Wednesday, February 8, 2023

"Shut Up and Quibble" : Basketball Health Issues I've Written About

2023 is upon us. Professional athletes got told to stay in their lane. "Shut up and dribble." As a doctor for almost 42 years, I ventured out of mine to play, study, and coach.

Here are a few of the medical pieces I've written for my basketball blog. As an aside, long ago I wrote two editorials for the official journal of the American College of Chest Physicians, Chest.

Diagnosis and treatment belongs to the doctor-patient relationship. "Current diagnosis and treatment" are constantly moving targets. Get specific advice from your physician. 

Managing Injury Risk  Excerpt:

"Use of lace-up ankle braces reduced the incidence but not the severity of acute ankle injuries in male and female high school basketball athletes both with and without a previous history of an ankle injury."

Fitness and Conditioning   Excerpt:

The Cooper 12-minute run test correlates well with maximal oxygen consumption, the most accurate metric of aerobic fitness. You run on a track or treadmill and apply the distance to the chart (below). Cooper studied air force officers so their fitness may not represent the general population.

Get medical authorization from your physician. Training for this half a dozen years ago didn't agree with my ankles and knees. 


Ankle injuries   Excerpt: 

Taping. Does ankle taping work? A study in European soccer professionals was stunning, "ankle inversion ROM in a taped ankle increased after 45 minutes of soccer from 7 degrees to 12.6 degrees, a figure which reflects 90.3% of the inversion ROM in an untaped ankle.  In other words, after 45 minutes of soccer match play, the ‘residual mechanical effectiveness’ of a professionally applied ankle taping job is minimal."

ACL Injuries   Excerpt:

Alan Stein, nationally known conditioning and basketball coach, shares his insights into ACL (anterior cruciate ligament) injury reduction. He correctly notes that the goal is reducing injury because you cannot completely prevent injury.



Promising yet early results in small numbers of patients. 

Note these are small observational studies with short-term followup not blinded, controlled studies with comparison to alternative treatments. 


There is some data showing benefit in maturation of ACL graft repair, patellar tendinopathy, and some patients with meniscus (cartilage) injury.

Early knee osteoarthritis subjects receiving PRP had relative disease stabilization with short-term (one-year) followup. 


Pitfalls? Physicians worry about confusing EIB with alternative causes of shortness of breath - especially myocarditis (heart inflammation), cardiomyopathy (heart muscles disease), congenital heart disease, and occasionally other types of lung disease (blood clots, pulmonary hypertension). During the COVID era, concerns about COVID-related myocarditis are especially relevant. 

Some patients with long-COVID syndrome have chronic shortness of breath and/or cough for months or longer. Jayson Tatum was a good example on the Celtics last season.  

Lagniappe (something extra). 5th metatarsal fracture.
 

A review of data on 26 NBA players who suffered Jones fractures, fractures of the base of the fifth metatarsal of the foot, between the 1994-1995 to 2012-2013 seasons reveal some interesting statistics. Return to previous level of competition was achieved by 85% of athletes. There was no change in player efficiency rating (PER) when pre- and post-injury performance was compared. Four of the 26 (15%) players did not return to play in a subsequent NBA game after the season in which a Jones fracture was sustained. Twenty-four of 26 (92%) athletes were treated with operative fixation, and 3 players (12%) underwent secondary reoperation. Recurrence of the injury was experienced by 5 players (19%).

Source: Sports Health: A Multidisciplinary Approach, December 1, 2015

More recent information is here although everything is individualized.

Lagniappe 2. At the risk of sounding heretical, zero second decisions don't start with triple threat.