Injury in the Women's National Basketball Association (WNBA) From 2015 to 2019

Biomechanical Factors Predisposing to Knee Injuries in Junior Female Basketball Players

This cross-sectional observational study aims to determine isokinetic normality data at different speeds, and isometric data of ankle and knee joints, in healthy basketball players aged 15-16 years old. The participants were recruited through non-probabilistic convenience sampling. Sociodemographic, anthropometric, and biomechanical variables were collected. The study involved 42 participants. Right-leg dominance was higher in women (85.7%) than in men (78.6%). Men had a higher weight, height, and body mass index compared to women. Statistically significant differences were observed between sex and height (p < 0.001). Significant differences were found between sexes in knee flexor and extensor strength at different isokinetic speeds (30°, 120°, and 180°/s), except for the maximum peak strength knee flexion at 180°/s in the right leg. In the ankle, the variables inversion, eversion, and work strength values at different isokinetic speeds and full RoM, by sex, were not significantly different, except for the right (p = 0.004) and the left (p = 0.035) ankle full RoM. The study found lower knee extensor strength in women, indicating the need to improve knee flexor/extensor strength in women to match that of men, as seen in other joints. The results can guide the development of preventive and therapeutic interventions for lower limb injuries in basketball players.

A multicomponent neuromuscular warm-up program reduces lower-extremity injuries in trained basketball players: a cluster randomized controlled trial

OBJECTIVE

To assess the effects of a novel multicomponent neuromuscular warm-up program on lower-extremity injury incidence in basketball players competing at the regional level.

METHODS

A cluster randomized controlled experimental design was adopted to compare injury incidence between players exposed to the injury prevention warm-up program and those exposed to a typical warm-up program across an entire basketball season. Four teams consisting of 57 players (male: n = 42; female: n = 15) were allocated to the intervention group (age: 21.6 ± 2.5 years; height: 186.2 ± 8.8 cm; body mass: 80.0 ± 10.4 kg) and four teams consisting of 55 players (male: n = 43; female: n = 12) were allocated to the control group (age: 21.6 ± 2.6 years; height: 186.9 ± 9.1 cm; body mass: 81.5 ± 10.9 kg). The novel warm-up combined running exercises with active stretching, plyometrics, balance, strength, and agility drills. Coaching and medical staff provided details on injury incidence each week. Data analyses included the use of poisson regression analyses and the incidence rate ratio (IRR) with 95% confidence intervals (CI).

RESULTS

The intervention group experienced a significantly lower ankle sprain incidence rate (IRR = 0.26, 95% CI = 0.05, 0.98, p = 0.02) and a tendency toward a lower knee injury incidence rate (IRR = 0.32, 95% CI = 0.03, 1.78, p = 0.07) compared to the control group. Considering only non-contact lower-extremity injuries of any type, the intervention group experienced a significantly lower incidence rate compared to the control group (IRR = 0.26, 95% CI = 0.05, 0.98, p < 0.001).

CONCLUSION

This multi-team study demonstrated a novel multicomponent warm-up program resulted in less lower-extremity injuries, particularly ankle sprains and knee injuries, compared to a typical warm-up program in regional-level male and female basketball players.

Perceptions of Physical Therapy and The Role of Physical Therapists In Injury Prevention Among Professional Basketball Players: A Qualitative Study

Background

Injury prevention is critical in competitive professional sports, however, the role of physical therapists in this aspect of healthcare is not fully understood.

Purpose

The purpose of this study was to describe professional basketball players' perceptions of physical therapy (PT) and physical therapists' role in injury prevention.

Study Design

Qualitative, semi-structured interview.

Methods

Thirty-five professional basketball players (mean age 23.1 years ± 3.9; 42% female; 72% African American; 90% college graduates) from over 20 teams participated. Athletes participated in semi-structured interviews that focused on injury prevention and utilization of PT services. Two researchers coded the transcripts, organized the findings into general categories, and created major themes. Data saturation was reached when no new information emerged.

