Handbook Of Sports Medicine And Science

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Handbook of Sports Medicineand ScienceBasketballEDITED BYDOUGLAS B. McKEAGMD, MSAmerican United Life Professor of Preventive Health Medicine andChairman, Department of Family MedicineDirector, IU Center for Sports MedicineDepartment of Family MedicineIndiana University School of MedicineIndianapolis, INUSABlackwellScience

Handbook of Sports Medicine and ScienceBasketball

IOC Medical CommissionSub-Commission on Publicationsin the Sport SciencesHoward G. Knuttgen PhD (Co-ordinator)Boston, Massachusetts, USAHarm Kuipers MD, PhDMaastricht, The NetherlandsPer A.F.H. Renström MD, PhDStockholm, Sweden

Handbook of Sports Medicineand ScienceBasketballEDITED BYDOUGLAS B. McKEAGMD, MSAmerican United Life Professor of Preventive Health Medicine andChairman, Department of Family MedicineDirector, IU Center for Sports MedicineDepartment of Family MedicineIndiana University School of MedicineIndianapolis, INUSABlackwellScience

2003 by Blackwell Science Ltda Blackwell Publishing companyBlackwell Science, Inc., 350 Main Street, Malden, Massachusetts 02148-5018, USABlackwell Publishing Ltd, 9600 Garsington Road, Oxford OX4 2DQ, UKBlackwell Science Asia Pty Ltd, 550 Swanston Street, Carlton South, Victoria 3053, AustraliaBlackwell Wissenschafts Verlag, Kurfürstendamm 57, 10707 Berlin, GermanyThe right of the Author to be identified as the Author of this Work has been asserted in accordance with the Copyright,Designs and Patents Act 1988.All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in anyform or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by theUK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher.First published 2003Library of Congress Cataloging-in-Publication DataBasketball / edited by Douglas B. McKeag.p. cm. — (Handbook of sports medicine and science)ISBN 0-632-05912-51. Basketball injuries. 2. Basketball—Physiological aspects. I. McKeag, Douglas, 1945–RC1220 .B33 B375 2003617.1′027—dc21ISBN 0-632-05912-5A catalogue record for this title is available from the British LibrarySet in 8.75/12pt Stone by Graphicraft Limited, Hong KongPrinted and bound in India by Replika Press PVT LtdCommissioning Editor: Andrew RobinsonProduction Editor: Nick MorganProduction Controller: Kate CharmanFor further information on Blackwell Publishing, visit our website:http://www.blackwellpublishing.comII. Series.2002152649

ContentsList of contributors, viForewords by the IOC, viiForeword by the FIBA, viiiPreface, ixIntroduction, xi1 Epidemiology of basketball injuries, 1Jay R. Hoffman2 Physiology of basketball, 12Jay R. Hoffman3 Nutrition guidelines for basketball, 25Leslie J. Bonci4 Preventive medicine in basketball, 38Thomas J. Mackowiak5 Preparticipation screening and the basketballplayer, 66Andrew L. Pipe6 The young basketball player, 75Kevin B. Gebke and Douglas B. McKeag7 The female athlete, 86Margot Putukian8 The special basketball player, 103Kevin B. Gebke and Douglas B. McKeag9 Psychological issues in basketball, 115Christopher M. Carr10 Basketball injuries: head and faceconsiderations, 128William F. Micheo and Enrique Amy11 Cardiovascular considerations in basketball, 140Andrew L. Pipe12 Medical illness, 151Margot Putukian13 Spine and pelvis, 164Jill Cook and Karim Khan14 Basketball injuries: upper extemityconsiderations, 177William F. Micheo and Eduardo Amy15 Lower extremity considerations, 191Karim Khan and Jill CookIndex, 217v

