The Prevention of Ankle Sprains in Sports

Abstract

To assess the published evidence on the effectiveness of various approaches to the prevention of ankle sprains in athletes, we used textbooks, journals, and experts in the field of sports medicine to identify citations. We identified 113 studies reporting the risk of ankle sprains in sports, methods to provide support, the effect of these interventions on performance, and comparison of prevention efforts. The most common risk factor for ankle sprain in sports is history of a previous sprain. Ten citations of studies involving athletes in basketball, football, soccer, or volleyball compared alternative methods of prevention. Methods tested included wrapping the ankle with tape or cloth, orthoses, high-top shoes, or some combination of these methods. Most studies indicate that appropriately applied braces, tape, or orthoses do not adversely affect performance. Based on our review, we recommend that athletes with a sprained ankle complete supervised rehabilitation before returning to practice or competition, and those athletes suffering a moderate or severe sprain should wear an appropriate orthosis for at least 6 months. Both coaches and players must assume responsibility for prevention of injuries in sports. Methodologic limitations of published studies suggested several areas for future research.

Treatment and prevention of acute and recurrent ankle sprain: an overview of systematic reviews with meta-analysis

“…Twenty-three reviews evaluated the efficacy of a physiotherapeutic intervention (which included exercise and manual therapies) in the treatment of CAI or recurrent ankle sprain17 19 20 23 32–36 41–43 45 46 50 51 54–57 59–61 (quality range 1–10). Following the removal of duplicates, these reviews included 122 individual papers (83 RCTs, 39 non-RCTs; N=26349, 82% male, 18% female).…”

“…Twenty-two of the included reviews evaluated exercise therapy for treating CAI or recurrent ankle sprain17 19 20 23 33–36 41–43 45 46 50 51 54–57 59–61 (quality range 1–10). Included in these reviews were 114 individual reports, 61 of these papers evaluated the efficacy of exercise therapy for the treatment of CAI or recurrent ankle sprain specifically (42 RCTs, 19 non-RCTs; N=13963; 70% male, 30% female) 65 96–99 101–104 106 107 110–113 118 119 121–123 128–135 229–261…”

“…Exercise therapy is generally considered effective in the treatment of CAI for the outcomes of self-reported function20 23 41 45 51 57 60 and reinjury incidence 16–20 33–36 42 43 46 50 51 54 55 60…”

“…Nine systematic reviews evaluated the efficacy of an external support intervention for the treatment of CAI21 22 24 34 46 47 54 55 61 (quality range 4–10). These reviews included 115 papers.…”

“…There was unanimous consensus among the reviews that bracing is effective at preventing a recurrence of an ankle sprain 21 22 24 34 46 47 54 55 61. With regard to taping, two reviews (quality=5/11;46 4/1122) concluded that its efficacy could not be supported (and that bracing was superior) whereas three reviews (quality=5/11;55 4/11;54 9/1121) advocated its value in the prevention of ankle sprain recurrence.…”