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March 30, 2001 -- "The main thing about basketball is: Enjoy it!" says Ali Motamedi, MD, assistant professor of orthopaedics at Oregon Health Sciences University in Portland.

Good advice, but it's hard to do that with an injured ankle.

"When you play basketball, there is some risk of being injured," Motamedi says. "Like any other sport, there are risks as well as benefits."

A recent courtside study of more than 10,000 mostly recreational b-ball players in Australia backs up that statement. Researchers there identified about 3.85 injuries per 1,000 players. Published in the British Journal of Sports Medicine, the report says almost half of the injuries occurred during landing, while sharp twists and turns were responsible for almost a third of all ankle injuries.

Players who already had injured their ankles were about five times more likely to do so again.

"The strongest predicator of ankle injury is a previous ankle injury," lead author Gaylene McKay says. "You can really get into a cycle of repeated ankle sprains, [and you] need to take steps to minimize that downward spiral and use thorough rehabilitation to counter repeated injury."

McKay is a physiotherapist and doctoral student at the School of Physiotherapy of La Trobe University in Victoria, Australia.

That's exactly right, says Laura Ramus, PT.

"The biggest problem is that people often think of the initial ankle injury as 'only an ankle sprain.' Actually, it needs thorough rehabilitation," says Ramus, an athletic trainer for the Detroit Shock professional women's basketball team and manager of sports medicine at St. John Hospital and Medical Center in Detroit.

During a sprain, the neurological pathway from the foot to the brain is damaged, Ramus says.

"You need to do exercises for both balance and strength after an ankle injury," she says. "Balance is the core behind all movement, so balance is something you want to work on. Start out on a level surface, then challenge yourself with unstable surfaces like a wobble board. If you're in school, you can go to your athletic trainer for these exercises; otherwise, seek out a physical therapist."

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