Comparison of the prevalence and mechanism of sports injuries among elite male basketball players
Subject Areas : Exercise Physiology and Performance
Mohammad Hasan Kordi Ashkezari
1
,
Abuzar Saadatian
2
1 - Department of Sports Injury and Corrective Exercises, Faculty of Sports Sciences, Shahid Bahonar University of Kerman, Iran
2 - Department of Physical Education and Sport Sciences, Yasuj University, Yasuj, Iran.
Keywords: Prevalence, mechanism, Basketball, sport injury,
Abstract :
Background: Basketball is a team-oriented and contact sport and participation in this sport entails accepting the risk of injury. The purpose of this study was to determine the causes and prevalence of sports injuries among male basketball players in the country. The aim of this study was to determine the causes and prevalence of sport injuries.Methods: This cross-sectional study employed a retrospective method and utilized a questionnaire on basketball injuries as documented by Marcus et al. The study surveyed 82 players from the Premier League and Division I, belonging to the 1401 basketball season. Data were analyzed by descriptive statistics and chi-square test (c2). Results: The results of the study showed that the frequency of injuries in the lower extremities (75%) was significantly higher than in the other parts of the body (p = 0.001, c2 = 94.46). In the lower limbs, knees and wrists had the highest injury rates (48.7%, and 46.2%, respectively) (p = 0.001, c2 = 41.49). Conversely, in the upper limb, shoulder had the highest injury rate (50%) though the difference was not significant (p = 0.26, c2 = 2.62). The mechanism of occurrence of damage was related to landing (44.2%), which was statistically significant (p = 0.001, c2 = 58.53).Conclusion: The majority of injuries among basketball players affect the lower extremities, particularly the knees and ankles, likely due to frequent jumping and rapid movements during the game.
Belali Jafar. Video analysis of basketball injuries in the Premier League of Iranian clubs. [MSc Thesis]. Place of publication: Physical education and sport science faculty. Esfahan University. 1388. [Farsi]
Deitch JR, Starkey C, Walters SL, Moseley JB. Injury risk in professional basketball players: a comparison of Women's National Basketball Association and National Basketball Association athletes. The American journal of sports medicine. 2006 Jul; 34(7):1077-83.
Khosro Zadeh Jahanbakhsh, Golpayegani Masud, Bani talebi Ebrahim, Esmi Behnam. The Prevalence and Causes of Physical Injuries among Basketball Players. Journal of Applied Exercise Physiology 1387; 4(8):45-52. [Farsi]
Jakson D and Mannarino. Prevention and rehabilitation. Medicine sport. 2002; 342- 363.
Dick, R., Hertel, J., Agel, J., Grossman, J., & Marshall, S. W. Descriptive Epidemiology of Collegiate Men’s Basketball Injuries: National Collegiate Athletic Association Injury Surveillance System, 1988–1989 Through 2003–2004. Journal of Athletic Training, 2007; 42(2), 194–201.
Flood, L.,Harrison, JE. Flood L, Harrison JE. Epidemiology of basketball and netball injuries that resulted in hospital admission in Australia, 2000–2004. Medical Journal of Australia. 2009; 190(2):87-90.
Barani Azam, Bambaei chi Efat, Rahnema Nader. Prevalence and injury mechanisms in female basketball athletes. Researrch in Sport Science. 1388; 23(3): 59-68. [Farsi]
Nelson AJ, Collins CL, Yard EE, Fields SK, Comstock RD. Ankle injuries among United States high school sports athletes, 2005–2006. Journal of athletic training. 2007; 42 (3):381.
Vanderlei FM, Bastos FN, de Lemes ÍR, Vanderlei LC, Júnior JN, Pastre CM. Sports injuries among adolescent basketball players according to position on the court. International archives of medicine. 2013; 6 (1):1-4.
Bahr R, Engebretsen L. Handbook of Sports Medicine and Science, Sports Injury Prevention. Chicester, United Kingdom. 2009: 7-17.
Hewett TE, Myer GD, Ford KR. Anterior cruciate ligament injuries in female athletes: Part 1, mechanisms and risk factors. The American journal of sports medicine. 2006; 34(2):299-311.
