Bilateral differences in muscle architecture and increased rate of injury in National Basketball Association players

Context: 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. Objective: To examine the relationship among skeletal muscle architecture, lower body power, and games missed because of lower extremity injury (%MISS) in professional basketball players. Design: Cross-sectional study. Setting: Human Performance Laboratory. Patients or Other Participants: 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. Main Outcome Measure(s): 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. Results: 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). Echointensity 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). Conclusions: 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.