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Blog post- Ankle Sprain.
Ankle Sprains are a very common sporting injury (Liu, 2017). In both professional and amateur sport, it is very common to know of an athlete with ankle issues (Henry, 2016); especially those sports such as American Football (Magill, 2017) with a high contact or quick directional changes like in Lacrosse (Khodaee, 2020). Furthermore, sports such as Football, Rugby union and Netball have lots of occasions where a quick change of direction is required to beat a player and this is where it is important to have sufficient ankle stability because if stability is a weakness then Ankle Sprains are much more prominent in a non-contact situation (Herzog, 2019). In terms of prescribing ankle prehab, you must take into consideration the characteristics of each client and how a plan will best suit them. When designing a plan, you could just focus on the ankle itself with focused isolation exercises or you could take a broader look into the kinetic chain and develop areas such as vastus medialis (VMO) with a horizontal lunge and glutes with one legged hip thrust (Brand, 2018).
When trying to reduce the percentage of a certain injury type such as an Ankle Sprain it is important to know the risk factors as you are then able to prescribe exercise that combats the risks. One risk factor associated with Ankle Sprain is previous injury (Tyler, 2006). Previous injury is one of the primary factors associated with an Ankle Sprain. This is because after an injury the tendons, ligaments and muscles will already have previous trauma and if they were not rehabbed to an adequate level then the ligaments will be more lax and the muscles will be weaker, which means when changing direction there is an increased risk of injury than in a normal athlete who has no previous injury. As stated, there are some sports in which participating athletes will be more prone to an Ankle Sprain such as Netball, due to the characteristics of the sport and how many times players plant on their toes and try to change direction. Another risk factor that could contribute to an Ankle Sprain is a high foot arch (Beynnon, 2002). This is a risk factor for Ankle Sprains as with a high foot arch it is easier for the ankle to go into eversion, putting strain on the Peroneal Longus and Brevis which are both responsible for eversion, which will lead to the Ankle Sprain (Williams Iii, 2001). Another two risk factors that can lead to Ankle Sprain are weak muscles and poor proprioception. These factors can lead to Ankle Sprain as with weak muscles it will be harder for the body to resist the overextension or the joint, which will lead to an Ankle Sprain. Moreover, when a player has a poor proprioception it means that they are not as balanced as they should be, this can lead to an increased risk of Ankle Sprain as in sporting situations, such as in Netball when you catch a ball while standing on one foot if you have poor proprioception you may then lose your balance and fall over giving the athlete an Ankle Sprain at the same time (Ergen, 2008).
When looking at different training techniques for reducing the risk of proprioception the needs of the injury need to be considered. There are training plans that can be developed which are focused on the prevention of an injury, but these programmes may not also be adept at also improving other areas. For example, a full 5-day gym plan based around Ankle Sprain could fail to keep agility work in the programme, which could decrease the ability of a performer on the field. Another technique that can be used for training to prevent injury is workout add-ons. Workout add-ons are effective as they mean that you can still train the components of fitness that the athlete needs too. For example, power and speed can still be done through the general programme that the athlete will be following, the additional exercise for the prevention of Ankle Sprain can be done as workout add-ons one-three times a week or be done on different days. This allows athletes to continue to learn the correct schema for the sport for example the sidestep in rugby, the refining of these skills will also reduce the risk of injury as athletes will be using better technique when they do movements which is the safest way to perform them and therefore the threat of injury will be reduced (Bahr, 1997). For prevention of pathology the primary things that can be done is the strengthening of muscles and the strengthening the ligaments that support. Strengthening the muscles can be achieved through either isometric or isokinetic movements in order to create overload to lead to muscular hypertrophy (Panzer, 2019). In order to strengthen the ligaments, the same techniques can be used. As well as this balance exercises can be used to make the body more reactive to change of contact area with the ground and different forces acting upon the body.
Overall, in order to develop a good injury prevention, plan the client and the trainer need to sit down and identify the scale of which the athlete wants the plan to be weather add-ons to existing workouts or a full session plan can be based around preventing a pathology.
References
Bahr, R. L. (1997). A twofold reduction in the incidence of acute Ankle Sprains in volleyball after the introduction of an injury prevention program: a prospective cohort study. Scandinavian journal of medicine & science in sports, 172-177.
Beynnon, B. D. (2002). Predictive factors for lateral Ankle Sprains: a literature review. Journal of athletic training, 376.
Brand, J. H. (2018). Kinetic Chain Injuries and Their Relationship to Subsequent ACL Tears. Sport Journal.
Ergen, E. &. (2008). Proprioception and ankle injuries in soccer. Clinics in sports medicine, 195-217.
Henry, T. E. (2016). Risk factors for noncontact ankle injuries in amateur male soccer players: a prospective cohort study. Clinical Journal of Sport Medicine, 251-258.
Herzog, M. M. (2019). Epidemiology of Ankle Sprains and chronic ankle instability. Journal of athletic training, 603-610.
Khodaee, M. K. (2020). Epidemiology of lacrosse injuries treated at the United States emergency departments between 1997 and 2015. Research in sports medicine, 1-11.
Liu, Q. L. (2017). Shapes of distal tibiofibular syndesmosis are associated with risk of recurrent lateral Ankle Sprains. Scientific reports, 1-7.
Magill, M. E. (2017). American Football 45. Foot and Ankle Sports Orthopaedics, 413.
Marandino, R. (2003). Strength training for power. NSCA’s Performance training journal, 15-20.
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Panzer, J. D. (2019). Echocardiography during submaximal isometric exercise in children with repaired coarctation of the aorta compared with controls. Open heart.
Tyler, T. F. (2006). Risk factors for noncontact Ankle Sprains in high school football players: the role of previous Ankle Sprains and body mass index. The American journal of sports medicine, 471-475.
van den Tillaar, R. L. (2019). Comparison of three types of warm-up upon sprint ability in experienced soccer players. Journal of Sport and Health Science, 574-578.
Van Hooren, B. &. (2018). Do we need a cool-down after exercise? A narrative review of the psychophysiological effects and the effects on performance, injuries and the long-term adaptive response. Sports Medicine, 1575-1595.
Williams Iii, D. S. (2001). Arch structure and injury patterns in runners. Clinical biomechanics, 341-347.