Agel J, Arendt EA, Bershadsky B. Anterior cruciate ligament injury in national collegiate athletic association basketball and soccer: a 13-year review. The American journal of sports medicine. 2005; 33(4):524-531.
Kofotolis N, Kellis E. Ankle sprain injuries: a 2-year prospective cohort study in female Greek professional basketball players. Journal of Athletic Training (National Athletic Trainers' Association). 2007 1; 42(3).
Cowley HR, Ford KR, Myer GD, Kernozek TW, Hewett TE. Differences in neuromuscular strategies between landing and cutting tasks in female basketball and soccer athletes. Journal of athletic training. 2006; 41(1):67.
McKay GD, Goldie PA, Payne WR, Oakes BW. Ankle injuries in basketball: injury rate and risk factors. British journal of sports medicine. 2001 Apr 1; 35(2):103-108.
Krosshaug T, Slauterbeck JR, Engebretsen L, Bahr R. Biomechanical analysis of anterior cruciate ligament injury mechanisms: three‐dimensional motion reconstruction from video sequences. Scandinavian journal of medicine & science in sports. 2007; 17(5):508-519.
Meeuwisse WH, Sellmer R, Hagel BE. Rates and risks of injury during intercollegiate basketball. The American journal of sports medicine. 2003; 31(3):379-385.
Olsen OE, Myklebust G, Engebretsen L, Bahr R. Injury mechanisms for anterior cruciate ligament injuries in team handball: a systematic video analysis. The American journal of sports medicine. 2004; 32(4):1002-1012.
Comparison of the prevalence, the and mechanism of sports injuries among the elite male basketball players of the Premier League and Division I of Iran
Abstract
Aim and Background: Basketball is a team-work and contacted sport and participation in this sport requires acceptance of the risk of injury. The purpose of this study was to determine the causes and prevalence of sport injuries among male basketball players of the country. The aim of this study was to determine the causes and prevalence of sport injuries.
Materials and methods: The present study was a cross-sectional study using retrospective method and a questionnaire on basketball injuries recorded by Marcus et al. The 82 players in the Premier League and Division I the 1401-year-old basketball team were surveyed in this study. Data were analyzed by descriptive statistics and chi square test (c2).
Results: The results of the study showed that the amount of injuries in the lower extremities (75%) was significantly higher than the other parts of the body (p = 0.001, c2 = 94.46). In the lower limbs, knee and wrists had the highest rate of damage (48.7%, 46.2%), respectively (p = 0.001, c2 = 41.49). While the upper limb, shoulder (50%) had the most damage, it was not significant (p = 0.26, c2 = 2.62). The mechanism of occurrence of damage was related to landing (44.2%), which was statistically significant (p = 0.001, c2 = 58.53).
Conclusion: Therefore, it can be concluded that the most harm injury in the basketball players is the lower limbsextremity, especially the knees and ankles, and because of frequent jumps and downsides in the game.
Key word: Prevalence, mechanism, sport injury, basketball
Funding: This article was not supported by any grant.
Conflict of interest: This article has not received any funding from the public and governmental, commercial, or non-profit sectors of the university or research center. The authors declare no conflict of interest.
Introduction:
Basketball is an aggressive, attractive sport and is widely considered one of the most popular sports in the world [1]. With the increasing interest in basketball, the correct diagnosis and treatment of its injuries becomes more important. In this regard, Kaftolis and Kilis reported in 2007 that the prevalence and risk of injury in basketball is high [2]. In this study whose statistical population was 108 players of the teams participating in the 1974 Sports Olympiad and the statistical sample included 80 people, it showed that 49% of the people in the research sample had injuries to the collateral ligaments in the ankle. The most important cause of injuries was 66% related to the impact, 20% using inappropriate shoes and 5% due to lack of preparation [3]. In this regard, Randall Dick and colleagues during a 16-year study in The American Basketball League reported that about 60% of the injuries were in the lower limb, and ankle sprain were the most common injuries that the players suffered. Also, the most common injury after the ankle was called knee disorders, which caused players to loss 10 days or even more matches [4]. McLee et al (2001) showed that the injury ratio was 18.3 per 1000 participating players (24.7 per 1000 hours of play) and official matches [5]. Common injuries in basketball are ankle and foot injuries, knee injuries, hamstring strains, thigh contusions, trunk and spine injuries, eye injuries, wrist and palm injuries, finger joints, palm joints, and hand and wrist fractures and sprain [6].
