expiratory flow rate, and an increase in both residual
lung volume and total lung capacity (Kobayashi,
2002).- Diagnosis can be made with history and sideline peak
flow testing (screening) or with graded exercise test-
ing with spirometry. Treatment should begin with
avoidance of triggers (cold, allergens), cardiovascular
training, and proper warm-up. Short acting inhaled
beta-agonists relief most symptoms and are readily
available for treatment. True underlying chronic
asthma with exercise related exacerbation should not
be treated with beta-agonist alone as this leads to
long-term decline in pulmonary function.
HEAT ILLNESS
•Organized basketball programs typically have access
to indoor, climate controlled courts—so heat illness is
less of a factor. Most basketball occurs in less organ-
ized situations on outdoor courts, which increases the
risk of injury. Hydration, monitoring body weight,
and attention to early symptoms are required to pre-
vent illness.
CARDIAC
- Basketball involves significant physiologic stress as
reflected in findings from professional players.
Heart rates average 169 beats per minute and are
above 85% predicted maximum for 75% of compet-
itive playing time (McInnes, Jones, and McKenna,
1995). - Hypertension is seen in basketball even though many
players are young. Blood pressure elevation over 140
systolic and 90 diastolic on two separate readings
should be investigated. Family history, supplement
and medication use, and substance abuse should be
considered while investigating other secondary
causes. - Blood pressure should be controlled before allowing
exercise. In mild and moderate hypertension, exercise
is often part of a treatment plan but in severe hyper-
tension it is contraindicated. When choosing treat-
ment options, medications with negative performance
side effects should be limited. - Sudden cardiac death is extremely rare with estimates
ranging from one in 150,000 to one in several million.
Preparticipation examination with a focus on history
taking is the best method to prevent sudden death.
High risk individuals with a family history of prema-
ture or sudden death, history of exercise related syn-
cope, or findings of Marfan’s syndrome should be
identified for further testing.
MUSCULOSKELETAL INJURY TYPES- Sprain:Acute injury to a ligament
- Grade 1 (mild): Stretch and microtrauma but no
discreet loss of continuity. Examination shows
pain with stress testing but no instability. - Grade 2 (moderate): Partial tear of ligament fibers.
Examination shows pain with stress testing, partial
joint opening but no gross instability. Endpoint
usually detected on ligament stress testing. - Grade 3 (severe): Complete rupture of ligament.
Examination shows complete joint instability and
no endpoint on ligament stress testing.
- Grade 1 (mild): Stretch and microtrauma but no
- Strain:Injury to musculotendinous unit from acute
trauma. The severity of strains may vary on the basis
of the degree of damage to the muscle or tendon
fibers. - Contusion:Blunt trauma that causes disruption of
underlying soft tissue. This typically involves damage
of blood vessels resulting in hemorrhage and visible
bruising. - Dislocation:Defined as loss of continuity of a joint.
The injury may quickly self-correct, reestablish joint
continuity, and never be visualized or remain dislo-
cated. There is a high risk of damage to surrounding
soft issues. - Fracture: Disruption of bony tissue that requires
immediate attention. Neurovascular compromise and
skin integrity must be assessed, as injury to these tis-
sues may change treatment options.
FACIAL AND ORAL INJURIES- Basketball has no accepted regulations and few play-
ers wear face guards for protection against injury.
Mouth guards are known to prevent injury but are not
generally worn by college or professional players.
There is ample contact between players, and most
facial injuries result from contact with elbows or fin-
gers from other players. Five to ten percent of basket-
ball injuries involve the face or scalp (Powell, 1989)
and an estimated 7500 eye injuries occur annually in
the United States (Jones, 1989). - Most lacerations occur over bony prominences, and
fractures must be suspected when significant force is
applied and symptoms extend beyond local mild ten-
derness and ecchymosis.
•Of eye injuries in professional basketball players,
eyelid lacerations make up 50%, 28% are periorbital
contusions and 12% are corneal abrasions (Zagelbaum
et al, 1995). - Dental injuries are often permanent as teeth do not
have much ability to heal. Mouth guards absorb force
466 SECTION 6 • SPORTS-SPECIFIC CONSIDERATIONS