South Florida Hospital News
Tuesday May 18, 2021
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January 2014 - Volume 10 - Issue 7
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Minimizing Musculoskeletal Overuse Injuries in Athletes

In the fall of 2013, Florida National University (FNU) opened its Athletic Department with an inaugural basketball team. The team of 17 players consists of a variety of ages, ethnicities and physical morphology from all across the U.S. and worldwide. Despite the uniqueness of each player, the most frequent complaints of pain or injury they presented with were unilateral back pain and ankle sprains. A review of current research and injury statistics correlates with the findings observed in the small population of the FNU basketball team. As a player, parent or clinician, what can be done to minimize these two common musculoskeletal injuries? First, it is important to recognize that as athletes specialize in one sport, they have a higher risk of overuse injuries. In the case of basketball players, low back pain is commonly felt on the same side as the hand they dominantly dribble and shoot with. The muscles of the lower back are typically tighter and/or bigger on the dominant side leading to possible asymmetry in pelvic alignment.
 
How can this be prevented?
While it is difficult to completely eliminate back pain throughout a full season, incorporating an off-season training routine focused not only on increasing strength and endurance, but overall muscle balance, provides a good starting platform. Additionally, athletes complaining of unilateral back pain typically exhibit poor hamstring, hip flexor and gluteal flexibility. Dynamic stretching of tight lower extremity muscles can improve flexibility while reducing the risk for increased muscle tension on one side of the low back. Most successful sport-specific training programs incorporate strengthening and stretching along with position-specific skill training. Unfortunately, not all athletes are exposed to this kind of training in middle-school, high-school or even college. Education of athletes, parents, coaches, and trainers on the importance of muscle balance and flexibility can significantly reduce the risk of back pain from over-use and excessive unilateral activity.
 
A lateral/inversion ankle sprain or “rolled ankle” is commonly suffered by a basketball player when landing improperly from a jump or a misstep while cutting. Athletes who demonstrate adequate ankle stability and flexibility have a greater chance of preventing an injury than an athlete with an unstable and rigid ankle. Improving ankle stability and flexibility will not only help prevent future ankle sprains, it will promote rapid recovery from an injury suffered during practice or competition. Contrary to popular belief, strong calf muscles are not enough to provide complete ankle stability. The ankle moves in multiple planes which is important to allow an athlete to change directions quickly. Using a resistance band to strengthen the ankle in all directions can be very helpful to promote ankle stability. As with low back pain, combining improved strength with an ankle stretching program will give an athlete the greatest chance for preventing overuse pains and ankle sprains commonly seen in both high level and recreational basketball players. All athletes, regardless of age or level of play, benefit from the resulting muscle balance that occurs by combining improved strength and flexibility; this not only rehabilitates an existing injury, but helps prevent over-use pains or injuries.
 
In order to safely initiate a sport-specific training program, it is highly recommended to consult with a licensed Physical Therapist, Certified Athletic Trainer, or Certified Strength and Condition Specialist. This approach will ensure a safe and balanced conditioning program based on an athlete’s or team’s needs.
Dr. Kelly Krenkel, Program Director, Physical Therapist Assistant Program, Florida National University, can be reached at kkrenkel@fnu.edu.
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