Dec. 3, 1999 (Atlanta) -- Ankle sprains are one of the most common injuries among athletes, and more research is needed to help prevent them, according to a recent report in the American Journal of Sports Medicine. Even with a lack of reliable data, the CDC says that preseason conditioning is clearly important.
Over 18 months, the CDC searched the literature on ankle sprains and reviewed more than 600 research studies, textbooks, and journals. Of these, 113 studies focused on the risks, treatment, and prevention of ankle injuries in sports. Ten studies looked at methods of prevention in specific sports.
In a study of basketball players who had suffered previous sprains, taping was shown to have a preventive effect when used in combination with high top shoes. In football players, bracing the ankle with orthotic stabilizers was shown to be more effective than taping. And in soccer players, a program of intensive physical conditioning, or training, significantly reduced the incidence of ankle sprains. Although the CDC investigators report major flaws in research techniques, there are implications for athletes, coaches, and trainers.
Most of the studies report that properly applied braces, tape, or orthoses do not adversely affect performance. A Swedish study suggests that an extensive preseason training program with properly taped ankles is very effective in preventing future ankle sprains.
After suffering an ankle sprain, athletes should complete supervised rehabilitation before returning to practice and competition, according to study author Julie Gilchrist, MD. "And athletes with moderate and severe sprains should wear an orthotic device for at least six months. Also, preseason conditioning for strength, agility, and flexibility shouldn't be underestimated for preventing ankle sprains." Gilchrist, who is with the CDC's National Center for Injury Prevention and Control, says these injuries should never be considered "just" a sprain.
"Ankle sprains are the biggest risk factor for future ankle sprains. They can sideline an athlete for weeks and months. So rather than ignoring them and playing through the pain, ankle sprains should be evaluated by a physician," says Gilchrist. "And athletes should complete whatever program of rehabilitation is recommended."
Sports medicine specialists agree. "After an ankle sprain, strength and balance need to be fully restored," says Kara Browning, MD. "If not, athletes may have residual instability that predisposes them to further injury. During rehabilitation, we redevelop the receptors that sense the position of the ankle. It's called proprioception, and it's a big part of preventing future sprains." Browning is a sports medicine specialist at Cleveland Clinic Sports Health in Ohio.
Still, researchers say the findings leave some questions unanswered. "We need to know if the effectiveness of these interventions is sport-specific and if they're equally effective in female athletes," says Gilchrist. "We also need to know if there are other risk factors for ankle sprains, like playing surfaces. All of these questions have important implications for elite athletes and weekend warriors alike."