Sports Medicine: Just the Facts

CHAPTER 77 • BASKETBALL 465

collegiate level (NCAA, 1998) and 47–56% at the
high school level. (Messina and DeLee, 1999)
•Following European professional players over two
years there were 37 surgeries (8.7%) performed on a
total of 423 injuries (Huget, 1999).

• Nonmusculoskeletal problems


• Cumulative data from 3 NBA seasons show 25.9% of
  reported medical problems were classified as nonath-
  letic related (Steingard, 1993).

INFECTIOUS DISEASE

• Mononucleosis is not specifically seen in basketball
  more than other sports but must be attentively treated.
  Resulting splenomegaly and risk of splenic rupture
  (even in the absence of splenic enlargement) from
  epstein barr virus(EBV) are significant and preclude
  active participation by an infected individual. Rapid
  monospot tests can have false negatives in the first
  7–10 days so individuals with suspected EBV should
  be tested for serum antibodies, which are more sensi-
  tive in the early course. Since splenic rupture occurs
  in the first 3–4 weeks after infection, it is recom-
  mended to keep players out of activities during this
  time. Recovery can be prolonged with fatigue that
  prevents return to play for weeks or months.


• Fungal infections are prevalent in athletes and tinea
  pedis is the most common dermatophytosis. High top
  shoes, perspiration, friction, and poor foot care con-
  tribute to recurrent problems. Drying feet, changing
  socks, absorbent powders (without corn starch), and
  over-the-counter(OTC) and prescription antifungals
  are effective treatment measures. Similar measures
  should be taken to treat tinea cruris or “jock itch”
  which is also common in athletes.


• Upper respiratory infections(URI) are common in bas-
  ketball athletes but treatment should vary little from
  standard measures. Symptomatic treatment including
  analgesics, decongestants, and antihistamines provide
  relief for most individuals. These infections are typi-
  cally viral so antibiotics should be reserved for cases
  that fail to improve with symptomatic treatment.

CONCUSSION

• Concussion or mild traumatic brain injury(MTBI)
  occurs in basketball from two mechanisms—player-
  to-player contact or contact with the floor. MTBI
  results from damage to the brain and functional
  deficits from rapid, strong compression, shear, or ten-
  sile forces to the head.
  
  
  • Signs and symptoms include loss of consciousness,
    headache, amnesia, dizziness, nausea, confusion, and
    visual disturbance. Individuals often have associated
    subjective complaints including difficulty concentrat-
    ing, sleep disturbance, emotional lability, behavioral
    changes, change in smell or taste, poor energy, cong-
    nitive decline, and irritability. Recovery is variable
    and often difficult to assess.
  
  
  • Mild head injury makes up more than 90% of all
    MTBI and is difficult to recognize since there is no
    loss of consciousness but a transient loss of alertness
    or a brief period of posttraumatic amnesia that may be
    difficult to recognize (Cantu, 1996).
  
  
  • The National Athletic Trainers Association injury sur-
    veillance program investigated MTBI for three years
    in high school basketball players from 114 schools.
    MTBI comprises 4.2% of injuries in males and 5.2%
    in females. Player collisions are the most likely eti-
    olgy and most of these occur in the open court, not
    under the basket (Powell, 1999).
  
  
  • Many concussion guidelines have been published
    including those by the American College of Sports
    Medicine, Dr. Robert Cantu, the American Medical
    Society for Sports Medicine, and the Colorado
    Medical Society. These guidelines generally utilize
    neurologic symptoms, sideline memory and functional
    testing, and loss of consciousness to classify concus-
    sion severity.
  
  
  • Return to play criteria is based on symptom resolu-
    tion and history of previous concussion. It is often
    challenging to evaluate concussive symptoms and
    new evidence suggests cognitive testing should be
    the main criteria for return to play decisions. Our
    understanding of concussion, treatment options, and
    recovery are changing rapidly. Established concus-
    sion guidelines are giving way to methods that uti-
    lize emerging return to play criteria based on
    cognitive and neuropsychiatric testing. This allows
    at risk players, sometimes not clinically sympto-
    matic, to be held while returning recovered players
    back to competition earlier than previously thought
    possible.
  
  
  
  

ASTHMA

•Exercise related bronchospasm is common in all

sports. Classic symptoms include shortness of breath

with chest tightness, cough, and wheezing. Symptoms

typically begin 8–10 min into moderate exercise.

• Pulmonary function tests show a >15% drop in forced
  expiratory volume in 1 s (FEV1), >35% decrease in
  forced expiratory flow rate, >10% decrease in peak