Balance, agility training help prevent ankle sprains

  • Published
  • By Guy Leahy
  • Health Promotions Flight
Since May is National Physical Fitness and Sports Month, let’s talk about a sports-related injury: ankle sprains.

Ankle sprains are one of the most common injuries in civilian populations. In military members, the rate of ankle sprain is over five times higher than in civilians.

For military personnel, ankle sprains are the second-most common injury, next to lower-back injuries. In members less than 30 years of age, ankle sprains are the most common injury.

To give some idea of how frequent ankle sprains are, data collected from 1998-2006 documents a total of 423,581 ankle sprains in military populations. Ankle sprains are most common in service members who are less than 20 years old, and injury rates decline with increasing age.

Ankle sprain incidence varies by service. The highest overall rate of ankle sprains has been seen in the Marine Corps and Army, while the Navy and Air Force have lower rates of injury.

In the Army, Navy and Marines, females have higher rates of ankle sprains than males. In the Air Force, males have higher rates of injury, with the exception of Airmen less than 20 years or more than 40 years old.

Overall, female service members are 21 percent more likely to sustain an ankle sprain than males. In civilian populations, females also have a higher rate of ankle sprain.

Adolescents have a higher rate than adults, and the highest rates of ankle sprains are seen in children.

The biggest risk for developing an ankle sprain is having already suffered one, so it’s very important to prevent that first sprain. The risk factors for ankle sprains may differ somewhat in military members compared to civilians. There also appear to be gender differences regarding which activities are risk factors.

One study of U.S. Military Academy cadets found that for males, height, weight, body-mass index and higher physical training test scores were associated with higher risk, but in females, none of these factors was associated with higher injury risk. When examining ankle sprain incidence by sport, basketball, rugby, lacrosse and soccer were associated with higher risk in males, while cheerleading, soccer, basketball and volleyball were associated with higher risk in females.

In civilians, risk factors for ankle sprains include participation in court or indoor sports such as basketball or tennis. Other risk factors for civilians include being overweight or obese, shoes with air cells, a previous ankle sprain, poor balance and low strength of muscles that control ankle motion.

Prevention exercises

What interventions actually work to prevent ankle sprains?

A large body of evidence indicates that agility and balance training is an effective tool for prevention and treatment of ankle sprains. One study using balance training in basketball players found a 35 percent reduction in ankle sprains for athletes who participated in the training, compared to those who did not, at the end of the season.

A related study, using subjects with chronic ankle instability, found a six-week balance-training program significantly improved balance and muscle reaction times compared to subjects that did not participate in the training. Several studies using wobble or balance boards have shown reductions in risk of ankle sprains.

One study with 12- to 70-year-old athletes who had suffered a previous ankle sprain found a home-based balance-board program was associated with a 35 percent reduction in risk of another sprain at the one-year follow-up. The greatest benefit was seen in athletes whose original sprain was not medically treated.

Ankle braces

Numerous studies have found wearing a semi-rigid ankle brace during high-risk activities, such as basketball and soccer, can reduce injury rates by nearly 50 percent.

Semi-rigid ankle braces also help prevent ankle injuries during military operations. One study with U.S. Army Rangers found ankle injuries were three times higher among Rangers not wearing ankle braces during parachute landings than those who did wear the braces.

Strength training has also been looked at to see whether it may reduce ankle-sprain risk. A handful of studies has found strength-training programs using rubber tubing and ankle-strength machines improve strength and balance of various ankle muscles. These improvements are greatest in subjects who have a history of repeated ankle sprains or ankle instability.

It’s not certain at this time whether these improvements in function translate to a lower recurrence of sprain injuries; more research is needed in this area.

To sum up, ankle sprains are very common, particularly in military personnel. Balance and agility training, as well as semi-rigid ankle braces, are evidence-based interventions that have been shown to reduce incidence and recurrence of ankle sprains.

The exercises don’t need to be complicated. For example, standing on one leg for up to 30 seconds, alternating each leg, for a total of five minutes, three days per week can improve balance.

For more information, contact the Health Promotions Flight at 846-1186.