Injuries in Girls’ High School Varsity Basketball
ABSTRACT & COMMENTARY
Synopsis: A prospective study of injuries in women’s high school varsity basketball showed an injury risk of 0.49 per season per athletea rate equal or greater than that of male basketball players.
Source: Gomez E, et al. Incidence of injury in Texas girls’ high school basketball. Am J Sports Med 1996;24:684-689.
Eight hundred ninety 14- to 18-year-old girls playing varsity basketball in Texas high schools had 436 injuries, a rate of 0.49 injuries per athlete per season. Although game time accounted for only 12.5% of exposure time, it represented one-half of injuries. Sprains and strains were the most common injuries (56%). Injuries to the ankle constituted 31% of the injuries, while those to the knee accounted for 19%. There were 34 severe injuries (0.038 per athlete per season) requiring surgery or hospitalization. These most often were knee injuries. Anterior cruciate ligament injuries accounted for 69% of severe knee injuries.
COMMENT BY BARRY GOLDBERG, MD, FAAP
Female athletics continues to grow in popularity, and basketball attracts many participants. The nature of the game has changed drastically from the past, and the fast pace and contact, along with intense training, have brought the injury risk of females equal to or greater than the male injury rate.1 The injury rate described in this study is higher than prior reports, but much depends on the definition of injury and the accuracy of reporting. Certainly, girls’ and women’s basketball can cause significant injuries, and the sport merits attention at defining mechanisms of injury and techniques for injury prevention.
The distribution of injuries in girls’ basketball follows an expected pattern for the activities of the sport, with the majority of injuries occurring in the lower extremities, followed by the hands and wrists. The anterior cruciate ligament appears to be uniquely at risk probably due to the required internal and external rotation of the tibia in the movements of the sport.2 Female players appear to be particularly susceptible, and factors such as a narrow intercondylar notch, weak hamstring strength, and small tibial eminences may underlie the increased risk. Other factors such as neuromuscular coordination can also play a role. X-ray screening of the knee for risk characteristics is not yet warranted, but consideration must be given to skill development, appropriate conditioning, and optimal playing surfaces.
In basketball, the ankle is most frequently injured, most commonly inversion on a plantar flexed foot. Prevention should be strength and proprioceptive conditioning and consideration for the use of outside supports such as bracing or taping.3 When tape is employed, it must be reinforced intermittently. When an ankle sprain does occur, rehabilitation of the injury deserves careful attention due to the frequent recurrence of injury.
The authors found 33 injuries to the head and face, making this area the fifth most commonly injured. Certainly, the risk of eye injury mandates the use of polycarbonate protective lenses in individuals whose vision cannot be corrected beyond 20/40, and many players now employ mouth guards.4 The control of unnecessary and excessive contact by the officials must play a role in controlling this injury.
The authors did not mention overuse injuries in their study, but patella tendinitis, peroneal tendinitis, Achilles tendinitis, patello-femoral dysfunction, Osgood-Schlatter disease, and others have become more frequent as the intensity of training for the sport increases, and certainly girls’ basketball has required significantly greater training over the recent years. As noted by Gomez et al, girls’ basketball is associated with a significant risk of injury and deserves the attention of physician and trainers. (Dr. Goldberg is Clinical Professor of Pediatrics and Director of Sports Medicine at the Yale University Health Services.)
References
1. Ray JM, et al. Basketball and volleyball. In: Reider BL, ed. Sports Medicine. The School-Aged Athletes. Philadelphia: WB Saunders; 1991.
2. Emerson RJ. Basketball knee injuries and the anterior cruciate ligament. Clin Sports Med 1995;12:317-328.
3. Rovere GD, et al. Retrospective comparison of taping and ankle stabilizers in preventing ankle injuries. Am J Sports Med 1988;16:228-233.
4. Jones NP. Eye injury in sports. Sports Med 1989; 7:163-181.
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