By Dr. John R. Mishock, PT, DPT, DC
Basketball is one of the most popular sports, with an estimated 300 million people playing worldwide. (www.sfia.org) Ankle injuries are the most common orthopedic injury in basketball. In a study of NCAA Division 1 basketball players, 27% of all musculoskeletal injuries occur in the ankle. Many of these ankle injuries result in considerable missed playing time and often require treatment, including surgical intervention. Studies show that following an ankle injury, the athlete will lose on average 20 to 46 playing days with up to a 70% chance of re-injury in that given year. (Am J Sports Med 2016, Phys Ther. Sport 2016).
During an ankle sprain, the ligaments and soft tissues that support the ankle are stretched beyond their normal limits. Sometimes it is so severe that the bones (Tibia or fibula) will fracture. This trauma leads to pain, swelling, weakness, which impairs walking or running. Beyond the soft tissue injury, there is also nerve injury to the joint proprioceptors. Joint proprioceptors are tiny nerve endings that send messages to the brain and back to muscles surrounding the joint, allowing the body to create quick movements with control and accuracy. One of the necessary treatments in the rehabilitation of the injured ankle is balance and coordination training, which improving proprioception reducing the re-occurrence rate of ankle injuries in that given year by up to 60%. (Int. J Risk Saf Med 2015)
Can ankle injuries in basketball players be prevented with balance training on the court?
Physical therapy balance training can prevent the incidence of ankle injuries by up to 46%. (Int J Sports Phys Ther, 2018) Balance exercises improve proprioception, allowing the body to react to perturbations (change of direction, pivoting, jumping) during playing protecting the ankle from injury. Basketball players should perform balance exercises as part of their dynamic warm-up, including; single-leg stands with limb movements, single-leg stands with ankle range of motion, heel walking, toe walking, and dynamic jumping activities.
Can ankle braces prevent re-injury of the ankle?
When returning the athlete to play following an ankle injury, ankle braces can help. The figure-eight, lace-up ankle braces (ASO ankle brace) are the best at improving dynamic postural stability, increase ankle joint stiffness, and reduce ankle joint excursion during landing. (Am J Sports Med 2016, Phys Ther Sport 2016). This brace will allow movement and mobility of the ankle while preventing extremes of movement that cause ankle injury. Wearing ankle braces protects the ankle allowing the athlete to return from injury quicker while reducing subsequent ankle re-injury.
Should ankle braces be worn to prevent injury in healthy basketball players?
Many believe that wearing ankle braces prophylactically (preventively in healthy individuals) will cause the ankles to become weak and stiff, increasing the chance of injury when braces are not worn. However, scientific evidence refutes this common belief. In studies of healthy high school and NCAA basketball players without previous ankle injury, ankle braces significantly improved dynamic postural control, single-limb stability and reduced the incidence of ankle injury by as much as 67% without causing weakness, limited range of motion, or other adverse outcomes. (J Sport Rehabil. 2015, AM J Sports Med 2011)
Bottom line, Physical therapy, balance training and ankle braces can play a significant role in the treatment and prevention of ankle injuries.
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Dr. Mishock is one of only a few clinicians with doctorate-level degrees in both physical therapy and chiropractic in the state of Pennsylvania. He uses the combination of the two to help his patients.
He has authored two books; “Fundamental Training Principles: Essential Knowledge for Building the Elite Athlete”, “The Rubber Arm; Using Science to Increase Pitch Control, Improve Velocity, and Prevent Elbow and Shoulder Injury”. Both can be bought on Amazon.