Results

Over half (62.9%) stated that PT mainly addressed post-injury and return-to-sport rehabilitation. An overwhelming majority of players highlighted the use of an athletic trainer (AT) over physical therapists in injury prevention due to perceived expertise and trust.

Conclusion

While PTs are educated in preventive care and acute injury management, professional basketball players viewed their role primarily for return-to-sport rehabilitation. The organizational structure of healthcare in professional basketball may promote closer professional relationships with ATs while limiting those with physical therapists. The result is that elite athletes may miss out on treatment specific to the PT profession.

Level of Evidence

Level 4.

A systematic literature review of injury epidemiology and surveillance practices in elite adult female field-based team sport

OBJECTIVES

To describe injury incidence and surveillance practices in elite adult female field-based team sports.

DESIGN

Systematic literature review.

METHODS

This review was prospectively registered (PROSPERO CRD42022318642). CINAHL, PubMed, MEDLINE, Scopus, SPORTDiscus, Web of Science, Open Grey and Google Scholar were searched from inception to 30th June inclusive. Peer reviewed original research articles that reported the incidence of injury sustained by females aged ≥18 years in elite field-based team sports were included. The Newcastle Ottawa Scale was used to assess the risk of bias.

RESULTS

Twenty prospective cohort studies investigating injury incidence in Australian football, American football, soccer, field hockey, rugby, rugby-7s and cricket were eligible. A higher injury incidence in match play compared to training was reported with the highest match and training incidence (132.7 and 42.1/1000 h of exposure respectively) in Australian football. The majority of the reported injuries were to the lower limb and involved muscle/tendon or joint/ligaments. There was heterogeneity in definitions of injury, severity and exposure, variations in methods of injury data collection and reporting with, not all data being collected/reported optimally, which limited comparison of studies.

CONCLUSIONS

This review highlights the lack of and need for injury data specific to this cohort. Establishing the incidence of injury with a robust injury surveillance system is the first step in the sequence of injury prevention. It requires consistency in definitions and methodologies, providing accurate and useful injury data, to guide targeted injury prevention strategies.

The incidence rate of ACL injuries and ankle sprains in basketball players: A systematic review and meta-analysis

OBJECTIVE

To quantify the incidence rate of anterior cruciate ligament (ACL) injuries and ankle sprains according to player sex, playing level, and exposure setting (training vs. games) in basketball players.

METHODS

PubMed, MEDLINE, Google Scholar, and ScienceDirect were searched. Only studies reporting the number of ACL injuries and/or ankle sprains alongside the number of athlete-exposures (training sessions and/or games) in basketball players were included.

RESULTS

Thirty studies (17 reporting ACL injuries and 16 reporting ankle sprains) were included in the meta-analysis. Higher (p < 0.05) ACL injury incidence rates per 1000 athlete-exposures were recorded in females (female: 0.20 95% confidence intervals [0.16-0.25]; male: 0.07 [0.05-0.08]; female-to-male ratio: 3.33 [3.10-3.57]), in players competing at higher playing levels (amateur: 0.06 [0.04-0.09]; intermediate: 0.16 [0.13-0.20]; elite: 0.25 [0.14-0.64]), and in games (games: female, 0.27 [0.21-0.32]; male, 0.06 [0.03-0.08]; training: female, 0.03 [0.02-0.05]; male: 0.01 [0.00-0.02]; game-to-training ratio: 7.90 [4.88-12.91]). Higher (p < 0.05) ankle sprain incidence rates per 1000 athlete-exposures were observed in males (female: 0.82 [0.61-1.03]; male: 0.90 [0.61-1.19]; female-to-male ratio: 0.91 [0.83-0.99]), in players competing at higher playing levels (amateur: 0.54 [0.51-0.57]; intermediate: 1.12 [1.00-1.24]; elite: 1.87 [1.29-2.46]), and in games (games: 2.51 [1.85-3.16]; training: 0.80 [0.52-0.80]; game-to-training ratio: 2.77 [2.35-3.26]).

