A study published recently on bmj.com concludes that an easy training program, based on a sequence of balancing movements, can be useful in cutting the risk of recurrent ankle sprains by 35 percent. This could reflect in huge savings in medical and lost productivity costs.

In the United States, an estimated 23,000 ankle sprains occur every day. In the Netherlands, an estimated 234,000 ankle sprains occur every year, costing over 84,000,000 euros. Ankle sprains are one of the most frequent and costly sports injuries.

Also, there is confirmation that athletes are at high risk of re-injury in the first year after an ankle sprain. Half of these injuries can lead to chronic pain and disability requiring extended medical care.

In the Netherlands, experts evaluated the usefulness of an unsupervised home-based training program. It consists of a series of exercises to develop balance and motor coordination skills which are known as proprioception abilities.

Two groups were divided at random from a total of 522 athletes (of which 274 were men and 248 were women) aged 12 to 70 years. They practiced a wide range of sports. Both groups received treatment according to standard care. The intervention group of 256 athletes received in addition an eight-week home-based proprioceptive training program.

The program consisted of three 30-minute training sessions per week. The athletes were urged to carry out the movements as part of their warm-up of their normal sporting activity. During the eight-week program, the exercises progressively increased in difficulty.

There was follow-up of all participants during one year. During the monitoring period, 145 athletes reported an ankle sprain recurrence: 22 percent (56) of the athletes in the intervention group and 33 percent (89) in the control group.

The intervention program was related to a 35 percent reduction in the risk of recurrent ankle sprains compared to the control group, of which most was ascribed to non-medically treated athletes.

This translates to the prevention of one ankle sprain recurrence for every nine athletes who completed the program.

The authors say: “These results show that an eight-week unsupervised home-based proprioceptive training program is effective in preventing ankle sprain recurrences after usual care.”This training program was particularly helpful in athletes whose inclusion ankle sprain was not medically treated.

“Effect of unsupervised home based proprioceptive training on recurrences of ankle sprain: randomised controlled trial”
Maarten D W Hupperets, PhD student, Evert A L M Verhagen, senior researcher, Willem van Mechelen, professor
BMJ 2009; 339:b2684

Written by Stephanie Brunner (B.A.)