Keys to an Injury Free Drive to the Basket: Ankle Injury Prevention Jared Berger, Spencer Bryant, Cody Deeks, Chase Mahar, Dan Morgano, and John Pavicic
Learning Objectives Learner will be able to: ➢ Identify the basic structures in the ankle joint ➢ Recognize the incidence of ankle injuries in HS athletes ➢ Understand how ankle injuries occur and common risk factors ➢ Understand prevention exercises available, including stretching, strengthening, and balance training and incorporate into daily practice ➢ Recognize the benefits ankle injury prevention exercises can have on quickness, agility, and jumping
Ankle Injuries in Basketball Video ➢ https://www.youtube.com/watch?v=D_uNfX_GQsg ➢ Click Link Above
Statistics on Ankle Injuries 1 ➢ 28,000 in the U.S. each day ➢ 45% of all athletic injuries ➢ Ankle inversion sprains most common injury in basketball ➢ Five times more likely to reinjure ankle after previous injury ➢ Sport specific: women’s basketball has highest incidence ➢ Women’s basketball players increased risk for Grade I ankle sprains ➢ Risks for Grade I and II were similar among gender Incidence had to do with previous ankle injuries
Anatomy of the Ankle 2 ➢ Bones - Tibia - Fibula - Talus
Anatomy of the Ankle - Musculature 2 ➢ Plantarflexors - Gastrocnemius - Soleus ➢ Dorsiflexors - Tibialis anterior - Extensor hallucis longus - Extensor digitorum longus ➢ Evertors - Fibularis longus - Fibularis brevis ➢ Invertors - Tibialis anterior
Anatomy of the Ankle - Ligaments 2 ➢ Ligaments are tissue that connect bones together ➢ Inside ligaments - Deltoid ligament ➢ Outside ligaments - Anterior Talofibular ligament - Posterior Talofibular ligament - Calcaneofibular ligament ➢ Ligaments on the outside of the ankle are most commonly sprained
Mechanism of Injury 3 ➢ Commonly occurs when - Landing from jumps Stepping on another athlete’s foot - - Foot contact while running - Other contact to the foot or leg ➢ Usually occurs when foot is rolled inward ➢ Lateral ligaments injured most frequently
Ankle Sprains 3 Grade I- micro tears of the ligament Grade II- partial tear of the ligament Grade III- complete tear of the ligament
Risk Factors ➢ Postural sway on one leg leads to a higher probability of ankle injury to that ankle 4 ➢ Unequal lower-leg strength for men and women athletes 5 ➢ Instability of the ankle increases your likelihood of ankle injury 6 ➢ Previous ankle injury is the most significant risk factor for ankle injuries 6
Stretching 7 Primarily done to increase flexibility of a muscle 7 Stretching is often used to prevent muscle strains (tears) 7 BUT … this is not the reason for stretching in ankle injury prevention
Stretching 7 The primary benefit of stretching for ankle injury preventions is maintaining stable positional alignment of the ankle 7 Positional alignment of the ankle joint is most affected by the flexibility of the calf muscles 7 Tight calves can cause the ankle joint to be placed in a positional alignment that increases the ankle’s vulnerability to spraining (rolling in or out) 7
Prevention Exercises - Stretching 7 How to stretch your calves: Bring your foot closer to your shin, or your shin closer to your foot Methods: Wall stance Slant board Downward dog
Stretching the Calves Remember: There are 2 calf muscles Gastrocnemius: Knee straight while moving the foot and shin closer together Soleus: Knee slightly bent while moving the foot and shin closer together
Gastrocnemius Stretches Gastrocnemius: Knee straight while moving A) Shin towards your foot or B) Foot towards your shin Stretch should be felt, but not pain!
Soleus Stretches Soleus: Knee slightly bent (flexed) while moving A) Shin towards your foot or B) Foot towards your shin Remember: It should not be painful! Ease off the stretch if it hurts!
