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Ankle, foot injuries most common for basketball

By Doug Haltom, M.D.

More than one million athletes participate in high school basketball, helping to make it one of the most popular sports in the United States.

Over the past 20 years, boys’ participation rates have risen 10 percent, and girls’ participation rates have risen 20 percent. Because of the physical demands of the sport, however, participation can lead to an increased risk of injury.

Ankle and foot injuries are the most common injuries in basketball at any level. A recent study found that ankle and foot injuries accounted for 40% of high school basketball injuries, followed by the knee (15%), head/face/neck (14%), arm/hand (10%), and hip/thigh/upper leg (8%). The most frequent injury diagnosis was ligament sprains, followed by muscle/tendon strains, contusions, fractures and concussions.

The “classic” ankle sprain, the most common injury in basketball, is an injury to the lateral stabilizing ligaments of the ankle. Three ligaments form the lateral ankle ligamentous complex, but the anterior talofibular ligament, or ATFL, is the most commonly injured , above. This is an inversion injury (with the ankle rolling in) that usually occurs while landing, often on an opposing player’s foot, above right. Injury severity can range from stretching to partial tearing to complete tearing of the ligamentous complex.

Treatment of ankle sprains depends on the severity of the injury. A combination of ice, elevation and anti-inflammatories is used to help with swelling and pain control. A brief period of immobilization in a walking boot is used if symptoms are more severe. Return to play varies, again depending on symptoms. An athlete with a very minor ankle sprain may not miss any time, whereas an athlete with a much more severe sprain may miss several weeks.

In more severe cases or in recurrent cases, physical therapy is prescribed. Surgery is usually reserved for cases in which chronic instability of the ankle develops.

Efforts have been made to prevent ankle sprains through the use of shoewear; ankle wrapping, taping or bracing; and ankle strengthening or proprioception training programs. Multiple studies have shown that the biggest risk factor for an ankle sprain is a history of a prior ankle sprain.

The most compelling evidence in the literature supports the use of a stirrup-type brace and a proprioception training program for the prevention of recurrent ankle sprains. This is not to say, however, that other preventive measures, such as shoewear and taping, are not effective for certain individual athletes.