Ankle Sprain
Why care?
Have you ever rolled your ankle? Does this topic even need explaining? Read on, and I bet you will take ankle sprains a whole lot more seriously.
Yes, a mild or moderate sprain is relatively easily recovered from, maybe requiring crutches for a few days to a week. Nevertheless, to an athlete, this can be devastating (as you know). In a great study by Waldén et al (2013), 1080 ankle injuries were recorded in the UEFA Champions League and accounted for 13% of all injuries. Of these, 50% were lateral ankle sprains (the most common type), and resulted in an average of 14.7 days’ lay-off. This alone attests to the prevalence and importance of this injury in the sport, even on the professional level. Ironically, there are definitive actions you can take to decrease your risk of spraining your ankle.
Moreover, each time you sprain your ankle you put yourself at a higher risk of spraining it again – eventually causing chronic instability at the joint, greater levels of arthritic and/or fibrotic changes, and, very likely, limited abilities to successfully perform to your max abilities. You work hard for playing time, so why wouldn’t you work on preventing injury and avoid having to remove yourself from the weekly lineup with something so mundane as an ankle sprain.
How & Why:
Many times, as you know, the cause is a simple, quick cutting maneuver that you would never think twice about - and it’s hard to avoid that. You can absolutely decrease your chances of rolling your ankle again, though. Your body’s ligaments, muscles and parts of some tendons have nerve endings that relay information to your brain about how your body is moving. These structures help you stand in the dark, balancing. Because of the information provided by these nerve endings, when/if you start to rock forward or to one side or the other (in the dark), you can sense this and respond by contracting certain muscles in your legs and trunk to regain your balance. This sense that I am talking about is called proprioception.
After these structures are damaged via overstretching or tearing (eg after an ankle roll) your proprioceptive ability is significantly impaired. This deficit can last a very long time, especially if not rehabilitated, and this is what predominately leads to increased risk for reinjury.
So what can you do?
Prevent it:
Proprioception, proprioception, proprioception. Train it. How?
Proprioception can be easily trained at home by balancing on one foot. It can be performed on a wobble board, DynoDisc or AirEx pad, or Bosu Ball to increase the challenge. The aim is to progressively challenge yourself as you train and get better and better at balancing. These surfaces are excellent ways of imitating different field conditions (eg uneven ground, mushy vs dry/hard patches, etc) and situations (eg stepping on another player’s foot or a sprinkler), and preparing your ankle to handle different unexpected movements.
An old but fantastic study in 1985 by Hans Tropp et al investigated the effects of ankle stability/proprioception training and orthotics (ankle braces) on incidence of ankle injury in elite soccer athletes and found that injury rate was significantly decreased with these tools - particularly in individuals with a history of ankle problems (injury/pain/discomfort in preceding 2 months). When all was said and done, only 2% of those who wore an orthosis (brace) and 5% of those who participated in stability training on a small dynamic platform (similar to a small, 1-foot diameter circular bosu-ball) experienced reinjury of their ankle, while those who did neither had a 25% recurrence rate. The training was 10 minutes, 5 x/week for 10 weeks before decreasing to 5 minutes, 3 x/week. This is something you can easily practice at home, and think about it - isn’t a 20% reduction in risk of being sidelined with injury (for avg. of 2 weeks/season) worth your 5-10 minutes a day?
Using an ‘AirEx’ (or generic brand’s similar product), the benefit is also that you can where your cleats on it without risking slipping and falling. This is beneficial because as they say, ‘practice as you play’ - turns out to be even more true in soccer, where the average boot is significantly smaller than players’ trainers kicks, leading to a false, heightened sense of ankle stability/security when wearing the trainers.
Take-Away
Either a brace or balance training can decrease your risk of suffering an ankle sprain. Balance training is recommended for healthy individuals, while a brace should likely be used during play in conjunction with balance training while initially returning to play following hip, knee, leg or ankle/foot injury, until your training performance is back up to par.
Take care of yourself.
Prevent your next injury before it ever happens.