Flood and colleagues (2009) in a research on the epidemiology of basketball injuries from 2000 to 2004 in Australia found fractures (49.4%) followed by dislocations (10.9%) and stated sprain and strain (10.6%) as the most common types of injuries and concluded that the injuries that occur in basketball have a strong relationship with the age of the athlete [6]. In another research by Barani et al (2008) in a research on female basketball players, the most common type of injury was sprain (36.8%), strain (26.3%) and fracture (21%), and in relation to the position of the players, center players ( 42.1%), guards (31.6%) and forwards (26.3%) were injured [7].
Van Mechelen in 1992 showed that a theoretical framework for the prevention of sports injuries is a four-step process that includes recognition, stating the cause and mechanism of injuries, the extent Their incidence and severity suggest the introduction of injury prevention methods and the evaluation of the effectiveness of preventive programs [8].
Since one of the important concerns in sports is injuries and injuries caused by sports, dealing with the category of sports injuries, prevention and treatment of injuries are important and up-to-date issues in all sports fields. Nowadays, due to the investment of clubs in team sport, especially basketball, and the costs that clubs incur in the field of recruiting players, there is a need to design a mechanism to prevent and reduce injuries. Basketball is one of the most injury-prone sports among Olympic sports [9].
Considering the above-mentioned context and due to the lack of comprehensive and new information on the prevalence and causes of sports injuries in male basketball players in Iran, therefore, in this research, with the aim of providing information on the mechanism and prevalence of injuries among male basketball players in Iran.
Material and methods:
This research was descriptive and retrospective. The male athletes of 13 teams participating in the Premier league and first division of Iran's 1401 basketball season (number=82/ Division I=45/ Premier=37) were investigated in this research. Among them, athletes who were injured (number=52) were considered as samples of this research. The average age of the subjects was 24.68 years, their height was 192.50 cm and their weight was 88.77 kg.
Data collection and measurement was done using the basketball injury questionnaire of Marcus et al. (2013 edition) [9], which was approved by experts in the field of sports injury and corrective exercise, and the researcher The reason for the accuracy of the results was completed by the interview method. This form consisted of several sections. The first part of information included background information, player position, game history, dominant side and training sessions per week. The second part included injury characteristics (anatomical location of injury, nature of injury, severity of injury, etc.).
SPSS version 19 statistical software was used for data analysis, and non-parametric descriptive and inferential statistics were used for data analysis. The chi square test (c2) to determine the ratio between groups was considered to be less than 0.05. Graphs were also drawn using Excel software.
Results:
The results of this research showed that 62.2% of the 82 players were injured. The average experience of the players was 10.9 years with a standard deviation of 5.3. 55 people played in the first division and 27 in the Premier League.
Based on the rate of injury per 1000 hours of play, Division I players are exposed to 44.02 and Premier League players are exposed to 41.34 injuries per 1000 hours of play. The amount of injuries occurred in the lower limbs (75%) was significantly higher than other parts of the body (p=0.001, c2=94.56). Also, in the lower limb, the knee and ankle area had the highest amount of damage (48.7%, 46.2% respectively) (p=0.001, c2=41.94). While in the upper limb, the shoulder (50%) suffered the most damage, but it was not significant (p=0.26, c2=2.62) (Tables 1, 2 and 3).
However, there was no significant difference between the Premier League and Division One in the injured area, injury mechanism, injury nature, injury severity, and playing positions.
