As a tournament physical therapist for the International Basketball Federation (FIBA), HelloPhysio’s senior physiotherapist Joe Zhang knows the challenges of keeping high-performance athletes, like basketball players, in optimal health. While fans eagerly await jaw-dropping dunks and artful assists, Joe focuses on players’ lower limb mechanics to prevent the most common basketball injuries from developing into more debilitating conditions.
Players jump and land on the court up to 70 times during a game, with centers usually jumping the most. The impact of landing can be four to six times their body weight, and players change direction every two to three seconds, adding pressure on their joints as they jump, cuts, sprint, and twist.
Basketball players require a robust chassis, much like a high-performance car, to support their large frames and to handle the intense stress generated by their movements. Big feet can translate into powerful performance as the large bones in the foot act as levers that generate the forces necessary for athletic maneuvers.
Basketball players require a robust chassis, much like a high-performance car, to support their large frames and to handle the intense stress generated by their movements. Big feet can translate into powerful performance as the large bones in the foot act as levers that generate the forces necessary for athletic maneuvers.
The foot’s 26 bones are interconnected via 33 joints and kept together by soft tissues such as muscles, tendons, and ligaments with the big toe, midfoot arch, and ankle acting as gears to facilitate motion.
Soft tissues in joints act as a spring, transferring energy between joints as in a suspension system that absorbs the shock of landing, forward propulsion, changing directions, and slowing down while running and jumping.
If this system is not sound, the entire process can break down.
Whether you’re gearing up for the season or recovering from an injury, physical therapy is an essential part of the game for basketball players. With its fast pace and high demands, basketball requires athletes to be physically and mentally at their best. Our team of high-performance sports physical therapists can guide you through a comprehensive exercise program, provide rehabilitative care, and help you recover from injury with the latest modalities.
Most Common Injuries in Basketball Players
The causes of basketball injuries can be diverse and unpredictable and can occur from nearly any direction or circumstance.
When it comes to the most common basketball injuries in players, it’s clear that the lower body burdens the brunt, accounting for 62.4 percent of injuries, with foot and ankle-related conditions representing 22 percent of the total [1]. During a session, a player faces a 25 percent chance of getting an ankle injury, highlighting the importance of preventative measures and proper treatment.
While less common than ankle injuries, bone stress fracture of the navicular, talus, tibia, and fibula is more susceptible and particularly frustrating as it hinders a player’s performance for weeks or months. A study found that only 30 percent of the athletes who incurred a stress fracture were able to return to their previous level of play a year after their injury [2], making this one of the worst basketball injuries to endure.
Professional players are at a high risk of game-related injuries, including patellofemoral inflammation, which can be a significant musculoskeletal injury and result in losing competition days. Knee injuries, such as jumper’s knee, can be quite severe, although true ligamentous knee injuries are relatively uncommon.
If a player’s ankle is too flexible, they may suffer from Achilles tendon tears, especially when the ankle bends at a 48-degree or more angle. This overuse injury affects the calf muscle and heel connection, causing discomfort and tendon swelling.
Conditioning Programs to Reduce the Risk of Injury
When a basketball player experiences an injury, it’s essential to involve a physical therapist in the recovery process. While a physician can address an injury, a physiotherapist can help heal and recover faster through a comprehensive rehabilitation process.
Physical therapists can help with basketball injury prevention and prepare players for the season with a comprehensive strength and conditioning program as well as address and treat any injuries that occur throughout the season to return the players to their sport safely and in optimal form. The pre-season exercise program focuses on strength training, flexibility, and aerobic conditioning to improve overall endurance and correct muscle imbalances.
HelloPhysio’s senior sports physical therapist, Joe Zhang, has extensively studied joint range of motion, arch mobility, and foot and ankle mechanics in basketball players in order to help mitigate injury risks. He specializes in designing personalized conditioning programs to address individual players’ needs, reducing the risk of injury by targeting weak or overused muscles.
It is equally vital to understand the dynamics of play in high-level basketball. Physical therapists usually prescribe a combination of range of motion exercises, strengthening movements, manual therapy that manipulates joints, and ankle mobility training. For example, while most people can move their big toe about 60 degrees, research points out that most basketball frontcourt players can only move it about 40 degrees [3]. That means their feet and ankles are less flexible than the average person’s, which can put them at higher risk for certain injuries.
By taking basketball-specific movements into consideration, our team tailors training techniques that target, for example, big toe extension, arch mobility, ankle flexion, hamstring flexibility, and hip range of motion, helping players perform risky maneuvers more safely.
Our training programs feature the latest in evidence-based practices for effective player condition, warm-up protocols, and post-game cooldowns, such as muscle activation while training, dynamic stretching before practice or games, and static stretching.
Simple home sports rehab equipment, including foam rollers or Theragun percussive massage devices, are recommended by our physiotherapy team to induce self-myofascial release to enhance mobility and reduce the severity of DOMS (delayed onset muscle soreness) as part of a comprehensive program.
Physical Therapy Rehabilitation after an Injury
Basketball, like any other sport, carries the risk of musculoskeletal injuries. These injuries typically fall into two categories: traumatic and overuse injuries. Acute injuries, like ankle sprains, are the most common injury in basketball and occur suddenly. On the other hand, overuse injuries result from repeated motions and can happen with sudden spikes in physical activity. Here are some of the common basketball injuries and treatments available:
Taping and Bracing
Taping and bracing can be beneficial in reducing the risk of injury by providing additional support to an injured joint. The type of bracing or taping applied will determine the specific benefits, such as enhancing proprioception, limiting mobility, and increasing the stability of an injured or unstable joint.
Stiffness & Scar Tissue Formation
Stretching muscles and joints following an injury is important as scar tissue forms and soft tissue contracts. Scar tissue is a natural part of the healing process after an injury, but excessive scar tissue can lead to stiffness and limited range of motion. INIDBA therapy works through a thermal effect on the affected tissue, promoting circulation. After that, we may use Shockwave Therapy to further break down the scar tissue. Combined with stretching exercises, most players are able to regain range of motion and mobility in the injured areas.
Strengthening Exercises
Due to basketball’s high-impact, fast-paced nature, injuries to the lower limb are the most prevalent, with most injuries occurring around the ankle and knee joints. Restricted foot and ankle mobility and limited hip flexibility create a tug-of-war between the upper and lower leg, ultimately affecting the knee joint and causing instability. Ankle strengthening and stability exercises can decrease the risk of recurrent injury and provide a strong foundation for a player’s overall movement.
Prehabilitation and Post-Surgery
Prehabilitation and post-operative care are critical for basketball players recovering from a surgical intervention is crucial to prepare players for a return to sport for an anterior cruciate ligament (ACL) injury. Prehabilitation involves exercises and training programs to strengthen the muscles and improve the range of motion to prepare the athlete’s body for surgery. After the surgery, the player will need to focus on rehabilitation to recover and regain strength and motion.
When it comes to the human body, it’s an incredibly complex biomechanical system made up of bones, joints, and tissues. After all, a team is only as strong as its weakest link, and injuries to any one player can have a significant impact on the team’s chances of winning a championship.
Let’s face it, basketball is an intense sport demanding the highest level of athleticism, endurance and agility. Whether your goal is to prepare your body to compete optimally during the season or you are looking for a return-to-sport recovery program after an injury, physiotherapy is key.
Joe Zhang is a senior physiotherapist at HelloPhysio. He has worked with high-performance athletes as a tournament and team physio for organizations including FIBA (International Basketball Federation), Hong Kong Jockey Club, the New South Wales (NSW) Waratahs Super Rugby team, and at the NSW Institute of Sports.
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