CONCLUSION

According to player sex, ACL injury incidence rate is higher in females, while ankle sprain incidence rate is greater in males. ACL injury and ankle sprain incidence rates are greater in players competing at higher playing levels and during games compared to training.

Epidemiology With Video Analysis of Knee Injuries in the Women's National Basketball Association

Background

Knee injuries are the most common type of injury seen in the Women's National Basketball Association (WNBA). However, there are sparse epidemiologic data regarding these injuries over the past 20 years.

Purpose/Hypothesis

The purpose of this study was to determine the prevalence, return to play (RTP) rate/length, and mechanism of knee injuries in the WNBA. We hypothesized that anterior cruciate ligament (ACL) tears would have the highest prevalence and longest RTP times.

Study Design

Descriptive epidemiology study.

Methods

Publicly available WNBA injury reports were used to find WNBA athletes who sustained knee injuries. The RTP length was determined by calculating the number of days between the date of the injury and the date of the first game they played after returning. The RTP rate was determined by calculating the number of players who returned to play from each injury compared with the total number of each injury. Incidence of knee injuries, frequency, and time to RTP were calculated for each injury. Available videos were analyzed to determine the mechanism and body position at the time of injury.

Results

Overall, 99 WNBA players were identified as having sustained a knee injury during the study period resulting in loss of play. ACL tears (n = 37; 37%) were the most devastating injury, resulting in the longest time before RTP (n = 375 days; 70%). The position with the highest incidence of knee injuries was guard, accounting for 53% of knee injuries. Video analysis conducted on 12 knee injuries revealed that such injuries were most commonly noncontact (83%).The mechanisms of injury were most commonly planting (58%) and landing from a jump (33%) with the knee flexed in the valgus position (100%).

Conclusion

Study findings indicated that ACL tears are the most common clinically significant knee injuries sustained in the WNBA, accounting for 37% of total knee injuries with a mean RTP rate of 375 days. The most common mechanism of injury was planting the foot or landing from a jump with a flexed knee in the valgus position. Knee injuries had a high RTP rate in WNBA players but resulted in them missing a significant amount of playing time.

Concussions in the Women's National Basketball Association: Analysis of Incidence, Return-to-Play Timing, and Player Performance From 1997 to 2020

Background:

The extent to which concussions affect Women’s National Basketball Association (WNBA) athletes has not been thoroughly examined.

Purpose:

To evaluate the incidence and impact of concussion injuries occurring in the WNBA.

Study Design:

Descriptive epidemiology study.

Methods:

Publicly available records were searched to identify all documented basketball-related concussions from WNBA seasons 1997 to 2020. Player demographics, injury details, and basketball career information were collected. Concussion incidence and return-to-play (RTP) timing were evaluated before and after the institution of the WNBA concussion protocol in 2012. Minutes per game and game score per minute were compared 5 games before and 5 games after the concussion was sustained. Player game availability and RTP performance were also compared with an age-, body mass index–, position-, and experience-matched control group of players who did not sustain any injuries during the index season.

Results:

A total of 70 concussions among 55 players were reported in the WNBA from 1997 to 2020, with a mean incidence of 2.9 ± 2.3 concussions per season. After the implementation of the WNBA concussion protocol, the incidence significantly increased from 1.7 to 5.0 concussions per season (P < .001). All players returned after a first-time concussion, missing a mean of 3.8 ± 4.7 games and 17.9 ± 20.7 days. After the adoption of the concussion protocol, the time to RTP significantly increased with games missed (P = .006) and days missed (P = .006). Minutes per game and game score per minute were not significantly affected by sustaining a concussion (P = .451 and P = .826, respectively).

Conclusion:

Since the adoption of the WNBA concussion protocol in the 2012 season, the incidence of concussions increased significantly. Athletes retained a high rate of RTP after missing a median of 4 games, and the time to RTP increased after the institution of the concussion protocol. Player game availability and performance within the same season were not significantly affected by concussion injuries after a successful RTP.

