Characterization of quadriceps muscle injuries in National Basketball Association athletes and effects on player performance following injury

Abstract Background In basketball, quadriceps strains and contusions are common due to the muscle’s role in knee extension and hip flexion, with the rectus femoris most prone to injury because it crosses both joints, making it vulnerable to eccentric loading. The purpose of this study was to describe the epidemiology of quadriceps injuries in National Basketball Association (NBA) players, assess changes in player performance statistics after injury, and to determine factors that were associated with a greater or equal player efficiency rating (PER) and usage percentage (USG%) 1 year and 2 years after a quadriceps injury. Methods Quadriceps muscle injury data from the 2015 to 2020 NBA seasons were extracted using a publicly available database. Injury characteristics and player demographics were evaluated with descriptive statistics. PER, USG%, points per game (PPG), and minutes per game (MPG) were calculated for the season prior, 1 season after, and 2 seasons after injury. A Poisson logistic regression analysis was performed to identify risk factors associated with greater or equal PER and USG% at 1 year and 2 years after injury. Results A total of 116 quadriceps muscle injuries were sustained among 89 NBA players. Contusion was the most common injury type, and the majority of injuries resulted in less than ten games missed. PER at 1 year after injury (15.8; P = 0.015) was significantly lower than baseline PER (16.5), but recovered at 2 years post-injury (16.8; P = 0.166). Older age was associated with a relative risk of having a decreased USG% (relative risk [RR] 0.83; 95% confidence interval [CI] 0.76–0.90) and a decreased PER (RR 0.75; 95% CI 0.64–0.88) at 1 year after injury, but these associations were not significant at 2 years after injury (P = 0.084 and P = 0.431, respectively). Conclusion Contusions are the most common quadriceps muscle injury sustained by NBA players. Older age may be associated with decreased usage and efficiency one year after injury. NBA players are likely to return to baseline PER and USG% statistics at two years post injury.