List of contributorsEduardo Amy MDKarim Khan MD PhDAssistant Professor, Department of Physical Medicine,Rehabilitation and Sports Medicine, University ofPuerto Rico, School of Medicine, PO Box 365067,San Juan, Puerto Rico 00936-5067University of British Columbia, Department of FamilyPractice (Sports Medicine) & School of Human Kinetics,211/2150 Western Parkway, Vancouver, BC V6T 1V6,CanadaEnrique Amy DMD MDSThomas J. Mackowiak ATCDirector and Assistant Professor, Center for SportsHealth and Exercise Sciences, Department of PhysicalMedicine, Rehabilitation and Sports Medicine,University of Puerto Rico, School of Medicine,PO Box 365067, San Juan, Puerto Rico 00936-5067Breslon Center, Z-22, Michigan State University,East Lansing, MI 48824, USALeslie J. Bonci MPH RDUPMC Center for Sports Medicine, 3200 S. Water Street,Pittsburgh, PA 15203, USAChristopher M. Carr PhDMethodist Sports Medicine Center, 201 PennsylvaniaParkway, Suite 200, Indianapolis, IN 46280, USAJill Cook PhD BAppSci (Phy)Musculoskeletal Research Centre, School ofPhysiotherapy, La Trobe University, Victoria, 3086,AustraliaKevin B. Gebke MDAssistant Professor of Clinical Family Medicine, andFellowship Director, IU Center for Sports Medicine,Department of Family Medicine, Indiana UniversitySchool of Medicine, 1110 W. Michigan Street, LO-200,Indianapolis, IN 46202-5102, USAJay R. Hoffman PhDDepartment of Health and Exercise Science, The Collegeof New Jersey, PO Box 7718, Ewing, NJ 08628-0718, USAviDouglas B. McKeag MD MSAmerican United Life Professor of Preventive HealthMedicine, and Chairman, Department of FamilyMedicine, Director, IU Center for Sports Medicine,Department of Family Medicine, Indiana UniversitySchool of Medicine, 1110 W. Michigan Street, LO-200,Indianapolis, IN 46202-5102, USAWilliam F. Micheo MDDepartment of Physical Medicine, Rehabilitation &Sports Medicine, University of Puerto Rico, Schoolof Medicine, PO Box 365067, San Juan, Puerto Rico00936-5067Andrew L. Pipe MDUniversity of Ottawa Heart Institute, 40 Ruskin Street,Ottawa, ON K1Y 4W7, CanadaMargot Putukian MDCenter for Sports Medicine, Penn State University,Department of Orthopedics and Rehabilitation,Hershey Medical Center, 1850 East Park Avenue,University Park, PA 16802, USA

Forewords by the IOCThe birth date of basketball is usually identifiedas 21 December 1891, with the first game takingplace in Springfield, Massachusetts, USA. Throughthe years, interest in the sport has appeared in practically every country in the world and participationspread internationally.The sport of basketball was first included in theOlympic Games as a full medal sport for menin 1936 and for women in 1976. Certainly one ofthe most popular sports internationally, basketballpresently attracts great attention from fans andmedia around the world. The admission of professional basketball players to Olympic competitionin 1992 has further enhanced the popularity of thesport and the quality of play internationally.The editor and contributing authors of this Handbook have covered in detail all of the basic science,the clinical aspects of injuries and other healthconcerns, and the practical information useful forthe medical doctors and health personnel who carefor basketball teams and players. The editor andauthors are to be congratulated on this excellent contribution to sports medicine/sports science literature.My sincere appreciation goes to the IOC MedicalCommission Chairman, Prince Alexandre deMerode, and to the IOC Medical Commission’s Subcommission on Publications in the Sport Sciencesfor yet another high-quality publication.Basketball is one of the most demanding sportsincluded in the Olympic programme as regards themany skills involved, the requirement for explosivemuscle power, and the necessary combination ofaerobic and anaerobic conditioning. Additionally,participation in the sport of basketball involvesa unique constellation of injury risks and relatedhealth problems. Therefore, the health and medicalcare of every basketball team and each individualplayer requires an unusual assemblage of knowledge and skill on the part of every health professional involved.This Handbook not only presents basic scientificand clinical information, but the editor and authorsaddress every aspect of the health and medical careof the participating athlete. This includes injuryprevention, the special needs of unique groups, theimmediate care of injuries, injury treatment andathlete rehabilitation.Professor Douglas McKeag and his internationalteam of contributing authors have succeeded inproducing this outstanding volume for the Handbooks of Sports Medicine and Science series.Prince Alexandre de MerodeChairman, IOC Medical CommissionDr Jacques RoggeIOC Presidentvii