Table 1. The number and percentage of injuries that occurred in the five areas of the body by league of play
location | Premier | Division I | total | |||
Frequency | Percentage | Frequency | Percentage | Frequency | Percentage | |
Lower extremity | 11 | 21.2 | 28 | 53.8 | 39 | 75 |
Upper extremity | 2 | 3.8 | 6 | 11.5 | 8 | 15.38 |
trunk | 0 | 0 | 3 | 5.8 | 3 | 5.76 |
Head and neck | 0 | 0 | 2 | 3.8 | 2 | 3.84 |
total | 13 | 25 | 39 | 75 | 52 | 100 |
Table 2. The number and percentage of lower extremity injuries by league
location | Premier | Division I | total | |||
Frequency | Percentage | Frequency | Percentage | Frequency | Percentage | |
knee | 5 | 12.8 | 14 | 35.9 | 19 | 48.7 |
ankle | 5 | 12.8 | 13 | 33.3 | 18 | 46.2 |
tight | 0 | 0 | 1 | 2.6 | 1 | 2.6 |
calf | 1 | 2.6 | 0 | 0 | 1 | 2.6 |
total | 11 | 28.2 | 28 | 71.8 | 39 | 100 |
Table 3. The number and percentage of upper limb extremity injuries by league
location | Premier | Division I | Total | |||
Frequency | Percentage | Frequency | Percentage | Frequency | Percentage | |
shoulder | 1 | 12.5 | 3 | 37.5 | 4 | 50 |
wrist | 1 | 12.5 | 2 | 25 | 3 | 37.5 |
elbow | 0 | 0 | 1 | 12.5 | 2 | 12.5 |
total | 2 | 25 | 6 | 75 | 8 | 100 |
Also, the results showed that the amount of damage in the superior dominant side was 40% (n=16) and in the non-superior dominant side was 60% (n=24). The statistical test showed that there is no significant difference in the amount of damage in the superior dominant and non-superior dominant side (p=0.074, c2=3.2).
The results also showed that the most important mechanism of injury was related to landing (44.2 %), and their statistical test showed a significant difference (p=0.001, c2=58.73) (Table 4).
Table 4. Mechanisms of incidence of injuries by league of play
Mechanism of injury | Premier | Division I | total | |||
Frequency | Percentage | Frequency | Percentage | Frequency | Percentage | |
landing | 6 | 11.5 | 17 | 32.7 | 23 | 44.2 |
cutting | 1 | 1.9 | 4 | 7.7 | 5 | 99.6 |
Rotation | 2 | 3.8 | 3 | 5.8 | 5 | 9.6 |
Contact with ball | 0 | 0 | 3 | 5.8 | 3 | 5.8 |
Pushing | 0 | 0 | 5 | 9.6 | 5 | 9.6 |
Running | 0 | 0 | 2 | 3.8 | 2 | 3.8 |
Diving | 0 | 0 | 2 | 3.8 | 2 | 3.8 |
other | 4 | 7.7 | 3 | 5.8 | 7 | 13.5 |
total | 13 | 25 | 39 | 75 | 52 | 100 |
The results are also mentioned about the nature of the damage in Table 5, which the statistical test showed that there was no significant difference (p=0.409, c2=1.78).
Table 5. The nature of the injuries by league
nature | Premier | Division I | Total | |||
Frequency | Percentage | Frequency | Percentage | Frequency | Percentage | |
Non-contact | 4 | 7.7 | 12 | 23.1 | 16 | 30.8 |
contact | 8 | 15.4 | 13 | 25 | 21 | 40.4 |
Over use | 1 | 1.9 | 14 | 26.9 | 15 | 28.8 |
total | 13 | 25 | 39 | 75 | 52 | 100 |
Also, the results of the statistical test showed that there was a significant difference in the severity of the injury (p=0.02, c2=3.86) (Table 6).
Table 6. The severity of the injuries by league
severity | Premier | Division I | Total | |||
Frequency | Percentage | Frequency | Percentage | Frequency | Percentage | |
mild | 4 | 7.7 | 9 | 17.3 | 13 | 25 |
middle | 2 | 3.8 | 12 | 23.1 | 14 | 26.9 |
sever | 7 | 13.5 | 18 | 34.6 | 25 | 48.1 |
total | 13 | 25 | 39 | 75 | 52 | 100 |
Return to normal activity 21 injuries had no signs of injury (40.4%) and 29 injuries had signs of injury (55.8%) and 2 injuries were option 3 (3.8%). It is significant (p=0.001 and c2=33.28) On the other hand, in terms of the time of injury, 42.3% (22) of injuries occurred during training and 57.7% (30) of injuries. It was during the competition that the results showed that there is no significant difference in terms of the time of injury (p=0.117, c2=2.46). Also, from the total number of athletes studied, 25% (number 13) suffered re-injury after returning to sports activities and 75% (number 39) of athletes did not suffer re-injury, the results showed that there is no significant difference in terms of re-injury. p=0.116, c2=2.46).
