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Sports Medicine

, Volume 33, Issue 15, pp 1145–1150 | Cite as

Prevention and Treatment of Ankle Sprain in Athletes

  • Michael D. Osborne
  • Thomas D. RizzoJr
Injury Clinic

Abstract

The frequent nature of ankle sprains and persistent disability that often ensues has lead to considerable medical costs. As prevention of disease and injury becomes an increasingly important part of the practice of medicine today, we strive to understand and identify interventions that optimally reduce the frequency of ankle sprain and re-injury. In doing so, considerable morbidity and unnecessary medical expenditures may potentially be averted. The prophylactic use of ankle braces is fairly common. Recent critical evaluation of their effectiveness supports their use for at least 6 months following injury in athletes who have sustained a moderate or severe sprain; however, their role in primary prevention of ankle sprain is less evident. Functional ankle rehabilitation is the mainstay of acute ankle sprain treatment and in recent reviews has been deemed preferable to immobilisation or early surgery for initial treatment of acutely injured ankles. Furthermore, certain components of ankle rehabilitation, such as proprioceptive exercises, have been found to protect the joint from re-injury. Multifaceted ankle sprain prevention programmes that incorporate a variety of strategies for injury reduction are also effective in sprain prevention, although the relative importance of each component of such programmes warrants further investigation. Surgery for ankle sprain is principally reserved for patients who fail a comprehensive non-operative treatment programme and can be highly successful in treating chronic functional instability. This paper examines the current literature regarding common ankle sprain prevention strategies and provides a review of appropriate treatment schemes.

Keywords

Ankle Sprain Ankle Instability Ankle Injury Lateral Ankle Sprain Injury Prevention Programme 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

No sources of funding were used to assist in the preparation of this manuscript. The authors have no conflicts of interest that are directly relevant to the content of this manuscript.

