Impact Study

Understanding injuries on the basketball court

Impact Study
Wearable sensors will give researchers data on impact loading in real-world game and practice situations. Image: NBA

Whether players are crashing the boards on rebounds, sprinting down court on a fast break or taking a charge on defense, basketball is a physically demanding sport that can take a toll on athletes' bodies.

In particular, basketball players experience a large number of high-impact loading events during their career and these repetitive loading events are thought to be related to the high incidence of lower-limb injury that elite players experience, including bone-stress injury. Unfortunately, the relationship between mechanical loading and injury is not clear because until now it has been difficult to measure impact loads during practice and games.

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A new study led by Irene Davis, Harvard Medical School professor of physical medicine and rehabilitation and the director of the Spaulding National Running Center plans to examine the role of fatigue on landing impacts and bone-stress injuries in basketball players.

The research team will be using small devices, called wearable sensors, that can be secured to the lower leg to measure these loads while players are on the court. The relationship between load and injury is affected by other factors such as sleep, nutrition, bony anatomy and the current state of bone health. To prevent bone-stress injury and help athletes recover from bone-stress injury, we must first have a better understanding of these mechanical and biological factors and how they relate to bone health, the researchers said.

“Ultimately, we want to understand the factors that affect the foot-bone loading a basketball player sustains over the course of a season,” Davis said.

The study is funded by the National Basketball Association and GE Orthopedics and Sports Medicine Collaboration.

Davis and her team will focus on foot-bone stress injuries as these are the most common in basketball players. They plan to first collect baseline measures of foot-bone anatomy and bone health using various types of imagining techniques. They will also gather data on nutrition and diet, such as the amount of vitamin D in the blood and daily caloric intake. The study team will then monitor how hard the players are landing with each step across practices and games throughout the season and also monitor sleep over the course of the season. Finally, the team will image the foot again to determine if any injuries are developing.

“Bone-stress injuries can progress to small cracks in the bone, and ultimately, complete fractures. These injuries can be season ending and sometimes career ending. Therefore, preventing them from happening is the best approach. We believe this study will provide important information for sports medicine professionals who oversee these athletes’ care,” Davis said.

The advent of wearable sensors that can accurately measure and monitor impact loads provides an opportunity to characterize the physical demands of the game in unprecedented ways, Davis said. This new form of data has the potential to influence the understanding of lower-limb injury, as well as provide crucial insight on how to alter training to mitigate injury risk and how to improve return-to-play decisions.

Understanding the role of mechanical loading in maintaining bone health is particularly relevant to young elite basketball athletes whose skeletons are still undergoing a modeling process and to freshman college athletes who might receive a dramatic increase in impact load exposure during preseason training that their skeletons have not yet adapted to.

By including both college and elite basketball athletes in this cohort, Davis said that her research will address several interesting research questions: How does lower-limb load exposure due to training differ between college and elite level basketball athletes? What is the impact load exposure during a game and how does this compare to training? How do lower-limb impact loads change during a game and throughout the season (i.e., is there a fatigue-related change in impact load)? And ultimately, does impact load exposure predict bone health and possibly, bone-stress injury?

The findings of the study should also provide insight that will be helpful for the health of people who happen not to be elite athletes, Davis said.

“Ultimately, measuring and monitoring the mechanical loads experienced by musculoskeletal tissue is critical to improve our understanding of musculoskeletal injury and health,” Davis said.

This story is adapted from a Spaulding Rehabilitation Network news story.