Also, the results of the statistical test showed that there is no significant difference in the amount of damage among the game posts (p=0.14, c2=3.86) (Table 6).
Table 7. The number and percentage of injuries of athletes by playing position and playing league
post | Premier | Division I | Total | |||
Frequency | Percentage | Frequency | Percentage | Frequency | Percentage | |
center | 5 | 9.6 | 14 | 26.9 | 19 | 36.5 |
forward | 5 | 9.6 | 16 | 30.8 | 21 | 40.4 |
guard | 3 | 5.8 | 9 | 17.3 | 12 | 23.1 |
total | 13 | 25 | 39 | 75 | 52 | 100 |
Discussion:
According to the results of the research, the highest amount of injuries occurred in the lower limbs and the ankle injury was the most common injury among male basketball players. These results are consistent with the results of Dich et al. [2] and Drakos et al. Nelson and colleagues have reported that the most common ankle injury among sports is related to basketball [9]. Drakus et al also reported that the most common injury in basketball players is related to the ankle. In basketball, ankle injuries are more common due to sudden and fast cutting movements while running away from the defender and unbalanced landings during throwing and rebounding movements. In these movements, the players are most focused on the ball or the movements of the opponent and are less accurate in their performance [10].
The results of the research also showed that knee injuries are one of the most common injuries in basketball. The results of previous research in the field of knee injuries of basketball players have shown that unbalanced landings, especially with valgus and sudden and rapid changes of direction and collisions between players can cause knee injuries [11, 12]. The results of this research showed that the rate of collision injuries is higher. Agel et al. also reported that most of the injuries during the game in female basketball players were of the collision type and most of the knee injuries were of the non-collision type [12]. Kofotoulis and Klis in The research reported that most of the ankle injuries in basketball are collision type. [13].
According to research results, the most traumatic injury mechanism in basketball is landing after jumping. Most ankle injuries in basketball are due to improper landing after jumping. In their research, Cooley and his colleagues introduced landing after jumping as the most dangerous movement in basketball and suggested neuromuscular improvement and preparation programs for these movements [14]. McKay et al also reported that almost half of ankle injuries occurred during landing and 3% during twisting and shearing movements. Basketball players frequently land from jumping and twisting and cutting [15], but not all of them lead to injury.
The injury rate of the center post and the forwards was higher. The results of the study by Miovis et al also show that the damage rate is high in these posts [17]. Center players have more ankle and knee injuries, forwards have more ankle injuries and guards have more head and neck injuries [15]. Center players, who have the primary function of rebounding in the trapezius zone, are at greater risk of ankle and knee injuries due to many landings with collisions. Forward players are also injured during attack and counter-attack with fast rotation and cutting movements. For these reasons, the amount of damage in center and forward positions is high [18]. Probably, due to the position under the ring, the guard players get injured in the neck area when the team defends on its field in a collision with other players and the ball [10]. The higher level of injury in first league players can be due to reasons such as: insufficient preparation of athletes, low quality training and game environment, insufficient skill of players and lack of use of quality equipment (such as shoes). Each of these factors in itself is one of the risk factors of injury.
Conclusion:
According to the results of the research, the damage rate of the center post and the forwards was higher. The results of the study by Miovis et al also show that the damage rate is high in these posts [17]. Center players have more ankle and knee injuries, forwards have more ankle injuries and guards have more head and neck injuries [15]. Center players, who have the primary function of rebounding in the trapezius zone, are at greater risk of ankle and knee injuries due to many landings with collisions. Forward players are also injured during attack and counter-attack with fast rotation and cutting movements. For these reasons, the amount of damage in center and forward positions is high [18]. Probably, due to the position under the ring, the guard players get injured in the neck area when the team defends on its field in a collision with other players and the ball [10]. The higher level of injury in first league players can be due to reasons such as: insufficient preparation of athletes, low quality training and game environment, insufficient skill of players and lack of use of quality equipment (such as shoes). Each of these factors in itself is one of the risk factors of injury.According to the results of the research the most injury in the basketball players is the lower extremity, especially the knees and ankles, and because of frequent jumps and downsides in the game. The most important mechanism of injury was related to landing. However, there was no significant difference between the Premier League and Division One in the injured area, injury mechanism, injury nature, injury severity, and playing positions.
