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Professional basketball players have demanding schedules that, in combination with certain underlying physical characteristics and side-to-side strength and power imbalances, may make them vulnerable to lower extremity injuries. To examine the relationship among skeletal muscle architecture, lower body power, and games missed because of lower extremity injury (%MISS) in professional basketball players. Cross-sectional study. Setting : Human Performance Laboratory. Nine players under contract for Orlando Magic were assessed. We compared athletes who were injured (n = 4, height = 203.2 ± 5.5 cm, mass = 105 ± 7.5 kg, age = 25.0 ± 2.8 years) and those who remained healthy (n = 5, height = 200.2 ± 12.2 cm, mass = 100.1 ± 16.6 kg, age = 22.4 ± 1.9 years) during the season. Bilateral ultrasonographic measurements of muscle thickness, pennation angle, echo intensity, and cross-sectional area of the rectus femoris and vastus lateralis were collected before regular-season play. Subsequently, muscle thickness and pennation angle were used to compute fascicle length. Along with unilateral jumping power, inferences were made upon the magnitude of the relationship between the percentage bilateral difference in these measures and %MISS, as well as between injured and healthy athletes. The data indicated likely relationships between %MISS and age (r = 0.772), and between %MISS and bilateral differences in rectus femoris cross-sectional area (7.8% ± 6.4%; r = 0.657) and vastus lateralis cross-sectional area (6.2% ± 4.8%; r = 0.521), as well as a possible relationship with vastus lateralis muscle thickness (7.9% ± 8.9%; r = 0.444). Echo-intensity differences in the vastus lateralis were greater in injured (8.0% ± 2.4%) versus healthy athletes (3.2% ± 2.0%). Although a 2-fold difference in mean jumping power was observed between injured (26.3 ± 14.9 W) and healthy athletes (13.6 ± 8.7 W), these differences were not statistically significant (P = .20). In the present sample, lower extremity side-to-side differences may be related to an increased risk for lower extremity injury. Future researchers using larger sample sizes need to identify normal versus at-risk ranges for bilateral differences in muscle structure and power of the lower extremities of professional basketball players and athletes in other sports.

Objectives: Players in the National Basketball Association (NBA) subject their lower extremities to significant repetitive loading during the season as well as during off-season training. Little is known about the incidence and impact of lower extremity bony stress injuries in these athletes. Methods: Using the player injury database maintained by the NBA Players’ Association, all bony stress injuries from 1992 to May 2016 were identified. Those not involving the lower extremity were excluded from the study. Stress fractures and stress reactions were grouped together. Number of games missed due to the injury as well as player statistics including points per game (ppg), assists per game (apg), steals per game (spg), and blocks per game (bpg) were collected from two years prior to the injury to two years after the injury. Results: 76 lower extremity bony stress injuries were identified involving 75 different NBA players with an average player age of 25.4 ± 4.1 years. 55.3% (42/76) involved the foot, 21.1% (16/76) involved the ankle or fibula, 17.1% (13/76) involved the tibia, and 6.6% (5/76) involved either the knee or patella. The majority of injuries occurred in season 82.9% (63/76) with half of the injuries occurring within the first 6 weeks of the season. 38.2% (29/76) of these injuries were managed surgically. An average of 25.1 ± 21.3 games were missed. 19.7% (15/76) of patients who sustained a stress fracture also had a subsequent injury. 29.2% (21/76) of players were not able to return to professional basketball after the season in which the injury was sustained; however, those who were able to return to the same level of play did not see a significant change in performance as measured by ppg, apg, spg, or bpg when comparing the season prior to the injury and either one or two years after the injury. Stress injuries to the foot carried the worst prognosis, 57.1% (12/21) of those unable to return to professional basketball sustained such an injury. Conclusion: While not extremely common in NBA players, lower extremity bony stress injuries may be career-ending. However, if they are able to return to the NBA following this injury, then their level of play should return to their pre-injury level.