Basket: Ankle Injury Prevention Jared Berger, Spencer Bryant, Cody - - PowerPoint PPT Presentation

Keys to an Injury Free Drive to the Basket: Ankle Injury Prevention

Jared Berger, Spencer Bryant, Cody Deeks, Chase Mahar, Dan Morgano, and John Pavicic

Learning Objectives

Learner will be able to: ➢Identify the basic structures in the ankle joint ➢Recognize the incidence of ankle injuries in HS athletes ➢Understand how ankle injuries occur and common risk factors ➢Understand prevention exercises available, including stretching, strengthening, and balance training and incorporate into daily practice ➢Recognize the benefits ankle injury prevention exercises can have on quickness, agility, and jumping

Ankle Injuries in Basketball Video

➢https://www.youtube.com/watch?v=D_uNfX_GQsg ➢Click Link Above

Statistics on Ankle Injuries 1

➢ 28,000 in the U.S. each day ➢ 45% of all athletic injuries ➢ Ankle inversion sprains most common injury in basketball ➢ Five times more likely to reinjure ankle after previous injury ➢ Sport specific: women’s basketball has highest incidence ➢ Women’s basketball players increased risk for Grade I ankle sprains ➢ Risks for Grade I and II were similar among gender Incidence had to do with previous ankle injuries

Anatomy of the Ankle 2

➢Bones

• Tibia
• Fibula
• Talus

Anatomy of the Ankle - Musculature 2

➢Plantarflexors

• Gastrocnemius
• Soleus

➢Dorsiflexors

• Tibialis anterior
• Extensor hallucis longus
• Extensor digitorum longus

➢Evertors

• Fibularis longus
• Fibularis brevis

➢Invertors

• Tibialis anterior

Anatomy of the Ankle - Ligaments 2

➢ Ligaments are tissue that connect bones together ➢ Inside ligaments

• Deltoid ligament

➢ Outside ligaments

• Anterior Talofibular ligament
• Posterior Talofibular

ligament

• Calcaneofibular ligament

➢Ligaments on the outside of the ankle are most commonly sprained

Mechanism of Injury 3

➢ Commonly occurs when

• Landing from jumps
• Stepping on another athlete’s foot
• Foot contact while running
• Other contact to the foot or leg

➢ Usually occurs when foot is rolled inward ➢ Lateral ligaments injured most frequently

Ankle Sprains 3

Grade I- micro tears of the ligament Grade II- partial tear of the ligament Grade III- complete tear of the ligament

Risk Factors

➢Postural sway on one leg leads to a higher probability of ankle injury to that ankle4 ➢Unequal lower-leg strength for men and women athletes5 ➢Instability of the ankle increases your likelihood of ankle injury6 ➢Previous ankle injury is the most significant risk factor for ankle injuries6

Stretching7

• Primarily done to increase flexibility of a muscle7
• Stretching is often used to prevent muscle strains (tears)7
• BUT… this is

not the reason for stretching in ankle injury prevention

Stretching7

• The primary benefit of stretching for ankle injury preventions is maintaining

stable positional alignment of the ankle7

• Positional alignment of the ankle joint is most affected by the flexibility of the

calf muscles7

• Tight calves can cause the ankle joint to be placed in a positional alignment

that increases the ankle’s vulnerability to spraining (rolling in or out)7

Prevention Exercises - Stretching 7

• How to stretch your calves:

Bring your foot closer to your shin,

• r your shin closer to your foot
• Methods:
• Wall stance
• Slant board
• Downward dog

Stretching the Calves

• Remember: There are 2 calf muscles
• Gastrocnemius:
• Knee straight while moving the

foot and shin closer together

• Soleus:
• Knee slightly bent while moving

the foot and shin closer together

Gastrocnemius Stretches

• Gastrocnemius:
• Knee straight while moving

A) Shin towards your foot

• r

B) Foot towards your shin

• Stretch should be felt, but not

pain!