Foreword by the FIBAAmong those who love the orange ball, the USAis widely regarded as the birthplace and thebastion of basketball. The sport, invented by JamesA. Naismith, has become a major Olympic event.The last Men’s World Championships organisedin Indianapolis showed a universalisation of thequality of the athletes and the game being played.FIBA has 212 national affiliated federations and,one could consider, by including the huge numberof Chinese, that the number of people practisingthe sport in the world is about 450 million.The Handbook of Sports Medicine and Science onBasketball, which deals with players’ health problems, is a wholly new and opportune book whichwill interest those responsible for the well-beingof teams: doctors, surgeons, orthopaedists, trainers,chiropodists, psychologists and, one hopes, coaches.The authors have approached the preventive andcurative aspect for all age groups. Professionalisation has grown enormously. In this aspect, thereader can find a collection offering solutions totechnical pathology, a real sports medicine.Citius, Altius, Fortius . . . Modern sport demandscontinuous self-improvement. To reinforce theintake and discharge of energy, specialists improve the fuel and the engine of the athlete. Awell-balanced diet and muscle growth serve thispurpose. The role of the doctor is to ensure thatdangerous and prohibited ‘supplementation’viiimethods are not used. The role of the doctor alsoconsists of detecting, as much as possible, the risksinduced by physical effortapreliminary medicalexaminations are a necessity at club and team level.Sudden death rarely strikes athletes and judges;however, it is our duty to evaluate this threat. Thepsychological aspect is also significant in the practice of basketball. The trainer is the provider of theright to participate. The dichotomic organisation ofthe game (five playing and five or seven watchingthem) has impacts on morale which interfere withmotivation, performance and team spirit.Naismith wanted a non-violent sport. Basketballdoes not have a reputation for being dangerous, butthe injury rates are not declining: a phenomenonlinked to the progression of athletic qualities anddefensive toughness. A basketballer injures him/herself either alone or through contact, beneath thehoop most often. Sprained ankles are the most common accidents (around 30%), but new pathologiesare appearing, in particular involving the arch ofthe footaprobably owing to repeated microtrauma,overuse by players or badly fitting shoes.FIBA congratulates the IOC Medical Commissionfor publishing this indisputably useful Manual forthe Basketball Family.Jacques Huguet MDPresident, FIBA Medical Council

PrefaceThe perfect sportI must have been around nine when it finally beganto sink in. That is: why my brother smiled when heplayed, why my father smiled when he watched. Atnine years old, it was just a game to me. I enjoyedplaying it mainly because I enjoyed the socializationthat took place with my friends. But to my father, itwas like a beautiful choreographed dance. The slowmotion that we so often see during televised games,he actually saw when he watched. He considered asuccessfully completed “pick-and-roll” play to be absolutely gorgeous. For the rest of my life as a high schooland college basketball player it became apparent tome just what he was looking atathe perfect sport.It is, by all measure, a contact sport, really more ofa subtle collision sport in which no protective equipment is routinely worn. The player’s expressions canbe seen on a court much closer for spectators thanmost athletic contests. The muscle twitch that comesjust before a quick move to elude a defender amplydisplays the biomechanical demands of a sport thatrequires an athlete to be able to run, jump, andexhibit upper and lower body strength, hand–eyecoordination and most important, body control.This is also a sport that demands both aerobicendurance and anaerobic fitnessaa sport thatrequires muscular proprioception and enhancedvisual fields.Basketball, when played right, is simply a beautiful thing to watch. This book, part of “The OlympicHandbook of Sports Medicine and Science” seriesattempts to present a sports-specific reference workfor use by physicians, trainers and coaches for thecare of their athletes. The demands of the sportcreate special problems for its players. Injuries andillnesses do occur. I have never seen a player yet whoenjoys being injured or missing competition. Thecorrect diagnosis and appropriate management intreatment of these injuries becomes of paramountimportance to the athletes and teams they play for.As editor of this volume, it was indeed an honorto work with the authors represented here. On the“world basketball scene”, many of these names arefamiliar. Their work as reflected in this volume represents the most complete approach to the sport ofbasketball and its injuries yet published. I am proudto have edited this volume and want to take thisopportunity to thank the authors for the excellenceof their work. Thanks also to Howard G. Knuttgenwho served as mentor in his role as overseer of theseries and Julie Elliott and Nick Morgan, productioneditors at Blackwell.My wish is that you find this book as interestingto use as I found it fun to put together. The entireworld seems to have embraced this sport, it can onlyget better.December 2002Douglas B. McKeag, MD, MSIndianapolis, IndianaDedicationThis book is dedicated to my “basketball team”,Diapoint guard and play makerKellyashooting guardHeatherafinesse forwardIanapower forward and re-bounderix

