PREVENTION OF ANKLE SPRAINS IN SPORT: A SYSTEMATIC REVIEW
Jerusalem Sports Medicine Institute, Lerner Sports Center, Hebrew University
of Jerusalem, Mount Scopus, Jerusalem, Israel
INTRODUCTION: Ankle sprains are reported to represent up to 25% of all
sports injuries of the musculoskeletal system, with approximately 20,000 injuries
reported daily in emergency rooms in the USA. Apart from the significant financial
implications, the time lost from practice and game sessions have a marked impact on
the sports team. 70- 80% of athletes will suffer a recurrent sprain and 20- 40% will
suffer chronic instability. The importance of finding ways to prevent theses injuries
are therefore of paramount importance to both the athletes, their teams and the
medical system as a whole.
AIM: To assess the published evidence on the effectiveness of the various reported
approaches to the prevention of ankle sprains in athletes. The evidence will be
concerned with the incidence, severity, etiology, mechanisms, preventative actions
and analysis to evaluate the preventative effect.
METHODOLOGY: A search was conducted using multiple databases, including
the Cochrane Musculoskeletal Injuries Group's specialized register, the Medline,
PubMed, Embase and Cinahl search registers (to present). All prospective, level 1 and
2, randomized and quasi-randomized were reviewed.
RESULTS: The most common prophylactic interventions reported included the
application of an external support, proprioceptive training to improve sensorimotor
co-ordination, muscle strengthening especially the ankle dorsiflexors and external
rotators, jump training, avoidance techniques and changes to the rules.
CONCLUSIONS: Semi–rigid orthoses or aircasts are more effective than taping
to reduce the incidence of sprains, but their effects are limited to athletes with
previous sprains. Sensorimotor control can be improved in previously injured ankles
such that the risk equals that of healthy ankles. Studies conducted in volleyball and
soccer show that most sprains are caused by player-player contact. As a result, rules
must be changed to limit contact between players. When the above interventions are
utilized effectively, ankle sprains can be quite significantly prevented.
BSc (Physio) MSc ( Sports Med) PhD Candidate MAPA RPT
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