Soleus Stretches

• Soleus:
• Knee slightly bent (flexed)

while moving A) Shin towards your foot

• r

B) Foot towards your shin

• Remember: It should not be painful!

Ease off the stretch if it hurts!

Calf Stretching Demonstration

• Perform two kinds of calf stretches that

stretch each of the two calf muscles

Prevention Exercises- Strength & Endurance

• Strengthening vs Endurance Training7
• Strengthening is designed to increase power and size of muscles
• 2-3 sets of 8-12 repetitions
• Endurance training is designed to keep muscles from fatiguing
• 3-5 sets of 15+ repetitions
• Prevention of ankle sprains should focus on endurance training6

Prevention Exercises -Strength & Endurance2,3

➢Training should focus on improving strength and endurance of ankle motions in all directions ➢Calf Raises ➢Resistance bands ➢Box jumps (two legs, one leg, landing) ➢Ski/Heisman jumps

Strengthening - Resistance Bands

Box Jumps

Ski/Heisman Jumps

Prevention Exercises- Balance Training 8

As defined….

• Balance is the ability to maintain the body’s center of gravity over

the base of support7 Balance training:

• Performing different stances and movements with or without the

use of specially designed equipment, to challenge an athlete in their ability to remain upright and standing within a controlled and safe manner. Examples of equipment include: foam pads, boxes, wobble boards, BOSU balls, etc.

Prevention Exercises- Balance Training

• Balance training starts in a static phase and progresses towards

dynamic activities8

• Stable surface → Unstable surface (foam pads, wobble board,

BOSU ball)

• 2 leg → single leg activities
• Eyes open → eyes closed
• Incorporate sport specific drills during balance activity (passing,

dribbling, jumping)

• Programs are designed to progressively challenge the athlete
• Start Easy and work your way up!

Prevention Exercises- Balance Training

• How can balance exercises be incorporated into a

basketball season?

• Effective programs start during preseason and can be continued

throughout the season8

• Preseason Prevention: 3-5 sessions per week
• Seasonal Maintenance: 2-3 sessions per week
• Specific programs designed last 10-30 minutes for easy incorporation

into practice times or workout sessions8,9

Prevention Exercises - Balance Training5

Common Exercises:

• Single leg stance on ground: Eyes Open → Eyes Closed

(30 second holds, alternate legs)

• Single Leg Stance on Box: Leg kick forward, sideways,

then mini squat (5 times per leg, then switch sides)

• Ski/Heisman Jumps: with single leg pauses

Basketball Specific Examples:

• 1. Single Leg Foam Stance with dribbling
• 2. Double/Single Leg BOSU ball chest passes
• 3. Double/Single Leg wobble board with dribbling

**Train Smart**

• Use a partner
• Stay within your

abilities

Benefits to Injury Prevention

• Balance training led to decreased lower-leg strength differences5
• Neuromuscular training increases ankle stability3
• Greatest risk factor for an ankle injury is history of previous injury3
• Prevention of the first injury is crucial
• One ankle sprain can lead to prolonged injuries, reduced physical

activity levels and long term ankle instability

• Balance training decreases chance of injury by at least 35-36%3,9
• Some studies show decreased chance of injury of 60-85%10
• Stay healthy and ready to hit the court!

Additional Benefits to Injury Prevention Exercises11,12

• Increased height of vertical

jump

• Increased agility
• Increased running speed
• Improved directional

acceleration

What Did You Learn? Visit Each Demonstration Station

• 1. Safety/Education
• 2. Stretching
• 3. Strengthening
• 4. Balance Training

Content Quiz

• 1. What side of the ankle is most commonly

injured during ankle sprains?

Answer: The outside (lateral) side of the ankle, causing an inversion (inward) ankle sprain.

Content Quiz

• 2. Can you name one of the three prevention

categories that we discussed, as well as an exercise that you can do to prevent an ankle injury?