The prevalence of chronic ankle instability in basketball athletes: a cross-sectional study

Background

Ankle sprain is the most common injury in basketball. Chronic ankle instability develops from an acute ankle sprain may cause negative effects on quality of life, ankle functionality or on increasing risk for recurrent ankle sprains and post-traumatic osteoarthritis. To facilitate a preventative strategy of chronic ankle instability (CAI) in the basketball population, gathering epidemiological data is essential. However, the epidemiological data of CAI in basketball is limited. Therefore, this study aims to investigate the prevalence of CAI in basketball athletes and to determine whether gender, competitive level, and basketball playing position influence this prevalence.

Methods

In a cross-sectional study, in total 391 Taiwanese basketball athletes from universities and sports clubs participated. Besides non-standardized questions about demographics and their history of ankle sprains, participants further filled out the standard Cumberland Ankle Instability Tool applied to determine the presence of ankle instability. Questionnaires from 255 collegiate and 133 semi-professional basketball athletes (male = 243, female = 145, 22.3 ± 3.8 years, 23.3 ± 2.2 kg/m²) were analyzed. Differences in prevalence between gender, competitive level and playing position were determined using the Chi-square test.

Results

In the surveyed cohort, 26% had unilateral CAI while 50% of them had bilateral CAI. Women had a higher prevalence than men in the whole surveyed cohort (X²(1) = 0.515, p = 0.003). This gender disparity also showed from sub-analyses, that the collegiate female athletes had a higher prevalence than collegiate men athletes (X²(1) = 0.203, p = 0.001). Prevalence showed no difference between competitive levels (p > 0.05) and among playing positions (p > 0.05).

Conclusions

CAI is highly prevalent in the basketball population. Gender affects the prevalence of CAI. Regardless of the competitive level and playing position the prevalence of CAI is similar. The characteristic of basketball contributes to the high prevalence. Prevention of CAI should be a focus in basketball. When applying the CAI prevention measures, gender should be taken into consideration.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13102-022-00418-0.

Plantar Pressure Evaluation during the Season in Five Basketball Movements

Sports activity is extremely important in the health context, with a clear motivation for its practice. One of the sports that involve more athletes is basketball, where the human body undergoes rapid reactions, emphasizing the contact of the foot with the ground. The main goal of the present study is to evaluate the distribution of plantar pressure in five different basketball movements. Supported by a group of nine volunteer female athletes from a senior basketball team, a data acquisition protocol was defined to identify the changes that occur throughout the sports season. In this study, the maximum values of plantar pressure were evaluated for both feet. The five movements that were defined and studied are all movements that might be performed during the basketball practice period. To guarantee the necessary conditions of data reliability and repeatability, at least seven repetitions were performed for each movement, which occurred at two different moments of the sports season: at the beginning of the competition in November, and at season peak, four months later, in March. Overall, the results obtained did not present statistically significant changes between the two seasons in this study. However, a slight decrease was observed throughout the sporting season for all movements, except for the rebound, where there was a contrary evaluation. Additionally, athletes with a higher level of experience show higher values of plantar pressure than less experienced athletes.

Determining the relationship between load markers and non-contact injuries during the competitive season among professional and semi-professional basketball players

This study examined the association and predictive ability of internal load markers (based on rating of perceived exertion, RPE) with non-contact injuries in basketball. 35 basketball players (age: 24 ± 6 years, stature: 196 ± 9 cm, body mass: 91 ± 12 kg) were prospectively followed during 1 or 2 seasons, during which non-contact injuries were recorded. Markers examined were: mean weekly RPE, weekly load, exposure, week-to-week load change, acute:chronic 1:2, 1:3, 1:4 load ratio. A generalized estimating equations analysis was used to determine association with non-contact injury in the subsequent week. Prediction was examined with receiver operating characteristic curve, area under the curve (AUC) and Youden index. No associations were found between load markers and non-contact injuries (all p > 0.05); load markers showed no injury predictive ability (AUC range: 0.468-537; Youden index range: 0.019-132). In conclusion, the load markers selected are not associated with non-contact injuries and they cannot be used to predict injuries in basketball.