Epidemiology and Impact on Performance of Lower Extremity Stress Injuries in Professional Basketball Players

Sports Health. 2018 Mar/Apr;10(2):169-174. doi: 10.1177/1941738117738988. Epub 2017 Nov 6.

Abstract

Background: Professional basketball players in the National Basketball Association (NBA) subject their lower extremities to significant repetitive loading during both regular-season and off-season training. Little is known about the incidence of lower extremity bony stress injuries and their impact on return to play and performance in these athletes.

Hypothesis: Stress injuries of the lower extremity will have significant impact on performance.

Study design: Case series.

Level of evidence: Level 4.

Methods: All bony stress injuries from 2005 to 2015 were identified from the NBA. Number of games missed due to injury and performance statistics were collected from 2 years prior to injury to 2 years after the injury. A linear regression analysis was performed to determine the impact of injury for players who returned to sport.

Results: A total of 76 lower extremity bony stress injuries involving 75 NBA players (mean age, 25.4 ± 4.1 years) were identified. Fifty-five percent (42/76) involved the foot, and most injuries occurred during the regular season (82.9%, 63/76), with half occurring within the first 6 weeks. Among players who sustained a fifth metatarsal stress fracture, 42.9% were unable to return to professional play. Players who sustained stress injuries had reduced play performance, specifically related to number of games played ( P = 0.014) and number of steals per game ( P = 0.004). Players who had surgery had significantly better performance at 2 years than those who were managed nonoperatively, independent of the type of injury (β = 4.561; 95% CI, 1.255-7.868).

Conclusion: Lower extremity bony stress injuries may significantly affect both short- and long-term player performance and career length. Stress injuries result in decreased player performance, and surgical intervention results in improved performance metrics compared with those treated using conservative methods.

Clinical relevance: Stress injuries result in decreased player performance, and surgical intervention results in improved performance metrics.

Keywords: National Basketball Association; ankle; basketball; foot; fractures; lower extremity; metatarsal; return to play; stress fractures.

MeSH terms

  • Adult
  • Athletic Performance / physiology
  • Basketball / injuries*
  • Cumulative Trauma Disorders / epidemiology*
  • Fractures, Stress / epidemiology*
  • Humans
  • Incidence
  • Lower Extremity / injuries*
  • Metatarsal Bones / injuries
  • Regression Analysis
  • Return to Sport
  • Risk Factors