References

  1. 1.
    Soboroff SH, Pappius EM, Komaroff AL. Benefits, risks, and costs of alternative approaches to the evaluation and treatment of severe ankle sprain. Clin Orthop 1984; (183): 160–8Google Scholar
  2. 2.
    Garrick JG, Requa RK. The epidemiology of foot and ankle injuries in sports. Clin Sports Med 1988; 7(1): 29–36PubMedGoogle Scholar
  3. 3.
    Berger-Vachon C, Gabard G, Moyen B. Soccer accidents in the French Rhone-Alpes Soccer Association. Sports Med 1986; 3(1): 69–77PubMedCrossRefGoogle Scholar
  4. 4.
    Ekstrand J, Tropp H. The incidence of ankle sprains in soccer. Foot Ankle 1990; 11(1): 41–4PubMedGoogle Scholar
  5. 5.
    Jackson DW, Ashley RL, Powell JW. Ankle sprains in young athletes: relation of severity and disability. Clin Orthop 1974; 101(1): 201–15PubMedGoogle Scholar
  6. 6.
    Verhagen RA, de Keizer G, van Dijk CN. Long-term follow-up of inversion trauma of the ankle. Arch Orthop Trauma Surg 1995; 114(2): 92–6PubMedCrossRefGoogle Scholar
  7. 7.
    Gerber JP, Williams GN, Scoville CR, et al. Persistent disability associated with ankle sprains: a prospective examination of an athletic population. Foot Ankle Int 1998 Oct; 19(10): 653–60PubMedGoogle Scholar
  8. 8.
    Handoll HH, Rowe BH, Quinn KM, et al. Interventions for preventing ankle ligament injuries. Available in The Cochrane Library [database on disk and CD ROM]. Updated quarterly. The Cochrane Collaboration; issue 4. Oxford: Update Software, 2002Google Scholar
  9. 9.
    Amoroso PJ, Ryan JB, Bickley B, et al. Braced for impact: reducing military paratroopers’ ankle sprains using outside-the-boot braces. J Trauma 1998; 45(3): 575–80PubMedCrossRefGoogle Scholar
  10. 10.
    Simon JE. Study of the comparative effectiveness of ankle taping and ankle wrapping on the prevention of ankle injuries. J Athl Train 1969; 4: 6–7Google Scholar
  11. 11.
    Sitler M, Ryan J, Wheeler B, et al. The efficacy of a semirigid ankle stabilizer to reduce acute ankle injuries in basketball: a randomized study at West Point. Am J Sports Med 1994; 22: 454–61PubMedCrossRefGoogle Scholar
  12. 12.
    Surve I, Schwellnus MP, Noakes T, et al. A fivefold reduction in the incidence of recurrent ankle sprains in soccer players using the Sport-Stirrup orthosis. Am J Sports Med 1994; 22(5): 601–6PubMedCrossRefGoogle Scholar
  13. 13.
    Hume PA, Gerrard DF. Effectiveness of external ankle support: bracing and taping in rugby union. Sports Med 1998 May; 25(5): 285–312PubMedCrossRefGoogle Scholar
  14. 14.
    Thacker SB, Stroup DF, Branche CM, et al. The prevention of ankle sprains in sports: a systematic review of the literature. Am J Sports Med 1999; 27(6): 753–60PubMedGoogle Scholar
  15. 15.
    Garrick JG, Requa RK. Role of external support in the prevention of ankle sprains. Med Sci Sports 1973; 5(3): 200–3PubMedGoogle Scholar
  16. 16.
    Barrett J, Bilisko T. The role of shoes in the prevention of ankle sprains. Sports Med 1995; 20(4): 277–80PubMedCrossRefGoogle Scholar
  17. 17.
    Osborne MD. Chronic ankle instability. In: Frontera WR, Silver JK, editors. Essentials of physical medicine and rehabilitation. Philadelphia (PA): Hanley & Belfus Inc, 2002: 409–13Google Scholar
  18. 18.
    Kerkhoffs GM, Rowe BH, Assendelft WJ, et al. Immobilisation for acute ankle sprain: a systematic review. Arch Orthop Trauma Surg 2001 Sep; 121(8): 462–71PubMedCrossRefGoogle Scholar
  19. 19.
    Almekinders LC. Anti-inflammatory treatment of muscular injuries in sport: an update of recent studies. Sports Med 1999; 28(6): 383–8PubMedCrossRefGoogle Scholar
  20. 20.
    Demaio M, Paine R, Drez D. Chronic lateral ankle instability-inversion sprains: part II. Orthopedics 1992; 15(1): 87–96PubMedGoogle Scholar
  21. 21.
    Rizzo TD, Osborne MD. Sprains and sprains. In: Sinaki M, editor. Basic clinical rehabilitation medicine. 3rd ed. St Louis (MO): Mosby Year Book. In pressGoogle Scholar
  22. 22.
    Goldie PA, Evans OM, Bach TM. Postural control following inversion injuries of the ankle. Arch Phys Med Rehabil 1994; 75: 969–75PubMedGoogle Scholar
  23. 23.
    Tropp H, Ekstrand J, Gilquist J. Stabilometry in functional instability of the ankle and its value in predicting injury. Med Sci Sports Exerc 1984; 16: 64–6PubMedGoogle Scholar
  24. 24.
    Tropp H, Odenrick P. Postural control in single-limb stance. J Orthop Res 1988; 6: 833–9PubMedCrossRefGoogle Scholar
  25. 25.
    Freeman M, Dean M, Hanham I. The etiology and prevention of functional instability of the foot. J Bone Joint Surg Br 1965; 47–B: 678–85Google Scholar
  26. 26.
    Hoffman M, Payne VG. The effects of proprioceptive ankle disk training on healthy subjects. J Orthop Sports Phys Ther 1995; 21: 90–3PubMedGoogle Scholar
  27. 27.
    Gauffin H, Tropp H, Odendrick P. Effect of ankle disk training on postural control in patients with functional instability of the ankle joint. Int J Sports Med 1988; 9: 141–4PubMedCrossRefGoogle Scholar
  28. 28.
    Tropp H, Askling C, Gillquist J. Prevention of ankle sprains. Am J Sports Med 1985; 13: 259–62PubMedCrossRefGoogle Scholar
  29. 29.
    Wester JU, Jespersen SM, Nielsen KD, et al. Wobble board training after partial sprains of the lateral ligament of the ankle: a prospective randomized study. J Orthop Sports Phys Ther 1996; 23: 332–6PubMedGoogle Scholar
  30. 30.
    Holme E, Magnusson SP, Becher K, et al. The effect of supervised rehabilitation on strength, postural sway, position sense and re-injury risk after acute ankle ligament sprain. Scand J Med Sci Sports 1999 Apr; 9(2): 104–9PubMedCrossRefGoogle Scholar
  31. 31.
    Sheth P, Yu B, Laskowski ER, et al. Ankle disk training influences reaction times of selected muscles in a simulated ankle sprain. Am J Sports Med 1997 Jul–Aug; 25(4): 538–43PubMedCrossRefGoogle Scholar
  32. 32.
    Osborne MD, Chou LS, Laskowski ER, et al. The effect of ankle disk training on muscle reaction time in subjects with a history of ankle sprain. Am J Sports Med 2001 Sep–Oct; 29(5): 627–32PubMedGoogle Scholar
  33. 33.
    Noonan TJ, Garrett Jr WE. Muscle strain injury: diagnosis and treatment. J Am Acad Orthop Surg 1999 Jul–Aug; 7(4): 262–9PubMedGoogle Scholar
  34. 34.
    Ekstrand J, Gillquist J, Liljedahl SO. Prevention of soccer injuries: supervision by doctor and physiotherapist. Am J Sports Med 1983; 11(3): 116–20PubMedCrossRefGoogle Scholar
  35. 35.
    Bahr R, Lian O, Bahr IA. A twofold reduction on the incidence of acute ankle sprains in volleyball after the introduction of an injury prevention program: a prospective cohort study. Scand J Med Sci Sports 1997; 7: 172–7PubMedCrossRefGoogle Scholar
  36. 36.
    Wedderkopp N, Kaltoft M, Lundgaard B, et al. Prevention of injuries in young female players in European team handball: a prospective intervention study. Scand J Med Sci Sports 1999 Feb; 9(1): 41–7PubMedCrossRefGoogle Scholar
  37. 37.
    Lynch SA, Renstrom AFH. Treatment of acute lateral ankle ligament rupture in the athlete. Sports Med 1999 Jan; 27(1): 67–71CrossRefGoogle Scholar
  38. 38.
    Kerkhoffs GMMJ, Handoll HHG, de Bie R, et al. Surgical versus conservative treatment for acute injuries of the lateral ligament complex of the ankle in adults. Available in The Cochrane Library [database on disk and CD ROM]. Updated quarterly. The Cochrane Collaboration; issue 4. Oxford: Update Software, 2002Google Scholar
  39. 39.
    Colville MR. Surgical treatment of the unstable ankle. J Am Acad Orthop Surg 1998; 6(6): 368–77PubMedGoogle Scholar
  40. 40.
    Peters JW, Trevio SG, Renstrom PA. Chronic lateral ankle instability. Foot Ankle 1991; 12(3): 182–91PubMedGoogle Scholar

Copyright information

© Adis Data Information BV 2003

Authors and Affiliations

  • Michael D. Osborne
    • 1
  • Thomas D. RizzoJr
    • 1
  1. 1.Department of Physical Medicine and RehabilitationMayo ClinicJacksonvilleUSA

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