on risks and costs of knee injuries in male and female youth participants in 12 sports.

Knee injuries are common and account in various sports for 15-50% of all sports injuries. The cost of knee injuries is therefore a large part of the cost for medical care of sports injuries. Furthermore, the risk of acquiring a knee injury during sports is considered higher for females than for males. The nationwide organization "Youth and Sports" represents the major source of organized sports and recreation for Swiss youth and engages annually around 370000 participants in the age group of 14 to 20 years. The purpose of this study was to combine data on knee injuries from two sources, the first being data on the exposure to risk found in the activity registration in "Youth and Sports" and the second injuries with their associated costs resulting from the activities and filed at the Swiss Military Insurance. This allowed calculation of knee injury incidences, to compare risks between males and females and to estimate the costs of medical treatment. The study comprises 3864 knee injuries from 12 sports during 7 years. Females were significantly more at risk in six sports: alpinism, downhill skiing, gymnastics, volleyball, basketball and team handball. The incidences of knee injuries and of cruciate ligament injuries in particular, together with the costs per hour of participation, all displayed the same sports as the top five for both females and males: ice hockey, team handball, soccer, downhill skiing and basketball. Female alpinism and gymnastics had also high rankings. Knee injuries comprised 10% of all injuries in males and 13% in females, but their proportional contribution to the costs per hour of participation was 27% and 33%, respectively. From this study it can be concluded that females were significantly more at risk for knee injuries than males in six sports and that knee injuries accounted for a high proportion of the costs of medical treatment.

Achilles tendon ruptures stratified by age, race, and cause of injury among active duty U.S. Military members.

A total of 865 members of the U.S. military underwent repair of Achilles tendon ruptures at U.S. military hospitals during calendar years 1994, 1995, and 1996. The discharge summaries of these patients were analyzed for patient demographic information, including age, race, and causative activity. Patients were then stratified by age, race, and cause of injury. Blacks were at increased risk for undergoing repair of the Achilles tendon compared with nonblacks (overall relative risk = 4.15, 95% confidence interval [CI] = 3.63, 4.74; summary odds ratio controlling for age = 3.69, CI = 3.25, 4.19). Participation in the game of basketball accounted for 64.9% of all injuries in black patients and 34.0% of all injuries in nonblack patients. Among those injured, blacks had a significantly increased risk for injury related to playing basketball than nonblacks (relative risk = 1.82, CI = 1.58, 2.10). This finding suggests that there may be other predisposing factor(s) that result in a higher risk of Achilles tendon ruptures in black individuals.

Sports members' participation in assessment of incidence rate of injuries in five sports from records of hospital-based clinical treatment.

This study is about the incidence rate of sports injuries in five different types of sports, gymnastics, soccer, volleyball, hockey, and basketball, for which 5,154 patients were admitted to the Emergency Unit of the Groningen University Hospital during the period 1990 through 1994. Incidence rate had been computed by membership participation. Basketball had the highest incidence rate (231 injured persons per 10,000 participants), followed by hockey (158 injured persons per 10,000 participants). The highest mean Injury Severity Score, 2.39, was found for gymnastics which had the lowest incidence rate (7 injured persons per 10,000 participants). Gymnastics had the highest percentage (12%) clinically treated patients, whereas basketball had the smallest percentage (2%) of clinically treated patients. The most frequent type of injury was distorsion, except for hockey, in which contusion had the highest percentage of occurrence. For all five types of sports, the majority (about 90%) of the injuries were observed at either the lower or at the upper extremities.

Cervical cord neurapraxia: classification, pathomechanics, morbidity, and management guidelines.

One hundred ten cases of the transient neurological phenomenon, cervical cord neurapraxia (CCN), are presented. The authors established a classification system for CCN, developed a new computerized measurement technique for magnetic resonance (MR) imaging, investigated the relationship of the cervical cord to the canal, and analyzed clinical, x-ray, and MR data. One hundred nine males and one female were included in the study; the average age of the participants was 21 years (range 13-33 years). All episodes occurred during sports participation; 87% occurred while the patient was playing football. Follow-up review lasting an average of 3.3 years was available for 105 patients (95%). Narrowing of the sagittal diameter of the cervical canal in the adult spine was confirmed to be a causative factor. Cervical cord neurapraxia was not associated with permanent neurological injury and no permanent morbidity occurred in patients who returned to contact activities. Of the patients returning to contact activities, 35 (56%) experienced a recurrent episode. The risk of recurrence was increased with smaller spinal canal/vertebral body ratio (p < 0.05), smaller disc-level canal diameter (p < 0.05), and less space available for the cord (p < 0.05). There was no correlation between either the classification of the CCN episode or the disease noted on MR imaging and x-ray films and the risk of recurrence. The authors conclude that: 1) CCN is a transient neurological phenomenon and individuals with uncomplicated CCN may be permitted to return to their previous activity without an increased risk of permanent neurological injury; 2) congenital or degenerative narrowing of the sagittal diameter of the cervical canal is a causative factor; 3) the overall recurrence rate after return to play is 56%; and 4) the risk of recurrence is strongly and inversely correlated with sagittal canal diameter and it is useful in the prediction of future episodes of CCN (p < 0.001). These data will enable the physician to counsel individuals regarding a predicted risk of recurrence based on canal measurements.

Tooth avulsions resulting from basketball net entanglement.

The authors conducted a survey of dentists reporting tooth avulsions from basketball net accidents. Although the number of people injured was small, the dental injuries were serious. In many cases, multiple teeth were avulsed as a result of the maxillary anterior teeth becoming entangled in the basketball net while the patients were attempting to slamdunk a basketball either on a lowered backboard or from a raised take-off area. The authors present recommendations for preventing tooth avulsions resulting from basketball net entanglement.

Parental attitudes toward mouthguards.

An 11-item, one-page questionnaire was mailed to 1800 parents chosen at random in the Henrico County, VA public school system. Parents were asked questions such as "who should be responsible for mouthguard wear?" "what sports should require mouthguards?" and "has [their] child ever sustained an oral or facial injury?" The parental responses indicate that mouthguard enforcement is the responsibility of both parents and coaches. Of the total injuries reported, 19% were sustained in basketball, 17% in baseball, and 11% in soccer. Despite these high injury rates, however, there was a lack of perceived need for mouthguard use in these sports. When asked which sports should require a mouthguard rule, the sports that generated the most responses were, in decreasing order, football, boxing, ice hockey, wrestling, field hockey, and karate. Parents were more likely to require mouthguards for their sons than daughters, and more likely to require them for their children who participated in a mandatory mouthguard sport, a contact sport, or who had been previously injured. The authors conclude that because parents view themselves as equally responsible as coaches for maintaining mouthguard use, both groups should be targeted and approached as a possible source for the recommendation of mandatory mouthguard rules in basketball, baseball, and soccer.

Assessment and treatment of basketball injuries.

In this article, we have discussed acute musculoskeletal injuries, acute exacerbations of illness related to basketball, and preparation for these emergencies. Although the acute nature of the problems require constant diligence on the part of the health care provider, the rewards of good management to the player and to the treating physician make it all worthwhile.