IntroductionBasketball: how it began*Basketball’s origin is unique among world sportsbecause it was actually invented.Who: Dr James A. NaismithWhen: December 21, 1891 at 11:30 a.m.Where: The YMCA Training School located atthe corner of State and Sherman in Springfield,MassachusettsWhy: “The invention of Basketball was not an accident.It was developed to meet a need. Those boys simplywould not play Drop the Handkerchief.”Dr James A. NaismithDr Naismith was a young 30-year-old instructorat the Springfield YMCA Training School whenhe accepted a challenge from his boss, Dr LutherGulick, to invent a winter game to be playedindoors. Those “boys” referred to in his quote werea class of 18 rowdy future YMCA directors that twoprevious instructors had given up on.Naismith had boasted that he could invent asport. Now he had two weeks in which to accomplish this challenge before the first class. For 13 dayshe tried to adapt Rugby, Soccer, American Footballand Lacrosseaall sports in which he excelled. This* This history is written by Ian Naismith, grandson ofDr James A. Naismith. Ian is currently the Founder andDirector of the Naismith International Basketball Foundation, headquartered in Chicago, Illinois. Phone: (312)782-8470, Fax: (312) 782-8475.failed because of possible injuries from physicalcontact.The game started taking shape when he realizedthat the ball had to be passed or shot at some kindof goal without any running or walking which eliminated tackling. Next, he had to decide on a goaland decided on two 18-inch boxes at either side ofthe gym. Remembering a childhood game called“Duck on a Rock” where a rock had to be thrown inan arc at an opponent rock, he decided that he mustelevate the boxes and put them on a horizontalplane so that the opposing team could not surroundthem.Now, with the fundamentals in place, he workedlate into the night and drafted the 13 “OriginalRules” (see Fig. 1 on pages xii and xiii).“The first game of Basketball was played in my bedthe night before the first class.”Dr James A. NaismithDr Naismith woke up in the morning and hurriedto the Secretary, Mrs Lyons. Mrs Lyons was asked totype the “Rules” while he went to the Janitor, MrStebbins, to locate boxes. Mr Stebbins told DrNaismith that he did not have any 18-inch boxes,but that he had two peach baskets in the basement.Naismith and Stebbins nailed the peach baskets tothe lower track railing of the gymawhich happenedto be exactly ten feet from the floor. The height ofthe basket today is still ten feet. Just think, we couldall be playing “Box Ball”!Then, at 11:30 a.m. on December 21, 1891, Jamespinned the two typed sheets of the “Original Rules”to the bulletin board. The first game of Basketballxi

xii IntroductionFig. 1 The original ‘Rules’ of basketball, typed and corrected by James A. Naismith himself. Anyone with an appreciationof the sport will be interested in how basketball has evolved from its origins. Reprinted here with permission from hisgrandson Ian Naismith.

Introduction xiii

xiv Introductionwas played. There were nine men per side and thescore was 1 to 0. Mr Stebbins stood on a ladder toretrieve the ball after a goal was made becausenobody thought of cutting the bottom out of thebaskets.Basketball caught on like wild fire spreading acrossthe country and overseas in a matter of months.Naismith credited the fact that the game was inventedin the YMCA as a major factor. The students tookthe game back to their home towns and countries.Basketball was played in China in 1893 and the firstwomen’s game was played at the Springfield, Massachusetts YMCA in February 1892. Maude Sherman,James’ future wife, played in the first women’s game.Senda Bernenson introduced a modified version tothe girls of Smith College in 1893.The dribble was always in the game, according toJames. When a player caught the ball, he had 15seconds to shoot or pass. If he could do neither,they would drop the ball and catch it to restart the15 seconds. Sometimes they would roll the ball onthe floor and pick it up to restart the clock. Thistechnique was called “Rollyball”.Dr Naismith invented the backboard not to bankthe shots, but to protect the basketball from thefingers of the opposing fans that would deflect theball from the goal.If you were to see a basketball game playedaccording to the 13 “Original Rules”, the gamewould look much the same. Much has been added,but little taken away.Dr Naismith was a lifetime member of the International Rules Committee and introduced the gameto the Olympics in 1936, one of his proudestmoments.I often say that to understand Basketball, youhave to understand Dr Naismith:“I am sure that no man can derive more pleasurefrom money or power than I do from seeing a pair ofbasketball goals in some out of the way place deepin the Wisconsin woods an old barrel hoop nailed toa tree, or a weather-beaten shed on the Mexicanborder with a rusty iron hoop nailed to one end.These sights are constant reminders that I have insome measure accomplished the objective that wasset years ago. Thousands of times, especially in thelast few years, I have been asked whether I ever gotanything out of basketball. To answer this question, I can only smile. It would be impossible for meto explain my feelings to the great masses of peoplewho ask this question, as my pay has not been indollars, but in satisfaction of giving something tothe world that is a benefit to masses of people.”Dr James A. Naismith, 1939

Chapter 1Epidemiology of basketballinjuriesJay R. HoffmanBasketball is a sport that is generally not associatedwith a high risk for injury. This is likely a result fromthe primarily noncontact nature of the sport. Whena player is on offense they often avoid contact byusing their athletic skills (e.g., running, slashingand cutting movements) to free themselves for anuncontested shot. On defense the player is taughtto use their athletic skills to defend the opposingplayer and prevent them from getting free. Althoughthe rules of basketball discourage most forms ofcontact (e.g., illegal contact will result in a foul),close interactions occurring d

Assistant Professor of Clinical Family Medicine, and Fellowship Director, IU Center for Sports Medicine, Department of Family Medicine, Indiana University School of Medicine, 1110 W. Michigan Street, LO-200, Indianapolis, IN 46202-5102, USA Jay R. Hoffman PhD Department of

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