Two different methods for the prevention of ankle joint injuries in soccer were tested. Coordination training on an ankle disk improves functional stabilty and postural control, whereas an orthosis provides mechanical sup port. Both techniques reduce the frequency of ankle sprains in soccer players with previous ankle problems. The orthosis is an alternative to taping, and can be used during the rehabilitation period after injury or when playing on uneven ground. Coordination training on an ankle disk ought to be included in the rehabilitation of ankle injuries to prevent functional instability. It may also be done prophylactically by players with previous ankle problems in order to break the vicious circle of recurrent sprains and feeling of giving way.

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This study investigated the relationship between exposure time and ankle sprains in soccer. Forty-one teams (639 players) from four male senior soccer divisions at different levels of skill (divisions I-VI) were followed prospectively for 1 year. The exposure to soccer and the number of injuries per player were higher in higher divisions, but the injury incidence, percentage of ankle injuries and incidence of ankle injuries were the same at different levels of skill. Of all injuries 17 to 20% were ankle sprains and the incidence varied between 1.7 to 2.0 ankle injuries per 1,000 hours of exposure. Since players with previous ankle problems run an increased risk of reinjury we suggest that these players receive preventive advice.

Presurgery physiotherapy decreases pain, risk of avoidance behavior, and worsening of psychological well-being, and improves quality of life and physical activity levels before surgery compared with waiting-list controls. These results were maintained only for activity levelspost surgery. Still, presurgery selection, content, dosage of exercises, and importance of being active in a presurgery physiotherapy intervention is of interest to study further to improve long-term outcome.

Functional instability, i.e. recurrent sprains or a feeling of giving way in the joint, is common after ankle sprain. Using stabilometry, an objective and quantitative method for studying postural control, we earlier showed that soccer players with pathological stabilometric results are at risk for ankle joint injury. In the present study we found that the ability to maintain postural equilibrium as demonstrated by stabilometry was reduced among players with functional instability, but was not affected by mechanical instability. The results indicate that coordination and postural control are important for functional instability of the ankle.