For most coaches and administrators, injuries are one of the capricious aspects of sports. Who suffers injury and who stays healthy is seemingly left to fate. But a recent study suggests there may be a convenient way to predict the answer. Recently published research has found that a simple five-minute test could identify high school basketball players who are at greater risk for common leg injuries, such as ankle sprains and ligament tears.
Phil Plisky, Residency Program Director and Senior Physical Therapist at ProRehab PC in Evansville, Ind., led the study, which was published in the December 2006 issue of the Journal of Orthopaedic & Sports Physical Therapy. Tracking 235 high school basketball players during the 2004-05 season, Plisky and his colleagues found that the Star Excursion Balance Test (SEBT) was a reliable method for identifying which players were most likely to suffer lower-body injuries.
In the SEBT test, athletes stand on each foot and reach as far as they can with the other foot in three directions: 12, 4, and 8 o'clock on a clock face. "The test requires flexibility, strength, balance, and coordination," says Plisky.
In the study, two variables proved the best indicators of injury risk: the difference between reaches with the left and right legs, and total-reach distance, which is the sum of reaches in all three directions. The researchers found that players with a more than four-centimeter (1.5 inch) difference between right and left reaches were more than twice as likely to suffer an injury than those with a smaller difference. And girls whose total-reach distance was less than 94 percent of their leg length were 6.5 times more likely to suffer a lower-body injury than girls with scores above 94 percent.
Although the specific types of lower-body injuries suffered were not broken down in the study, Plisky says they followed typical injury trends. "Ankle sprains were the most common injury, followed by knee injuries," he says.
Once athletes are identified through the SEBT as being at a higher risk of injury, more detailed testing can pinpoint the reasons why. "The test red flags people who should then go through a more comprehensive assessment by an athletic trainer or physical therapist," says Plisky. "From there we can assess if they have tight gastrocs and that's why they couldn't reach far forward, or poor quad or hamstring strength, or a muscle imbalance or a faulty movement pattern. Then we recommend specific things the athlete can work on to reduce their injury risk."
Although the study was limited to high school basketball players, Plisky has made the SEBT a part of the standard pre-participation physical examination (PPE) given to all athletes at his clinic from grade school to NCAA Division I. Plisky says it takes about five minutes to administer, and he expects about 30 percent of athletes will be flagged by the SEBT for further testing, although some of them may turn out to have no specific deficiencies to correct. "There's so little risk from doing this test that I'd rather have to deal with a few false positives because it will identify many more athletes who are at a greater risk for injury," he says.
Terry Collins, Head Athletic Trainer at the University of Evansville, is currently using the test with his men's and women's soccer teams. "It is a reasonably quick way to test functional movement as a screening tool," he says. "Once we've identified those who didn't score well, we can look closer to see if the problem is in their hamstring or quadriceps or somewhere else."
According to Plisky, the SEBT is well suited as a screening tool because it encompasses a wide range of factors that make up athletic movement. "This has them doing something that more closely relates to sport than some of our traditional preseason measurements, such as the ankle's range of motion in a non-weight bearing position," he says. "We've always known that functional movement matters, and this is a way to quantify that movement."
To view a video of a Star Excursion Balance Test, go to: www.ebppartners.com and click on "Y-Balance Test."
To read "Star Excursion Balance Test as a Predictor of Lower Extremity Injury in High School Basketball Players" in the December 2006 edition of the Journal of Orthopaedic & Sports Physical Therapy, go to: www.jospt.org and click on "past issues."