In this article, we will discuss training and injury prevention.
Do you know what are the most common injuries in basketball games?
I don't have the latest information, but when I studied basic medicine, I learned that the most common basketball injury is anterior cruciate ligament injury in girls.
In clinical practice, there were about four cases that fit the description, and I believe that this was a moderate encounter rate among the small number of basketball players I intervened with.
I would like to introduce a study that investigates the interventions that were done to prevent such knee injuries.
The study
Using a musculoskeletal model of the lower extremity, the purpose of the study is to evaluate the effects of strength training interventions on muscles and joint contact forces experienced by untrained landing women.
Sixteen untrained women between the ages of 18~28 years participated in this cohort study and were equally divided into an intervention group and a control group.The intervention group received training for 8 weeks with the goal of improving the strength of the posterior lower extremity muscles.
Mechanisms of bilateral and unilateral drop landings from a 30 cm platform were recorded before and after the intervention, as well as isometric strength of the lower extremities during hip extension tests.
Contact forces between the internal intercostal muscles and joints were calculated using the FreeBody musculoskeletal model.
The results showed an average 35% increase in strength for the intervention group, while the control group showed no change.
There was only a slight change in kinematics and ground reaction forces during landing from pre-test to post-test, which was not statistically significant.
Both groups showed a post-test increase in gluteal strength during landings and a lateral to medial shift in tibiofemoral joint loading on both landings.
However, the magnitude of the increase in gluteal force and lateral to medial shift was significantly greater in the intervention group.
Commentary
The above is just a translation and description of the results of the study, but it may not be easy to understand the content.
In this study, the focus was on how the body weight is applied when landing.
Basically, it is thought that if the weight is more easily applied to the outside of the long axis of the foot, the burden on the knee will increase.
In the study, the training was designed to correct this misalignment of the axis.
When a person relies too much on external muscle strength, the load is unbalanced in the area of the vastus medialis, vastus lateralis, peroneus and gastrocnemius muscles.
When we implemented a program to correct this unbalanced muscular strength, the kinematic benefits remained the same, but we were able to change the weight that was being placed on the lateral aspect to the medial aspect.
This was achieved by training the posterior aspect of the thigh, i.e. the hamstrings, part of the adductor muscle group, and the vastus lateralis muscle (part of which is anatomically located on the posterior aspect of the thigh).
My personal impression is that this event was reproducible from my clinical experience, but I was surprised that the kinematic changes were not.
Czasche MB, Goodwin JE, Bull AMJ, Cleather DJ. Effects of an 8-week strength training intervention on tibiofemoral joint loading during landing: a cohort study. BMJ Open Sport Exerc Med. 2018;4(1):e000273. published 2018 Jan 13. doi:10.1136/bmjsem-2017-000273
Conclusion
The results of this study suggest that training to increase posterior thigh muscle strength to reduce knee stress may prevent expected knee trauma.
This is a recommendation based on experience that is easily reproducible, so it's worth knowing if you are in your first year of clinical experience.
