The NBA playoffs provide a stage for some of the greatest and tallest athletes in the world. Immediately average height of 6 feet, 7 inches and an average weight of 225 poundsplayers have a lot of skin, bone and muscle to support.
That’s why their feet play such an outsized role – literally and figuratively.
Like a physiotherapist And researcher working closely with NBA athletes, I know how difficult it is to maintain the health of players who are at the higher end of the foot size spectrum.
And so while fans eagerly await eye-popping dunks and clever assists, I’ll be keeping an eye on the footwork of players like Kevin Durant, Joel Embid And LeBron Jamesall of whom have had problems keeping their feet healthy.
The importance of a strong foundation
NBA players’ bodies go through a lot.
They jump and crash onto the field up to 70 times per game, with midfielders – usually the tallest players on the field – usually jump the most.
When players land, the impact on the ground can be as high as four to six times their body weight. The average player also changes direction every two to three seconds, requiring them to stop, turn, and speed up. Together, the jumps, twists, dekes, and sprints put enormous pressure on the players’ foot, ankle, and knee joints.
Like a tall building, basketball players need a solid foundation to support their massive bodies and withstand the force generated by all these movements.
This is where the feet come into play. The average shoe size of NBA players is close to one US size 15. NBA Hall-of-Famers who famously wore Shaquille O’Neal and Bob Lanier size 22 shoes. Among the current players, Kevin Durant (18), Andre Drummond (19), Brook and Robin Lopez (20), Karl Anthony Towns (20) and Tacko Fall (22) lead the pack. The typical shoe size for an American adult male is 10.5.
Having big feet means having big bones that act as levers to create forces needed for athletic maneuvers. The 26 bones of the foot are intricately connected to each other through a series of 33 joints and linked together by soft tissues such as muscles, tendons and ligaments. The big toe, the arch of the midfoot and the ankle are the gears that facilitate movement.
The soft tissue connecting these joints acts like a spring. Energy must be transferred from one joint to another in a lever-like system that allows athletes to propel themselves forward while running and jumping. Likewise, these joints must work together to absorb the shock of landing, slowing down, or changing direction.
If this structure is not right, the whole process can collapse.
What goes up must come down
According to sports medicine specialist Mark C. Drakos, 62% of injuries in the NBA occur below the waist, with foot and ankle injuries accounting for more than 22% of them. Ankle injuries are the most common: A player has a 25.8% chance of incurring one over the course of a season.
Stress fractures, although less common, can be extremely debilitating and last for weeks or months. Most ordinary bones in the feet and lower leg, stress fractures experience the navicular bone, talus bone, tibia, and fibula.
Orthopedic surgeon Moin Kahn did a case study and found that only 30% of athletes those who suffered a stress fracture from 2005 to 2015 were able to return to their previous level a year after their injury.
Having big feet doesn’t mean an NBA athlete is destined to sustain an injury. But many great men have had their battles. This list includes former players Bill Walton, Arvydas Sabonis, Yao Ming and Greg Oden, all of whom wore size 19 boots.
Standing at 7 feet, 3 inches, NBA prospect Victor Wembanyama has already had his fair share health issues, including a fibular stress fracture. He wears shoe size 20.5.
Step onto the right foot
Our research team has studied joint range of motion, arch mobility, and foot and ankle mechanics in NBA players to help athletes reduce these injury risks.
Part of that work includes building a database of the normal clinical measures for elite basketball players — big toe extension, arch mobility, ankle flexion, hamstring flexibility, and hip range of motion.
Understanding normal physical dimensions helps physiotherapists and trainers understand the risk of injury based on vulnerabilities in a player’s physical condition.
For example, the average range of big toe extension for the general population is 60 degrees. However, our research shows that the average NBA front court player has about 40 degrees of motion. This means that the typical NBA player has feet and ankles that are stiffer than those of the average person.
While this stiffness can be beneficial and acts like a coiled spring that helps a basketball player run and jump, physical therapists must constantly work on these muscles to loosen them up. That’s because too much can cause stiffness bone injuries.
Understanding what happens during the heat of the action is also important.
We found that Achilles tendon rupture usually occur when the ankle bends more than 48 degrees. We suspect this can happen when players’ ankles aren’t stiff enough: the tendon isn’t sufficiently resistant to the forces it encounters during play.
The foot – a complex network of bones, joints and tissue – is only as strong as its weakest link. And the health of a team’s feet may ultimately be the only thing standing between them and a championship.