Prevention of ankle sprains in sport: a systematic literature review.
ABSTRACT Background Ankle sprains are the most common musculoskeletal injuries that occur in athletes. The importance of finding ways to prevent these injuries is therefore of paramount importance to athletes, their teams and the medical system as a whole. Objective To review the published evidence on the effectiveness of various methods in the prevention of ankle sprains in the athletic population. Design A literature search was conducted using multiple databases and only included prospective, level 1 and 2, randomised and quasi-randomised controlled trials (RCTs) published between 1980 and August 2010. Keywords used in the search were prevention in combination with ankle sprains. Results Overall, 19 RCTs were reviewed consisting of a total of 12 233 participants. The studies showed a significant reduction in the number of ankle sprains in individuals allocated to an external ankle support group. This reduction was greater for those with a previous history of ankle sprains. Braces seemed to be more effective in preventing ankle sprains than tape. Appropriately applied braces, tape or orthoses, do not adversely affect performance. Proprioceptive training reduced the incidence of ankle sprains in athletes with recurrent ankle sprains to the same level as subjects without any history of ankle sprains. Conclusion Semi-rigid orthoses or aircasts are more effective than taping to reduce the incidence of sprains. Sensori-motor control can seemingly be improved in previously injured ankles, such that the risk equals that of healthy ankles. Rules must be changed to limit contact between players and possibly harsher penalties introduced. When the above interventions are utilised effectively, ankle sprains can be significantly prevented.
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ABSTRACT: Five cadaveric ankles were used to determine the effects of prophylactic bracing and tape on resisting an inversion moment applied to the ankle. The ankles were tested in neutral flexion and 30 degrees of plantar flexion and with both low- and high-top shoes. Eight different strap-on braces were studied. High-top sneakers significantly increased the passive resistance to inversion afforded by all braces and tape. Many of the braces functioned to resist inversion at a level that was comparable with or exceeded the capability of freshly applied tape. This finding was independent of the type of footwear. Braces that were not as effective as freshly applied tape nevertheless retained the advantage over tape in that they could be easily readjusted and their effectiveness restored, whereas the quality of the support provided with tape deteriorated with usage.The American Journal of Sports Medicine 01/1994; 22(1):78-82. · 4.44 Impact Factor
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ABSTRACT: A large proportion of all soccer injuries occur at the ankle and take the form of damage to the collateral ligaments. In order to examine the possible influence of footwear on these injuries an experimental and theoretical study was made of the effect of different types of boot on loads in the collateral ligaments during inversion and eversion. This consisted of an experimental measurement of the stiffness of different types of boot in inversion and eversion followed by analysis of a simplified model of the boot and ankle to predict the loads in the collateral ligaments. It was concluded that the old fashioned high boot was 50% stiffer than the current low boot and that it reduced consider-ably the ligamentous load. Furthermore, it was shown that, if low cut footwear was preferred for reasons of mobility, it should be as flexible as possible in the region of the ankle.Journal of Biomechanics 02/1976; 9(9):581-5. · 2.72 Impact Factor
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ABSTRACT: We measured the maximal isometric eversion moment developed under full weightbearing in 20 healthy adult men (age, 24.4 +/- 3.4 years; mean +/- SD) with their ankles in 15 degrees of inversion. Tests were performed at both 0 degree and 32 degrees of ankle plantar flexion in low- and in three-quarter-top shoes with and without adhesive athletic tape or one of three proprietary ankle orthoses. At 0 degree of ankle plantar flexion, the mean maximal voluntary resistance of the unprotected ankle to an inversion moment was 50 +/- 8 N-m; this increased by an average of 12% (or 6 N-m) when the subject wore a three-quarter-top basketball shoe. The maximal voluntary resistances to inversion moments developed with the ankles further protected by athletic tape or any of three orthoses were not significantly different. Biomechanical calculations suggest that at 15 degrees of inversion the fully active ankle evertor muscles isometrically developed a moment up to six times larger than that developed when an athlete wears a three-quarter-top shoe alone and more than three times larger than that developed passively when the athlete has tape or an orthosis worn inside a three-quarter-top shoe. We conclude that fully activated and strong ankle evertor muscles are the best protection for a near-maximally inverted ankle at footstrike.The American Journal of Sports Medicine 01/1996; 24(6):800-9. · 4.44 Impact Factor