Possible Answers:

• Stretching
• Strengthening
• Balance Training

Content Quiz

• 3. Name one additional benefit to the injury

prevention exercises we discussed

Possible Answers:

• Increase Vertical Jump
• Increased Agility
• Improved Directional Acceleration
• Increased Running Speed

Take Home Message

➢Ankle injuries are the most common injury suffered by high school athletes ➢Simple preventative measures can be taken to reduce the chances of ankle sprain injury

• These include stretching, strengthening, and balance training

➢These preventative measures can be used before and during the season to help keep athletes safe and on the court

References

1. BD, Vacek PM, Murphy D, Alosa D, Paller D. First-time inversion ankle ligament trauma: The effects of sex, level of competition, and sport on the incidence of injury. Am J Sports Med. 2005;33(10):1485-1491. 2. Neumann DA: Kinesiology of the Musculoskeletal System: Foundations for Physical Rehabilitation. 2nd Edition, St. Louis, Mosby-Elsivier, Inc, 2010. 3. Kaminski TW, Hertel J, Amendola N, et al. National Athletic Trainers' Association position statement: conservative management and prevention of ankle sprains in athletes. J Athl Train. 2013; 48(4): 528-45. doi: 10.4085/1062-6050-48.4.02. 4. Wang H, Chen C, Shiang T, Jan M, Lin K. Original article: Risk-Factor Analysis of High School Basketball–Player Ankle Injuries: A Prospective Controlled Cohort Study Evaluating Postural Sway, Ankle Strength, and Flexibility. Archives Of Physical Medicine And Rehabilitation [serial

• nline]. January 1, 2006;87:821-825. Available from: ScienceDirect, Ipswich, MA. Accessed September 20, 2016.

5. Sannicandro I, Cofano G, Rosa R, Piccinno A. Balance Training Exercises Decrease Lower-Limb Strength Asymmetry in Young Tennis

• Players. Journal Of Sports Science & Medicine [serial online]. June 2014;13(2):397-402. Available from: SPORTDiscus with Full Text, Ipswich,
• MA. Accessed October 5, 2016.

6. Thacker S, Stroup D, Branche C, Gilchrist J, Goodman R. Prevention of ankle sprains in sports: An update. International Sportmed Journal [serial online]. July 2003;4(4):1-17. Available from: SPORTDiscus with Full Text, Ipswich, MA. Accessed October 4, 2016. 7. Kisner C, Colby L, Therapeutic Exercise: Foundations and Techniques. 6th ed. Philadelphia, PA. F.A. Davis Company; 2012.

References

8. McGuine T, Keene J. The effect of a balance training program on the risk of ankle sprains in high school athletes. The American Journal Of Sports Medicine [serial online]. 2006;(7):1103. Available from: InfoTrac Health Reference Center Academic, Ipswich, MA. Accessed October 18, 2016. 9. Eils E, Schröter R, Schröder M, Gerss J, Rosenbaum D. Multistation Proprioceptive Exercise Program Prevents Ankle Injuries in Basketball. Medicine & Science in Sports & Exercise. 2010;42(11):2098-2105. doi:10.1249/mss.0b013e3181e03667. 10. McGuine T, Hetzel S, Pennuto A, Brooks A. Basketball Coaches’ Utilization of Ankle Injury Prevention Strategies. Sports Health: A Multidisciplinary Approach [serial online]. September 2013;5(5):410-416. Available from: SPORTDiscus with Full Text, Ipswich, MA. Accessed September 21, 2016. 11. Salaj S, Milanovic D, Jukic I. The Effects of Proprioceptive Training on Jumping and Agility Performance. Kinesiology. 2007; 39 (2): 131-141. http://eds.a.ebscohost.com/eds/pdfviewer/pdfviewer?sid=ae883749-4cfa-4bd9-9b1b-490886a78314%40sessionmgr4007&vid=5&hid=4108 12. Hrysomallis C. Balance Ability and Athletic Performance. Sports Medicine [serial online]. March 2011;41(3):221-232. Available from: SPORTDiscus with Full Text, Ipswich, MA. Accessed October 5, 2016.