Acknowledgement:
We are grateful to all the coaching staff and players of Iran's premier league and first division clubs for their voluntary cooperation in this research project.
References:
[1] Belali Jafar. Video analysis of basketball injuries in the Premier League of Iranian clubs. [MSc Thesis]. Place of publication: Physical education and sport science faculty. Esfahan University. 1388. [Farsi]
[2] Deitch JR, Starkey C, Walters SL, Moseley JB. Injury risk in professional basketball players: a comparison of Women's National Basketball Association and National Basketball Association athletes. The American journal of sports medicine. 2006 Jul; 34(7):1077-83.
[3] Khosro Zadeh Jahanbakhsh, Golpayegani Masud, Bani talebi Ebrahim, Esmi Behnam. The Prevalence and Causes of Physical Injuries among Basketball Players. Journal of Applied Exercise Physiology 1387; 4(8):45-52. [Farsi]
[4] Jakson D and Mannarino. Prevention and rehabilitation. Medicine sport. 2002; 342- 363.
[5] Dick, R., Hertel, J., Agel, J., Grossman, J., & Marshall, S. W. Descriptive Epidemiology of Collegiate Men’s Basketball Injuries: National Collegiate Athletic Association Injury Surveillance System, 1988–1989 Through 2003–2004. Journal of Athletic Training, 2007; 42(2), 194–201.
[6] Flood, L.,Harrison, JE. Flood L, Harrison JE. Epidemiology of basketball and netball injuries that resulted in hospital admission in Australia, 2000–2004. Medical Journal of Australia. 2009; 190(2):87-90.
[7] Barani Azam, Bambaei chi Efat, Rahnema Nader. Prevalence and injury mechanisms in female basketball athletes. Researrch in Sport Science. 1388; 23(3): 59-68. [Farsi]
[8] Nelson AJ, Collins CL, Yard EE, Fields SK, Comstock RD. Ankle injuries among United States high school sports athletes, 2005–2006. Journal of athletic training. 2007; 42 (3):381.
[9] Vanderlei FM, Bastos FN, de Lemes ÍR, Vanderlei LC, Júnior JN, Pastre CM. Sports injuries among adolescent basketball players according to position on the court. International archives of medicine. 2013; 6 (1):1-4.
[10] Bahr R, Engebretsen L. Handbook of Sports Medicine and Science, Sports Injury Prevention. Chicester, United Kingdom. 2009: 7-17.
[11] Hewett TE, Myer GD, Ford KR. Anterior cruciate ligament injuries in female athletes: Part 1, mechanisms and risk factors. The American journal of sports medicine. 2006; 34(2):299-311.
[12] Agel J, Arendt EA, Bershadsky B. Anterior cruciate ligament injury in national collegiate athletic association basketball and soccer: a 13-year review. The American journal of sports medicine. 2005; 33(4):524-531.
[13] Kofotolis N, Kellis E. Ankle sprain injuries: a 2-year prospective cohort study in female Greek professional basketball players. Journal of Athletic Training (National Athletic Trainers' Association). 2007 1; 42(3).
[14] Cowley HR, Ford KR, Myer GD, Kernozek TW, Hewett TE. Differences in neuromuscular strategies between landing and cutting tasks in female basketball and soccer athletes. Journal of athletic training. 2006; 41(1):67.
[15] McKay GD, Goldie PA, Payne WR, Oakes BW. Ankle injuries in basketball: injury rate and risk factors. British journal of sports medicine. 2001 Apr 1; 35(2):103-108.
[16] Krosshaug T, Slauterbeck JR, Engebretsen L, Bahr R. Biomechanical analysis of anterior cruciate ligament injury mechanisms: three‐dimensional motion reconstruction from video sequences. Scandinavian journal of medicine & science in sports. 2007; 17(5):508-519.
[17] Meeuwisse WH, Sellmer R, Hagel BE. Rates and risks of injury during intercollegiate basketball. The American journal of sports medicine. 2003; 31(3):379-385.
[18] Olsen OE, Myklebust G, Engebretsen L, Bahr R. Injury mechanisms for anterior cruciate ligament injuries in team handball: a systematic video analysis. The American journal of sports medicine. 2004; 32(4):1002-1012.