ACL Injuries in the NBA

You may have heard about some recent basketball injuries among NBA players.  One was former Chicago Bulls MVP Derrick Rose, and the other was rookie guard Iman Shumpert, of the Knicks.  Interestingly both were non-contact injuries.  Probably not more than a week later, I heard of yet another player, Baron Davis of the Knicks who also went down with a very scary looking non-contact injury to… you guessed it...  ACL.  

The ACL is the anterior cruciate ligament, a vital structure in supporting the knee stability.  Without it, pivoting and cutting maneuvers are limited.  The pain from tearing an ACL during sports is most often immediate and severe.  I have first-hand experience with this, I had this happen in 2011 to my right knee.   The main difference between my ACL injury and these three mentioned above, is that mine was a contact injury where a “valgus” force, coming from the outside impacted my knee joint at high speed.  In contrast, these ACL injuries were non-contact.  In other words, watching the replays, there was no one who hit their knee that caused this. 

So how does a non-contact ACL injury occur?  If we can understand how it occurs then we can take measures to prevent it. 

If you watch a video replay of non-contact ACL ruptures, you will notice several things.  First of all, the knee is in a relatively straight position.  Secondly, most of the athlete’s weight is over the soon to be injured limb.  And usually their trunk is leaning over towards the same side of injury.  I recall watching the replay in slow motion for Davis’ and Shumpert’s injuries and the above description would fit their injuries quite accurately. 

There are biomechanical factors which make these injuries more likely to happen in certain individuals compared with others.  Even though these three examples are in men, the fact is, most non-contact ACL ruptures occur in females.  Studies have examined the neuromuscular imbalances that occur and create a greater risk in females for ACL rupture.  These include greater leg dominance, greater reliance on ligaments rather than muscle, greater reliance on one muscle group, and increased trunk dominance.  I will discuss these in greater detail on my future post. 

There are also other factors, perhaps less esoteric and hopefully may be of help to someone reading this article.  If you consider that Shumpert’s injury and Davis’ injury happened in the third quarter, and that Rose’s injury occurred in the final few minutes of the fourth quarter, it is very plausible that fatigue had a factor in these injuries.  When the body is worn down from prior injury and cumulative minutes of play, there is a gradual breakdown in the proper form necessary to complete tasks such as cutting and pivoting.  I realize I am only theorizing here, but if these three players were given five days off prior to the dates of their injuries to recover from their previous games, I doubt they would have injured themselves in the same manner.  But that’s just conjecture and it is not helpful  to say “what if” once something has already happened. 

So how can we learn from what has happened?  If you are a person who exercises daily out of routine, and you get injured, allow adequate time for healing and consider proper rehabilitation prior to resuming your routine.  In essence, you are allowing yourself to come back to your baseline before continuing your prior activities.  Failure to properly rehabilitate can lead to more serious injury down the line. 

Also, pay attention to your fatigue level if you’re playing sports.  For parents in particular, who have children playing sports year-round, be aware that a pain that persists for more than several days can be the body telling you that it needs a break.  Moreover, it is important to realize that even though your child is playing sports year round, he/she can still have relative neuromuscular imbalances that will not self-correct simply from more practice.  High level athletes are just as prone to injuries such as ACL tears, as less competitive athletes.  In fact high level athletes are at greater risk. 

If you have a dominant leg that is much stronger than the non-dominant leg, or have a history of repeated pulled hamstrings, this may be a sign that you have relative weakness of one or more muscle groups.  I advise athletes to consider physical therapy or strength and conditioning program.  

In summary, be proactive in monitoring signs and symptoms of injury and fatigue.  Consider visiting our facility for biomechanical analysis and gait analysis to discover muscle imbalances.  For our athletes, video-taping gait and jumping patterns utilizing Optojump can pinpoint certain muscle groups that are relatively weak and are a liability for future injury.  Whether  you play sports professionally or just like to maintain an active lifestyle, I hope that this article was helpful to shed some light on a common injury.