Calf Stretching Demonstration • Perform two kinds of calf stretches that stretch each of the two calf muscles
Prevention Exercises- Strength & Endurance Strengthening vs Endurance Training 7 Strengthening is designed to increase power and size of muscles 2-3 sets of 8-12 repetitions Endurance training is designed to keep muscles from fatiguing 3-5 sets of 15+ repetitions Prevention of ankle sprains should focus on endurance training 6
Prevention Exercises -Strength & Endurance 2,3 ➢ Training should focus on improving strength and endurance of ankle motions in all directions ➢ Calf Raises ➢ Resistance bands ➢ Box jumps (two legs, one leg, landing) ➢ Ski/Heisman jumps
Strengthening - Resistance Bands
Box Jumps
Ski/Heisman Jumps
Prevention Exercises- Balance Training 8 As defined…. Balance is the ability to maintain the body’s center of gravity over the base of support 7 Balance training: Performing different stances and movements with or without the use of specially designed equipment, to challenge an athlete in their ability to remain upright and standing within a controlled and safe manner. Examples of equipment include: foam pads, boxes, wobble boards, BOSU balls, etc.
Prevention Exercises- Balance Training Balance training starts in a static phase and progresses towards dynamic activities 8 Stable surface → Unstable surface (foam pads, wobble board, BOSU ball) 2 leg → single leg activities Eyes open → eyes closed Incorporate sport specific drills during balance activity (passing, dribbling, jumping) Programs are designed to progressively challenge the athlete Start Easy and work your way up!
Prevention Exercises- Balance Training How can balance exercises be incorporated into a basketball season? Effective programs start during preseason and can be continued throughout the season 8 Preseason Prevention: 3-5 sessions per week Seasonal Maintenance: 2-3 sessions per week Specific programs designed last 10-30 minutes for easy incorporation into practice times or workout sessions 8,9
Prevention Exercises - Balance Training 5 Common Exercises: Single leg stance on ground : Eyes Open → Eyes Closed (30 second holds, alternate legs) Single Leg Stance on Box: Leg kick forward, sideways, then mini squat (5 times per leg, then switch sides) Ski/Heisman Jumps: with single leg pauses **Train Smart** Basketball Specific Examples: ● Use a partner ● Stay within your 1. Single Leg Foam Stance with dribbling abilities 2. Double/Single Leg BOSU ball chest passes 3. Double/Single Leg wobble board with dribbling
Benefits to Injury Prevention Balance training led to decreased lower-leg strength differences 5 Neuromuscular training increases ankle stability 3 Greatest risk factor for an ankle injury is history of previous injury 3 Prevention of the first injury is crucial One ankle sprain can lead to prolonged injuries, reduced physical activity levels and long term ankle instability Balance training decreases chance of injury by at least 35-36% 3,9 Some studies show decreased chance of injury of 60-85% 10 Stay healthy and ready to hit the court!
Additional Benefits to Injury Prevention Exercises 11,12 ● Increased height of vertical jump ● Increased agility ● Increased running speed ● Improved directional acceleration
What Did You Learn? Visit Each Demonstration Station 1. Safety/Education 2. Stretching 3. Strengthening 4. Balance Training
Content Quiz 1. What side of the ankle is most commonly injured during ankle sprains?
Answer: The outside (lateral) side of the ankle, causing an inversion (inward) ankle sprain.
Content Quiz 2. Can you name one of the three prevention categories that we discussed, as well as an exercise that you can do to prevent an ankle injury?
Possible Answers: - Stretching - Strengthening - Balance Training
Content Quiz 3. Name one additional benefit to the injury prevention exercises we discussed
Possible Answers: -Increase Vertical Jump -Increased Agility -Improved Directional Acceleration -Increased Running Speed
Take Home Message ➢ Ankle injuries are the most common injury suffered by high school athletes ➢ Simple preventative measures can be taken to reduce the chances of ankle sprain injury - These include stretching, strengthening, and balance training ➢ These preventative measures can be used before and during the season to help keep athletes safe and on the court
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